The rest of the sounds in the courtyard had diminished. I was glad the ground was covered with stones rather than grass, so that I could at least hear my quarry. A giggle came from my far right, and ahead someone was trying to step silently but merely prolonging the quiet crunch his or her feet made on the gravel.
“My friends and patients,” I called out. “This is Dr. Gachet speaking. I am an extern in training here. Some of you may know me, and the artists among you might know my friend Amand Gautier. He came tonight dressed as a Roman soldier. I would like you please to rejoin the party. I am concerned about our patients being out in the cold night air.”
“Fuck the night air!” said a female voice.
“Amen to that!” said a man, and laughter echoed back and forth. I was walking toward the light of the torch, hoping that an art student still held it.
“You’ll have to find us!” trilled a woman.
“It’s cache-cache, so come seek the hidden!” answered another. “La-la-la-la-la, here I am,” she sang, and her feet made rhythmic noises in the gravel.
I was trying to sound authoritative, but my breath was coming faster. The voices around me gave the scene the air of a nightmare. I kept walking steadily toward the torch.
“Are you hearing voices, Doctor?” sang out a woman. “Just like the rest of the crazies! Oh, ha, ha, ha!”
“He’s one of us now!”
“Take him to Bicêtre!”
“No, keep him with the women at the Salpêtrière! We’ll entertain him!”
“Who’s mad anyway?” asked a female voice nearby, sounding utterly reasonable. “Not I.”
“Nor I!”
“Nor I!”
They came from all around me now, a series of echoing voices. Some, I knew, were the men speaking in falsetto. The rest were the women, drawn together in uncanny unison the likes of which I had never witnessed. One of the marks of the mad was that they inhabited their own worlds and not those of others. That night, in the damp and the dark with the torch flaring straight in the sky, they were acting and thinking together. Saner than ever, one might have thought.
I reached the torch only to find that it had been tied to an old wellhead with a strip of fur-trimmed leather from someone’s costume. Without thinking, I untied it, then clambered up onto the wide stone lip of the well. I had hoped that the height would allow me to see better, but the circle of light around me made the darkness more profound. Across the yard, I could see the orange glow of my torch reflected from a window. I heard Lemaire’s footsteps pounding toward me.
“The gates are closed. There is one doorway into a building, but it leads only to another locked door. They must all be here,” he panted.
“Oh, it’s the yellow-haired doctor,” one of the patients said, quite near to us. “Dr. Saffron.” The torch I held over my head must have made my features visible.
“Oh, I like him,” someone else replied from behind me. “He’s a nice one.”
“Then I hope you will do as I suggest,” I broke in quickly. “Why don’t you all come here, toward the torch, and we will go join our friends at the ball? Dr. Lemaire, will you open the gate?”
From where I stood on the lip of the well, the workroom beckoned a hundred meters away. The rounded panels at the tops of the windows had been opened, and music escaped, this time a waltz. The light streamed through the mist in palpable-looking golden blocks. The sight was as good as a signpost: “This way to warmth and comfort and music.”
“Let us go, then,” I called out and jumped down from the well. “Can someone tell me if there are prizes at this ball? For the best costume, perhaps?” I started forward, walking with purpose and what I hoped looked like confidence.
I listened for a moment. There was silence. Only my footsteps crunched on the gravel, one, two, three, four … Then I heard a deep sigh very close to me. “Well, the doctor has a point,” a woman said, stepping into the light. She was an older patient who was one of the gifted needlewomen of the curtain workroom. Once, I had walked through her atelier and seen her in charge, calmly beating a tambourine to establish the rhythm for the other women’s stitches. “It’s a little bit chilly for outdoor games, no?”
“Marthe, you old woman!”
“That’s it, Solange,” she called back. “Too old for this kind of fun, anyway.” Marthe was trudging alongside me now, her arm linked in mine. I was hopeful. My authority as a doctor alone might not have been sufficient to lure the women inside, but with Marthe’s help, I thought I could safely lead all of our charges back to the party.
I heard footsteps coming forward, and a few faces emerged into the torchlight. I counted six, seven women joining us. None of the men. I kept on walking.
Then someone screamed. I knew right away who it was. Odette was easy to overlook in any group. She was neither young nor old, neither tall nor short, and her behavior was such that she could pass for normal—except when she was screaming. And she did not simply scream: she threw herself to the ground and flailed and thrashed around, kicking and hitting anything nearby.
She was not vicious and had never hurt another woman, but she was often restrained. What else could one do? The power of those fists and feet posed a threat. And now, so did the power of her voice.
Once again, I had no time to plan. The evening had become a nightmare. I could only act and hope for the best. “Marthe,” I said, to the woman next to me. “Will you take the torch and lead everyone inside? I need to help Odette, and I don’t want the other women upset.”
She nodded decisively but said, “Keep the torch. They will follow me, and you should never put fire in the hand of a madwoman, Doctor. Surely that was the first thing they taught you?” With a little smile she ran past me down the path, calling out, “Come to me, ladies, let us see who won the prize!”
I followed the sound of the screaming, which was coming from somewhere to my left. A figure brushed past me, away from Odette, with a papery rustle as I hurried to her. I remembered the lion costume with its clever brown-paper mane.
I slowed down, because I could hear that I was getting close to Odette now, and that she was on the ground. Her body was grinding against the gravel, and her boots were thudding steadily as she drummed her feet. I didn’t want to be in the way of her blows, but it seemed imperative to touch her.
I had seen Odette in this kind of fit only once. It was at dinner, and the noisy order of the refectory was suddenly broken by a clatter as she threw down her mug and fell to the floor. To my surprise, the other patients just glanced at her and went on with their meals. Only the wardress came to her side and spoke to her gently, with a hand on her shoulder. It had seemed to me that Odette almost knew what she was doing. Almost. The screaming and thrashing were a way to shut out her surroundings. It did not appear that she was in control of herself, exactly, or that she had deliberately launched herself into this state, but it did seem that something had alarmed her and the fit was a form of self-protection.
As I knelt beside Odette on the damp, cold pebbles, I began to speak, though I doubted she could hear me through her screams. “Odette,” I said, “Odette.” Nothing more. I reached toward her thrashing body but was defeated. Her stiff arms batted away my outstretched hand. When I reached again, I touched only her chest or her breast. She was rolling on her back, becoming rigid. “Odette,” I tried again. “Odette!” In a moment the flailing and screaming stopped. I wondered why, and what was happening to her. I reached out again, and made contact with her arm. It felt stiff, as if she were gripping something.
Footsteps approached, from behind me, then the gloom brightened as a soft ring of light surrounded us. Lemaire had returned with a lantern. “Dr. Theroux is the senior physician on duty tonight,” he said, panting, kneeling beside me. “He will be here in a moment.” He held the lantern high so that we could see Odette more clearly.
She looked dreadful. She was lying on her side, with her stiff body arched backward into a near semicircle. I couldn’t imagine how she even drew breath
with her body so contorted. Just a few minutes earlier, I had thought I could reach her with touch or a gentle voice, but now it seemed as if Odette was not even present. Lemaire gently pulled up one of her eyelids. Her eye was white, the pupil rolled back. Lemaire touched the back of his hand to her neck.
“So strange,” he said. “It’s like death, only not.”
I put my hand to her wrist. I had no watch to time her pulse, but it was steady. I felt both ignorant and helpless.
More footsteps came our way, several sets this time. I turned my head. It occurred to me that Lemaire and I, kneeling side by side in front of Odette’s body, looked like mourners at a corpse’s bier. Dr. Theroux had brought another lantern, two porters carrying a stretcher, and a black bag. I noticed that he was in evening dress, as if he had been called from a dinner.
“Gentlemen,” he acknowledged Lemaire and me as he leaned down to look at Odette. “What happened here?” he asked, straightening up. His lantern along with Lemaire’s made the scene almost brilliant. I rose to my feet.
“Odette was at the ball, sir,” I began, then explained about the improvised grand march, my attempt to gather our scattered patients, and Odette’s screaming fit. Theroux nodded. I tried to read his expression, but the lantern light reflected off his eyeglasses and cast strange shadows down his face. “Did you do anything to help her?”
I opened my mouth to speak but closed it again. No. I hadn’t done anything to help her.
Lemaire broke in. “Sir, there was no time. By the time Dr. Gachet and I found Odette, she was … beyond help.” And, I added to myself, we did not know what to do.
Dr. Theroux looked over to the porters, who picked up the stretcher and laid it next to Odette. He bent down again, and, in a gesture that looked comforting, put his palm on her forehead. Then he straightened and nodded. “Perhaps you young men would help,” he said to us. “This is a classic case of hysteria. If you have not encountered it yet in your studies, you can count this as an excellent clinical opportunity. The patient is in what we call the rainbow position. It is not possible to assume this position voluntarily. After a while the rigor wears off. The duration varies. Nothing I know of acts consistently to halt it. But we can at least get her indoors, out of the damp.”
It was awkward, lifting her. She was rigid as a piece of wood, but the drastic arch of her body meant that she did not fit easily onto the stretcher. The best we could do was balance her on the poles, rather than nestle her body onto the canvas in between. It was surprising to look up at the windows of the workroom and hear cheering as we shuffled down the walkway. “I suppose they must have crowned the king and queen of the ball,” Dr. Theroux commented. “They will be returning to their dormitories quite soon. We will take this patient to the infirmary.”
Once we had Odette lying in the brightness of the ward, I could see how alarming she looked. Her gray uniform gown was wet and muddy. One of her cheeks was bruised, and her wrists were scratched. It was hard to know if she had done it to herself. What had set her off? What event, tiny or significant, had launched her into her flight from reality?
Remembering this episode as I sat in Charcot’s classroom at the Salpêtrière, I thought of Odette with pity. Her attacks continued after the ball, and in the ever-shorter periods between them, she seemed oppressed. Before I finished my term as an extern, she had been transferred to another division, where the women were even more closely supervised, and generally restrained. It was tacitly acknowledged that there was no hope they would improve.
In the years since my encounter with Odette, I had seen many more female hysterics, and they always made me uneasy. So often the triggers for their attacks are mysterious and the attacks themselves terrifying. I tended to refer hysterical women to one of the specialist doctors who offered rest cures. I had not given much thought to hysteria in men, however. Hysteria, with noisy, thrashing attacks, hallucinations, nightmares. Hysteria that answered to no treatment.
As my mind wandered in this fashion, the melancholiac woman was led away. I had not heard the treatment plan. Charcot took out his watch and spoke in a low voice to the orderly next to him, then addressed us. “We do not have much longer, gentlemen, but I do have a case here that I would like you to see. As most of you know, many hysterics exhibit hysterogenic zones. When we stimulate these portions of their bodies, we bring on an attack. Now, I must reiterate that I do not believe hysteria to be the result of a misplaced uterus, as was the opinion of our medical ancestors. Yet … well, we shall see.”
The next patient was a little man with pale skin and very fair hair. If he had been an animal, he would have been a white mouse. He was a clerk for the railroad. His problems dated from the moment he witnessed a fearsome accident in which an engine had severed the left leg of a track attendant. He had not himself been touched—although he was near enough to be spattered by blood—but he found, shortly after the event, that he had terrible shooting pains in his left leg.
“I cannot say how these events may be related to what I am about to demonstrate,” Charcot said. “They may have no bearing at all, but merely be a coincidence. We are very far from knowing how our mental experiences affect the functioning of our bodies. I have just mentioned hysterogenic zones. This patient, we have discovered, exhibits them, and they are located precisely where a woman’s ovaries would be. Would you mind standing, to show my colleagues?” The patient stood, wordlessly. The attendant lifted the white gown he was wearing and turned him around so that his back was to us. There were two ovals inked onto his lower back, on either side of the spinal cord. Charcot was now facing the patient. “May we?” he asked. The response was a slight nod. Charcot in turn nodded to one of his young colleagues, who stepped over and put the heels of his hands against the inked circles.
He leaned against the man’s back. The attendant moved around to serve as a brace against the pressure. We all waited. Nothing happened. Charcot had taken out his watch again and was looking at it, keeping track of the time. Then suddenly, the patient’s back went rigid, and he fell to the ground.
As an extern in this very hospital, I had grown accustomed to seeing a fellow human apparently released from all civilized controls. I’d seen patients bite warders and tear their own hair, I’d heard cries to wake the dead. But I was never as shocked as I was watching this man.
There was something cold-blooded about the situation, I thought. We all sat upright in our coats and shoes, watching a fellow human writhe on the floor. His gown was rucked up beneath his shoulders, and he was naked beneath it, no better than an animal. Two attendants knelt next to him, each holding one wrist so that he couldn’t tear at his face with his nails. He bellowed: a bold, deep, blaring cry. One would never have thought such a sound could emerge from his slight frame. He beat his heels so hard so that I was afraid he would draw blood, then tried to crack his head against the floor. I could not believe that the poor man had consented to undergo this torture.
The convulsions began to subside, but as the patient’s physical distress diminished, his mental distress increased. He was sitting now, cross-legged, and his garment had been restored to order. He rocked back and forth, as if in tremendous grief, and his eyes streamed tears. His mouth was open to voice an endless wail, but no sound emerged. Then a change came over him, and he leapt to his feet, crouching, fists clenched at his sides. Where before he had resembled a mouse, he was now a mouse prepared to fight to the death.
“Now we see the attitudes passionnelles,” Charcot said quietly, as the patient glared around him fiercely. “The classic phases of the hysterical attack do not always present themselves in the cases of men. The patient has never, for example, fallen into the rainbow pose. He does not spend a long time in any of the stages, and his recovery is correspondingly brief. This makes him an excellent patient for demonstrations. Also remarkable is the clear relationship between pressure on the hysterogenic zone and the onset of the attack.” Charcot glanced at the patient, who was now smiling quietly but rap
tly, like a mystic hearing voices. “We will leave Monsieur Bernet; he will come to himself shortly. Gentlemen, that is all for today, thank you.” He nodded at us, and we stood to file out the door. Our route took us to within a foot of poor Monsieur Bernet. I looked down at the top of his head as I passed him. His scalp showed pink through the strands of his hair, dampened with sweat. He was murmuring quietly to his folded hands while the attendants crouched patiently by his side.
Dr. Charcot was answering a question from a student, so I waited by the door, watching the patient. He appeared to be discussing something with himself, taking two sides of an argument. One of the attendants leaned forward and spoke quietly in his ear, but he did not seem to hear. When Charcot introduced himself to me, he also looked at Bernet.
“What is the next phase of the attack?” I asked as we left the room.
“For Bernet, after a short fit like this, probably a deep sleep. He may feel weakened. Possibly he will have a headache for a few hours.”
“And when will he come back to himself?”
“Quite soon. Probably within an hour. I must return to my office; I find that my colleagues get agitated when I am not where they expect me to be. Will you walk with me? Your note mentioned your concern for a painter, if I remember correctly. Is he someone I know of? Did he exhibit at the last Salon?”
I hastened to explain first Vincent’s marginal position in the world of conventional painting and then my own concern with him. I finished with a synopsis of his medical history as I understood it. By this time we were seated in his surprisingly modest office, tucked into a corner of a new building called the Policlinique.
“My knowledge of Monsieur van Gogh’s attacks is very limited,” I said in summary. “But there are hysterical features, it seems. He was diagnosed as epileptic, yet during his fits he is apparently destructive and noisy. In his letters he wrote of hallucinations, both auditory and visual, though when I asked him, he had little memory of them. He is a menace to himself and others.”
Leaving Van Gogh Page 18