Madness and Glory: (25): Therapy
The story of Philippe Pinel, father of modern psychiatry
Posted May 27, 2019
This is a work of historical fiction
Denis walked through the corridor toward the large stone-pillared inmate’s hall. At the doorway, he stopped and looked into the large enclosure, quickly sweeping a practiced gaze over each of the inmates lying or moving around in different postures and positions. A few lay stretched out on the floor or huddled onto portions of a bed, some paced through the room constantly moving their lips or talking loudly, one had tightly squeezed himself into a corner. A tall man wearing a strait jacket stared at Denis from the middle of the room, the corners of his mouth stretched awkwardly in a grimace. Near the doorway, a man was covering both sides of his face with his hands and pushing his head against the wall as though avoiding the light or, more likely, a terrifying sight.
Nothing special here, he thought. It seemed to be working out all right, no chains at all, using just strait jackets at times of violence. Not a single bad attack since quite a while back before the unchaining when that younger attendant forgot to look behind him and got bludgeoned to a bloody stump with chains. He couldn’t help feeling a little bit wound up, though, still had to be watchful and on guard. Some inmate might still jump another one, become wild and furious, or else come at you out of the blue. Like that Rastillon, with the stand-up hair, did the week before. And they find every way anyone can imagine to hurt themselves badly, scraping themselves with whatever they could get hold of—stones, glass, buttons they hone for hours, forks. Banging their heads against the walls.
A short, muscular man who was baring his teeth spasmodically caught Denis’s eye. The man walked toward him, beating his arms against his sides, stopped a few paces away, raised his hands to his head, pulled vigorously at clumps of his hair, and turned away.
Questions, recently recurring frequently as he worked, came into his mind. What makes this happen? What is wrong with these men? The people in this hall hadn’t, as far as he knew, committed any crime, so—son of a dog that such a thought comes to me!—was there maybe a crime they wanted to commit? Then the fighting, maybe even the self-harm, stops their goddam impulses to do greater harm. Most of these are not killers, taking the chains away shows that. Sure can tell real ones, real killers, they’re all around, operating every day, plenty close at hand. He thought of being on the Place de la Revolution when they executed the former queen, remembering again the way she looked at him. They recently cut off the heads of the Girondins, the ones who helped start the Revolution. Who does all this? The Revolution was his own cause from the first, he always was for stopping aristocrat privilege and plundering by priests. But who orders the killings of one kind of person, then another—queen, patriot, ugly women, good-looking ones, people who cry for the dead, men who make too much profit in their stores? No one is safe from slaughter. If the big-shot condemners went wild and beat their arms against their sides, would that stop them from calling for actual killings? He looked again at faces of the men in the large room. The one baring his teeth could just be that overblown deputy Saint-Just—even looked a little bit like him—who screamed when they were chasing Lalladiere at the Place.
Denis continued down the hallway. He realized his thoughts about the queen’s execution came because he was on his way to attend Lalladiere, recently returned. Back at Bicêtre, what a challenge! There was still something about Lalladiere, that cleverness, the successful evasions when he escaped, the work as Necker’s assistant before, and the keeping of the loyalty of proud Genevieve Raston. This lunatic was surely not, like people say, possessed of the devil, or filled with anything like bad humors. In a certain way, he was actually a little bit like Denis’s father—smart, persistent, and in some ways strange, but always the center of his own and his mother’s lives.
He reached Lalladiere’s cell and roused him up to bring him to Dr. Pinel’s examining room. As they walked together back up the hallway, Denis saw that Lalladiere was weaker, walking slowly with a tendency to drag one foot. Denis knew about the treatment at Humanité, Lalladiere had become worse than before.
They passed together by a small cell and then the bath treatment room. Inside this room, at an angle where Lalladiere could not see him, was the attendant Ajacis setting up for a bath to another inmate. Looking up from his work at the noise of their steps, Ajacis recognized the form of Lalladiere walking at the side of Denis, and was surprised. He did not know this inmate he despised had returned to Bicêtre. He had heard from Jean-Claude, whom he drank with from time to time at a tavern at the Palais Royale, that Lalladiere had been the same obnoxious and grandiose lunatic at the Hospice d’Humanité. Vehemently, Jean-Claude added, he would never get well. Ajacis had agreed, emphasizing that everyone gave too much attention to Lalladiere. He said that the rotten inmate needed to be beaten constantly even though that didn’t always prevent his disgusting tactics. But, as Jean-Claude knew, that was no longer allowed at Bicêtre.
Seeing Lalladiere walking past now, again within his jurisdiction, Ajacis vowed he would at the first opportunity physically put him straight, as he knew best to do. He had not up to then been caught and Lalladiere was, he knew, too afraid to report him. He would take the risk when he could. Beating would stop the lunacy and reduce Lalladiere’s continual overbearing pride. Ajacis looked forward to using his skills for inducing memorable pain.
“You have come back to us, been through the streets of Paris, gone to Robespierre’s dwelling, received the treatments of Hospice d’Humanité, and now perhaps you will tell us what causes your so passionate behavior,” Dr. Pinel said after Lalladiere entered and sat down. Denis drew up a chair nearby.
Lalladiere was silent, head down, face without expression.
“Come now, my fellow, I have heard of your accusations against some of our leading republicans, and I am prepared to listen.”
Lalladiere raised his head sideways and looked at Dr. Pinel out of the corner of his eye. He said nothing.
“I tell you,” Pinel said, “I will listen to whatever you have to say. I am here to help you. I have seen that sometimes you become mute and paralyzed. A mentally-induced paralysis, that is. Other times you speak very strangely. But there are moments, I believe, when you want to be understood.”
Lalladiere made small propelling motions with his head.
Do not trust him. He is trying to fool you.
Under his breath, he repeated what he just heard, “Do not trust him. He tries—“
“What is that? You say someone should not be trusted? Is that myself? But we treat you well here. No bloodletting, no chains.”
Lalladiere, slightly reassured and not having seen Ajacis, started to speak.
You must be chained, prevented from moving.
The first words of acknowledgement became then choked in his throat, and he mumbled incoherently.
“You are, I think, trying to say something to me,” Pinel perceived a reaction, though miniscule.
“To me, the tell. They must save the salt. And also the corn and beans.”
“Yes, we are here to help you,” Pinel uncomprehending, intuitively persisted. “And so, Guillaume Lalladiere, what are these things you know about secret plotting in the government? I have heard of some dissatisfactions myself.”
Denis, at Lalladiere’s side, shifted uncomfortably in his chair. Often present at Pinel’s sessions with inmates, Denis had become impressed with the doctor’s receptive, humane approach. The madmen opened up to him, and Denis found out things he never knew. Pinel was, he realized, working hard to get Lalladiere to reveal himself and to learn about him, but Denis worried about the dangerous comment about dissatisfactions. No one in these times makes open criticisms of the government. The risk of slaughter. Just saying that any things were better in the past put people under the blade of the guillotine.
“What about the plots? It must be very difficult to feel constantly misunderstood,” Pinel volunteered.
“Danton, then Robespierre...” Lalladiere started, a knot clutching his belly. He broke off.
“Yes, yes. It is about these men? What can you tell us?”
Lalladiere looked directly at Dr. Pinel. Simply dressed in white cravat and dark jacket, compactly built, angular face with a straight slightly elongated nose, the doctor was not, even to a cowering lunatic, an imposing presence. But his clear blue eyes seemed to draw the small amount of light in the room, they were shining and attentive. His slightly pursed mouth added assurance and thoughtfulness.
Lalladiere started again.
Quickly, and with effort, he decided to defy the warning voice: “It’s the Revolution. They’re going to take over, destroy the Revolution.”
“How will they do that?” Pinel asked in an even tone.
Don’t, don’t say—
“Use Robespierre, the Incorruptible,” Lalladiere pushed out. He paused, looked down at his side, sighed deeply, then continued. “He will destroy Danton. Danton will appear as overly ambitious. Corrupt. They will cloak him in corruption.”
Pinel, hearing Denis shift in his chair and knowing he was startled, avoided looking at him and leaned forward toward Lalladiere.
“But that has already happened. Danton and his followers have been guillotined!”
Lalladiere was also startled, and surprised.
Watch out. You’re next. They are going to get you.
He refused then either to listen to the warning or think about the dying. Death was not real, only a type of punishment. But the plot, the terrifying plot, was progressing. Nevertheless, he felt reassured by Dr. Pinel’s presence. The man was listening to him, someone was taking him seriously.
“Robespierre. He did it?” Lalladiere now broke his inner prohibition against asking questions.
“Yes, of course. The Committee of Public Safety condemned Danton, but Robespierre is the leader there.”
“The Revolution, it must be saved,” Lalladiere said loudly. Then, clearly and succintly: “Next, they will destroy this very important idealist Robespierre, find a way to bring him down.”
“How do you know about such a diabolical, far-reaching plot?” Pinel asked. “How could you find it out?”
Denis stared, unbelieving. Talking about Danton’s death? A plot to bring about Danton’s death? The accusation, the words themselves, were dangerously traitorous. This man is insane. Why does the doctor continue?
Seeing Lalladiere’s eyes shift to the attendant, Pinel noted the extreme suspiciousness. Despite the co-incidence of Danton’s death, the man had paranoid symptoms and the story would likely turn out to be delusional. On the other hand, passions, he believed, made people insane. He needed to know what this story was all about, what passions were involved whether it were true or not. A fear of speaking before an attendant, or even speaking to himself, about governmental plots was, in these perilous times, he realized, quite natural. Not itself a proof of insanity.
“You seem fearful of speaking,” he, now on target, said to Lalladiere,” it must be because you talk here of things that matter ardently to you.”
Slowly, gradually, Lalladiere’s words again came without interference. He eked out the story of the plot he overheard. At the doctor’s prompting, he described the voices of the men he heard, said they belonged to Jean-Lambert Tallien and Paul Barras, both of whom he had known when he was Necker’s assistant. With his long, slender hands, he gave a picture of the cubby hole space between the house and the street where, immobile and not being seen, he heard all they said. Pinel was impressed by the elaborate, detailed description. Denis, a reluctant audience, vaguely remembered the disagreeable deputy Tallien having inspected the asylum possibly at about the time of Lalladiere’s first escape. He was astounded by this claim of a chance encounter. Beyond that, he was unnerved by the doctor’s listening to the accusations and the open use of the Jacobin leaders’ names. He was actively encouraging Lalladiere to spell it all out, and seemingly even believed it.
“You say it was Tallien that developed the plot? The butcher of Bordeaux?” Pinel asked.
Outside all limits, Denis thought, frowning and shifting in his seat. He heard rumors from other attendants that the doctor had government-condemned friends. Speaking in front of anybody this way, Dr. Pinel was risking disaster. Denis wished he weren’t a witness sitting there, but at the same time he couldn’t help being fascinated by what both men were saying.
“Yes, Tallien,” Lalladiere said, encouraged by Dr. Pinel’s acceptance. “He also supervised the massacre of the prisoners—they were priests and young boys, I saw it—here at Bicêtre.”
Pinel knew that history well, and the well-remembered day that Tallien re-visited the Bicêtre had been for him extremely difficult. He heard that Tallien was one of the men in the government who had early opposed both the unchainings and his attempts to separate the criminals from the insane. But he pushed those thoughts aside. Lalladiere, as he was very pleased to see, was becoming progressively more lucid, speaking of events and making clear connections. He pressed on.
“Well, how have these men worked to elevate Robespierre? He is surely in charge now, leads the Committee and the governing Mountain of the National Convention.”
Lalladiere leaned forward, his voice low and conspiratorial. “Tallien,” he said, speaking clearly and coherently, “I know it well, was a fervent revolutionary Jacobin. He organized the Fête de la Liberté, wrote pamphlets, posted notices on walls. The man is eloquent despite a speech inflection, and is very persuasive. His allegations of betrayal and corruption would be widely believed. Barras, I remember, was very upright, a military leader with lots of money.”
Lalladiere’s tone and detailed knowledge led Pinel to wonder about the extent of his past government relationships. What had happened back then?
“Were these people hindrances to Minister Necker? Did they try to obstruct or betray him?”
Lalladiere stared at Pinel, saying nothing.
“Speaking of the past is burdensome to you, is that not so?” Pinel said, seeing Lalladiere’s hesitation and sensing a retreat. “The painful intrigues and provocations in the government,” he added, sympathetically..
Lalladiere silently shook his head from side to side, fighting against the resurgence of an unbidden warning.
“It must seem dangerous, even now, to speak about betrayals around you,” Pinel said, trying to guess at reasons for the apparent blocking.
Lalladiere sat silently, continuing the unseen, internal, battle. Then, with a sharp backward pitch of his head, as though throwing off an attacker, he said,
“I was the betrayer.”
“What do you mean? Betrayer of whom? Betrayed what?” Pinel’s words gushed out with surprise.
“I betrayed the minister. Brought him down,” Lalladiere said, shaking as he looked fixedly over Pinel’s shoulder at the blank wall behind him.
Denis jumped up, reflexly prepared to act. Pinel motioned him to sit down. Staring incredulously, he did so. This man spoke of betraying Necker, the hero of the people. Denis never forgot how he and his father, together with hordes of other Parisiens, carried images of Necker on poles as they marched through the streets starting the Revolution, 14 July, 1789, with the attack on the Bastille. That was the day their hero Necker was fired by the king. Was that what Lalladiere was talking about? What had the doctor uncovered? What terrible secrets were in this man’s lunatic head?