Literature and Medicine I

Christine Marks, University of Mainz, Germany

1In her autobiographical essay “Extracts from a Story of the Wounded Self,” American author Siri Hustvedt confesses to her existential fear “that thresholds and boundaries won’t hold, that things will go to pieces” (197). This anxiety over the fragility of boundaries finds expression in most of Hustvedt’s works: physical thresholds and distinctions between self and other emerge as permeable and unstable constructs. When considering questions of the body and identity, Hustvedt emphasizes the inevitable transgression of physical and symbolical limits and the inseparability of the self from the world. The bounded self as idealized in a Cartesian worldview, safely detached from the body it inhabits, does not exist in Hustvedt’s oeuvre. In an essay on the painter Philip Guston, she writes that “the world penetrates us. We eat, we smoke, and have sex. But language and images enter us too. They become us” (Mysteries 58). Rather than imagining an inner self that is somehow separated from the outside by fixed borders, Hustvedt thus envisions the self as a compound of physical matter and “idea-winds that gust through people’s minds and then become scars on the landscape” (Loved 366).

2The author’s fascination with the penetrable boundaries of the self, in which the material and the symbolical interfuse, may find its furthest development in her contemplation of hysteria in the 2003 novel What I Loved. In the novel, a fictional autobiography written from the perspective of a male art historian, Hustvedt reinterprets the relationship between female hysterical patients and their doctors at the French hospital La Salpêtrière at the end of the nineteenth century. Hustvedt’s portrayal of the way doctors – most prominently Jean-Martin Charcot – treat their female patients at the Salpètriêre reveals complex negotiations of identity boundaries, oscillating between an emphasis on the doctor as the dominating mastermind guiding the hysterics’ behavior, on the one hand, and explorations of hysteria as an escape from a society in which women were overpoweringly restricted, on the other. This paper sets out to analyze the relation between illness and constructions of feminine identity in Hustvedt’s interpretation of hysteria. It traces the relation between hysterics and their physicians as an example of a self which has become overmixed with its environment, in which the distinction between inside and outside has become blurred to the point of dissolution.

3Narrated from the point of a view of art historian Leo Hertzberg, the novel is set in the New York art world and deals with questions of identity, love, loss, art, madness, and perception, among other themes. Violet Blom, the lover and later wife of Leo’s best friend, the artist Bill Wechsler, writes her dissertation about hysteria at the French hospital La Salpêtrière. Bill takes this as inspiration to create a series of art works on hysteria. In the second half of the nineteenth century, La Salpêtrière became (in)famous for the way its doctors treated hysterical patients—through hypnosis, dermagraphism, public stagings, and photographic documentation. At the Salpêtrière, hysteria was turned into a staged performance of symptoms, with doctors as directors and patients as actors. As Elizabeth Bronfen describes the relationship between doctors and patients,

the patients styled their attacks according to the questions posed to them by the physicians, supporting and sustaining their desire by behaving the way they surmised these physicians [...] wanted them to behave, watching and learning from each other, becoming ever more dramatic as they saw the effect their performances had on the audience. (183)

In What I Loved, Hustvedt conceptualizes the relationship between female hysterical patients and their doctors at the Salpêtrière as a performance of transgression, in which the hysteric is converted into an object of the clinical gaze, a canvas for the doctor’s artistic skills, and a spectacle of a self without boundaries.[1] Hustvedt’s references to hysteria and other medical disorders such as anorexia nervosa are carefully researched. In the back of the book, she lists a number of scientific publications that she consulted in her research; for her interpretation of hysteria, Hustvedt also profited from her sister Asti Hustvedt’s research – whose unpublished Ph.D thesis serves as the basis for Violet’s dissertation – research in the Salpêtrière Hospital archives (Loved 370). Violet points out how strongly the hysterics’ symptoms were related to the expectations of their doctors. Talking about one of the most famous patients, Blanche Wittmann, she remarks: “‘They called her “the Queen of the Hysterics.” She was featured in Charcot’s demonstrations of hysteria and hypnosis. [...] But after Charcot died, Blanche Wittmann never had another hysterical attack.’ [...] ‘She adored Charcot and wanted to please him, so she gave him what he wanted’” (275). The mutability of symptoms and the complete absence thereof after the death of the master physician Charcot highlights the heteronomy at work between doctors and patients at the Salpêtrière. Their relationship was coined by the hysteric’s modeling of her behavior according to her physician’s suggestion, an opening up of her identity boundaries that transformed her into a spectacular performer of the physician’s desire.

4Making a spectacle of oneself is, according to Mary Russo, “a specifically feminine danger” closely connected to a “loss of boundaries” (318). This remark reverberates with an idea of women’s bodies as being more open than men’s (see, for example, Margrit Shildrick’s Leaky Bodies and Boundaries) and female ego boundaries as more permeable than male ego boundaries (see, for example, Nancy Chodorow’s Reproduction of Mothering). Doctors’ representations of the hysterics, as Janet Beizer points out, characterized their patients as “incontinent slave to her secretions, unable to control her dripping, flowing, spurting, oozing bodily fluids” (41), which served to underline the notion of the female body as “intrinsically pathological” (Hurley 120). The body of the hysteric is thus located in the midst of a far-reaching debate over feminine identity and social norms. “If the body is synecdochal for the social system per se or a site in which open systems converge,” Judith Butler holds, “then any kind of unregulated permeability constitutes a site of pollution and endangerment” (132). While Butler applies this to criticize constructions of “homosexual pollution” (132), the concept also appears to match the sexually open and unregulated body displayed by the hysterics and their accordant marginalization in society (they were, after all, institutionalized in asylums). The pathologization of the female body reinforced the epistemological control of medical science and a patriarchal social order that denied female agency: “the doctor symbolizes truth, health, the moral and spiritual foundations of society while the hysteric is the fallen woman/villainess, infecting the social body” (Diamond 10).

5Hustvedt’s protagonist Violet draws attention to the miserable conditions under which most hysterics had to suffer before being institutionalized. Hysteria, she claims, may have been “‘a permissible way out’” (54). This way out, however, turned out to lead most hysterics into deeper confinement; no matter how suffocating and traumatizing their lives had been before their institutionalization, their situation can hardly be described as improved by the kind of treatment they received at the Salpêtrière. The real way out, and this is a significant aspect of the novel, was to escape both from the Salpêtrière and the confinements of society in general by cross-dressing as a man, thus disguising the femininity to which the illness seemed to be tied.