by F. R. Tallis
As Tavernier was speaking, a question arose in my mind. If the bokors are anxious to maintain the illusion of their possessing magical powers, then I must suppose that they also guard their secrets closely. How is it, then, that these mysteries were revealed to you?’
‘I introduced one of them to morphine and when he was addicted, I told him that I wouldn’t supply him with any more unless he explained how the deception was accomplished.’ Tavernier produced a wide grin. ‘It was child’s play!’
‘Why were you so interested?’
‘Soon after my arrival here, a young woman with whom I was acquainted died, and the following week I saw her stumbling around behind the brothel where she formerly plied her trade.’ He adopted a frozen attitude, raising his eyebrows theatrically. It gave me quite a shock, I can tell you, but I’m a sceptic by nature. I knew there would be a rational explanation and immediately began to make enquiries.’
I was unnerved by Tavernier’s matter-of-fact manner. Unwanted images kept on invading my mind: the rain of blood, the decapitation, the mob dismembering the fallen body, the fitful orange light around the summit of La Cheminée.
‘What’s the matter? asked Tavernier.
‘We have just witnessed a murder,’ I said, flatly.
‘No, Paul, you are quite mistaken. We have just witnessed the liberation of a soul. Aristide had become the slave of a bokor. Can’t you see what that means to the villagers? For them, there is nothing worse than slavery. It is a fate worse than death.’ A drum began to sound and its jaunty rhythm was almost immediately supplemented by another. ‘See?’ Tavernier continued. ‘They’re celebrating. Aristide is free now. He can join the ancestral spirits.’
I stubbed out my cigar and said, ‘Perhaps we should report what we saw to the authorities.’
Tavernier laughed. ‘The authorities? Go on then, go down to Port Basieux and tell them what happened. Do you honestly think that they’ll be the slightest bit interested? Now, if a horse had been stolen from one of the plantations, that would be a different matter . . .’ He waved a languid hand in the direction of the drums, leaving a trail of cigar smoke. ‘The life of a villager has no monetary value. It is of little consequence to the authorities.’ He stood up and strolled over to the balustrade. ‘Anyway,’ he continued, gazing out into the darkness. ‘It wouldn’t be such a good idea for you, having made a promise to the bokor. You promised to say nothing. If you break that promise, you’ll go to hell. That’s what he warned. Remember?’ When Tavernier turned round, he was grinning like a maniac and his head was surrounded by darting points of light. Unsurprisingly, I did not find his irony amusing.
PART ONE
Damnation
1
AUTUMN 1873
Paris
I returned from Saint-Sébastien to a Paris that, although not quite recovered from its humiliating defeat, was starting to show signs of restored confidence. As soon as I had found somewhere to lodge, I wrote to my father, and we met shortly after to discuss my prospects. I was becoming increasingly fascinated by the nervous system and was keen to learn more from an expert. Indeed, ever since that fateful night when I had witnessed the murder of Aristide, I had become preoccupied with the brain and its workings. I wondered to what extent consciousness was preserved in the living dead? What – if anything – did they experience? These sober reflections prompted broader philosophical inquiries, concerning the mind and its relation to the body.
‘Duchenne,’ said my father. ‘That is who you should work with.’
This seemed an absurd suggestion. Guillaume Duchenne de Boulogne was the leading authority on nervous diseases. He had been an early advocate of electrical treatments, had made advances in the field of experimental physiology and was the first doctor to use photography as a means of recording laboratory and clinical phenomena.
‘Why should he employ me?’ I asked.
My father then explained that we were distantly related. A letter was written, and a week later I received an invitation to visit Duchenne’s laboratory. He was of sage appearance, possessing a bald, flattish head, thick eyebrows, strong nose and long, bushy side whiskers that stopped just short of meeting beneath his chin. I learned during the course of our conversation that his son, Emile, had died during the Paris siege after contracting typhoid. Émile had been Duchenne’s assistant and the old man had made no attempt to find a replacement. Perhaps he was feeling lonely, or maybe our distant kinship influenced his thinking; whatever the cause, Duchenne was disposed to offer me the position formerly occupied by his son, and I accepted without hesitation.
Shortly after commencing my work with Duchenne, I read his handbook on batteries, pathology and therapeutics. Needless to say, I was already aware that electrical devices were routinely employed to treat a variety of medical conditions, but had never before come across examples of their use to resuscitate. I was surprised to learn that Duchenne had been conducting experiments in this area for almost twenty years. One of his earliest case reports concerned a pastry cook’s boy, a fifteen-year-old who – because of some imaginary trouble – had imbibed a large quantity of alcohol before climbing into his master’s oven, where he fell asleep and became asphyxiated. He was found the following morning and his apparently lifeless body dragged out. As luck would have it, the doctor lodging above the bakery happened to be Duchenne. The boy had stopped breathing and no pulse could be felt with the hand, although a feeble murmur was heard through the stethoscope. A battery was swiftly brought down from Duchenne’s rooms and an electrical charge was delivered to the boy’s heart. After a few seconds, slow and weak respiratory movements appeared and in due course he gave a loud cry and began to kick. His circulation and respiration were re-established, his colour returned and he was soon able to answer questions.
Other attempts to resuscitate are recorded in Duchenne’s handbook, but he was careful not to exaggerate his achievements. He offered a balanced review. Most of the cases he reported were only partial successes: temporary recovery, followed by the final and complete loss of vital signs. Even so, I was fascinated by these findings and wanted to learn more. Duchenne was an obliging mentor and demonstrated his method using rats as experimental subjects. Each animal was chloroformed until it stopped breathing and general movements ceased. Then, electrodes were touched to the mouth and rectum, until convulsive movements and twitching provided the first evidence of reanimation. As with human subjects, outcomes varied. Most of the animals did not respond at all to electrical stimulation, some enjoyed a brief recovery which lasted a few minutes, but one or two rats from each basket were successfully brought back to life.
In his middle years, Duchenne had become interested in the physical mechanisms underlying the expression of human feelings. He had shown that, by applying electrodes to the face, it was possible to stimulate muscular contractions and manufacture emotion. His photographic record of these experiments was reproduced in a landmark publication, The Mechanisms of Human Facial Expression. It is a masterpiece of medical portraiture. For the work of a man of science, Duchenne’s preface begins with a surprisingly unscientific assertion. He states that the human face is animated by the spirit, and I suspected that, although he had ostensibly been engaged in identifying the muscle groups that excite the appearance of emotion, the true nature of his project was somewhat deeper. For Duchenne, there was no tension between religion and Enlightenment values. The presence of God could be felt as strongly in the laboratory as in a cathedral. He was not really studying facial expression, he was studying the soul.
Duchenne’s notebooks were filled with observations and ideas which were worthy of more extended treatment. I suggested that some of this material might be incorporated into academic articles that I was willing to draft. He did not object and we worked together on several papers that were eventually published. One of them took the form of a comprehensive review of the literature on resuscitation.
At that time, I made no connection between Duchenne’s pioneering a
ttempts at resuscitation, which began in the 1850s, and his subsequent book on facial expression, which appeared some ten years later. Had I been more astute, I would have discerned a natural progression. There was a reason why Duchenne wanted to study the soul, but I would not discover that reason for several years, and then only on the night that he died.
I chose to work late and when my labours were completed, Duchenne would invite me into his parlour, where we would sit and talk until the street sounds diminished and there was silence outside. On one such occasion, we were discussing a rare form of palsy, when Duchenne suddenly said, ‘There’s a fine example just admitted into the Hôpital de la Charité. Let’s see how the poor fellow’s getting on.’ He rose from his seat and went to fetch his coat.
‘What?’ I replied, ‘Now?’
Duchenne looked at me askance. ‘Yes. Why not?’
And so it was that I discovered my mentor’s peculiar habit of visiting hospitals at irregular hours. He did this so often that his appearance on wards at two or three in the morning was usually greeted with indifference by the nurses. On arriving, he would usually check up on his patients and then look for interesting cases. He was permitted such liberty, not only because of his considerable reputation, but also because of his impressive virtue. If he discovered an impoverished patient with a painful condition who could not afford to continue treatment, Duchenne invariably offered his services without charge. I remember him moving between the beds on the wards, a gaunt figure, passing in front of the faintly glowing gaslights, head bowed as if in prayer, administering drugs with the gentle authority of a priest giving Communion.
We were particularly welcome at the Salpêtrière, because the chief of services and recently appointed chair of pathological anatomy, Jean-Martin Charcot, was a former pupil of Duchenne. Under his canny stewardship the Salpêtrière, previously an insignificant hospice, was already on the way to becoming a neurological school of international renown. More like a city within a city than a medical institution, the Salpêtrière consisted of over forty buildings arranged around squares, markets and gardens. It even had its own church, a baroque edifice with an octagonal cupola, large enough to accommodate over a thousand congregants. Although Charcot was a proud man, whenever we encountered him he always treated Duchenne with the utmost respect, and if accompanied by an entourage of students, he would introduce his old teacher (a little too theatrically, perhaps) as ‘the master’.
After a year as Duchenne’s assistant, I had settled into a very comfortable routine. The possibility of finding employment elsewhere had never occurred to me. However, one day, Duchenne informed me that Charcot was looking for someone young to fill a post at the Salpêtrière and he advised me to apply. I protested, but Duchenne was insistent. ‘I cannot be responsible,’ he said, ‘for holding you back. This is a splendid opportunity and I will be mortified if you do not take it.’ He sent a letter of recommendation to Charcot and, such was his influence that news of my official appointment, when it arrived, was a mere formality.
As a junior doctor, I was obliged to attend Charcot’s Friday morning lectures, which at the time of my appointment were still relatively modest affairs. Long before his arrival, the auditorium would begin to fill, not only with physicians, but also with curious members of the public: writers, artists or journalists. The platform was littered with posters mounted on stands, showing enlargements of microscopic slides, family trees and different categories of neurological illness. Brain parts floated in jars of preservative next to dangling skeletons with deformed joints. The doors would fly open, revealing Charcot, accompanied by an illustrious foreign visitor and a troop of assistants. He would ascend to the podium, pause, allow the silence to thicken and then start his address in sombre tones. Occasionally, he would stop and illustrate his observations with skilful drawings on a blackboard, or ask one of his assistants to man the projector, and images would suddenly materialize on a hitherto empty screen. Charcot was never a great orator, yet he knew how to manage a performance and compensated for his deficiencies with solid, reliable stagecraft.
I was never entirely comfortable in Charcot’s presence. I found him too self-conscious, too obviously the author of his own legend. He was humane, told jokes, and abhorred cruelty to animals, but essentially he was an authoritarian. None of his interns dared to question his theories. It was common knowledge that some of our predecessors had been dismissed for voicing imprudent objections. Irrespective of my reservations concerning his character, our professional relationship was friendly and collegiate. He was favourably disposed towards me, probably because of Duchenne’s letter of recommendation, and our meetings were always agreeable. I was accepted into Charcot’s inner circle and began to receive invitations to his soirees; these became, like his Friday lectures, an obligatory fixture in my diary.
Charcot lived in a cul-de-sac adjoining the busy Rue Saint-Lazare, situated between the train station and the Church of the Trinity. It was a substantial if not particularly striking residence, which belied his prosperity. He had married a young widow who, in addition to inheriting her deceased husband’s fortune, was also (being the daughter of a highly successful clothier) independently wealthy. This shrewd connection ensured Charcot’s complete financial security and guaranteed his admission into the upper echelons of society.
The Salpêtrière was an energetic hospital and its corridors reverberated with academic debate. There was a kind of fervour in the air, fuelled by the constant thrill of discovery. Although my feelings towards Charcot were mixed, it would be churlish to deny that he was an inspiration. Because of his patronage, I was introduced into a talented fellowship and profited greatly from the lively conversation of my peers. When I was sufficiently established, I accepted more clinical responsibilities and the additional remuneration I received enabled me to secure better rooms. Life was good, but for one sad event: the death of my old teacher, Duchenne de Boulogne.
When I received news of Duchenne’s illness, I immediately sent a message, informing him that I was at his disposal. He declined my offer of assistance but requested that I visit him at my earliest convenience. This note of urgency filled me with apprehension. He had obviously determined that his remaining days were few in number. An arrangement was made for me to call on him the following evening, which – as Duchenne had suspected – proved to be his last.
A storm broke as I travelled to his apartment. Thunderclaps preceded a downpour of exceptional ferocity. My driver had to stop twice: once to don his oilskins, and a second time in order to calm the horses. When we arrived at our destination, I thanked him for persevering. A maid escorted me to Duchenne’s bedroom, and when I entered I was shocked by his appearance. He was sitting up in bed, his back supported by pillows, a frail, desiccated creature, with grizzled side whiskers. As I closed the door, he began to stir.
‘Paul, is that you?’ His voice was barely a croak.
‘Yes, it’s me.’
I crossed the room, sat at his bedside and noticed that he was clutching a wooden crucifix. He released the object from his grip and reached towards me, whereupon I took his hand in mine and squeezed it gently.
‘Thank you so much for coming,’ he said. ‘It’s a terrible night. Listen to that rain.’ Then, twisting his neck so he could see me better, he added: ‘How are you? Are you keeping well?’
His solicitous remark brought me close to tears.
‘I am very well.’
‘Good. I wish I could say the same. But, as you can see, I am very weak. Indeed, I fear that I have little chance of making a recovery. Still . . .’He left his sentence unfinished, and shrugged, suggesting that he was confronting the prospect of death with equanimity. He did not dwell on his predicament, but instead made some polite enquiries about my duties at the Salpêtrière. When I had finished answering his questions he closed his eyes and became very still. It seemed that he was no longer breathing: a flash of lightning transformed his face into a collection of hollows and cavities. My anxi
ety subsided when his eyes opened again and he whispered, ‘Lately, I have been troubled by certain matters that I now wish to talk to you about.’ He paused and seemed a little uncomfortable, even embarrassed. ‘The first of these concerns my son, Émile. I am sorry to say that I misled you. He did not die during the siege. He became ill . . . mentally ill. It was necessary to have him interned at the asylum of Saint Anne in Boulogne-sur-Mer. He is still there today.’
‘Do you want me to visit him?’ I asked, ‘Check that he is being properly looked after?’
‘No, no. Provision has been made for his care. Besides, I would not dream of burdening you with such a commitment. You understand, I hope, that I do not wish to die with a lie on my conscience.’
‘It is perfectly understandable that you should—’
‘That is the first matter,’ Duchenne interjected, raising his hand to silence my protest. ‘There is also a second.’ He swallowed and moistened his dry lips with his tongue. Another flash of lightning was followed by a colossal thunderclap. ‘Paul, you were always interested in resuscitation.’
‘Indeed.’
‘It is regrettable that resuscitation by electrical stimulation is rarely attempted. The field has hardly progressed since the publication of my early reports, yet I still believe that this is a branch of medicine that promises to be of the greatest benefit to mankind. I can envisage applications beyond the remit of clinical practice. Batteries might prove to be a kind of philosophical tool.’
