Human Traces

  ‘Equally,’ said Charcot, ‘it can thus be halted by pressure to the ovaries.’ He nodded again. A bearded intern stepped forward and, while Mlle Cottard and Dr Gilles de la Tourette pinioned the woman’s flailing arms, pushed his hand down the waistband of her skirt. After a few moments of the intern’s manual pressure, she relaxed, her seizure left her and she was once more escorted to her chair where she sat, panting, with her sweat-drenched hair hanging down over her face and breasts.

  There was no smile or look of triumph on Charcot’s face as he checked his watch and turned in conclusion to the audience. ‘So there, ladies and gentlemen, we have been able to watch an hysterical attack – not in a partial or bastard form, but in a pure and classic form, fulfilling each of the four defining phases of its nosology. You may have found the pathology confusing, particularly my description of the effects of mental activity, auto-suggestion and remembered experience in such a somatic complaint as this. I propose, however, that the explanation is available to us if we are to consider the as-yet unfound lesion of hysteria to be not a static but a dynamic lesion, caused by an alteration in the tissue of the brain brought on by metabolic or chemical change. Such process is quite consonant with our understanding of hereditary disease. I propose to you that although the lesion is imperceptible to present-day science, this will not be the case for long. I am a practical man and I do not like, as my students know, to theorise. However, I am prepared to offer an hypothesis that the lesion will be found in the grey matter on the side opposite to the hemiplegia, which you saw begin during that attack, probably in the motor zone of the arm.’

  Charcot began to gather the notes from the table behind him. ‘As to the connection with what I have called the mental side, I do not see an insurmountable problem there; I do not see anything in that complication that need remove hysteria from the domain of neurology and hand it to the alienists. One need only view the problem this way. As one may describe the physiology of the lungs as breathing or the physiology of the colon as the evacuation of waste matter, then one need merely envisage what we call “psychology”, or thought, as the physiology of the cortex. In that way,’ he said, levelling off the edges of his gathered notes, ‘the entire process falls within the map of human neurology as we have it.’

  He thrust his notes at the chest of his chief assistant, Pierre Marie, said, ‘Arrange all this for publication,’ and strode from the stage.

  That afternoon, as Jacques was walking in a delirium of excitement across the Promenade de la Hauteur towards the chapel, Mlle Cottard came hurrying towards him. ‘I have a note for you, young man,’ she said. ‘From Dr Babinski.’

  ‘For me?’ Jacques felt honoured that Babinski, one of Charcot’s favoured sons, should even know who he was, and Mlle Cottard’s raised eyebrows suggested that she agreed.

  ‘Monsieur,’ said Babinski’s note, ‘I have heard good reports of the freelance teaching work you have done with the first-year students. I know that you are close to the end of your time with us and I believe that your defence of your thesis before the examining board will be a formality. I wonder therefore if, in the name of our common search for knowledge, you would care to offer a second opinion on a private patient, a young woman with a mild nervous affliction. Since you are not yet formally qualified, this must of course be viewed as an intellectual exercise only.

  ‘However, the young woman’s family is extremely wealthy and will continue to require medical services. Doubtless you are aware that our great professor himself enjoyed such patronage at the start of his career, travelling abroad as physician to an entire family, and that that aspect of his work continues to flourish. Please call in after my clinic tomorrow at five if the idea interests you. Yours truly, Joseph Babinski.’

  Jacques began to run back to Madame Maurel’s boarding house. He was not late, but there was no other way in which he could express his happiness. In the morning he had witnessed human beings at the edge of greatness, men standing on top of the mountain that only they, by virtue of their genius and determination, had known how to scale, and looking for the first time into a promised land the other side. These great explorers peering narrow-eyed into the mist . . . He had seen them, been with them in the room, and he knew, as they knew, that when their gaze became accustomed to the view and the mist began to clear, the vista that emerged was little less than a complete landscape of what it meant to be a human – body, mind and soul – the geography of being, revealed in all its beautiful simplicity by the pure light of science. As if that exhilaration were not enough, one of the expedition leaders had now singled him out by name to join them – to be an associate in that enterprise.

  The classes were coming out as he ran down the Ecole de Médecine. From the Ecole Pratique, the weary students issued onto the cobbles, cigars clenched between their teeth, and, just like the fastidious ladies who had once so irritated him, he held his breath as he went past them. He stopped to buy a bag of roast chestnuts on the corner of the Boulevard St Germain, then, in a moment of exhilarated self-indulgence, went into a café and drank a glass of hot rum at the counter. He smacked the empty tumbler down on the zinc, wiped his moustache on his sleeve, and went on his way, down into the dingiest streets of the Latin Quarter, where the students and the prostitutes lived, where the artists’ models and the provincial boys from Angoulême and Aurillac who had to find their fortune co-existed with widows of dwindling income, powdery dotards and sharp-featured men with bad clothes looking for investors in their fail-safe business schemes.

  Representatives of all such people dined at Madame Maurel’s at seven in the evening. The panelled parlour was filled with the vapour of their failing aspirations; it hung like fog above the pewter candlesticks, with the smell of tallow, boiled vegetable and Madame Maurel’s tomcat. Jacques took his napkin from its place in a wooden box on the sideboard, reserved to the dozen full-time residents of the boarding house. This inner core was joined at dinner by half a dozen others, drawn to Madame Maurel’s table by the modest rate the old widow charged them for their mutton and potatoes with mealy white bread. When the ‘externs’, as Jacques thought of them, had gone home, the residents felt free to comment on their pretensions, hygiene and appearance. Between themselves the ‘interns’ kept a semblance of civility, though Madame Tavernier and her round-faced daughter, who had the second largest suite of rooms on the first floor, found it hard to conceal their distaste for Pivot, the lank-haired travelling salesman in the single above them, who disturbed their sleep by walking up and down on the bare boards to ease the torment of his psoriasis. He in turn referred to them as Marie Antoinette and her little pug bitch and relished the way they wiped the rims of the greasy wineglasses before deigning to touch them with their lips. ‘Mend those lace cuffs one more time,’ he said, ‘and there’ll be no lace left.’ ‘Do not answer the gentleman,’ said Madame Tavernier with a sniff.

  After dinner, the guests who could afford it took a cup of coffee in the drawing room, a place furnished with the pieces of furniture that other houses had rejected; Jacques thought they were like the women of the Salpêtrière, given asylum by Madame Maurel because no one else would have them. There were indestructible sideboards, tastelessly carved, a table with an oilcloth and a wooden clock with copper inlay, greened with verdigris. The room was cold because its fire was never lit; even when Pivot took a glass of cheap cognac, it seemed to bring no warmth to him, because the air had the same saturated quality as that of the parlour, as though it had been too often exhaled from damp lungs.

  Jacques’s was one of four attic rooms, next to that of a law student from Tours who played the violin. These were the cheapest lodgings, uncleaned, unvisited by the handyman; they were the rooms whose occupants Carine was last to call in the mornings, and then only if her legs were not too swollen to permit her to climb the final flight.

  He lit a candle, pulled his chair up to the table and began to write:

  My dearest Sonia,

  May I call you that? To me
you are most dear – the most dear person in the world, dearer even than your brother – dearer even than my own brother, whom I love without reservation! I think of you in your lovely room, looking over at the church. No – it is nine in the evening, so you are still downstairs. You have dined in one of your fine dresses and entertained whatever dull merchant your parents wish you to impress. You have been loving and dutiful; but is there that look – what is the English word? – playful, perhaps, a little humorous, in your eye, as though you wished that there was somebody else there, whose eye you could catch? And could that somebody be me? You seem so far away that sometimes I wonder if I can still exist in your heart, or in your memory.

  Now you are reading your book, wondering when it might be time for you to leave and go upstairs. My heart hurts with your absence. Yes, I feel it there against my ribs. I do not care what modern science says; that is the organ of my emotions!

  But today, dear Sonia, has been a great day. We are on the edge of making such discoveries here as will change the treatment of the sick, but more than this it will change what we understand it means to be a human being (I have not expressed that well). And today one of the most distinguished doctors offered me one of his private patients! I shall see this young lady

  Jacques dropped his pen with a cry. Where would he see this young lady? Charcot had a palace on the Boulevard St Germain, Babinski had a respectable consulting room at the hospital, no doubt; but he, he could not invite a society lady into the tubercular stew of Madame Maurel’s parlour, invite her to disrobe and leave her silk dress – where, next to Pivot’s soiled napkin on the sideboard, out behind the kitchen door on top of the suspended meatsafe? God. He picked up his pen again.

  Tell Thomas that when you both come to join me in the summer he must take decent rooms from which we can both consult. I know he has saved some money from his pay at the asylum. If I can find somewhere to do my first consultations, I too should be able to save something to contribute. Once we have a little practice running it will pay for itself, but these landlords are cruel about wanting a deposit, so we must have something to offer.

  Sonia, I cannot wait for you to come. I can arrange for Thomas to walk the wards at the Salpêtrière for a time; most important is that he comes to Charcot’s lectures, which are changing the course of medicine.

  Thank you for your last letter. I love reading about Torrington. It feels almost like a home to me – more like a home than my own in Sainte Agnès, where I shall never return.

  I do not believe that Violet still talks of me. I think you are flattering. I can write no more. I am too happy and too full of plans. Until the morning!

  When the letter was delivered to Torrington House, Sonia was not there to receive it; she was sitting in Dr Faverill’s office at the asylum, where she had gone to visit Thomas.

  ‘I am most disappointed, Mrs Prendergast, that your brother has given notice that he intends to quit his position here,’ said Faverill. ‘He will have been with us less than two years, and I can say without fear of contradiction that he has a greater flair for mad-doctoring than any man I have yet worked with.’

  ‘I am sure he would be delighted to hear that.’

  ‘No, no,’ said Faverill, twisting the beard beneath his jaw, ‘I am sincere. He is so modest, so inquiring. Nihil humanum sibi puto alienum esse, if you take my meaning. And he has such joyous optimism, the ebullience of youth.’

  Sonia smiled. ‘He is not moody, not rash?’

  Faverill looked surprised. ‘No. Neither of those things. I have never seen a man more dedicated to his work. And the hours he labours! He has tried to conceal it from me, but no. I suffer from an inability to sleep, and frequently I walk about the asylum in the night. Occasionally I have come across him in the wards, but more often I have seen the candle burning in his window.’

  ‘Ah yes. Thomas has always read a great many books. Even as a boy.’

  Faverill nodded his head several times and pursed his lips. ‘Well, it is a great shame, is it not, Matilda?’

  Sonia looked across the fireplace to where Matilda sat opposite her; but she did not answer Faverill, appearing to be lost in thoughts of her own.

  ‘Has Miss Whitman found you a satisfactory bedroom?’ said Faverill.

  ‘It is verypleasant, thankyou. Are you sure it is not irregular for me to stay?’

  ‘Not at all. Perhaps the Commissioners might find it so, but the consolation for being superintendent here is that I can do whatever I wish. I am the emperor of this small realm. It is a pleasure for us – we have very few voluntary visitors . . . And in any event, I understand the experience may be useful to you in your new life.’

  ‘In what way?’

  ‘Your brother tells me that you plan to join him and your husband in a medical venture overseas.’

  Sonia found herself blushing. ‘I – he is not yet my husband.’ She had a superstitious dread of anticipating the longed-for event.

  ‘I beg your pardon.’

  ‘No, but you are correct. We are to go to Paris and then, I think, to Germany. It is a great adventure.’

  ‘Indeed. Indeed.’ Faverill tapped his lip with a lead pencil he had taken from the desk.

  Sonia looked about his book-lined room and had the sense, as her brother had before her, of some unspoken agitation in Faverill. Men of his age, she thought, eminent in their work, surrounded by the calfskin and vellum of their elders, should be sage and bonhomous; Faverill, though kindly, seemed distraught.

  ‘May I ask you something?’ she said. ‘When you spoke a moment ago, you said that being emperor here was a consolation. For what are you to be consoled?’

  Faverill shot a look across the room at Matilda. ‘It was a figure of speech. A philosophical one. I was thinking of Boethius and the De Consolatione.’ He smiled. ‘No, that is not altogether true. I suppose I had a homelier thought in mind. When I was a young doctor, there was much optimism in the air. The new asylums were embodiments of our hope. I believed – as did my colleagues – that we could not merely care for mad people, we could cure them. That was our article of faith. Now, thirty years later, I have cured almost no one. The most common ailments in this asylum are idiocy, which is inherited and incurable, and epilepsy which may have some source in the activity of the brain, though we know not where. Then there is general paralysis of the insane, the results of which I have observed post-mortem when the brain is horribly damaged. But we have no idea what causes it. My own suspicion is that it is somehow connected with syphilis, but we have no way of demonstrating this. And finally there is a kind of dementia, hearing voices and so on, which appears to begin in young people and to intensify. We are far from agreeing even a description, let alone a cure for that. Some forms of mania and melancholia do seem to improve, but whether that is because of hot baths and cascarilla or whether they have just run their course, I could not say. It is a damnable state of affairs.’

  ‘But we will understand madness, will we not?’ said Sonia. She was thinking of Jacques’s poor brother. ‘We will cure it.’

  Faverill stood up. ‘That is why I admire your brother, Mrs Prendergast, and am so loth to see him go. He too believes there will be cures. And unlike me, he has the energy and the will to find them.’

  ‘Do you no longer believe we will discover remedies?’

  ‘Not until we understand what makes us who we are. My instinct, though I am pitifully far from being able to prove it true, is that what makes us mad is almost the same thing as that which makes us human.’

  Sonia frowned. ‘You mean that we are fallen? Imperfect? That God gave us the capacity to suffer more than other animals?’

  ‘Yes,’ said Faverill. ‘That is one way of explaining it. It is the price we pay for being favoured by the Almighty. Mr Darwin might prefer to put it differently. If we were to borrow his language, we could say that when the brain one day developed the capacity that made the species Homo sapiens, it developed simultaneously a predisposition to kinds of insan
ity. Though since we are the only animals to have madness, you may regard what I have just said as no more than a simple tautology.’

  ‘I see,’ said Sonia, not quite certainly.

  ‘Whether you choose to explain it in the terms of the Bible or Mr Darwin seems to me to make almost no difference,’ said Faverill.

  There was a knock at the door. ‘Ah, Midwinter,’ said Faverill warmly. ‘I was explaining to your sister how much we are going to miss you.’

  ‘Thank you,’ said Thomas. ‘And I shall miss you, and some of the patients.’

  ‘Not all?’

  Thomas laughed. ‘By no means all. Now, Sonia, I promised you a tour of the asylum. I am going to show you some of the improvements we are making. May I, sir?’

  ‘You may take the lady where you wish, Midwinter. Though there are perhaps one or two wards which might . . . The gentler sex, you understand . . .’

  ‘Of course.’

  As she followed Thomas out, Sonia felt a little chastened by her interview with Faverill. She did not understand what he had meant about Mr Darwin, whose book she had only ever heard spoken of with derision. Faverill seemed to suggest that human beings were not an absolute thing, but could easily have developed into something similar but slightly different. The ‘variation’ that transformed them from pre-human into human entailed weaknesses that made them mad. If that tiny change had gone another way, they would not have been mad, but presumably they would not have been quite human either . . .

  Thomas led her to a small brick outbuilding.

  ‘I am going to show you my secret project,’ he said. ‘Shut the door and make sure you pull that black curtain across. Now follow me.’

  The building was divided into two parts, the second of which they now entered. The brick walls were painted black, the floor was made of earth, but there were two electric lights, one white, one red, whichThomas switched on. ‘You never expected to find such modern equipment at our asylum, did you, Sonia? Electricity! Only for the darkroom, I am afraid, not yet for the poor patients. I had to spend some time persuading Dr Faverill.’