Leaving Van Gogh

Two





I THOUGHT OCCASIONALLY about Vincent van Gogh in the subsequent weeks. Theo’s visit had piqued my curiosity. I was convinced that Vincent’s state would improve once he was settled in Auvers. We are all affected by our surroundings—surely a painter, with his artist’s sensitivity, would be especially susceptible to the peace and beauty of our village.

And then, before I knew it, spring came. As I get older, I find myself more astonished every year when the gray tones of winter give way to the gentle tide of green that creeps across our landscape. That spring, it seems to me, I was already anticipating Vincent’s presence, seeing the village with the eyes of an artist seeking subjects to paint.

Auvers nestles along the bank of the Oise, northwest of Paris. The town fits into a narrow band between the river and a high chalk plateau. Although the railroad came out from Paris before 1850, it brought very little change: there are neither factories nor suburban villas in Auvers. It is still farming country. The plateau is planted with wheat, and the fields along the river are a patchwork of peas, asparagus, and grapevines. Old chestnut trees line the main street, known simply as la grande Rue, which runs east to west through the village.

It was the beauty of this landscape that brought Daubigny here in the 1850s. Daumier came too, though of course orchards and peasants made quite a contrast to his usual urban subjects. Then Pissarro moved to neighboring Pontoise. This was in the late 1860s, just before the years when many of the other painters—Monet and Caillebotte, for instance—were working in the industrialized suburb Argenteuil, with its strange and alluring contrasts. But while Argenteuil offered smokestacks and laundry boats alongside the Seine, Auvers and Pontoise had an old-fashioned charm that Pissarro preferred. Its highlights were simply the everyday sights of trees and fields and the weather that acted on them.

In the early 1870s, before I had moved to Auvers, I frequently came out from Paris to visit the Pissarro family as a doctor and as a friend. The train ride took only an hour from the Gare du Nord, but one might have been traveling back through time as well, so great was the contrast between the bustle of Paris and the deep peace of the countryside. Cézanne was staying nearby, and he and Pissarro sometimes painted side by side—such beautiful pictures! I still have a number of them. I cannot say I care for the direction Cézanne’s work took after that period; I find his canvases from the South harsh and sometimes unpleasant. But he painted my house several times, and I never fail to wonder at the solidity he managed to convey in those pictures. The house is a white cube, perched on a rock, surrounded by trees, approached by the curving road. In Cézanne’s paintings, it appears quite monumental.

My house had once been a boarding school. It is on the upper side of the rue Rémy, situated slightly above the town. I must have thought, when I bought it, that higher ground would be better for my wife, Blanche. It was for her sake that we moved from Paris. She needed better air. There were other reasons, of course: we were living in the apartment on the rue du Faubourg St. Denis, which was and still is my office. It was not always easy to see patients there while Blanche and the baby, Marguerite, and our housekeeper were just steps away. Sometimes I administered electrical treatments that startled or pained my patients (temporarily only, I must add). Sometimes the baby cried, which I found distracting. The streets outside were noisy and crowded and dirty.

But in truth, I hoped the move would improve Blanche’s health. I knew she had consumption. She must have known as well; her mother had died of the disease, and Blanche surely recognized the symptoms. I could not bear to think of her breathing the dirty air of Paris. There was nothing I would not have done for her, or so I thought. And indeed, she loved Auvers. Our tall white house very soon shed any trace of the pensionnat. We planted gardens, in front of the house and behind. Our housekeeper, Madame Chevalier, who was the willing slave of the baby, Marguerite, sat for hours on the grass outside, watching the child explore her new surroundings. One of my prized mementos from that period is an etching I made of the two of them sitting on the grass side by side. They had their backs to me, and they were shaped exactly the same, the stout little woman and the sturdy toddler.

To our human household we added animals. I have never been able to resist the plight of a wounded beast, and sometimes villagers would bring me their injured creatures. Blanche never minded that the animals rarely returned to their original owners. She was even patient about the peacocks, which Madame Chevalier despised. It was true that the male’s showy plumes never did grow back after his encounter with a herding dog, and nobody could love the sound a peacock makes. Madame Chevalier often threatened to bake them into a pie.

Having come to us first in Paris as housekeeping help for Blanche, Madame Chevalier soon revealed her true nature as a benevolent despot. She took over the housekeeping, working with an efficiency that made Blanche’s efforts unnecessary. (“Go play the piano, Madame,” she would say when my wife picked up a duster. “The work will go so quickly if I can listen to you.”) Then when Marguerite was born, she ruled the nursery as well. She was pleased with our move to Auvers, sure that all children should be raised in the country, though she herself was Parisian born and bred.

And then we had Paul, as lovely a baby as Marguerite had been, and curiously elegant for an infant. To this day he has long, slender hands, an inheritance from his piano-playing mother.

Blanche’s symptoms went into remission while she was pregnant: tuberculosis often retreats that way. So we were a happy family of four in our tall white house on the hillside. Briefly. Then Blanche died. It was a terrible time.

Blanche had been gone for fifteen years when Vincent came to Auvers. The children were almost grown by then. That summer Paul was still in the lycée in Paris, coming home on weekends until the term ended in June. He was tall, fair-skinned, blue-eyed—a very handsome boy. He had a fastidious quality unusual in a youth of seventeen. Yet he was a feckless student, given to secrecy and a kind of mute stubbornness. Now that we are both grown men, he is something of a confidant and colleague. But in that summer of 1890, I was anxious about him; I could not imagine his course in life. I know that Madame Chevalier shared my concern. She adored the boy, but she wanted to be proud of him. He did not always make that possible.

While Paul went to no trouble to please his elders, Marguerite never ceased doing so. She was a sober, earnest girl, quick to understand what we expected. She learned to keep house at Madame Chevalier’s side, wearing her own miniature apron, pushing around a tiny broom with grave self-importance. Paul’s fluent chatter may have heightened Marguerite’s tendency to reticence. But she was a musician, as Blanche had been. I often thought that Marguerite did not need words because she had the piano. Sometimes when I heard her playing, I would think for a heart-catching instant that she was her mother, though Blanche had seldom played the piano in this house. She was generally too ill, too weak to do very much at all. Still, Marguerite found a folder of her sheet music some years ago—well before that summer Vincent was with us. She learned to play those Chopin pieces as quickly as she could. Blanche had marked the music with fingerings and dynamic notations, which Marguerite found difficult to read. Seeing my wife’s handwriting gave me a little shock when Marguerite brought it to me to decipher.

Yet for me, these memories of Blanche gave a special sweetness to our comfortable, peaceful way of life. I hoped it would bring solace to Theo van Gogh’s brother, if he came to Auvers. I thought about him from time to time as April passed. I had expected to meet the two brothers in Paris, once Vincent had made the voyage north, but that was not what happened.

On a sunny morning late in May, I was in the scullery at home in Auvers, sorting some herbs to dry. This was a matter of some contention in my house. As a homeopath, I sometimes brewed remedies from ingredients grown in my own garden. But Madame Chevalier (who, I might add, benefited substantially from my tonics and tinctures) had more than once voiced her displeasure at the preparations taking place in what she called, quite incorrectly, her kitchen. We reached a truce when I conceded to use only the scullery for my practices, and only at certain very limited hours. That afternoon I had just begun to hear Madame Chevalier muttering in my vicinity (I discerned the words sorrel and luncheon and possibly soup) when the bell for the street door rang. Her muttering crescendoed into a complaint about visitors who had so little sense that they arrived while she was supposed to be preparing the midday meal. As the house is above the road, it is reached by a long flight of stone steps that descend through our terraced garden to a gate. Visitors ring the bell there, and Madame Chevalier must trot down, grumbling, to let them in. The grumbling is something of a performance; she begrudges nothing she does for us.

I listened very carefully to the footsteps when Madame Chevalier returned—I heard a man’s heavier tread as well as the housekeeper’s own pattering. Our house is not large, so I could hear her somewhat shrill voice insisting that the visitor stay where he was while she got the doctor. She spoke to him as if he might be hard of hearing.

“A man to see you, Doctor,” she told me, coming back to the scullery. “Says he has a letter for you. He brought a whole load of …” She shook her head. “Sticks. And things. A bundle. Very untidy.” It certainly did not occur to me that this could be Vincent. I had expected to hear from Theo before he appeared.

I took off my smock and heard our pug, Pekin, begin to howl. He was the only animal allowed in the house, and he took his responsibilities as a watchdog very seriously. I was imagining a woodcutter of some sort—though why would he have come to the front rather than the back door?—being assaulted by the small, determined dog as I opened the door to the little room where Madame Chevalier had put my visitor. But of course, it was no woodcutter.

Theo’s warning had not prepared me for the physical state of his brother. The two looked alike, enough so that I recognized Vincent right away from his blue eyes, fair skin, and reddish hair. But Theo’s features were smooth, refined into conventionality. Vincent’s cheekbones, in contrast, were more pronounced, and he had a heavy ridge of bone above his very blue eyes. His skin was rough and uneven, as though it had been ruined by sun or by poor nutrition, and he had not shaved in recent days. More than that, he wore workman’s clothes: sturdy boots and heavy canvas trousers and a blue shirt with an open collar. And he smelled. A strong tang of turpentine, tobacco, oil paint, and unwashed man filled the room.

“Dr. Gachet, I apologize for coming to you with no warning,” he said, holding out a letter. “Here is a note from my brother Theo. It explains everything. I am Vincent van Gogh.” His voice had a cracked, rusty quality, like a hinge that was rarely used and never oiled.

“Of course,” I answered, nodding at him and shaking his hand. His grip was firm and the skin of his palm as hard as a laborer’s. “Won’t you come sit in my salon? This is not a terribly comfortable room.”

The dog was now frantic, in the manner of pugs. He jumped repeatedly on the legs of the painter, howling a challenge. I picked Pekin up and showed Vincent into the salon across the hall. “Please sit down, make yourself comfortable. I must dispose of this animal. Can I offer you some coffee?”

“No, thank you,” he answered, looking around the room. His eyes went immediately to the prints and paintings on the walls, an eclectic group. There were, among others, several eighteenth-century portraits, a copy of Titian’s Salome, two strange figures created from fruits by an Italian artist called Arcimboldo, and a group of Dutch flower paintings from the seventeenth century. I wondered what Vincent would make of them. I left him in order to toss the dog outside and ask Madame Chevalier to bring us coffee and some rolls. Vincent was desperately thin, all hollows and sinews beneath his loose shirt.

When I returned to the salon, Vincent turned and said, “My brother said you are very much interested in painting.”

“I am,” I answered. “I try to keep up with the way art has changed, I go to the galleries and the exhibitions. And I’m lucky enough to possess some paintings that I think very highly of. I don’t hang them down here.” I gestured around the room. “These are more …”

“Conventional,” he finished the sentence for me.

“Yes,” I agreed. “Some of the others are somewhat … demanding, perhaps. They are all upstairs. Perhaps you’d like to see them later?”

“Very much,” he answered.

Madame Chevalier came in with the tray and set it with some emphasis on the table between us, making it clear that she had better things to do than treat peddlers as honored guests.

I sat on the small sofa and gestured to the armchair. Vincent sat down. He might have looked like a laborer, but I could tell from the way he moved in my salon that he had once been used to surroundings like these. Some of my patients in Paris—the ones I treated without charge—were overwhelmed by my parquet floors and very ordinary brocade upholstery. They would sit rigidly on a chair, unconscious of their fingers tracing the patterns in the fabric. But these things were not new to Vincent van Gogh. More, they did not matter to him. They were simply not worth noticing.

Once I had taken in his shabbiness and his general air of poor health—he looked ten years older than Theo—I was struck by Vincent’s alertness. And indeed, over the next months, each time we met I marveled again at how I could see him looking. It was as if his eyes had a special sensitivity. You could almost feel him scanning everything around him and accepting or rejecting objects as interesting, or not. Sometimes this created a strange tension as people became aware that, sooner or later, he would look at them. One would want to be worth looking at.

He didn’t care for my furniture, that was clear. The salon was furnished with a few antique pieces I had bought years before—a big Renaissance buffet, a Louis XIII armchair—and Vincent’s eyes passed over them without hesitation. The stained glass I had installed in the north window might as well have been invisible. But I could sense his curiosity when he spotted the portfolios of prints next to the large table I used as a desk.

I poured a cup of coffee and handed it to him. “Would you care for milk? I would recommend it,” I said. “In fact, I suggest you drink milk every day. Preferably goat’s milk. We have a goat here who keeps us well supplied, and there would be plenty for you.”

“No, thank you, Doctor,” he said, politely enough.

“Take a roll, then,” I urged him, “for you must have made a very early start. I will read the letter from your brother.” As I bent my head to Theo’s clear handwriting, I noticed that Vincent seemed to chew with some discomfort. False teeth, I thought. That might explain his thinness, if it hurt him to eat.

“Can you tell me,” I asked him, “about your stay in Paris? Monsieur Theo said you found it tiring?”

He gulped the last of his coffee and set the cup neatly in the saucer. “The noise.” He shook his head. “I had forgotten … Or I was so unused to it …” He looked up at me, and again I saw his brother’s gaze, but with greater concentration. “Do you know the South, Doctor?” I nodded. “Then you know how the nights are. The enormous stars, the crickets, that warm air like a current of water, the sense of all the tiny creatures of the night moving around you. Or the days, the afternoons when nothing moves that isn’t tossed by the wind? When the train pulled into the station in Paris, I felt like a little moth, or a tamarisk leaf. Buffeted. So much movement, so much noise, and all of it human! I was completely overwhelmed.”

I poured more coffee into his cup, but he was so caught up in his description that he didn’t notice. “And then at Theo’s—Well, Doctor, you know what an asylum is like. You do, don’t you?”

“I do. All those separate people, in their own worlds. It can be terrible, because you cannot make a connection.”

“True, but at the same time, you owe them nothing. If you feel like howling, you howl. Now imagine going from that to a lovely little bourgeois apartment with a wife who was meeting me for the first time. What kind of impression could I make on her? And then there is the new baby. Everything must be so soft, so controlled!” He shook his head. “I cannot do that, Doctor. At least, not now. I have forgotten how. Theo and Jo live in such a way that, if one draws a breath, the other notices. I am not …” He paused, picking at a bit of rough skin on his thumb. “I am not sufficiently master of myself for that.”

“Yes,” I answered, careful to sound as if his concerns were ordinary. “I have often noticed what a large task that is. Those of us who manage it completely tend to underestimate the effort involved. Tell me about how you felt in St.-Rémy. Monsieur Theo mentioned that the other patients were a problem?”

“Not at first,” he answered, picking up a roll. He tore into it, looked at it, and put it down on the tray. “I was very poorly myself, you understand. Did Theo explain?”

I nodded. “Yes, but it would be helpful to hear how it felt to you at the time.”

“It’s difficult to explain,” he answered. “There were periods that I don’t remember at all. When I did terrible things.” He gestured to his ear. “This, for instance. I have no memory of that. But more generally, I would say …” His voice trailed off. “Unhappy, of course. I was unhappy. And afraid.” He brightened a bit. “Perhaps you will be able to see from the pictures. The last paintings I did at St.-Rémy were not dry when I left. I am having them sent here. Theo has others, some of the paintings from Arles, and the early ones from St.-Rémy. They may help you to understand.” He paused again, then went on. “There is one that, I think, captures the mental effect of life there. It is a view down the central hall—it is long in real life, but I made it look interminable. Arches and arches receding, and a tiny figure scurrying into a doorway.”

“Did you sleep in wards?” I asked, thinking about the long rows of beds at the Salpêtrière. It is necessary in an asylum to be able to watch the patients lest they harm themselves or someone else. Yet for a man with Vincent’s sensibility, this enforced togetherness must have been a constant irritant.

“No, there were private chambers,” he answered. “They were quite large, and since many rooms were empty, they gave me one as a studio.”

“And can you describe it further for me?” I wondered if he would be able to talk about this period of his life with calm and detachment.

“Oh, gladly,” he replied. “It was once, I believe, a monastery, St. Paulde-Mausole. Some of the buildings are very, very old, and it is not in good repair. The asylum is in a long, low building, yellow, with green shutters. There are beautiful gardens, full of flowers and trees, with benches and fountains. I suppose this is where the monks used to walk and pray. I painted the gardens a good deal.”

“I look forward to seeing your paintings,” I said. I agreed with his premise; surely they would permit me some insight into his mental state at the time. “And the treatment?”

“Oh, no, Doctor, there was very little treatment in this place. Dr. Peyron had no expertise in mental maladies. There were baths, of course. They often calmed us down.”

“And how often did the doctor see you?”

“He lived there, so he saw us all the time.”

“But examinations?”

“When we arrived.”

“Then how did you spend your days?”

“That was the difficulty, you see. Aside from painting, I read a great deal when I felt well enough. I see that we share some of the same tastes,” he added, looking at the bookshelf. There were several novels on the corner of my desk, and he turned his head to read the titles on their spines. “Ah! Bel-Ami! I did a still life in Paris—a little figure of Venus, a vase of roses, and this novel. Do you like Maupassant? Have you read A Life? Theo loaned it to me just before I came here. I would be happy to bring it to you when I am finished with it.”

“I would like that very much,” I answered, pleased. I was not accustomed to discussing literature with my patients, but of course Vincent was not, strictly speaking, a patient. Perhaps he might even become something of a companion. I found his enthusiasm appealing. “So your days in the asylum—there was no structure, no schedule?”

“No, Doctor. For the most part, the patients just sat.”

I was startled, but I should not have been. The doctrines of moral treatment—kindliness, tolerance, distraction, and a firm effort to make the patient aware of his delusions—that I had absorbed in Paris thirty-some years earlier had not been accepted everywhere. And of course they required a great deal of effort from the medical staff, not to mention training. The asylum at St.-Rémy was probably one of the more benign institutions, even if the patients received little care.

“But you were able to work?”

“Yes,” Vincent answered. “Dr. Peyron felt it would not harm me. He was right about that. It would have been a great deal worse for me if I had not been able to paint. As it was, I was able to turn out some things I am not ashamed of.”

The coffeepot was empty, and so was the basket of rolls.

“Monsieur van Gogh, this has been very helpful. I told your brother that I could not officially be your medical practitioner; I work in Paris, and the doctor here is Dr. Mazery. If you were to become ill here, he would care for you, but he will certainly consult with me. I would be able to suggest treatments if they were required; a sleeping draft, for instance, or a homeopathic cordial to reduce agitation. As you may know, I have considerable experience with maladies of the nerves and the mind. I have often been able to help patients regain their mental equilibrium.”

“I am glad to hear you say so, Doctor, for it is a terrible thing to misplace,” Vincent said with a wry little smile.

I smiled back at him. “If I am to be of any help in your mental troubles, I must examine you physically. It is somewhat awkward to do this here, where I do not have a proper examination room. But we could go up to the studio, where the light is good. It won’t take long. Would you mind?”

“No, Doctor,” he answered, getting up. “If it must be done, let us not delay.”

I preceded Vincent up the stairs, feeling somewhat self-conscious. I was usually delighted to show off my collection of paintings. But I found myself especially eager to please this man. It was peculiar. I was older than he by a generation. I was the expert, the doctor, about to examine him. Yet I was almost apprehensive. I wanted him to like my pictures. I had found myself disappointed that he did not compliment the atmosphere of the salon; visitors usually admired my antiques and decorative objects. I considered myself a man of taste, yet apparently Vincent van Gogh did not.

I saw my familiar studio as if with new eyes when I stepped through the door that day. I noticed how small and stuffy the room was, how low the ceiling, how much space was taken up by the dusty printing press. The plaster walls were stained in many places, something I had ignored until now. Still, I thought, the paintings were beautiful, and I hoped Vincent would agree.

Some of the pictures were too fragile to hang on the walls; Cézanne had left a few studies on cardboard that I didn’t care to expose to sunlight. I could not afford to frame all of them, either, so many were simply stacked against each other on the floor, stretcher resting on stretcher. But I remember clearly that I had Pissarro’s painting of the red house in wintertime on one wall, for Vincent made his way instantly to stand before it. While I cleared various paint boxes and rolls of paper from the little divan and pulled it into the light, he stood before the picture.

“May I take this down?” he asked, his hands poised to lift the canvas from its hook.

“Of course,” I replied. “Take it to the window.”

He did so, turning the canvas this way and that to examine the paint in the raking light. It is a small picture, a simple scene of chestnut trees in front of the house, with a woman and child standing on the snow and a winter sky behind. When Pissarro painted it, I was astounded at its freshness, the way it captured the instant with the blue shadows on the snow, the lively, interlocking branches of the trees, and the peaceful charm of the house right in the center. I heard Vincent sigh a little bit, and turned around as he gently placed it back on its hook.

“It is very fine,” he said. He glanced around at the other paintings: a Sisley of the Canal St.-Martin in Paris, my tiny Renoir portrait of a woman in profile, a Guillaumin of some smokestacks outlined between a setting sun and the blue-gold surface of the Seine. “I can see that you have some beautiful things here.”

“They give me great pleasure,” I told him, grateful that he approved of my taste. “And you are welcome to come and look at them whenever you like. I normally spend four days a week in Paris, but Madame Chevalier will be glad to let you in. For that matter, I hope you will visit often when I am here, from Saturday evening to Tuesday morning. Now, if you could take off your shirt and sit down here. I will be back in a moment.”

I went downstairs to get my stethoscope, and when I returned, slightly breathless, Vincent was on his knees in front of a row of paintings, flicking through them. “I hope you don’t mind, Doctor,” he addressed me without turning around. “I was overcome by curiosity.”

“Not at all,” I answered. “But now, if you could sit down here.” I patted the faded wine-colored plush of the divan, and a tiny cloud of dust billowed into the shaft of light coming through the window. Vincent had simply dropped his shirt on the floor, and as he crossed the room I picked it up. There was no hook or hanger for it, so I draped it on the back of my easel, which I moved toward the wall. I was grateful that there was no unfinished canvas on it. I would not have liked to watch Vincent’s blue eyes pass over my work and move on without comment.

The little couch was so low that Vincent’s head was not much higher than my waist when I stood over him. I looked down on the top of his head, the tops of his ears, his shoulders.

There was a little stool in the corner, spattered with paint. I stepped forward to seize it and brought it back to the divan. Vincent sat, waiting, his forearms resting on his thighs and his hands dangling. Compliant, enduring. He had undergone, I supposed, many examinations. I sat on the stool. Now my eyes were level with my patient’s. I set my hands beside his neck, turning his head back and forth, pressing down on his skin. I was sitting on his left side, nearest the ear he had slashed. Gently, I folded it forward, feeling the scar tissue along the cartilage where he had cut the lobe. A disturbing idea came to me.

“Did you hear voices? Do you think that is why you cut your ear? To stop them?” If that was the case, he was more troubled than he seemed. Now that I thought of it, I had asked Theo this question, and he had not answered it directly.

“I don’t know if I did,” he answered. “My memory is so addled …” He said no more.

For all my experience as a man and as a doctor, I knew I could not quite imagine his predicament. I am a sympathetic man. I have known melancholy and a kind of panic-stricken grief when it seemed that to exist for a moment longer was beyond what a man could endure. One of the reasons I was so drawn to Blanche was that she seemed able to push back those dark tides of feeling. She had a temperament of sunny certitude that I grew to rely on. When she died, I was left in a terrible state, nearly paralyzed by my emotions. But I have always managed to retain control of myself. What must it be like, to know yourself untrustworthy, to have something take over your free will? Was it like being possessed? It is difficult enough to live, knowing one’s strengths and limitations. But most of us stumbling through life do not bear the burden of knowing that we may turn into monsters. Vincent seemed to have put this particular threat behind him, but the memory of it must, I thought, influence his nervous state.

“Has your hearing been affected?” I asked, releasing the ear.

“No,” he answered. “I don’t believe that was ever a concern. I was very ill afterward, and I remember none of it. Theo says he came to Arles, but apparently I did not recognize him. I was raving in the hospital. I suppose they had restrained me by that point.”

I was certain that they had. Even though Dr. Pinel and his followers had gradually done away with the use of chains on the mad, there were still times when a patient was so disturbed that he or she had to be subdued. The solution was the gilet de force, a heavy canvas jacket that fastened up the back. The sleeves were extraordinarily long; crossed over at the waist in front and tied in the back, they immobilized an unruly patient’s hands. It was always shocking to see a patient controlled in that way, but it was frequently a necessary measure.

I stood up and moved the stool around to place myself directly in front of Vincent. “Were you often restrained at St.-Rémy?” I looked into his eyes as he answered. The whites were perhaps a touch yellowed. The irises were a clear, deep blue, each with a dark ring; the pupils small black dots in the flood of light from the windows. He had stiff reddish lashes, bleached by the sun, and faint scars from bad sunburns on his brow and cheekbones. It was a workman’s skin, the skin of a man who spends his days outside in all weathers.

“They sometimes put patients in straitjackets, so I expect I was restrained, too.”

“Would you mind opening your mouth?” I asked.

He did so, stretching his jaws wide. As I’d thought, some of his teeth were false. His gums were inflamed, bleeding in places. His breath smelled of coffee.

“When did you lose those teeth?” I asked.

“Ten years ago, perhaps? I was very ill when I came back from the Borinage. I hadn’t been eating.”

“Do the false ones hurt you?”

“Not especially,” he said. “My own teeth, the ones they pulled out, hurt a great deal by the end.”

I sat back on the stool. “I have said this before, but it bears repeating. You must eat. Simple meals. Food gives you the strength to work.” I put a hand on his right shoulder, and stretched his arm out. Blood vessels, muscle, and sinew ran beneath the pale skin. He looked almost like an écorché, one of those flayed figures used to teach art students about anatomy. His hands, as ravaged by the sun as his face, were dingy with paint. It looked as if he applied his pigments with his fingers.

It was warm in the studio, so I stood to open the window. The fly that had been buzzing against the pane flew out, and a current of fresh air drifted in. In the garden below, the goat’s bell jingled and one of the larger dogs barked.

I went back to my patient and asked him, “Could you turn around? I would like to listen to your lungs.” He shifted his legs to offer me his bare back. The knobs of his spine were clearly visible, as vulnerable as a small boy’s. I applied the stethoscope and adjusted the earpieces. “Breathe in, please. Out. In again.” The air rushed in and out smoothly, without catches or gurgles or rasps. “Thank you. Now lie down.”

He lay back and hung his legs over the edge of the divan. Once again, I could see every muscle, every bone. The hollow of his belly made the outline of his ribs as dramatic as a skeleton. I palpated his abdomen, pressing down firmly to feel the shapes of his organs. “Now your heart,” I said, applying the stethoscope to his chest. As I bent down to listen, the double beat came, firm and regular. His heart was not the problem any more than his eyes, lungs, or hands were. I closed my eyes for a moment, listening to Vincent slowly breathing. He sounded peaceful, at ease.

I straightened, and folded my stethoscope back into its case. “You may sit up,” I told him. When he rose, his eyes met mine. There was no question in them. “Am I well? Will I be ill again?” You can always read that anxiety in a patient’s face. Not with Vincent. His body did not interest him unless it failed him.

“I see nothing wrong,” I said cheerfully, as though to a child. “Your body is strong, though you are thinner than I would like. I am slightly concerned about your liver.”

I lifted his shirt from the easel and handed it to him. Normally, as with disrobing, patients would retire behind a screen for this moment, the resumption of the public face. Vincent merely slipped his arms into the sleeves and fastened the crude buttons. He looked down at the last of them, then looked up at me. This time there was a question in his eyes, and I felt I must answer it. I have thought about this moment so often. Was there something else I could have said? A warning I could have delivered that would have changed the outcome? I will never know. He did not seem particularly mad. The episode of the ear had occurred about eighteen months earlier and was not repeated by further injury or aggression. I did not doubt that Vincent drove himself hard or that he fitted uneasily into society, as Theo had warned me. But there had been considerable wisdom in his decision to stay in the asylum until he felt steadier.

“As for your mind,” I told him, “I am confident. You have been through a difficult ordeal, but you have recovered. You traveled here on your own without incident. Paris was too noisy, and you had the good sense to leave. This is an excellent sign. You must, you must come to me if you feel any change. A new sense of difficulty, perhaps. Melancholy. Despair. Trouble sleeping.” He was buttoning his cuffs, head down. “I do not rule these things out, but they would surprise me. You are perfectly lucid, your reasoning is intact, your senses are undisturbed. Still, I can help you if you require it.”

“And you believe I should continue to work?” he asked.

“Oh, yes,” I said, “you must! I have seen many alienated patients improve by working, though it was usually labor of a routine kind, repetitive. Your work is—” I paused and caught his eye again. I tried to make my voice as impressive as possible. “If I understand you at all, Monsieur van Gogh, your painting is the reason you continue to live, is it not?”

He nodded, his eyes still on mine, his hands hanging at his sides.

“Then paint,” I added quietly. “Paint and live. And come to me if you feel disturbed.” I put my hand on his shoulder and turned him to face the stairs. “Now let us find you a place to stay.”