Seized: Temporal Lobe Epilepsy as a Medical, Historical, and Artistic Phenomenon
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Seized: Temporal Lobe Epilepsy as a Medical, Historical, and Artistic Phenomenon
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Product Details
| ISBN-13: | 9781504032773 |
|---|---|
| Publisher: | Open Road Distribution |
| Publication date: | 03/22/2016 |
| Sold by: | Barnes & Noble |
| Format: | eBook |
| Pages: | 272 |
| File size: | 347 KB |
About the Author
Read an Excerpt
Seized
By Eve LaPlante
Harper Collins
Copyright © 2000 Eve LaPlanteAll rights reserved.
ISBN: 978-1-5040-3277-3
CHAPTER 1
A Classic Case
In 1888, in the south of France, a country doctor made a clever diagnosis. His patient was a thirty-five-year-old Dutch painter who had been living in the village of Arles for ten months. On Christmas morning, police brought the artist to the local hospital, where the doctor, Felix Rey, was on duty. The artist, Rey noted, was delirious, his head bloody; the night before, he had cut off part of his left ear. That afternoon and again the next morning, the two men strolled the hospital grounds, enumerating the patient's troubles over recent months. He had been feeling agitated and depressed. He feared that he was going mad. His brain wasn't working right: he had heard voices, and there were chunks of time that he could not recall. On December 26, the doctor wrote in the patient's hospital chart, "M. van Gogh suffers from a form of epilepsy."
That form of epilepsy, now known as temporal lobe epilepsy, or TLE, consists of seizures in a part of the brain controlling feelings and memories. During a TLE seizure a person is overtaken by a powerful emotion, usually anger or fear, by hallucinatory voices or visions, or by a vivid flashback. The seizure lasts moments or minutes, rarely more than an hour, and it is accompanied by no apparent physical change, except sometimes a dull stare or a trembling of the arm or mouth. During the seizure the person may move about as if sleepwalking and may perform automatic acts, sometimes violent, which she is later unable to recall. Unlike the far better known seizures of grand mal epilepsy, which consists of noticeable bodily convulsions, TLE seizures are not easily recognized. They affect only part — not all — of the brain, and they involve only alteration — not cessation — of consciousness. TLE has been alluded to since the fifth century B.C., when Hippocrates published The Sacred Disease, his treatise on the epilepsies. Its designation as a separate disorder, however, is not universally accepted even now: some doctors refuse to say a patient has epilepsy unless he loses consciousness. Despite this diagnostic problem, TLE seizures are today the most common form of seizures in adults: for every two adults with grand mal epilepsy, there are three with TLE.
In van Gogh's time, this form of epilepsy was hardly known. Yet Felix Rey had already seen another patient who sliced off an earlobe and was diagnosed as epileptic. Spurred by a medical-school classmate who had just completed a thesis on the disorder, the young doctor had then read contemporary journal articles on the subject, including those by John Hughlings Jackson, an English neurologist who was one of the first to define TLE. Jackson wrote that there was no objective test for "psychic epilepsy," as he called it, and that only by taking a patient's history could a doctor discover its presence. Using this method, similar to the one still used today in diagnosing TLE, Rey listened to van Gogh and pieced together a picture of how his epilepsy had evolved.
The artist's difficult birth, in 1853 in the village of Zundert in the Netherlands, was at the root of his problem, the doctor suspected. Seizures result from electrical, chemical, or physical problems in the brain; in van Gogh, Rey thought, the cause was physical. Van Gogh's mother's labor had been long, and in the birth canal the baby had briefly been without oxygen. The doctor theorized that a cluster of Vincent's brain cells, starved for oxygen, had been damaged, leaving a little scar, a spot where, years later, seizures could start. Rey noted the striking asymmetry of van Gogh's face, a visible sign of damage to one side of the brain that is consistent with scarring of one hemisphere, which can inhibit the development of one side of the body. Another factor strengthening the diagnosis of epilepsy was the artist's family history of brain disorders: one of his sisters spent her adulthood in a hospital for the insane; his mother's sister had grand mal seizures; and other relatives were diagnosed as epileptic. Rey knew that although epilepsy is not inherited directly, a predisposition to it runs in families.
The artist's early development also signaled to the doctor that something within van Gogh was unusual. Since childhood, van Gogh recalled, he had suffered from periodic headaches, stomach aches, dizziness, and depression. He shunned people, spending most of his time alone. As a young man, hoping to follow his father into the Protestant ministry, he became a missionary, traveling to impoverished Belgian villages to preach Christianity. Though he lacked the necessary stability, his fervor was legendary. He punished himself by refusing to eat and wearing rags. Villagers nicknamed him "God's madman," and church officials dismissed him from one post for his "excess of zeal bordering on the scandalous." In his late twenties, after ten lonely years of evangelical work, he abandoned religion in favor of art. Unable to make a living in either field, he told the doctor, he was supported financially by his father and his younger brother, Theo.
In his early thirties, van Gogh continued, his behavior had become more erratic. He had mystical visions, including one of a resurrected Christ, and frequent attacks of rage. In 1886, overcome by fury in a crowded Paris art gallery, he actually took off all his clothes. This experience reminded Rey of an article he had read about TLE by Jackson: "Probably ... in cases in which a man all at once passes into a violent rage from no apparent cause, or into a state somewhat like somnambulism, in which he may walk a mile or two, or walk into a canal, or in which he takes off his boots in church, or undresses himself in the streets, there is epilepsy."
About two years after disrobing in the gallery, van Gogh had moved to Arles to paint in the region's beautiful light. Over the next few months he wrote numerous letters to his friend the painter Paul Gauguin, begging him to come to Arles. In October 1888, Gauguin at last arrived and moved into the yellow house that van Gogh had rented and furnished.
Their shared life was easy at first. They spent the days painting and the evenings drinking and talking in cafés. Van Gogh was delighted that Gauguin liked to shop, while he preferred to cook; this simplified their division of chores.
In the past few weeks, van Gogh told Rey, life had suddenly grown hard. He developed terrible stomach pains, lost his appetite, and experienced hallucinations. One day, as he was painting peonies, the right half of his visual field went dark, while the flowers in the left half turned upside down. He became moody and irritable. One December afternoon, as Gauguin completed a portrait of van Gogh at his easel painting sunflowers, van Gogh said of the likeness, "That's me all right, but me gone mad." Increasingly he resented the hours that Gauguin spent with local women and prostitutes. On December 23, as the two men were drinking together in a café, van Gogh suddenly reached for his glass, which contained the cloudy green spirit absinthe, and threw it at Gauguin's head. Gauguin dodged the glass, grabbed van Gogh, and dragged him home to bed.
The next morning, when van Gogh awoke from an unusually deep sleep, Gauguin announced that he would soon leave Arles. Van Gogh pleaded with his friend to stay and apologized profusely for his outburst, which, he admitted, he could hardly recall. Gauguin refused to reconsider. All day he kept his distance. At dusk, he left the house for a walk to the public garden, leaving van Gogh at home alone.
Going to his mirror and taking up his razor, van Gogh began to shave the edges of his ruddy beard. Just then, he told the doctor, he heard a disembodied voice commanding him to kill Gauguin. In Rey's opinion, van Gogh had seized; the voice was a TLE seizure, coming from inside his brain.
Prompted by the voice, van Gogh went out into the empty street. He approached the public garden, passed between the firs and bougainvillea bushes that marked its entrance, and walked along the garden path, the blade still in his hand.
In a few minutes he reached Gauguin who, hearing footsteps, turned to find his host, fifteen feet behind him, looking crazed and holding up a blade. Van Gogh appeared to be in a trance. Moments later, he swung around and ran home, where he used the blade on himself, slicing off the lower half of his ear, the source of the voice that had told him to kill Gauguin.
To stanch the blood gushing from the wound, van Gogh pressed towel after towel to his head, dropping the soiled ones to the floor. Hours passed. Gauguin did not return; he had decided to spend the night at a hotel.
Around midnight, van Gogh picked up his severed ear, wrapped it in paper, and went out. He walked through the village to a brothel that Gauguin frequented, where he left his ear on the stoop with a note saying it was a "keepsake" for a prostitute who had once posed for him. He returned home, escorted by a neighbor who had been alerted to his strange behavior, and went to sleep. The next morning, roused by officers summoned by the neighbor, he was taken to the hospital, where he met Felix Rey.
To treat the condition he diagnosed, Rey prescribed most everything then available for any form of epilepsy. Potassium bromide, a drug first used as an antiepileptic in 1857 and now discontinued, seemed to van Gogh to lessen his "unbearable hallucinations," but otherwise it did not help him. Rey advised the artist to stop drinking alcohol, which in sufficient quantities can cause seizures. Van Gogh had not drunk regularly until 1886, in Paris, when he joined a café-going group of artists, among them Gauguin, Pissarro, and Toulouse-Lautrec. The crowd's favorite spirit, absinthe, is so epileptogenic that it was banned for human use in 1914 and has since been used experimentally to create seizures in dogs. Van Gogh had drunk no absinthe from the time of his departure from Paris, early in 1888, until the recent weeks with Gauguin. Now, when he again stopped drinking and started eating regularly at the hospital, his condition improved.
Two weeks after his admission, van Gogh felt well enough to paint. In fact his desire to work was huge. Among the numerous paintings he did while under Rey's care are a portrait of the doctor and a series of self-portraits with his head bandaged. He also wrote obsessively. Instead of sending his brother Theo one letter a day, as he had before, he now sent two or three letters daily, many of them six or more pages long. By the middle of January, he felt well enough to return to his house.
At the end of the month, however, his seizures returned, and now they were worse. "The storm within," as he called his typical seizure, consisted of hallucinations, unprovoked feelings of anger, confusion, and fear, and floods of early memories that disturbed him because they were outside his control. In one such seizure, he "saw again every room at the house in Zundert" where he had been born, "every path, every plant in the garden, the views in the fields roundabout ... down to a magpie's nest in a tall acacia in the graveyard." During many seizures, he forgot where he was, or else his surroundings seemed unreal. At times his hearing and vision were affected: nearby voices seemed to come from afar; objects appeared to shrink; and faces were distorted. He suffered "moods of indescribable mental anguish" and an "undercurrent of vague sadness." He became paranoid, suspecting people in the village of wanting to poison him. Early in February, he was readmitted to the hospital, where he threatened Rey with a razor, as he had once threatened Gauguin.
Thus began a pattern that would endure for the rest of van Gogh's short life. From then on, he alternated between periods of near madness and highly productive calm. In the nineteen months that began in December 1888, he required almost constant hospitalization; yet he painted more often and more expressively than ever before, producing hundreds of watercolors, oil paintings, and drawings — nearly half his lifetime output. As he deteriorated in body and mind, he created the canvases for which he is best known, including some of the most coveted works in the history of art.
As he saw it, whatever was destroying him also fueled his painting. He felt himself developing an "excessive sensitivity" to the visual world that he had not known before. "The cypress [I am painting] is always occupying my thoughts," he wrote to Theo from Arles. "It is as beautiful in line and proportion as an Egyptian obelisk, and the green has a quality of high distinction. It is a splash of black in a sunny landscape, but it is one of the most interesting of the black notes, and the most difficult to strike exactly that I can imagine. But then you must see the cypress against the blue, in the blue rather. To paint nature here, as everywhere, you must have lived in it a long time. I should like to make something of the cypresses like the canvases of the sunflowers; it astonishes me that they have never been done as I see them. ... Sometimes I draw sketches almost against my will. Is it not emotion, the sincerity of one's feeling for nature, that draws us? And if the emotions are sometimes so strong that one works without knowing one works, when sometimes the strokes come with a continuity and coherence like words in a speech or a letter. ... One must strike while the iron is hot."
Rey had read in Jackson's writings of a link between "psychic epilepsy" and creativity, but he was more concerned about his patient's health than his art, so he ordered van Gogh to rest — not to paint. Van Gogh responded by moving, in May 1889, from the hospital in Arles to an asylum for epileptics and the insane in nearby Saint-Rémy-de-Provence, where he committed himself. The doctor at Saint-Rémy, Theophile-Zacharie-Auguste Peyron, concurred with Rey's diagnosis of epilepsy and his recommendation that van Gogh avoid "mental work." But Peyron offered the artist two cells, one to sleep in and the other in which he could paint.
Van Gogh continued to suffer and produce. In his seizures, which were now "abominable, horrible, terrible," he screamed and cursed, sleepwalked, and undressed in public. One day, while painting in a quarry near the asylum and attended by a hospital worker, van Gogh had a seizure in which his entire body convulsed. "There is quite definitely something or other deranged in my brain," he wrote to his brother. Still, whenever he felt well he worked "like a steam engine," according to his doctor's son. Explaining his motivation to paint in a letter to Theo, Vincent wrote, "Work distracts me, and I must have some distraction; or rather work keeps me in control, so that I don't deny myself it ... I miss the work more than it tires me." He added by way of understatement, "I love to paint. The more ugly, old, ill, and poor I get, the more I want to take my revenge by painting in brilliant colors, well-arranged, resplendent."
The desire to express himself artistically was not the only emotion that intensified. His anger and his dependence both were pushed to new extremes. His attacks of rage exploded regularly in threats, insults, and violence toward other patients and his doctors. At Saint-Rémy he twice attempted suicide by swallowing kerosene, oil paint, and turpentine.
His reliance on his brother and on Gauguin also increased. He called his relationship with Theo a "lawful union," as if it were a marriage. Though younger by four years, Theo had at twenty-three assumed the burden of supporting Vincent, sending him money, canvases, and paints, and trying in vain to sell his paintings. The brothers had lived together in Paris from 1886 until early 1888, when Vincent moved to Arles. When Theo became engaged in December 1888, Vincent's happiness for his brother was obscured by his sadness for himself. Feeling abandoned, he desperately tried to transfer his dependency from Theo to Gauguin, who did not play a supporting role nearly as well as Theo. After Vincent cut his ear, for instance, Gauguin left Arles without a word to him, while Theo immediately halted a vacation with his fiancée to nurse his brother. Even so, Vincent had a hard time parting with Gauguin. He continued fantasizing that they would live together again. As late as 1890, he sent Gauguin gifts of paintings and considered following him to Madagascar.
After a year at Saint-Rémy and against his doctor's orders, van Gogh decided to move. Depressed and afraid, he wanted to be near his brother, who now lived in Paris with his wife and infant son. In May 1890, the artist traveled north to the village of Auvers-sur-Oise, where he settled in an inn. From there he visited Theo in Paris, but family obligations prevented Theo from giving his brother the attention he wanted. When Theo decided that to save money he would take his summer holiday at his wife's home in Holland, rather than with Vincent in Auvers, the artist left Paris for Auvers in a rage. A new series of seizures overtook him. He saw horrifying visions and heard voices. No longer able to work, he fell into despair. On Sunday, July 27, in the afternoon, he walked into a field of hay and shot himself in the chest.
At dusk, he stumbled into the inn where he was staying. Doctors could not remove the bullet. In his coat pocket they found a letter addressed to his brother. "Once back here I set to work again, though the brush almost slipped from my fingers," it read. "Knowing exactly what I wanted, I painted three more big canvases. They are vast stretches of corn under troubled skies, and I did not need to go out of my way to express sadness and extreme loneliness."
(Continues...)
Excerpted from Seized by Eve LaPlante. Copyright © 2000 Eve LaPlante. Excerpted by permission of Harper Collins.
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Table of Contents
Contents
Preface,1. A Classic Case,
2. Pioneers,
3. Ordinary People,
4. Mental States,
5. Personality,
6. Intervention,
7. Body and Mind,
Selected Sources,
Acknowledgments,