Leaving Van Gogh (17 page)

I will not deny that these words stung, and I wondered again what it was that I had said or done to convince Vincent I was “more ill” than he. He might resent me, I supposed, for failing to stabilize his mental state, but that did not mean I was mad.

I let the letter drop and looked across the room. In the alcove above the baby’s crib gleamed the celestial blue of the almond-blossom painting. I wondered if Vincent could paint a canvas like that now. I thought not.

I picked up the letter and read it again. As in the first letter I’d read, he leapt from topic to topic, from my shortcomings to his artistic output back to my shortcomings and thence to the asylum at St.-Rémy, which he now termed a “prison.” Compared to the earlier letters that I had just read, this one was disjointed in the extreme. There was a confusing passage in which he laid out plans to rent three small rooms—where? In Paris? In Auvers? He referred to paintings that were stored at Tanguy’s, and how they were assets going to ruin. It was not the communication of a man whose mind was clear.

I thought back to the days a month earlier when Vincent had painted my portrait. It was a diagnosis of sorts. He had created an image, using my features, of a melancholy man. I could summon it in my mind, the unseeing gaze at the viewer and the skin at the temple wrinkled where the fist pressed against it, as it did now. That was how Vincent saw me.

Perhaps the difficulty was that my view of Vincent had been incomplete. For Vincent, merely seeing was enough. His eyes told him everything he needed to know about a person or, for that matter, a flower or a vineyard. His genius—part of his genius—was that he could absorb so much about the very nature of a subject from appearance alone. It seemed, then, that I was not as good a doctor as Vincent van Gogh was a painter. But perhaps I had known that all along. I heard myself sigh deeply, as if Vincent’s own gloom inhabited me. I knew my shortcomings. I had no need of a painter to point them out to me. After all, I was the doctor who had not saved his wife. No one knew this. No living person knew how I had failed Blanche. Yet Vincent’s uncanny eyes had discerned my grief.

Madame van Gogh emerged from the kitchen holding the baby. She moved gently, gliding to the crib and setting the child down. He stirred as she placed him in his bed, wriggling into greater comfort.

“Is the baby’s health recovered?” I asked her, keeping my voice low.

“Yes, thank you, Doctor. You know how one worries when they are this small.”

“I do,” I said, getting up. “I fear you have a great deal to worry about, Madame van Gogh.”

She did not deny it, but smiled slightly. “I do my best to take care of them. That is all I can do. Did Vincent’s letter help you? I am sorry you had to read the cruel things he said about you. I am sure you realize that these are not Theo’s opinions.”

I smiled at her. “Thank you. I appreciate Monsieur Theo’s confidence. I will not trouble you anymore, but I thank you for your hospitality. And for your company. We will do our best for Vincent, as you say.” I paused. It was not really my affair, but the most recent letter somehow made it seem so. “I am glad you are taking little Vincent to Holland,” I said. “It will be good for Theo to show his baby to his mother, whatever brother Vincent may say about it.”

“I am pleased you see it that way,” she answered, walking with me to her front door. “It is for Theo’s sake that we are going.” She paused with her hand on the doorknob. “What will you do, Doctor? Is there some way you can help Vincent?’

“I do not know, madame,” I had to answer her. “All I can say is that I will try to find it.”

I was anything but cheerful as I walked home, exchanging the quiet of the Van Goghs’ secluded building for the merciless tumult of the Gare du Nord and the surrounding commercial streets. Nor was I able to raise my spirits as I met with my patients that afternoon.

Madame Duval, with her endless rheumatic aches, struck me as a spoiled and fretful creature. She had always pretended to be younger than her fifty-odd years, but she must have known that a doctor, of all men, cannot be fooled. On this afternoon I flexed her knee, feeling the unmistakable friction of bone rubbing bone. “Of course as we get on in years,” I began to say. Fortunately I caught sight of her face before I could finish the sentence. I was less careful with the notary Japrisot, who had poor digestion yet insisted on eating six-course dinners. His self-satisfaction prevented him from accepting any advice, and I often wondered why he even troubled to visit me. On this afternoon I informed him that I could not help him if he did not follow my instructions. Normally, I try to offer some consolation. Sympathy has value, but I had none to spare that day.

The rain that had dampened me in the morning began to come down in earnest, and the light of the long summer evening dimmed. I had a dinner that night, a meeting of the Société des Éclectiques, a group of congenial souls from different professions who met monthly to discuss art or poetry or theater. As I pushed my cuff links into the starch-stiffened sleeves of my shirt, I stood at the window looking down at the traffic and considered staying at home. I am usually eager for company at the end of a day, but I felt so gruff and out of sorts that I could not imagine enjoying this gathering.

Directly below where I stood, the wheel had come off an omnibus. Furious passengers gathered around, some shouting, some waiting miserably under inadequate umbrellas for the repair to be finished. Everything was brown or gray, like the ugly painting of the peasants eating potatoes in the Van Goghs’ apartment. All around, drivers yelled vulgarities as they passed the disabled vehicle. The noise was intolerable. I went to my dinner rather than hear the cacophony for a minute more. The first name I heard as I sat down at the table was Charcot’s.

Charcot was famous, of course. His name was probably uttered at dozens of dinners every night in Paris. The man who mentioned him, a young journalist, had attended one of Charcot’s famous biweekly lectures at the Salpêtrière on the previous Friday. We had all read about these by now, but none of us had ever attended one, so we let the boy talk. He described the amphitheater packed with students, the bright lights, the mounted photographs and informative placards, and the colored backdrops to set off the subjects’ poses: it sounded as if medicine came very close to theater in these events. At this particular lecture Charcot had hypnotized a man, it seemed, and brought on a hysterical fit in a woman. It did not actually sound very different from the art students gathering at the
bal des folles
of so many years ago, if hundreds of spectators packed into the Salpêtrière to gape at the antics of the mad.

But though Charcot was inclined to drama, he was nevertheless an excellent physician. The popular newspapers might write about the Friday lectures, but the medical press was where Charcot and his students published their findings on illnesses of the nervous system. I found his diagnostic skills admirable. He had been an intern at the Salpêtrière ahead of me, but as a medical doctor, treating lungs and hearts and gastric complaints rather than mental maladies. The two groups of interns rarely mixed, but even then I had heard his name. He had published constantly in the decades since returning to the hospital in 1862 as the chief of a division. In fact, I realized, a collection of his informal diagnostic lectures had appeared not long before this evening, and was reviewed in a journal I received.

I was suddenly very anxious to be at home, and to read the article about Charcot. I made my farewells amid much teasing, for I am rarely the first to leave a gathering. Nothing could keep me there, however, while I was so preoccupied.

When I got back to my apartment, a new frustration arose. I was quite certain I had been reading the medical journal in bed. There is an ottoman between the bed and the window where my reading material accumulates. As I took off my cravat, I began to leaf through the pile: newspapers,
Gazette des Beaux-Arts
, Maupassant’s latest volume of stories, more newspapers, a folder of prints. That was disheartening; I try to keep at least my engravings and etchings in portfolios. I put the folder on the bed. Beneath the bed, by the most comfortable chair, on the little table in the salon, I found much fascinating material but not
Le Progrès médical
. When it finally came to light, I had found two more folders of prints, a letter from a relative of Blanche’s, and a solicitation for a soldiers’ charity. This is normally how things come to my attention. My life was much more orderly while my wife was alive.

The review of Charcot’s book was quite long. The volume under consideration was a compilation of clinical lessons the great doctor had given at the Salpêtrière. He would examine patient after patient for the benefit of his students and other interested medical personnel. Diagnoses ranged from epilepsy through paralysis and syphilis to hysteria, with endless combinations of these and other ailments. What startled me was the inclusion of men. Charcot had added a section of male patients to the population at the hospital, as well as an outpatient service. These sufferers were naturally less acutely ill, giving the doctor a greater range of subjects on whom to hone his diagnostic skills.

The conclusion seemed perfectly clear: Jean-Martin Charcot was a brilliant diagnostician. I should enlist his help in Van Gogh’s case. It was said that physicians were welcomed at the informal clinical lessons held on Tuesdays, so I resolved to go to the Salpêtrière the following week. Perhaps I would be able to persuade Charcot, an art lover, to see Vincent as a private patient. If not, one of his students might help us. They might be able to make up for my own shortcomings. I felt much relieved as I prepared to go to sleep.

E
leven

O
NCE AGAIN
V
INCENT
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.