Asti Hustvedt's thought-provoking history of hysteria has inspired angry reviews from ME sufferers who feel she is disparaging their condition, implying it is psychological rather than "real".These comments miss the point - Medical Muses is not a dismissal of anyone's illness but rather a careful attempt to explore how disease is located in society and history as well as in the mind and body.
Dr Jean-Martin Charcot's famous investigations into hysteria at the Salpêtrière hospital in Paris in the late 19th century remain irresistible to artists, writers and historians, not least those with feminist sympathies. The amply documented Salpêtrière hysterics live on in a wealth of photographs, transcriptions, drawings, histories and speculations.
Well over a century later, they still evoke complex relations between gender and power, the body and the mind, making the material almost overwhelmingly suggestive.
Happily, at its best Hustvedt's history finds sufficient distance from the seething source material to begin to suggest why the hysterics still fascinate us, long after their illness vanished to be replaced by modern syndromes such as depression, eating disorders and post-traumatic stress.Even in Charcot's time, sceptics pointed out that the symptoms he discovered in his hysterical patients were rarely reproducible outside the Salpêtrière.
Unsurprisingly, many versions of that history have depicted the doctors as manipulative patriarchs exploiting vulnerable women. But Hustvedt resists wielding this kind of ethical sledgehammer in order to pursue a more complex truth. While she is always quick to point out the currents of power and oppression in the (male) doctors' treatment of (female) hysterics, she also rehabilitates Charcot for modern medicine.
He did important groundwork in the understanding of, for example, Parkinson's disease and multiple sclerosis, while his treatment of hysteria was far more humane than any previous approaches to insanity - not least, perhaps, because he saw it not as a mental illness but organic in origin.Freud studied with him and was inspired by Charcot and colleagues' interest in documenting patients' childhood experiences, dreams and fears.
Hustvedt also shows how, far from being blind to his own limitations, towards the end of his life Charcot reflected on how hypnotically induced states and placebo effects had potentially radical implications for medicine as a whole - implications that we have yet to fully understand today.Medical Muses reveals that illness is as much of a social construct as it is an objective physical reality and the bulk of the book is taken up with case studies of three of the Salpêtrière's most famous patients.Each woman enables Hustvedt to explore different aspects of the hospital. Through Blanche, we are introduced to the star system which made exemplary hysterics famous in public lectures and demonstrations. Through Augustine, we learn more about the hospital's official photographs that helped popularise and pathologise the chaotic effect of hysteria, while, finally, in the weakest chapter, Genevieve inspires Hustvedt to attempt to unpack hysteria's relation to older concepts of demonic possession and religious ecstasy.Charcot was adept at documenting his work and drawings and photographs of his experiments are reproduced throughout the book.Particularly creepy are photographs of "passionate poses", including a famous series of Augustine which the doctors helpfully captioned by categories such as "Auditory Hallucinations" or "Amorous Supplication".These images are both strange and familiar - they resemble the kind of advertisement in which a model looks rapturously at a blender or jumps for joy for no apparent reason. Hustvedt brackets the book with an introduction and epilogue where she allows herself to make more explicit links between Charcot's system and modern ideas. But in the main she sticks to the almost implausibly fascinating history of her chosen case studies.
As the author says of Augustine, no fictional account can outdo "the true story of a girl who became Charcot's most photographed hysteric and then, after years of submission, fled the hospital and male medical authority, dressed as a man".One of the book's pleasures is how these histories, without too much intervention from Hustvedt, inevitably suggest links between then and now.
From / The National