Leaving Van Gogh (19 page)

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 raptly, 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.”

“Does Monsieur van Gogh’s reasoning seem disturbed?”

“Without doubt,” I said, describing the Foreign Legion scheme. Charcot nodded, tapping the end of a pen against his blotter. There was a moment’s pause. I waited, for it seemed he was formulating a statement.

“Of course you know, Doctor, that I cannot make a diagnosis without seeing the patient.” I nodded without interrupting him. “I would be very interested to meet this gentleman. There seems to be a high incidence of hysteria among men of genius; painters, musicians, authors. However, they are resistant patients. Sometimes they fear that improvement of their mental illness will adversely affect their creative abilities. I treat some of these gentlemen privately. I cannot intervene with them as strenuously as I do with my patients at the clinic. Some of the treatments, or indeed the diagnostic methods, are painful or unpleasant, like what you just witnessed. The patients who come to me reluctantly would not tolerate them.”

“And, if I may ask—why does a patient like that poor Bernet willingly submit to having an attack brought on?” I asked.

“Because he is so unhappy, and he hopes we will be able to help him,” Charcot answered. “With some patients who exhibit hysterogenic zones, like Bernet, an attack can be halted—as well as initiated—with pressure. We have not found this to be true yet for Bernet, but we hope that in time it will be.”

I was not aware that my expression revealed my pity, but the doctor was famous for his powers of observation. “You must remember, colleague, that as doctors we are sometimes required to inflict pain in order to find out how to end it.” I could only nod my acceptance. “Now, to return to your Monsieur van Gogh,” he went on. “I would eagerly see him as a private patient. I have a sizable practice based at my house on Boulevard St.-Germain. Do you think Van Gogh would consent to an examination?”

“I don’t know, Doctor. I believe he is very distressed. He is a great stoic, but at the moment he is in despair. If he thought his suffering could be relieved, he might see you.”

Charcot now picked up his pen and held it gently between his two extended forefingers. He sighed and replaced it on the blotter, then raised his dark eyes to mine. “I cannot pretend to you that we have any way to end hysteria,” he said. “I have known the attacks to become less frequent, less violent. More generally, though, they continue.”

“Until?” I asked. “For the rest of life?”

He leaned back in his chair. “Our specialty is a difficult one, isn’t it? I sometimes envy the men who can set a bone or stitch up a wound and be confident they have accomplished something. Despite all the progress we have made, these mental maladies are still baffling. Before you leave, Doctor, I suggest you visit the old sections of the hospital, where the
restantes
stay. The dormitories and workshops are still full. We sometimes cure patients. Usually that is when they have not been ill for long. But the truth is that we do not know exactly how we do it. When a patient leaves here and has no more hysterical attacks, we do not know whether the baths helped her, or the separation from her family, or the nourishing food. I sometimes send my private patients to Dr. Fourgon in Passy, and the hysterics are sometimes cured, in about the same proportion as the hysterics who stay here. But, again, I don’t know why.”

He got to his feet. I rose, too. I am not a tall man, but he was even shorter than I. Still, there was a strong air about him, an impression of competence and assurance. Next to him I felt somehow insubstantial, as if I were not quite everything I had thought.

“Thank you for your generosity and your frankness, dear Doctor,” I said, holding out my hand. “I will talk to Monsieur van Gogh. I hope I can persuade him to come and see you. His last visit to Paris was unhappy, but if I accompany him …” I trailed off. “I will send word if we decide to make the trip. Thank you again.” He shook my hand warmly and inclined his head to acknowledge my thanks.

I visited the older wards of the hospital as Dr. Charcot had suggested. I had intended to all along: what man, returning to the site of his professional formation, would not take the time to roam around and attempt to come to terms with the intervening years? What man would not walk the paths he used to walk, hoping to see his younger self, hurrying forward toward some goal? We want to know what is the same and what is different, in us and in that old world. As I came around the corner to the
cour des agités
, I smiled slightly, and resolved to walk part of the way home, past the École des Beaux-Arts. Perhaps I would see a saffron-haired ghost peering out of a garret window on the rue de Seine.