Before its inauguration, the number of applicant families was surprisingly high, and though they were all from Buenos Aires, pleading letters began to arrive from the provinces within a few months of operation—from Paraguay, Peru, and Brazil, each one underscoring the great need in America for a place to treat phrenitis, mania, melancholia, and other more or less familiar mental ailments with the very latest scientific advances. To tell the truth, it was almost as though such diseases did not exist in the American upper classes until Dr. Weiss and I arrived to treat them; one might infer from the silence prevailing across the continent that those infirmities, at least without the existence of a science able to identify them, had been taken to be standard personality traits, which might explain all those incomprehensible deeds in our history. What is known is that the Casa was nearly full shortly after opening, and in the following year the doctor began to draw up plans for the construction of a supplementary wing.
This warm reception is easily explained: For those who do not know how to manage them, the mad rarely prove dangerous, but are always tiring. Even when families endure them with goodwill and, above all, lots of patience, at a certain point they exhaust themselves. Trying to make a madman behave like everyone else is like turning the course of a river: I do not mean that it is impossible, but rather that only a good engineer, lacking any prior assurance of his success, can try to set the water running the other way. For the general populace, the madman’s outlandish behavior is stubbornness, pure and simple, or even a fabrication. Impervious to common sense and reason, those who insist too much on trying to redeem the mad are the very persons who find their own minds disturbed. Take into account, also, that the stricter the principles of their environment, the more the lunatics’ peculiarities will stand out and the more ridiculous their eccentricities will seem. Among the poor, bound by survival to display more tolerant principles, madness seems more natural, as if it contrasts less with the senselessness of their misery. But one of the oldest wishes of the mighty, precisely the one upon which they would base their power, is to embody reason; madness in their midst, then, poses a real problem. A madman endangers a house of rank from ceiling to cellar, costing the occupants their respectability, and so they almost always hide mental illness like a scandal. There must be many families over there, too, that do not know what to do with their mad, Dr. Weiss said to me one day in Madrid, as we waited for the Court’s authorization to open our house in the Viceroyalty. For the science that makes them its object, the mad are an enigma, but for the families who keep them in their homes, they are nuisances. Obviously, complications arise when the external signs of insanity become too obvious. In the cases that go unnoticed, though, which are far more frequent than one might believe, that same insanity can rise through the ranks by general consensus, to hold the world on a string.
As I realize many of my words today still reflect the influence of my revered teacher, I believe it is advisable to evoke him in greater detail. Of his appearance, suffice to say that at first glance he betrayed himself as a man of science: tall, a little heavy; a deeply receding hairline that left graying blond hair permanently disheveled around a reddened brow. This exposed the ongoing activity within his head, which was rather larger than normal and well situated atop strong shoulders. Bright blue eyes shone behind gold-rimmed glasses, which danced against his chest on a fine gold chain around his neck (when they were not creeping up his nose)—roving and perceptive eyes, slightly ironic, and, in moments of great concentration, they disappeared behind half-closed lids, betraying his mind’s utmost occupation. His frank, ruddy face darkened slightly when he examined a patient, but at the dinner hour, after a day of hard work, wine and conversation were his chief pleasures. Nearly ten years after his death, I betray no secret in writing of his passion for the female sex; it was exaggerated even at his advanced age, and, as occurs often in northerners, his predilection was for the darker races. Brothels did not frighten him; on the contrary, they exercised too great a draw, and married women seemed to emanate further and unfathomable charm for his sensual appetites. As I was his principal interlocutor, his assistant, and his faithful disciple, and I found myself so often at his side as to be mistaken for his shadow, I became, for obvious reasons, his confidante. So I consider myself with all clarity of conscience to be the person who, at least in the final third of his life, knew him best. When Casa de Salud no longer stood and, for reasons beyond our control, we had to separate upon our return to Europe, he went back to Amsterdam while I began as an intern at the hospital in Rennes, of which I am currently the deputy director; until the day of his death we continued to write each other, mingling the scientific with the personal in our correspondence with fluency and good cheer. He was scrupulous about hygiene and, when the weather was hot, he liked to dress impeccably in white; on summer nights in Buenos Aires, when he left after dinner to pursue his fondest pastime, it was not uncommon, on seeing him pass by from darkened thresholds, from half-lit bedrooms, through wide-open windows seeking to catch a phantom breeze, to hear a male voice murmur in the darkness, mocking yet understanding, There goes the blond doctor, looking for whores. I believe the best way to describe Dr. Weiss is by that capacity he possessed for practicing his vices freely, for all to see, without loss of respectability. This was likely because he never mixed business with pleasure and was a man of his word: I never heard him tell a lie nor promise something he was not prepared to carry out. His immoderate and mysterious love of married women forced him to perform the odd moral balancing act, and on two or three occasions, forced by circumstance into inevitable duplicity, I saw him give up, resignedly, the pleasures he had already been assured. From these proclivities he fashioned a way of life, a discipline of knowledge and of living, almost a metaphysics. In a letter from his final days, he wrote to me: The moment, esteemed friend, is death, death alone. Sex, wine, and philosophy, they tear us from the moment, they keep us, temporary things, from death. Although he seemed to make no distinction between healthy and diseased, he treated our patients with the greatest decency, as though he thought he owed them more respect than the sane. And in a way, he was correct: Abandoned by families who rarely came to visit, the madmen were entirely in our hands; to them we represented a last link to the world. Upon the opening of Casa de Salud, Dr. Weiss warned the other staff and me that it was foolishness to lie to the patients, and that the sick would have sniffed us out just as sane people discern when madmen do everything possible to conceal their insanity, not realizing that those very efforts betray them. According to Dr. Weiss, deception is pointless because madness, by mere fact of its existence, renders the truth problematic. A detail that intrigued me when I heard him talk with patients: Often, in the face of the madmen’s wildest assertions, he would flash a brief smile of approval, not in his tightened lips, but in his blue eyes.
Illnesses—and not just mental, but physical, which he was capable of treating with equal skill, though which he refrained from so as not to alienate other medical practitioners in the city, unwilling to draw away their clients—were not my teacher’s only area of interest: All the most varied manifestations of the natural world aroused the same curiosity in him, stimulating his gifts of reason and observation, from the regular turning of the stars to the tiniest prairie flowers, which he collected in a detailed herbarium. An insect, a mild October breeze, the behavior of horses, or the phases of the moon held equal value for him as objects of reflection, and more than once I heard him say that contrary to what man had made, there was no hierarchy in nature, and the laws that dictate the entire universe are present in every natural phenomenon. So by accurately explaining, for example, a flea-jump—he always liked trivial examples—one might comprehend the operation of the solar system. He also noted that the correct interpretation of a natural fact was in any event impossible, for as knowledge of the world increased, so too did its mysterious dark side.
He was a pleasant, helpful man, or perhaps more than pleasant and helpful: He was given to com
passion. That feature of his character was much more commendable in him than in any other. Indeed, it kept him in check, as, in religious matters, I never saw a more avowed atheist. In one of his letters from Amsterdam, he told me: As God does not exist, it falls to us men to correct the world’s flaws. How I would have liked to leave him to that task—at the end of days, if he exists, evil would be his responsibility—and to be able to dedicate all my time to the one perfect thing he is known to have created: the female sex! His atheism sometimes left me perplexed; he always appeared to think the nonexistence of God an exhilarating condition. Although I shared his beliefs, I must confess that often, in my innermost thoughts, it all seemed rather discouraging, less for the infinite nothingness it attributed to my own being than for the incredible waste, supposing the existence of such a vast universe, varied and colorful, burst open at some time, some fine day, and generously left in our charge, all so it might suddenly collapse and disappear. Such an eventuality left Dr. Weiss unmoved; on the contrary, it seemed to encourage him. I believe that if he were to stand at the mouth of an erupting volcano—a speculation, in any case, though I think he lived in Naples a few years before we met—he would not have fled, but rather rubbed his hands together, preparing to study the igneous material about to consume him. This is an adequate comparison to describe our fourteen years at Casa de Salud. Seething lava threatened us from all sides: Indians, bandits, the English, and the Spanish royalists we called godos (in order of increasing ferocity), not to mention storms, floods, droughts, locusts, accusations, lawsuits, wars, and revolutions. Our hospital-laboratory, as the doctor called it, conceived as peaceful and white, ended as a miserable ruin, which, a friend has informed me, still exists today among the weeds. It seems, after the tragic scattering of our boarders—we searched for them for weeks without success—two of them returned the following year and settled in the ruins with no family to claim them. (Until their death, the Indians worshiped them and brought them food each day. Later, my friend learned the Indians were Christian converts from Areco who, in secret, were practicing a sort of cult around the two madmen, whom the Indians treated well so as to gain protection from the forces of evil.)
Politics and money are useful, no doubt, but they distract from what matters: Also distracting were the successive wars and greed of certain families, who paid the first year’s costs to cast off their sick and, having entrusted them to the Casa, forgot to continue payment, bringing an end to our venture. As for the authorities, while some enlightened persons encouraged us, many leaders, mostly businessmen, petty lawyers, ranchers, churchmen, and soldiers, nearly all of them eager, obscurantist, and uneducated, watched us constantly and created all manners of interference to our growth. Only those who dealt with Dr. Weiss directly supported us, having experienced his goodness, sincerity, and efficiency in their exchanges. And perhaps because they depended on him and because he had been known to ease their suffering on more than one occasion, the patients idolized him. I can tell you, he was able to speak with even the most violent of patients who thought he held them prisoner without cause and was torturing them, even patients who thought him their enemy and never stopped trying to hurt or threaten him. Despite this, those very men clearly respected him, though perhaps they never realized it, and when they feigned the belief that the doctor was the cause of all their ills, I could see in their words and carriage that they did not truly believe their claims. One way or another, they seemed to want him to give a sign that they were mistaken, or maybe extra attention or special interest, trying to goad him with libelous insults that the doctor bore with his impassive little smile, sometimes coming to nod his head affirmatively as though he approved of them. The workers in the Casa, those he was likewise mentoring—they, too, were devoted to him. For the most part, the doctor dealt with fairly uneducated people, but he believed the attributes his work required—intelligence, gentleness, physical strength, and patience—did not depend on schooling. Some ladies from the city tried to work with the Casa as an act of charity, but, with diplomatic cleverness, the doctor convinced them that it was dangerous work, at least in certain cases, terribly rare, to be sure, and once he managed to rid himself of them, he remarked to me confidentially, with his habitual little smile and a twinkle in his eye, Though I must say, I wouldn’t mind requesting a certain service from the younger ones.
It was the doctor who conceived and executed plans for the Casa. It consisted of a single, rectangular floor with a series of corridors that enclosed three courtyards. The façade faced the river, Just as the temple of Concordia faces the sea in the land of Empedocles, he would joke. The stout adobe walls were always an immaculate white; the trellis beneath the windows suggested colonial mansions, but rows of rooms that opened onto impeccable courtyards evoked the convent, monastery, or a rustic Academy. Only in the last corridor of the last courtyard did the doors have a lock. In the others, including my teacher’s, such protection was unnecessary. We lived alongside our mad. As for those working in the Casa, they kept only what they wished, which was very little, under lock and key. The rooms at the far end were reserved for patients who underwent periods of serious volatility. Certain madmen grew accustomed to their constant frenzy, or resigned themselves to it, but the sudden attacks of the silent, gloomy ones were often the most aggressive. In those cases, isolation became necessary, and we left them alone until their melancholia won out again. Strictly speaking, with our method, which is to say, Dr. Weiss’s method, over those fourteen years, we rarely faced raving lunatics who might have endangered our community or any of its members. When violence tempted our patients, it was more often against themselves. One of them would sometimes go suddenly running with a bang against the wall, for no apparent reason, leaving himself dazed and bloodied. Another, without prior warning, thought to cut himself all over with a knife. But in fourteen years, we mourned only three suicides. A Brazilian boy, ever and irresistibly drawn to water, found his end by casting himself into the river; one old man hung himself from a tree in the second courtyard one winter morning; and one woman poisoned herself. (She had given herself six months to recover, and, as she explained in the letter she left behind, she had arrived at the Casa with the poison hidden and had resolved to use it if the doctor’s treatment, her last hope for a cure, should fail.)
The staff, intermingled with the patients, was distributed throughout the three sets of corridors; they actually formed three squares, each with two shared interior sides. Built in a row and all continuous, the three squares aligned to form a rectangle together. The middle square shared two transverse walls with the first square past the entrance and the one farthest off; in matters of architecture, the doctor was fond of geometry. The first of those transverse sides in the middle square was a long salon that served as a refectory with a kitchen at one end. The cook was an employee, but his helpers and serving boys were all mad. Per Dr. Weiss’s instructions, when one of them wanted to cook, the chef placed the kitchen at his disposal. In fact, the cook once went to visit his family on the other side of Buenos Aires for two or three days, leaving the kitchen in the hands of a patient. In the lateral corridors opposite the lower square, just past the entrance, Dr. Weiss and I each had our rooms, which also served as our offices, his to the left and mine to the right.
In our Casa de Salud, truth be told, there were very few medicinal remedies. According to Dr. Weiss, of the various causes that might explain insanity, the most improbable were those that came from the body, and he posited that in matters of mental illness, the cause must be sought out in the mind. As the doctor told me in one of his first letters from Amsterdam: But that mixture of sensations, passions, imagination and thought, truth and lies, good and evil, love and hate, crime and remorse, desire and renunciation that is the mind, does not make our work easier. In a sense, for men the body is a remote region of their very selves, and if they hold it responsible for all their evils, they resign those evils to the control of nature, which for them is synonymous with fate. In what the
y call the mind, however, they themselves are deeply implicated. In the vast majority of cases, exchange with the outer world does not occur within the body, but in the mind. The body is a hidden land that few are privileged to tread or contemplate, while the mind is in constant exchange in the public square, and those who boast of maintaining a pure, hidden mind fail to see the point: That property they believe to be remote and ethereal, others can sully. For this reason, practically everyone prefers to find the cause of all wrongdoing in the body.
At any rate, Dr. Weiss’s principal method consisted of maintaining identical relations with the patients as he did with the sane, and only in extreme cases did he try some sort of treatment, often temporarily: the prescription of certain medications, for example, or confinement, or hot or cold baths. On rare occasions we found ourselves obliged to use a straitjacket. As for the baths, they were part of our routine, and patients bathed in a separate structure near the river, as white and well kept as the main building. We treated physical ailments by the usual methods, and in more serious cases, the doctor did not hesitate to summon one of his colleagues from Buenos Aires for a consultation. But I must add, if I want to abide by the utmost truth, that the vast majority of the many patients under our care seemed to enjoy exceptional health, physically speaking. Ensconced in their own worlds created entirely by their delirious imaginations and often incomprehensible to the rest of us, they seemed protected from the natural condition endured by those who enjoy, as they say, their full faculties. Encased in their own illusory worlds, the patients seemed to take root, and so did not suffer the decay that befalls all physical substance, but rather an interminable drying-up, a slow calcination whose hardening was not measurable with known instruments. The parts of them that came dislodged—hairs; teeth; skin; the occasional eye that seemed to vanish into thin air from behind a sealed eyelid; a few fingers severed in an accident; a leg that seized up and refused to walk, obliging one to always drag it like an old piece of furniture—these were like shreds of wrapping, torn in the bustle and commotion of a journey without the parcel they protect suffering the slightest damage.
The Clouds Page 2
