Paris’s 19th century institutionalized female hysterics

Maud Casey dedicates her new novel to “my fellow incurables.” The three words boldly expose, upfront, the book’s deepest truth in its claim of unity with women labeled “hysterical,” wrong to be filled with so much desire, so hyperactive they must be crazy or disturbed, worse, mentally ill, a gender misunderstood. I think of the young woman driven mad in Charlotte Perkins Gilman’s 1892 short story The Yellow Wallpaper and Britney Spears public breakdowns a century later. Let us not overlook the cause.

Delve into the book, and you’ll enter Paris’s Salpêtrière hospital, a vast enclave of a city within a city, including a market, laundry, bakery, school, library, and post office. Inside the psychiatric compound, female patients were treated by the renowned 19th century neurologist Jean-Martin Charcot, who invented the diagnosis “hysteria”. They performed their symptoms — or what Maud Casey terms “the language of our pain” — in an amphitheater where Charcot photographed the “shapes that spell hysteria,” which include “amorous supplications, eroticism, ecstasy, hallucinations, crucifixion, mockery, menace, the cry, etc.”

Charcot is long dead, his theories derided, we are told by our storyteller that is a collective consciousness, the hospital’s ghosts speaking with a calm, all-knowing divinity. They give the pulled-back vision, what brings us to a discerning sigh of the obvious. “There were so many ways we didn’t make sense,” they say, and how could they? Before their confinement to Charcot’s wards, these hysterics were orphans or born into impoverished families and fated to work in factories or as seamstresses and domestic servants. Vulnerable and taken advantage of by other women’s husbands, starved and maltreated by factory foremen, sexually used and abused and discarded, they lost their minds. Who wouldn’t throw a fit?

We hoped to be faithful not fallen. Who sets out to be fallen? None of us wanted to fall, but then we were falling.

So much is attractive in City of Incurable Women, an evocative blend of fiction and nonfiction spirited with emotional power and historic significance. Casey creatively illustrates her connected essays with archival material from Salpêtrière, including patient photos and medical documents, creating a uniquely envisioned, impressionistic experience, one of artistic sensory power, whereby we get it, the reality and the tragedy and the futility and the misguided male doctors who used the women as specimens for their clinical studies.

A Clinical Lesson at the Salpêtrière, 1887, by André Brouillet as featured on page 71 in City of Incurable Women. Image/painting: Université Paris Descartes; photograph from Wikimedia Commons

Showcased are the stories of Augustine, Marie, and Geneviève: Augustine, one of the doctor’s best girls, performed for the camera unashamed, all the various stages of hysteria, holding the poses for as long as needed; Marie an epileptic once apprenticed to a furrier, she like Augustine embraced the photographic swoon; and Geneviève, a girl with braids, pretty bows tied at their ends, and a forlorn expression who made a pilgrimage to visit a stigmatic girl but was turned away by the curate for lack of a church letter and the smell of beer on her breath.

You weren’t drunk, you’d protested in that tavern a town or four back. They suspected every word out of your mouth – hello, nice weather, I love you – sounded like protest. Whether you’re drunk or not isn’t the point, said the man who threw you out. You wanted to know what was the point. You really, really wanted to know, you said. A woman alone, he began, but did not finish. These men explaining things to you had started to sound alike.

I love this small book, its alluring assemblage of visuals and the poignant often piercing prose. It invites itself to be kept close, put in a purse or satchel for browsing in an idle moment after the once-through reading, so much to hear from the ghostly hysterics: “We were saints. We were witches. We were burned at the stake. We are on fire still.” Maude Casey has written a triumphant homage to the women of Paris’s Salpêtrière asylum, and her fellow incurables everywhere.