Madness and Glory (34): The Patient Speaks
The story of Phillipe Pinel father of modern psychiatry
Posted Jun 02, 2019
When, prior to the courtyard confrontation, the sans-culottes entered Dr. Pinel’s apartment, he and his wife Jeanne had been eating dinner. Pushing their way past the amazed woman who came to the door, a large portion of the group crowded into the small dining room and surrounded the doctor in his chair. He knew about this people’s army mode of arrest—no warning, no statement of authorization, or of charge—but was thoroughly taken aback by their presence in his house. A firm supporter of the Revolution, he had done nothing against the people. Far from it, he was devoted to freedom and human rights.
“What are you doing here?” he asked the men and women standing around him, bolting up from the table while searching for their spokesman.
“We have come to arrest you, citizen. You are an enemy of the people,” said the red-capped young butcher, pushing himself to the head of the tightly packed band.
“That cannot be,” Pinel said.” I am a municipal officer of Paris. I have done everything I can to support and advance the republic.”
Jeanne Pinel, standing behind a man in the doorway, addressed the entire group in a desperate tone, “Please, citizens, my husband Dr. Pinel is Physician of this asylum. You must know he is vital to the institution, to France. He takes care of all the people here.”
“Yes, he frees the lunatics and they come walking into our houses,” a round-faced woman, wearing the apron of a vegetable seller, said.
“No, those here are sick people,” Pinel said. Clinging to his belief in reason, he tried to explain: “Equal, as all of us are, and also like us, they are needful of liberty. They are not possessed but people gone out of their minds because they are ill. With the treatment here, they are getting well.”
“You are an aristocrat and a monarchist,” the butcher said.
“I am no aristocrat. I come from St. Andrew d’Alayrec in the Languedoc, my father was a barber-surgeon as was his father before him.”
“We are wasting time here,” a thin, pock-faced man, also red-capped, said. He spit out Tallien’s charges about Pinel’s helping to hide a condemned man, repeated words from the letter expressing sympathy for the executed king.
Pinel shivered. He had indeed shielded Condorcet, the constitutionist, paragon of reason, wrongly accused of disloyalty and treason. His revulsion about the execution of the king was stamped in his memory, but he wondered how his private letter had been revealed. What madness was surrounding him now, that he should be arrested for defending and protecting a man who was a pillar of the Revolution and for abhorring, privately or in public, the bloody vengeance and murder of a king? A king who was highly injudicious and overwhelmed by circumstance, but a largely devoted and well-meaning human being.
The thin, pock-faced man came up behind Pinel and started pushing him toward the door. Turning his head around, Pinel peered directly into the man’s eyes, and said:
“I have, from the beginning, supported the Revolution and the republic with all my heart. I believe in the equality and worth, right here and throughout the country, of every person, no matter who.”
“No,” said the greengrocer, grimacing and puffing out his urn-shaped cheeks, “you put each lunatic above the rest of us, above what we want and need. You put yourself up there, too. You are not for the people. For the republic.”
Pinel shifted to look at the greengrocer. He saw hatred in the man’s ugly but intelligent face, and the press of the surrounding group had become overwhelming. He said nothing.
“Come on, let’s go,” the butcher said, “the man is accused. The Tribunal will decide.” Three in the group pushed forward and prodded the doctor out the doorway, down the stairs, and into the courtyard.
There, several minutes later, Lalladiere, Denis, and the other inmates, emerged and stood facing the entire group. Pinel, like those around him, was astonished. He stared, and for a brief moment, he and Lalladiere looked into each other’s eyes. The usually calm, searching eyes were filled, Lalladiere saw, with surprise and apprehension. Pinel now expected the worst, but after Lalladiere began speaking to the group directly and with complete coherence, the alarm building within him changed into fascination.
“You, good citizens, must stop what you are doing,” Lalladiere said. “You must not take away this good man, the director of this asylum, the citizen doctor Philippe Pinel.”
The pock-faced red-hatted man, who at first was speechless with astonishment, found his voice with a blast, “Who the hell are you to block us this way?” He lowered his pike and pointed it menacingly.
“My name is Guillaume Lalladiere. I, an inmate here, was the first assistant to Consul General Jacques Necker. You remember our great, beloved Minister Necker? Do you not remember him?”
“Shit yes, so what?” the butcher, standing next to the thin man, angrily called out.
“Minister Necker was the start of it all, that is what. Do you not remember?” Lalladiere continued, words and thoughts coming clearly and rapidly to his mind, “Because of him we, the people, all sans-culottes, fought at the water’s edge, the drawbridges, and the turrettes of the dreary Bastille fortress at the height of the blazing, hot summer. I was there and climbed inside over the garden rooftops. Because of Minister Necker who doubled the representatives of the Third Estate, we started the Revolution. We started our Revolution, the beginning of liberty, fraternity, and equality, on the day the named Consul General Necker was fired by the king. We rose up that day, that glorious day, and started the overthrow of the privileged classes.”
“What, you damn lunatic,” the still angry butcher retorted, “has that to do with this doctor?”
Others around him, recovered from surprise, now muttered challenging and derisive epithets. Standing further back, Théo Rochereau, the only man in the group who had seen Lalladiere before, did not, in this animated state, recognize him as the previously inert man in his house.
“Dr. Pinel has helped me. Has been making me well. I have been a lunatic. That’s right, insane. And I was driven to that state when—” Lalladiere paused, became momentarily anxious, then with a squaring of his shoulders, he continued— “when the minister left, that great hero went out of the country, never to return. I became then the lowest of the low, living in chains and filth, out of my mind. Now, because of this doctor, I am better. The incomparable Dr. Pinel. He is no traitor, not in any way. He, like me, like Minister Necker, like Necker’s assistant—myself—is devoted to the people, to all of us. He is a patriot.”
The group became quiet. André Bartolon, the soldier, moved forward to stand at Lalladiere’s side. “Comrades, you see here a soldier of the nation. I have fought in Valmy, I have fought in the low countries, all for our glorious republic. My head was burst with the sound of guns and I was interned here at Bicêtre. And at first I was chained for month after month against a wall in a dank, dark dungeon cell. Dr. Pinel said to remove my chains and I am free.”
“You are a lunatic now, regardless of what you were before,” the greengrocer snorted. He looked around, nodded at a short, rotund woman behind him, and with a gesture of appeal to several men standing behind her, including Rochereau, he declaimed, “You should not be free to hurt our wives and children.”
“Do you not see I am all right? I would not hurt anyone except, as a soldier, in the line of duty. And soon, very soon, I expect to return to fight faithfully again for our country.”
Two more inmates came forward from behind the cart. They insisted the sans-culottes listen to them also, and they spoke co-herently and with strong feeling, as surprising to themselves as it was effective with their listeners. This doctor, they said, put no lancets into their heads for bleeding, and did not have their insides continually purged, as done in other asylums. They were both poor but he listened to them, spoke kindly, gave them freedom, and both of them were better. They were sure he must be a great humanitarian, and could never be a traitor. What was more, he was vitally needed by all in the asylum. The assembled group of sans-culottes, which had been murmuring up to that point, now seemed entirely to be listening. The clockmaker with the decapitation delusion, came out from inside the cart and earnestly proclaimed, without going into the strange details, that Dr. Pinel had saved him, as a devoted sans-culotte himself, from the guillotine.
“Are we going to believe a shitload of lunatics?” the butcher, standing in front of the group, asked loudly. Then, he addressed Lalladiere:
“Take this damn cart out of the way. We are going to bring this treasonous monarchist in. Necker, eh? You and Necker? Well, all of you are just plain raving, degenerate maniacs.” As he spoke, close to Lalladiere’s face, he shoved him and caused him to stumble.
Denis, seeing the shove, moved forward to prevent further contact or violence. Up to that point he had stood by, not sure what to do. This was not because of lingering concerns about Dr. Pinel’s loyalty, he was convinced that the doctor’s competence outweighed any other considerations. Also, he was suspicious about who was behind the arrest. But, moved and amazed by the testimonies and organized behavior of the inmates, he had momentarily forgotten he was there both to control and protect.
Lalladiere gained his balance, gesturing to Denis that he was all right. “A raving maniac?” he said, loud enough to be heard by the butcher and those behind. “We have indeed all been out of our heads at one time or another. That is why we have come. But still you must see, you must know, we are human. Like yourselves, our minds contain ordinary human thoughts. With no food we ache with hunger, when it is cold we shiver, from warmth we are soothed. We all have felt—whatever that means to us now—sorrow, loyalty, hope, even love. And we know fear—much, much fear. Now, because of this doctor, Dr. Pinel, we can reason, know for ourselves that we are fully human, not degenerate worms. And we reason well enough to know that Dr. Pinel is dedicated to the Revolution and the republic, to liberty, equality, and fraternity.”
“Were you really assistant to Necker? You do speak pretty high-faluting.” asked the pock-faced man. He turned to the men standing behind him as Lalladiere nodded forcefully. “You know, Necker stood up for us against those other conniving ministers, over the queen, even the king. If he was here now, we’d all have bread, and there’d be no price control. This fellow says he once worked for Necker, is on the people’s side. Maybe he’s all right. Maybe, anyway, we should get out of this place, the doctor is probably all right, too.”
“Do you think this doctor is crying over the death of Louis Capet?” the stone carver, still standing near the horses, asked Lalladiere loudly.
“No,” Lalladiere answered, “no more than being sorry for any small person’s death.”
Lalladiere’s reply was partly drowned out by the other inmates who, after the pock-faced man’s concession, began openly assenting, laughing and nodding, raising up a hand or arm. One got down on his knees in supplication to the group. Those who spoke before repeated vivid parts of what they said on the doctor’s behalf, an inmate shouted that Dr. Pinel was no monarchist but an ardent patriot. The sans-culottes began to shuffle back and forth, tilt down their spikes, and mumble to each other with uncertainty. Still standing, restrained, in the midst of the group, Pinel dropped his head toward his chest. He knew he cared for the inmates as human beings, was very moved to hear what the suffering men said. What’s more, they had spoken sounding clear and sane, Lalladiere especially, to a defiant mob. Pinel raised his head and looked over at the cart and the large horses which had disgorged the inmates. Chariot of gods. Conveyance of deliverance.
“Well, I have to admit,” the butcher said, “they’ve been saying this big shot doctor stopped that damn bloodletting. It may surprise you all but I never could understand it, pushing out blood, losing blood from the head. That can’t help a person. Could be he actually is doing some kind of good here.”
“A man who thinks like this doctor does is probably an aristocrat,” the greengrocer snapped. He then looked thoughtful, and followed with: “But, anyway who knows, if I became a lunatic, maybe I would want the likes of him to be my doctor.”
“You better hire him up, because you’re not too far from being a loony now,” said the round-faced vegetable seller familiarly.
Several members of the group laughed with relief. Then, through some continuing sounds of shuffling and uncertainty, one person called out, “The soldier fought for us in the war. He swears the man is not a traitor.” Another person in the group, noticing that Denis, the asylum attendant, was silent, moved toward him to ask whether the lunatics could be saying something true.
“The medical director,” Denis replied earnestly and without hesitation, “is an upstanding man in his profession, a kind, virtuous doctor who would never commit treason.”
From the midst of the group, Rochereau, who had been staring at Lalladiere for some time, broke out into a loud exclamation of surprise. He suddenly realized who this man was who spoke so long and well.
“He’s the goddamned same man. This one saying about being human and all that is the very same escaped maniac I told all of you about. The one my son brought to my house. God in heaven, he’s actually all right. Not a bit crazy any more.”
At Rochereau’s side, a man who was a reluctant follower and hanger-on from the first, was convinced. He walked brusquely away from the group and started to leave the courtyard.
“Let’s get the hell out of here,” he said loudly and several others started to go with him, murmuring about other cleanup work to do that day.
“What about that Condorcet fellow? Didn’t this doctor salt him away?” asked the greengrocer.
Pinel’s strong feelings for his friend stirred him to open and dangerous defiance. “Falsely accused,” he shouted.
Others, for whom the name Condorcet was unknown, began to walk out, citing the spookiness of the asylum, the fact that Pinel was, after all, a doctor, and that possibly he was doing something for poor inmates, whether or not they could tell what it was. But it didn’t seem like he could be doing treason. The butcher, responding to the general mood, acknowledged that Tallien might, just this time, be wrong.
As the first of those departing, the reluctant hanger-on approached the entranceway and grabbed one horse’s halter. He turned the gray and tan dray, moved it to a spot partly outside and shouted, “Did anyone, lunatic or saint, ever see such big, beautiful horses?”
Everyone, the previously worked-up men, sturdy and devoted women, and their leaders slowly began to go out, leaving the relieved Pinel, proud Denis, and the triumphant inmates in the courtyard. Some of the sans-culottes group were disappointed, some found themselves surprisingly glad at not for once having to enforce bloody rectitude and vengeance. Others felt confused, following the rest but not quite sure what had occurred. The broad-shouldered stone carver grasped the halters of the still partly obstructing horses, and though at first reluctant to respond to the unfamiliar hand, the animals followed him out of the entranceway. As the departing group walked past where he parked the cart, each person stopped for several moments to look and admire the snorting, sleek, and powerful Percheron horses.