Van Gogh (144 page)

Accommodations varied, of course, “according to the class of boarder,” but the institution’s Swiss cows provided “plentiful natural dairy foods” to all equally. Rooms were set aside for the manual work of women (sewing) and the amusement of men (billiards). A library provided access to “illustrated journals, books, and various games fit for recreation.” Facilities allowed patients so inclined to play music, write, or draw. A parlor was available for visiting with family members. Boarders of “higher social rank” had secluded apartments of their own, attended by “domestics dedicated to their service.”

Patients were encouraged to spend as much time as possible out-of-doors, strolling the long allées of tall, knotty pines, bent by the wind into graceful apostrophes, or the pathways bordered by a profusion of iris and laurel; or just to sit on one of the many stone benches that lined the arcaded courtyards and listen to the plashing of a fountain, or watch the swallows nesting beneath the ancient arches.

Even with these amenities, Saint Paul could not fill all the beds it had inherited from a previous era when charity alone paid the bills and mental afflictions called for the ministrations of a priest, not a doctor. Fewer than half the rooms were occupied. When Vincent arrived on May 8, he joined a cadre of ten male patients and about twice that number of women (madness being still seen as primarily a female affliction). Dwindling revenues had taken their toll on the “first-quality foods” and “well-planted gardens” described in the brochure. Vincent found the daily fare served in the refectory “a bit musty”—short on meat and heavy on beans—“as in a cockroach-infested restaurant in Paris, or in a boarding-house.” The “neglected gardens” went for months without pruning or weeding, lending to the old stone buildings an air of decline hardly befitting a retreat dedicated to spiritual renewal.

At the helm of this listing enterprise stood Dr. Théophile Peyron, a fat, bespectacled widower with a quick temper and a gouty leg. The law required that
the asylum be captained by a doctor, not a priest, but did not yet credit the science of “mental alienation” enough to demand that the captain have any special training in it. Peyron, an ophthalmologist by trade and a navy doctor by experience, brought nothing to his retirement sinecure at Saint Paul other than a general knowledge of medicine, an officer’s mania for order, and an accountant’s eye for expenses. He demanded that a rigorous log be kept of all arrivals and departures, and relentlessly squeezed the budget. Outbursts of misbehavior were dealt with swiftly and summarily by sequestration in a secluded courtyard, or, in the worst cases, a distant, briglike ward, far from the rest of the “boarders.”

In this measured, monitored, orderly world apart, Vincent thrived. “I think I have done well to come here,” he wrote only days after his arrival. “I have never been so peaceful as here.” For Theo, he described in loving detail the tidy, well-lighted space that he now called home. “I have a small room with greenish-gray paper with two sea-green curtains with a design of very pale roses,” he wrote; “very pretty.” He admired the old armchair as if it had been chosen especially for him: “[It] is covered in a tapestry speckled like a Diaz or a Monticelli in brown, red, pink, white, cream, black, forget-me-not blue and bottle green.” The window was barred, of course, but it overlooked an enclosed wheat field—“a prospect like a Van Goyen”—and faced east, so that “in the morning, I watch the sun rise in all its glory.”

In the asylum’s cloistered calm, undisturbed by police, creditors, landlords, street boys, or spying neighbors, Vincent found the serenity he had always longed for. “Where I must follow a rule,” he once said, “I feel at peace.” Here he could eat regularly, if not well, and drink in moderation, without facing the temptations of the Café de la Gare. During the day, he could stroll the grounds, enjoying the aromatic plants and the clear air (“one can see so much farther here than at home”), or just sit and study the scenery. “I never get tired of the blue sky,” he wrote.

Twice a week, he took a two-hour bath—a therapeutic ritual that “steadies me a lot,” he said. At night, he could settle into his Monticelli armchair, read a book or newspaper, and smoke in peace. No paintings stared down from the walls—no ghosts from the past. All had been either sent to Theo or left in Arles. The great weights of ambition and expectation had been lifted from his shoulders. “We don’t have to live for great ideas any longer,” he wrote, “but, believe me, for small ones only. And I find that a wonderful relief.” Because the money for his upkeep never passed through his hands, he could escape, temporarily at least, the “grinding daily task of earning a living”—or, worse, the “crushing feeling [of] debt and worthlessness.” Even the mistral no longer tormented him. “Because there are mountains around,” he marveled, “[it] seems much less tiresome than in Arles, where you always got it firsthand.”

Other winds shifted in Vincent’s favor, too. Compared to the people of Arles,
the patients at Saint Paul proved a model of civility and sympathy. “They say we must tolerate others so that the others may tolerate us,” Vincent reported, “and we understand each other very well.” For the first time in his career as an artist, he could draw and paint in public unmolested and unmocked. In the princely Hague, they spat on him; in Nuenen, they banished him; in Arles, they threw stones at him. But in the arcaded garden of Saint-Paul-de-Mausole, where he spent most of his time, he found the peace he needed to work and recover. Nearby, games of
boules
and checkers went on undisturbed. Passersby might stop to watch, but always from a respectful distance. Unlike “the good people of Arles,” he observed of his fellow boarders,
“they
have the discretion and manners to leave me alone.” Indeed, he reveled in their innocent attentions, noting, “It has always been my great desire to paint for those who do not know the artistic aspect of a picture.”

B
ATHS, ASYLUM OF
S
AINT-PAUL-DE-MAUSOLE
(
Illustration credit 39.2
)

As Vincent reported, the patients at Saint Paul were, in general, a refined and courteous lot. The person playing
boules
while he painted, or sitting next to him at the refectory table, was as likely to be the victim of a family quarrel as a mental affliction (a “ruined rich person,” in Vincent’s parlance), or perhaps a misunderstood eccentric who insisted on dressing for travel (with hat, cane,
and coat) even when he went to bed. One was a frustrated law student who had “greatly overtired his brain” in preparing for examinations, according to asylum records; another, an accused pedophile. At least one was diagnosed as an “idiot” because he could only grunt and nod. Vincent found him an excellent listener. “I can talk with [him] because he is not afraid of me,” he said. There were shouters, too, of course; and, at night, howlers. And some who, like Vincent, burst suddenly into fits of paranoia and hallucinatory panic. But when they did, other patients would rush to calm them—not flee in fear—even before the wardens arrived. “People get to know each other very well,” Vincent wrote, “and help each other when their attacks come on.”

Not even the worst cases could resist such solicitude, he believed, citing the example of a recent arrival, a young man who “smashes everything and shouts day and night, wildly tears his straitjackets, overturns his food, destroys his bed and everything else in his room.” It was a “very sad” case, Vincent wrote, but he knew that his fellow inmates, especially the veterans, would “intervene to ensure that he does not harm himself” when an attack came on. “They will pull him through,” he predicted confidently.

By the same twist of logic, every outburst, every maniacal fit, every howl in the night, calmed Vincent’s own anxieties about the future. “By seeing the
reality
of the life of the various madmen and lunatics in this menagerie,” he wrote, “I am losing the vague dread, the fear of the thing.” And every intervention by his fellow patients made him feel part of a community, just as he did a decade earlier in the Borinage when injured miners nursed each other: a community not of idiots and outcasts, but of true fellowship and mutual consolation. “For though there are some who howl or rave a great deal,” he noted, “there is
much
true friendship here.”

Even as the routine and familiarity of Saint Paul imposed order on Vincent’s daily life, his sessions with Dr. Peyron dispelled the shadows in his head. He had brought from the Arles hospital an official diagnosis of “acute mania with generalized delirium.” It was during an attack of these symptoms in December, his admission report concluded, that Vincent had cut off part of his ear. But Dr. Rey had also passed along to Peyron his belief that Vincent suffered “a kind of epilepsy.” Not the kind, known since antiquity, that caused the limbs to jerk and the body to collapse (“the falling sickness,” as it was sometimes called), but a
mental
epilepsy—a seizing up of the mind: a collapse of thought, perception, reason, and emotion that manifested itself entirely in the brain and often prompted bizarre, dramatic behavior. Among Vincent’s Arles doctors, only the young intern Rey knew much about this recently defined variant of the ancient and dreaded disease.

—

THE EXISTENCE OF
a nonconvulsive epilepsy had been known to doctors in France and elsewhere for fifty years, but its causes and its elusive symptoms had long defeated positive identification. The names they gave it betrayed their frustration with defining it. They called it “latent epilepsy” or “larval epilepsy” for its long periods of dormancy between episodes, during which the sufferer could lead a relatively normal life, unaware that the incubus was forming within. They called it “masked epilepsy” for its hidden causes and various guises. Some doctors refused to consider it epilepsy at all, given its vague symptomology. Some called it the “intellectual disease” for its cruel targeting of higher brain functions, but tried to impose on its invisible seizures the same hierarchy of “grand mal” and “petit mal” applied to visible ones. Some, like Rey, called it simply “a kind of epilepsy” to bridge the conceptual chasm between the most extroverted of mental afflictions and its most introverted expression.

In Arles, Rey had already discussed his diagnosis with Vincent (who worried that the Foreign Legion might not take “an epileptic”), and even given him reassuring statistics on the prevalence and relative benignity of the broader disease. “There are 50,000 epileptics in France,” Vincent cheerfully informed his brother in May, “only 4,000 of whom are confined, so it is not extraordinary.” Rey explained how the mental seizures of latent epilepsy sometimes produced hallucinations—auditory, visual, and olfactory—that drove their victims to desperate acts of self-mutilation such as biting their tongues or cutting off their ears.

If Rey described to him the “epileptic character,” as it had been limned by two generations of French doctors, Vincent undoubtedly saw a familiar figure in the mirror. With a “disposition to irritation or anger,” latent epileptics astonished and frightened family and friends with their changeable moods, easy excitability, furious work habits, and “exaggerated mental activity.” Even the most trifling offense could provoke a latent epileptic to anger—or worse, “epileptic fury,” which the leading French psychiatrist had described in 1853 as “lightning condensed into terrible deeds.” Latent epileptics were always on the move, as unstable in their lives as in their minds: never staying in any one place for long, as their wild, unpredictable outbursts irritated, alienated, and ultimately infuriated everyone around them.

The portrait matched so perfectly that Peyron, who probably heard it from Rey in advance, immediately credited the young intern’s diagnosis, writing in the asylum register only twenty-four hours after Vincent’s arrival: “I believe, in light of all the facts, that M. Van Gogh is subject to some epileptic fits from time to time now and then.” (Vincent reported to Theo: “As far as I can make out, the doctor here is inclined to consider what I have had some sort of epileptic attack.”) Over the following weeks, Peyron interviewed Vincent, taking details of his story and family history. A scrupulous, if unempathetic, observer, he found only confirmation of Rey’s opinion. “I have every reason to believe,” he wrote
Theo at the end of May, “that the attack which [Vincent] has had is the result of a state of epilepsy.” Although an eye doctor by training, Peyron “nevertheless kept abreast of what was then known about mental illness,” according to a colleague, and during his sessions with Vincent, he no doubt filled in the portrait of the latent-epileptic “type” that Rey had sketched.

The disease often showed itself first in childhood, in the form of “mischievous restlessness and irritability,” according to one of the leading authorities on the subject in the 1880s. Attacks could be triggered by anything from excessive sun or alcohol, to disruptive emotions: especially feelings of guilt. The excitation of “profound mental suffering” was the most commonly reported prelude to an attack. Some patients described feeling suddenly trapped in a waking nightmare, or “falling into a chasm.” Pangs of conscience were known to bring on attacks, especially in cases where the victim felt haunted by inexplicable or insurmountable misfortune. Painful memories could trigger attacks, as could religious obsessions, especially over sins perceived to be unremitted.