Eleven
ONCE AGAIN VINCENT avoided our house during the weekend, increasing my anxiety about him. That made me all the more glad that I might be able to enlist the aid of Dr. Charcot. I had written a note to him and received a very civil reply. He would be happy to discuss a patient with a former colleague, as he put it. This terminology went some small way to console me for Vincent’s low estimation of my skills.
It was strange to see the changes surrounding the Salpêtrière when I arrived that Tuesday. In the thirty years since I had been there, the city had swallowed the hospital. As a student, I had often fancied that countryside lay just beyond its walls. There was a quiet, a limpid quality to the light in those days that made it easy to envision cattle grazing and rustic yokels in smocks carrying water in wooden buckets. The Gare d’Austerlitz now dominated the area. Its tracks sliced between the hospital grounds and the river, bringing whistles and coal smoke and even a kind of urgent vibration to the very earth that had once been a sodden riverbank—an inescapable reminder that times had changed.
I had to ask at the gate for directions to the new outpatient clinic where Charcot’s Tuesday lessons were held. The doctor wanted to train others to see as he saw. Thus the sessions were small and informal, located in a ground-floor room holding little more than a group of chairs and a battered table. I knew I had arrived in the right place because I recognized Dr. Charcot from the famous 1887 Salon painting called Une leçon clinique à la Salpêtrière. The painting had been widely distributed in a lithographed version, and of course I possessed a copy. It was disconcerting at first to see the celebrated physician in person, since his image was so familiar to me; the barrel-shaped body, the hair worn brushing his collar, the solidly fleshed face. Everyone looked at me as I entered the room, so I introduced myself, adding, for the benefit of the young men, that I had been an extern myself more than thirty years earlier.
The first case was a porter at Les Halles who, several months earlier, had astounded everyone around him by falling into a fit and causing considerable damage to the stalls nearby. Worse, the fits had continued. Charcot swiftly read through a file while the man sat brooding on a plain chair before us, eyes cast to the ground. The doctor raised his eyes and addressed us. “The question, here, gentlemen, is this: epilepsy or hysteria? They are very easy to confuse. I hope we can establish a diagnosis in this man’s case. I see there is some history of nervous illness in the family. Your father suffered mentally?” he asked the patient. The man looked up readily.
“Poor man went mad,” he confirmed. “Thought he was St. Peter. And then sometimes it was Napoleon. When he was Napoleon, he always thought he was being poisoned. Anyway, he couldn’t work. Ended up at Bicêtre.”
“So you see, we have an inheritance of weakened mental processes,” Charcot told us all. “We also have a situation of partial anesthesias,” he read from papers in his hands. “Dr. Lagarde, perhaps you would like to demonstrate?” At this point one of the younger doctors showed us, by pricking the flesh with a long pin, how there were several areas of the patient’s body that appeared to have no feeling at all. Charcot went on noting information from the chart: the attacks were sometimes preceded by warning periods with various sensory disorders. The patient heard voices; he had once seen a cabbage turn into a bleeding skull. When in the throes of a fit, he shouted and thrashed and had to be restrained, which, owing to his size and strength, was often difficult to do. Once a fit wore off, he was perfectly lucid.
Fortunately I had brought a little notebook, and I scribbled down all of these details as they were described, for this case sounded very similar to Vincent’s. Charcot pointed out that the attacks differed from epilepsy in an important way: an epileptic falls in one place and does not create further disturbance. Vincent’s attacks, then, sounded more like hysteria than like epilepsy. But it was the conclusion of the presentation that I found especially intriguing.
“In many cases of masculine hysteria,” Charcot said, “we see changes in the patient’s behavior. This is certainly true in this instance. According to the patient’s wife, who accompanied him here, he has been a different man since the first episode. He is nervous, suspicious, mournful. He is withdrawn where he used to be sociable, irritable where he used to be merry. He has terrible dreams, and resists sleeping for fear of them. For all of these reasons, I believe that the patient suffers from hysteria. The standard medication for epilepsy, potassium bromide, does not appear to be efficacious in this situation, so we will keep our patient for a while.” Here he put his hand on the man’s shoulder. “And see what other treatments may do for him. Perhaps we shall see him again, in an improved state.” He nodded, and the man was led out.
In came a tall wraith of a woman, so thin and withdrawn that her very clothes seemed to be weeping, or rather oozing around her. I followed Charcot’s description of her symptoms—she had stopped eating, spoke only in monosyllables, slept around the clock—while part of my mind wandered to hysteria. I was particularly intrigued by the list of the hysterical patient’s mood changes: his insomnia, his suspicions, his withdrawal. This certainly matched Vincent’s behavior. If he were suffering from hysteria, would that not explain why he had avoided coming to our house? Might it even be responsible for his dark thoughts about me?
I was first introduced to hysteria during the bal des folles, the annual costume ball at the Salpêtrière that took place several weeks before Easter. I had been at the hospital for only a few months, and I found the idea of the ball disturbing. Some of our patients, it seemed to me, were quite fragile. I could not see how the excitement of a ball would improve their mental states. Yet it was obviously a long-standing tradition that the staff and patients anticipated keenly. In the weeks before the ball, little else was discussed. The most coherent patients spent hours thinking about their costumes, hoarding scraps of fabric, bartering and collaborating. One woman with nimble fingers might twist ends of ribbon into flowers while another folded gold paper into a halo. Even the patients who were apparently lost in their madness sometimes responded to the atmosphere of anticipation. The melancholy might speak; the furieuse—confined to a straitjacket to prevent violence—might cease her raving and smile.
I was not on duty on the night of the ball, but the junior medical staff was expected to attend, costumed, to mingle with the patients and keep order if necessary. Like my charges, I gave considerable thought to my costume. I did not want to appear undignified, so I borrowed a wine-colored velvet robe from my friend Gautier. He said the garment came from a costume chest at the École des Beaux-Arts, which was evident—it smelled quite strongly of turpentine and had streaks of oil paint on the bottoms of the full sleeves. With a long gilt chain over my shoulders, I felt that I looked like a courtier in one of the larger Rubens canvases. In the interest of verisimilitude, I should not have worn my trousers and boots, but I did not believe anyone would notice my footwear. As it happened, I was grateful for this later.
The ball was a jolly affair. The largest sewing workroom had been adapted ingeniously for the festivities. It seemed that every oil lamp and every candle in the building had been brought to the atelier and set aflame. Mirrors had appeared from somewhere and had been hung high on the walls, reflecting the light and the heads of the dancers. The window frames and the enormous portrait of Dr. Pinel had all been decorated with garlands, which I had seen prepared in the previous days: they were stitched from rags and dyed a deep pink with the peelings of beetroots, then hung to dry in the sunniest corner of a courtyard for several days.
The music was no less improvised and no less gleeful than the garlands: the chapel organist, wearing a plum velvet jacket in the style of the Restoration, with puffed shoulders and long tails, was seated at an upright piano, pounding away at a polka. He was keeping time with his head so emphatically that he almost flew off the piano bench, coattails flapping, at each downbeat. One of the groundskeepers squeezed an accordion with his eyes shut tight, while a clerk from the registrar
’s office sawed away on a violin. I heard, but did not see, a trumpeter and someone with a pair of cymbals.
And our patients danced. They whirled around merrily, in pairs or threesomes or alone, some keeping time and some merely moving with the crowd. The stamp and shuffle of their feet added to the din, and the heat in the room was pronounced. There were benches lined up on three sides, most of them empty, except for one that was occupied by the furieuses, restrained in their canvas jackets but nodding to the music. A few melancholiacs sat in the darkest corner, apparently oblivious to all the stimulation. I supposed that their wardress had wanted to see the ball and had roused them from their normal stunned state to bring them along. Perhaps she thought the music would cheer them.
I had not intended to dance, but shortly after my arrival my hands were seized by a tall dark-haired woman in the conical headdress of the Middle Ages. “Come, Doctor!” she shouted over the noise. “We’ll have no hanging back. All who come to the bal des folles must dance!” And indeed as we whirled around the room I saw doctors, patients, gardeners, warders, even a fat laundress dressed as Marie Antoinette, complete with a white wig apparently made from a mop.
I was relieved when the music stopped with an abrupt crashing chord and the whirling circle of dancers jostled to a halt. Gathering up the hem of my robe, I hastened to what I hoped would be a quiet corner but was halted by a strong hand on my shoulder. This time it was my friend Gautier, resplendent in the costume of a Roman centurion. I was surprised to see him there; though he had obtained my costume for me, he never hinted that he, too, planned to be present. But, he explained, attendance at the bal des folles was a tradition for the students of the École des Beaux-Arts.
“Where did you get that costume?” I asked.
“Borrowed it, just like yours. I wanted something showy for the parade.”
“What parade?”
“There’s always a parade at a costume party, Gachet, surely you’ve been to one?” Then a wavering note sounded from the accordion and the dancing resumed. Without another word, Gautier plunged into the crowd. I managed to avoid dancing again by standing behind the furieuses. More men in costume had appeared; I saw a monk, a Pierrot, and several musketeers in thigh-high boots and capes. Gautier had apparently been correct. The women gaily flocked around the men, smiling and laughing.
I did not know what to think of it. It was the animal side of their nature that caused trouble for many of our patients, since their mental state often stripped away the controls of civilization. Some women, despite every precaution, managed to get pregnant every year, and bore their babies, who were subsequently sent to an orphanage. I wondered at the wisdom of bringing these young male students into the asylum to mingle with madwomen.
But then a hubbub near the door caught my attention. All I could see over the crowd was a giraffe’s head, apparently constructed of canvas and yarn. It was crude but very charming, with shiny black eyes fringed with layers of stiff bristles; numerous paintbrushes must have been sacrificed for the effect. The movement at the far side of the room suggested that the giraffe had brought quite a few friends. The door was blocked for a moment by the head of an elephant whose back end was somewhat too wide. The trunk must have been guided from the inside by wire, for it slithered through the crowd or lashed up in the air in a lifelike way. One of the musicians, watching from the dais, picked up his trumpet and made a rude blurting noise with his hand in the bell. The elephant’s trunk stretched out straight in response, and all who saw it laughed.
This group of art students had all managed to dress as zoo animals; in addition to the elephant and the giraffe, there were exotic birds, a jaguar with a real animal’s skin and a lion with a brown-paper mane, an enormous fish, a bear, and three mischievous monkeys. The menagerie heightened the gaiety of the evening. I was hauled back onto the dance floor by the Marie Antoinette laundress, and as she steered me capably through the crowd, I got more than one strong whiff of wine or brandy, brought no doubt by the students. Our patients were never permitted to drink spirits.
“What do you think of our ball?” the laundress shouted as we took up our position at the end of a line of couples. The chapel organist was trying to organize a quadrille, apparently.
“It seems very festive,” I said, despite my growing unease. I looked up the line of women’s faces across from me. There was a range of expressions on them, a much greater range than you would normally see at a dance. Yes, I saw the laughter, happiness, vague annoyance, concentration on the music that bourgeois women would display. But there were also frowns, inattention, and that expression I have only ever seen among the mad—you might call it exaltation, an exaggerated excitement in which every emotion, every perception reaches an intensity unknown to the sane.
But then I could see no more, because our two lines became a single column of pairs, and we began our grand parade around the room. We paced by the portrait of Dr. Pinel, and past the bench of the furieuses, who stamped their feet in approval.
Normally, the dance would have ended once we had made a circuit of the room, filed back into our original positions, and bowed to each other. But before we reached the end, the room grew much less noisy, and as the laundress and I turned the corner, we saw that there was no double line of dancers in the center of the room. Instead, one of the monkeys snatched a pair of candles from a sconce on the wall and handed one to the monkey behind him. They linked arms with their partners and disappeared through the door.
The laundress and I looked at each other in horror. This possibility had never occurred to me. I had been worried about women getting too stimulated by the dancing and the costumes and the lights, but I had never imagined that they would be taken out of the room, let alone into the darkness of the quadrangle below.
A knight and a musketeer had seized the accordion and violin from the band: they played a medley of marches at the head of the group. They were skipping up the long walkway, lit only by the flickering from candle flames or oil lamps that had been snatched from the walls. The misty evening softened the outlines of the dancers in the dark.
“Was that gate open when you came in?” the laundress asked me, pointing to the end of the enclosure.
“I didn’t enter that way. I’ll go check it now,” I said and lifted my robe to my knees. Harm could still be averted. The Salpêtrière was like a maze. Most courtyards had two or three gates, and most buildings had two or three entrances. Of course these were all supposed to be locked—one of our primary responsibilities was quite simply to maintain custody of our charges. But what if the gates were open? I could imagine it all too clearly. Carried away by the music and the costumes and the lights, our patients could so easily get lost, become frightened and anxious. This was where madness told: these women would not be able to help themselves. They would not be able to stay calm, to scan the sky for light coming from a nearby courtyard, to listen for voices, to call for help, even to remember which way they had come—or why.
And then there were the young men, as spirited and stimulated as the women. Who knew what kinds of violations they were capable of?
I was almost at the head of the line now, a few meters from the men with the instruments, who marched triumphantly backward, facing the stream of dancing followers. A confusion of voices arose. “The wall! Mind the wall!” “Pay attention to the gate!” people called, as the leaders backed into the obstruction they could not see. As they hit the gate, they did not fall: they merely mimed the impact and pretended to stagger. Then, to my relief, they turned, following the wall, steering the crowd around the edge of the yard. Everyone changed course happily, as a procession would turn a corner in a church, following their leader, absorbed in the movement rather than the destination.
I finally reached the end of the courtyard and stood panting next to the gate. The leaders of the parade were marching gaily toward the glow of light from the tall windows of the atelier. As the stragglers paced toward me, ready to turn the corner, I leaned back against t
he heavy wooden panel of the gate to draw a deep breath.
But it did not support me. It shifted. I staggered as the knight with the accordion had, then fell when the gate swung open. I tumbled onto my back and rolled quickly to my knees, but not before a small group separated from the procession and followed me through the gate.
I couldn’t count them in the dark. One of the art students carried something like a torch, but there was no other light. I scrambled to my feet and pushed the gate closed but met resistance. Someone was pushing against me. I set my feet in the gravel and put my shoulder to the heavy timber to push with all my strength, while behind me I heard someone shout, “Let’s play hide-and-seek!”
Amid the clamor, I heard a voice calling my name. “Gachet! Gachet, it’s Lemaire!” I stood up straight and pulled back the gate. One of the other young externs slipped through, then closed it behind him.
“How many are there?” he asked me.
“Perhaps a dozen.”
“How many are patients?”
“Most,” I answered. “And three young men, I believe. But they’ve split up, they’re playing hide-and-seek.” As I said this, one of the male voices cried out in the dark, “Cache-cache!”
“Are there other entrances to this yard?”
“I think so,” I said. “We must be sure they are closed off. But I may know one of the men from the École. Let me see if they won’t help us gather the women.”
“Yes, you do that. Try to start them moving back inside, will you? I’ll be with you in a moment. Thank God this is one of the smaller gardens,” he called as he ran off.
Leaving Van Gogh Page 17