Leaving Van Gogh

Eight





THEO MIGHT HAVE THOUGHT I would be doing a good deed by watching over Vincent, but instead I felt grateful to Theo for sending Vincent to me. I had at first been drawn to the idea of Vincent as a patient. I had looked forward to observing him, to tracing the links—for I was certain they existed—between his genius and his melancholy. The melancholy had not yet declared itself, but the genius thrilled me.

Vincent’s presence seemed to be affecting my children as well. Paul had taken to drawing with an enthusiasm that was utterly unlike his usual aimlessness. I often found the studio littered with sketches of every pot or flask in the house. One might have wished for a somewhat steadier figure for Paul to emulate than Vincent, yet I was happy that my son, who had always seemed rather idle, should be inspired to take up an interest in art. But what about Marguerite? Was it possible that, in her innocence, she could mistake the attention of a painter for the attention of a man? I feared so.



It was with great relief that I stepped onto the platform at the Auvers station on Saturday evening. In late June the sun lingers on the horizon, casting its long amber rays on field and hedge and cottage. It was a good deal cooler than in Paris, and I listened with pleasure to the sounds of a summer evening in the country: the leisurely clop of one tired horse’s hooves, the shrieks of children playing out of sight, kitchen clatter drifting through an open window. I ambled along the street, watching the dust film my city boots. The week had been dry. The wheat up on the plateau would be ripening, I thought—a fine subject for Vincent.

As I passed the sturdy little town hall, made grandiose by the square and the pollarded trees before it, I remembered that Madame Chevalier had asked me to order some wine. Ravoux sold wines from a little counter in the front of the café facing the mairie, so I crossed the street and went in.

The room was quite a bit darker than the street, so at first I did not quite grasp what I was seeing, only that there was a female figure just steps from the door, clad in a light-colored dress and hastily moving backward. But the confusion was momentary—the girl in front of me carrying a market basket was Marguerite!

While Marguerite routinely ran errands for Madame Chevalier, there were some tasks that were inappropriate for a young lady. We did not send her to a certain farmer’s barn to buy grain for our band of poultry and the goat, nor of course to the blacksmith’s to buy nails or hooks or tools. There were too many coarse men in those places who had nothing better to do than lean on a counter and make remarks about young ladies. What was true of the ironmonger was even more true of Ravoux’s café. It was not a place where a young lady would go alone.

My daughter knew this. When I stepped into the dim space, she gasped, and tried to vanish between her basket and the tiny wine counter.

“Ah! Marguerite!” I said, thinking quickly. Auvers, like all villages, is full of gossip, and I did not want to provide a delightful scene for the pleasure of those watching. “Madame Chevalier has sent us on the same errand!”

She was scarlet with embarrassment and could not speak. I took the basket from her arm. “Is your business here finished? Shall we walk home together?” I turned to Ravoux, who was standing behind the counter with an impassively pleasant smile. “Has my daughter managed to let you know what we need? I am surprised Madame Chevalier sent her—affairs must be in a terrible state in the kitchen!”

He laughed, showing all of his big white teeth. “We were having a little bit of difficulty, Doctor. Mademoiselle did not seem to know what you would like to drink with dinner.”

“My dear, what are we eating?”

“I don’t know,” she whispered to my shoes. I hastily asked for a bottle of the local ginglet, put it in the basket, and shepherded my daughter out of the café with an elbow under her arm.

We walked for a few minutes. I was aware that Marguerite kept darting glances at me.

“My dear,” I finally began. She did not answer. “Paul goes for the wine. Was he not at home?”

“No. Madame Chevalier could not find him.”

“All the same,” I went on. “You should not be going to Ravoux’s. It is not a suitable place for you.”

“No.” The answer was so quiet that I barely heard her.

What else could I do? What more could I say? She was all but cowering at my side. I did not have the heart to show my displeasure. My puzzlement about her behavior was even greater.

I shared my concern with Madame Chevalier, when I asked her to join me for coffee in the salon. For a moment I allowed myself to imagine discussing my worries with Blanche instead. A mother and a daughter shared a kind of sympathy, I thought. Blanche would have known how Marguerite felt, and I—well, I would not have needed to intervene.

After Madame Chevalier stirred her coffee, she set her spoon on her saucer and looked expectantly at me.

“As I was coming home from the train this evening,” I said quietly, “I stopped in at Ravoux’s for some wine. Marguerite was there.”

“At Ravoux’s! Inside?”

I nodded. “The pretext appeared to be buying wine for dinner. She did not know what you were cooking, though.”

She shook her head. “Were there many people there? No one made any comments?”

I thought back to the figures I’d seen at the tables. “No. Ravoux was there, and his daughter was serving at the tables. I think he keeps order while she is there.”

“He is a father, after all,” she observed. “Not so different from you.” Then she sighed. “Marguerite has been very strange this week, Doctor.”

I got up and brought the decanter of brandy over to my desk, where we were sitting. “How so?” I asked, gesturing toward her coffee cup with the decanter.

She nodded. “Dreamy, absentminded.” She took a sip of the brandy-laced coffee and smiled up at me. “You know Marguerite is like my own daughter, Doctor. I love her. She has never wanted anything other than to please me, and to please you. Now there is something new,” she concluded, shrugging her shoulders.

“Vincent,” I said, a statement rather than a question.

“I believe so,” she answered. “You remember he brought her those flowers on Monday.” I nodded. “Well, poppies, daisies, how long do they last once cut? So on Wednesday I went into her room to take them away, and besides I wanted the little jug to keep some béchamel cool in the larder. The flowers weren’t faded, Doctor. She must have put new ones in.”

This did not seem conclusive to me. “Perhaps she just liked having the flowers in her room?”

“Yes, but she must have gone up to the wheat fields where Vincent paints to cut new poppies. I can’t think where any grow down here.”

“Or perhaps she just wanted to replicate the bouquet, or she wanted a long walk. I am not so worried by that. This evening, when she went to Ravoux’s—the only reason to do that was to see Vincent.” Once again, she nodded, to confirm my notion. “Has there been another time this week when she might have been … out wandering?”

“Marguerite, no,” she said firmly. “Paul, very possibly.”

“But Paul wanders anyway. There is no place in Auvers where Paul should not go.”

“No, Doctor. Not so much that. But I suspect he may be following Monsieur van Gogh.”

“Why would he do that?” I asked, baffled.

“He’s done nothing but draw all week. I doubt there’s any paper left in the studio. I think he hoped Monsieur van Gogh would help him. But I don’t know if he ever actually spoke to him.”

“What makes you think he’d been trying to find him?”

“You know how Monsieur van Gogh is not very neat,” she began, replacing her coffee cup on the saucer. “And how when he first came, Paul would bring home those paint tubes he’d found that Monsieur van Gogh had discarded, and show them to us. Well, he stopped after a few days. Lost interest. But he’s begun again, only he keeps them in his room.”

I looked at her for a moment, trying to imagine the four days that had just passed while I was in Paris, with my children apparently roaming around Auvers, hoping to catch a glimpse of Vincent. Or, more likely, to attract his attention in some way.

“Let me ask you this, Madame Chevalier. You have seen how Vincent is with Marguerite. Do you think there is …” I did not know how to phrase it. “Is he, has he shown any signs of special interest in her?”

“None at all,” she stated. “He barely knows she’s alive.”

I laughed. “But he painted her!”

“Oh, of course. But he paints flowers, too,” she pointed out. “And thinks no more of them when he’s finished.”

“True,” I conceded, relieved. “But the little bouquet of poppies?”

“A gesture,” she said, waving her hand. “Kindly meant, soon forgotten. Mind you, Doctor,” she went on, leaning forward, “you can see how a girl as innocent as she is might take it amiss.”

“But what can I do?” I asked. “Do you think I should send her away? I’ve been thinking that she ought to get to know some young men. Maybe a visit to Blanche’s family?”

“Not now,” she answered with confidence. “Doctor, look at Monsieur van Gogh. He is not so very different from the woodcutter I thought he was at first. Uncouth. Let her come to realize that on her own. The business of the flowers, and her going to Ravoux’s, is odd. But when you think about what other girls have gotten up to, Doctor, we’ve nothing to be concerned about. Nothing.” With that she got up, putting my empty cup on the tray. “Anyway, with you here this weekend, Doctor, Monsieur van Gogh will be around and both Paul and Marguerite can get their fill of him. That may be enough. Open their eyes.”

Vincent came to lunch the next day. I found myself watching my children very carefully. I thought Marguerite had made a special effort in her dress: there was a brooch of Blanche’s pinned to her collar, an unusual bit of coquetry for her. Paul was somewhat bumptious, eager to insert himself into the conversation even when we were discussing topics he could know nothing of, like Gauguin’s current misery in Brittany, or a portrait by Puvis de Chavannes of which Vincent thought very highly. Even Vincent seemed more peculiar. There was a quality to his conversation that I had not noticed before. He spoke just a little bit too loud, just a little bit too fast, and appeared unable to let an idea go until he had brought everyone around to his view of the thing. He had been painting a peasant woman’s portrait that week, and was exalted with the triumph of it. The modern portrait, he informed us, would not be a mere visual record but rather an evocation of a certain grief and tension that was our lot in the nineteenth century. A hundred years hence, when we were all forgotten as individuals, he hoped his canvases would still be seen, and felt, and understood. He had told me almost exactly the same thing while painting my portrait.

Aside from the improbability of the scenario he described, he was lecturing us. Marguerite was content simply to look at him, Paul hung on his words, and Madame Chevalier’s mind was clearly elsewhere. I began to understand what Theo had endured while living with his brother. Theo had told me that sometimes he would go to bed to try to evade Vincent’s monologues, but his brother would simply pull up a chair next to the bed and keep talking, hectoring Theo for a reaction, but growing furious if he disagreed. I had once found this difficult to imagine, but on that Sunday, I detected the first hint of Vincent’s mind in an unbalanced state.

I feel ashamed of this now, but it must be remembered that I was, I am, a doctor. As his friend, I wanted only a quiet, easy life for him, but as a medical man, I was keenly interested in this hint of manic behavior.

When luncheon was finished, Vincent and I went up to the studio because he wanted to look again at my Cézanne flower paintings. He had been contemplating his own canvases that had been sent from St.-Rémy, among them a magnificent vase of irises set against a yellow wall. Though he did not care for most of Cézanne’s paintings, he thought the flower pictures the best of them, and I believe he wanted to measure his own against that standard.

He was in a fault-finding mood. I had not seen this irritable quality in him before now. Cézanne’s palette, with its grayed colors, struck him as murky and unpleasant. He also took exception to the older artist’s brushwork, which he called “timid.” Of course, in comparison with his own bold treatment of paint, it would have been difficult to find brushwork that was not “timid.” There was no pleasing him that day, though.

I had just found one of my favorite Cézannes, a painting of my house under heavy gray winter skies, when I heard Vincent exclaim. I think it was a Dutch oath; I could not understand what he had said.

I turned around to see what was amiss. He was standing facing me, with my Guillaumin nude dangling from his hand. “Doctor!” he snapped. “You were going to frame this!”

I was taken aback. I had ordered the frame from Levert, the town carpenter, but he had not yet finished it. The delay did not seem to merit Vincent’s fury. “Yes,” I said. “I am going to. The frame is not yet ready.”

He stepped forward, coming very close to me in the small space. He was quivering with rage, the knuckles of his free hand clenched white, his skin flushed. “Is this the way you treat the work of painters who have bled for these paintings?” he spat at me. “You think you are a patron of artists! But look!” He gestured to the paintings stacked on the floor. “You are hoarding these things, stuffing them in an attic, pretending to appreciate them. You are the ruin of these artists!”

He raised the Guillaumin over his head with two hands, as if to bring it down with a crash, his eyes darting around to find the most satisfying object to hit. I could hear him panting, and there was an odor coming from him, a kind of rankness in his sweat. Suddenly I was alert, my mind racing. Until that moment, I would have said that Vincent was much the same as any other man. But in that instant when I glanced at his face, it was as if I saw what I had been waiting to see all along. Finally, I could imagine Vincent slashing his ear or requiring a straitjacket. It was true, then: he could be dangerous.

But I knew what to do. I even, I must confess it, felt a surge of pride. How many times had I confronted a raving patient at the Salpêtrière and brought her back to her senses? This was not a common skill; if my Auvers colleague, Dr. Mazery, were confronted by Vincent on the verge of a violent act, he would not have been capable of calming him. I was glad to think that I could take care of this man.

Moving slowly, I placed the canvas I was holding on the cabinet behind me, keeping my eyes on Vincent’s. I then positioned myself in front of him with my hands hanging at my sides. When you are attempting to pacify the deranged, you must call them back to the actual world from their alienated state. This requires a combination of force and composure. I took a deep breath.

“The frame is being made. Give me the painting,” I said, with the sternest voice I could muster. His blue eyes were boring into mine, but I did everything I could to project the power of my will. The doctor must determine the reality—he cannot allow the patient’s view of things to prevail. That is his duty to the patient. I stood still for an instant longer, then raised a hand, imperious. The gesture repeated my command: “Give me the painting.” My breath was now coming as fast as his.

There is a game they play in the cafés, when two men clasp hands and each tries to push the other’s arm to the table. It is a test of strength, and you can see one man’s force gradually overcoming the other man’s. I felt that happening, that afternoon: Vincent resisted, the madness in him tried to overcome my sanity, but I stood firm. “The painting,” I repeated.

Then he put it into my hand. A look of puzzlement came over his face. He glanced around, as if to confirm where he was. The surroundings seemed to reassure him. “I’m sorry, Doctor, what were you saying?” he asked. The rage was gone. It was as if a beast had peered through his eyes and then retreated somewhere deep within. Now in front of me stood my friend, the painter Vincent van Gogh, chastened, alarmed. I confess to a brief, private surge of triumph.

“I was saying that Levert is making the frame for this painting and it should be ready next week.” I scrutinized him. “Come, sit down,” I said, drawing him toward the divan where I had first examined him. “You seemed somewhat unwell just then. Sit and rest for a moment.”

He allowed himself to be guided to the dusty old divan and collapsed. He was now quite pale. “Stay here for a moment,” I told him. “I am going to get you some cordial. If you feel faint, lie down.”

“Why would I feel faint?” he said as I went down the stairs.

In a moment I was back before him, with a glass of water into which I had poured a special calming cordial I had developed. It has an unfortunately unpleasant flavor, being derived from the lavender plant. I try to mask the bitterness with a syrup of elderberry, but I must admit, my patients dislike it. Vincent made no comment, however, drinking it down obediently.

“Does your head ache?” I asked, laying my palm across his brow. It seemed cool enough.

“Perhaps a little bit.”

“Can you hear me properly?” He just nodded. “And only me? Nothing else?” This time he shook his head very slightly, as if unwilling to jar his brain.

“Vincent, has anything like this happened before? Theo did not mention spells or attacks.” Actually, I remembered, I had asked Theo about attacks, but he did not answer me directly. A sense of unease crept over me.

“I wish I could answer you properly, Doctor. I have no memory of the time when I injured myself, and there were days afterward that I do not remember, either. I suppose that could be considered an attack of sorts.”

“You do not know how you behaved?”

“Aside from taking a knife to my own body, Doctor, I do not.”

I sat back on the floor, looking up at him. “Has anyone ever suggested that you were epileptic? In the asylum perhaps?” But surely Theo would have mentioned that to me.

“Yes.” He seemed terribly weary.

“It’s not exactly the same as madness, you know.”

“What does that matter?” he asked. “It’s not the same as being sane. Can you stop it? Prevent it?”

“We can certainly give you potassium bromide. It is usually very effective against seizures.”

“Yes, I suppose I have taken it. I believe it made me drowsy.”

“I have none here in the house, but I can send Paul to Mazery to get some,” I offered, still watching him carefully. Was he epileptic? Or had he almost slipped into a kind of manic delusion? It was difficult to tell, but I thought it was the latter.

He dropped his head into his hands. “I should be all right for a while now,” he said. After a long moment of silence, he slapped his hands on his knees and pushed himself to standing. He looked exhausted and haggard. “I am fortunate—we are both fortunate, Doctor—that it was insignificant. Or perhaps”—he brightened—“you were able to stave it off?”

“I believe so,” I said. “I wish you would stay here and rest a little longer. Would you like a proper bed downstairs? Sometimes it helps to sleep after a disturbance.”

“No, Doctor, I am going to cure myself in my own way,” he said, turning away from me to the stairs. “I’m going to paint. It will quiet the noise in my head.”

I argued, I remonstrated, I mentioned what Theo would have wanted, but there was no swaying him. The authority I’d used on the madman did not work on the sane man. Maybe I didn’t dare exert it to the same extent. For though he was lucid again, it was clear that Vincent was fragile.

The mistake I made, I know now, was to let him go that afternoon. In a way it set a pattern; I believe that, for the rest of the summer, Vincent used painting as a way to soothe himself. It was the only way he knew of to escape his trouble. Yet there might have been another way, if I had come to a better understanding of his illness.

An alienated patient’s ailment is not visible; there is no rash, no wound, no fever. Doctors must rely on the patient’s perceptions in order to judge the malady. However, this is by definition a faulty method because the patient’s perceptions are damaged. We used to say at the Salpêtrière that it was only the patients who acknowledged being mad who did not belong there. The others, furiously proclaiming their sanity, were clearly far from sane. Sometimes a patient can be believed, and sometimes not. Only experience helps a doctor distinguish the well from the ill.

I learned this lesson in a dramatic fashion at the Salpêtrière. It was summer, a terrible, hot day in August. There was a dreadful reek coming from the river, an odor of rot and muck, while the damp corners of the hospital buildings sent out a kind of olfactory echo, a whiff of mildew and drains. I was confined to a dank ground-floor cubicle, examining reports on our patients. This is one of the reasons I did not pursue one of the grand medical careers in Paris; I am not at home in the world of rules and files and committees. I believed fifty years ago, as I believe now, that a doctor’s business is with his patients rather than with other doctors.

Thus I had a patient with me, even though I was away from the ward. We had some freedom in this regard: though the women’s days were very strictly regimented, a doctor could request that an individual be released from her normal routine. Marie-Claude was unusual in that she could read and write. She had been raised by an uncle who was a priest, and upon his death she secured a job as a governess, but a subsequent series of misfortunes brought her to us, a victim of mania. On more than one occasion she had attacked fellow patients, wardresses, even, once, an unfortunate gardener. Yet between these episodes she was calm and highly intelligent. I had borrowed her from the workroom to help me with my current task alphabetizing three months’ worth of intake reports and checking them for completeness.

Marie-Claude was in her early thirties, and what distinguished her from her fellow patients was her expression. I thought it was something about her eyes: They moved in conventional fashion. She looked at things, examined them perhaps, then looked away once she had gleaned the information she wanted. She met my gaze but did not stare. She might frown over a page that she had trouble reading, and hold it closer to the lamp—it was so dark in that wretched room that we had to light a lamp in the middle of the August afternoon. She never looked too long or too closely at anything though, and her eyes did not evade you.

We talked as we worked. This was not the first time I had asked for her help, and I wanted to be sure that she did not resent my appropriating her time.

“Will you still be paid, even though you are not in the workroom?” I asked, as we settled down to our task. I had had to go to the atelier to pick her up: even the patients considered closest to recovery were never permitted to wander around alone.

“I’ll be sure of that, Doctor,” she said, with a smile. “I’m quite sharp with numbers, and I always check my pay packet.”

“Would you like to do work like this when you leave here?” I asked, sitting at the desk and pulling the folder of reports toward me.

“Who says I’m to be leaving here?” she asked, startled.

“No one. But you are doing so well.”

She shrugged. “That’s as may be, Doctor. Well today does not mean well tomorrow.”

I opened the folder and took out a sheaf of reports, each of which described a patient’s first examination. We were thorough; we could not dismiss the possibility that mental ailments might have their origin in physical causes, so each woman was examined minutely and the results recorded. I spread the sheaf out on the desk, and Marie-Claude, reading the patients’ names from the other side of the desk, began to pluck them from the pile.

“Do you not think you are cured?” I asked. “There is not another woman in this hospital who could do what you are doing at the moment.”

She paused for a moment, and looked at me. “Doctor, I would not want to be disrespectful,” she began. “I am grateful for your interest.” Her hands were still on the documents.

“And? But?” I prodded.

There was a long pause. She seemed to be formulating her response. After drawing a deep breath, she said, “I was going to tell you that you should not rely on a patient’s opinion. Yet there are times when we can judge our own condition. The difficulty is that we cannot tell the difference, we do not know when we are right and when we are wrong. And you, Doctor, can’t, either.”

I sat up, excited. Marie-Claude was the patient we all looked for, the patient who was sufficiently lucid and educated to describe her state. Perhaps she could help me understand what it was like to be mad. I had my ideas, I thought I might know, certainly I was sympathetic. However, she was the one who could not walk from one building to another without a wardress, the one who slept in a row of a dozen beds and was watched even as she bathed.

“But what does it feel like?” I asked, leaning toward her. “Can you remember? Do you recognize it?”

She shook her head regretfully. “No. I cannot say that I do.” She looked back down at the papers, and plucked four more from the sheaf, placing them facedown in what I knew would be the correct order.

“I’m sorry,” I said, suddenly overcome by a convulsion of conventional manners. One should not pursue a topic that made anyone uncomfortable. Marie-Claude seemed unwilling to discuss this matter further. But it was such a chance for me! “You have no way to describe the state? Or is it different each time?”

“I don’t even know,” she answered, and went back to her work.

I had pressed her too hard, it was clear. The next time I tried to borrow her from the workshop, the supervisor told me she could not be spared. She kept her eyes lowered the whole time I was in the room. I was terribly downcast.

Yet that was not the great lesson I learned from Marie-Claude, if indeed I could glean anything from this puzzling encounter. It was a few weeks later that I saw her again. We externs were required to be on duty several nights a month. The senior medical staff went home at night, naturally, but a doctor had to be available in case of a crisis. We slept in a kind of annex not far from the women’s dormitories, and the nights were normally uneventful. On this occasion, however, I was roused well after midnight by an orderly with a lantern that looked as if it had been left behind some time before the Revolution.

“Doctor,” he whispered, though we were alone in the room. “You’re needed.”

I sat up and ran a hand through my hair. It took me a long minute to understand where I was. “Yes, I’m coming,” I said, feeling beneath my cot for my boots. I thought about leaving my coat hanging on the chair where I had left it: It was still a hot night. Reluctantly, I shrugged it on. If I were to be the doctor, I must look like the doctor. I picked up my medical bag as well, having no idea what I might do with it.

I was apprehensive, I will admit. This was my first midnight call, and I did not know what to expect. As the orderly led me to the ward, I listened for disturbance, but there was none—merely our footsteps, treading quickly down the long stone corridors. “Here we are,” he said, finally, turning a corner.

I was surprised. There was no crisis. We were at the door of the principal dormitory of Falret’s division, where the most capable women were assigned. The two women at the door were the wardress, a capable woman known as Madame Boguet, and Marie-Claude. They stood side by side, apparently awaiting my intervention. They were not speaking. I looked for recognition in Marie-Claude’s expression, thinking that my presence might reassure her. There was none.

The orderly turned and took his ancient lantern down another corridor, while Madame Boguet began to explain the situation in a whisper. That must have been why the orderly did not speak aloud to me; he had carried his whispered instructions the length of the building and delivered them as he received them.

“Marie-Claude is unwell,” she said. She glanced at our patient in an unfriendly way. “She claims she needs to be confined in a gilet de force. You know that I need the approval of a doctor for this, and she insisted that you be roused. So here we are. In the middle of the night. With two dozen women awake on the other side of this door, and a fine time we’ll have settling them down!”

I glanced around. It seemed to me that my first step should be to separate Marie-Claude from this forceful and angry woman. I would have liked to find a little room where we could speak calmly. The corridor, of course, was dark as pitch, and Madame Boguet had the only lantern. There was a window a few meters away, a deep indentation in the thick walls, through which the hazy moonlight seeped.

“May I speak to Marie-Claude?” I asked Madame Boguet. “I would like to step over to that window, so that we might not further disturb your patients.”

She looked at the window, at me, at Marie-Claude, then nodded. “I must check on them. I will come out in a few moments,” she said and whisked herself through the heavy oak door to the dormitory. I took Marie-Claude by the elbow and led her to the window, positioning her so that the light fell on her face. It was not much help. Her expression was closed.

“Can you tell me, Marie-Claude, why you want the gilet?” I asked. I hated to see the women bundled into those coarse strappings of canvas, shuffling along with their balance impaired, lost without the use of their hands. I saw it as a punishment, and a return to the old days of chains. Surely we had made progress beyond this.

She took a deep breath, but it was not steady, and she closed her eyes. Then she shook her head.

“Are you hearing voices?”

Another shake of the head. I stood still for a moment. I could not think what to do. “May I take your pulse?” I finally asked, thinking that I might receive some information in that way. She did not answer but did not object when I took hold of her wrist. Her pulse was fast, but not alarming. I considered taking out my stethoscope—I was grasping at straws—but Madame Boguet came shuffling out of the dormitory, closing the door behind her.

“Well, Doctor,” she hissed, approaching us. “Will you put Marie-Claude in the jacket?”

“Can you tell me something more of the circumstances?” I asked. “Has Marie-Claude felt unwell before today? Is there … has she been weak, or had headaches?”

Madame Boguet looked at me with manifest impatience. “Marie-Claude is a lunatic, Doctor, like the rest of the women here. There is no telling, ever, what any of them will do. When we find a patient sensible enough to ask for constraint, normally we put her in the jacket. I don’t hold with the doctors interfering, we do very well on our own and we know what’s what. Marie-Claude is a good girl, but she’s done some harm in her bad moments.” Here she put a reassuring hand on the patient’s arm. I found this confusing.

Who was right? I was the doctor. I was the one with the training, the seven years of medical school. I was the one wearing the black coat and carrying the bag full of diagnostic tools. The wardress, it seemed to me, was harsh. She could know nothing of what we doctors were trying to achieve. Yet her comforting touch told me she had Marie-Claude’s well-being at heart.

Clearly, there would be no help from Marie-Claude herself. If anything, she seemed to have withdrawn further.

It seemed so wrong. The gilet was humiliating. Nevertheless, the patient had requested it. I had regarded her as practically sane, even ready for freedom, but now she wanted to be confined. She had warned me of precisely this turn of events; that even she could not judge her own condition.

And yet where was the harm in granting her wishes? I could feel my mind changing. If I granted Marie-Claude’s request, threaded her arms through the long sleeves, tied the knots up her back—what then? She would sleep poorly, perhaps. If I denied the request, the risk was much greater—Marie-Claude might rise from her bed and attack one of the other patients. Her records proved the potential for violence; she had once come close to throttling a woman much larger than she.

So I gave in. I agreed that Marie-Claude should spend the night confined, and further ordered a series of cold baths over the next few days. Many women found that these restored them to normalcy. I returned to my cot and lay down with my boots on, running over the sequence of events in my mind. I should have stood firm, I thought. I had submitted to the authority of a madwoman and an uneducated wardress who, for all I knew, had done her own time as a patient. Could they possibly know more than I, the physician?