Socrates on the beach, Issue 9, 2023
« Patrick Autréaux’s bewitching “A School of Life” (translated from the French by Tobias Ryan) tells of the author’s beginnings as a writer, while sunk in the profession of doctor, before his own bout of illness settles over the whole picture, creating certain paradoxes. »
Greg Gerke, Editor of Socrates on the beach
« From the beginning of my studies, I considered the progressive inner desiccation that medical thinking induced as though it were a symptom to be concealed. If at first I had been keen to master its knowledge and methods, I felt there was a tendency in medicine to systematize a kind of reasoning that threatened to extinguish the irreducible mystery one might want to interrogate when faced with a body going haywire, with madness, or when confronting the fate of a sick individual. I sometimes even had the impression that in depriving me of that, it was undoing me.
Later, when I started transcribing the reports of hospitalized patients, those little-known morsels of literature, I often felt a reticence to confidently employ words that seemed so distant from the experiences they were intended to relate. What link was there between the exhausted woman with a delirious look and the “hallucinatory and intuitive delusions” which led to her being committed? What between the word “avolition” and that sad, old man with the wrinkled brow, who spoke to me of a daughter who had died? Or between the profoundly understated movements of the head which gave such and such young man the appearance of an angelic musician and the phrase “attentive attitude” on the office’s certificate of hospitalisation? So many semiological terms obscuring subjective realities that escaped me, leaving me suspended above a banal enough question, whose depths, nonetheless, leapt vehemently out at me from certain hospital rooms or ER cubicles.
I subsequently have a persistent memory of my embarrassment as a young doctor who endeavoured to flout patients’ interiority, to marginalise it, at least, for the sake of reasoning, or reduce it to psychological symptoms – thus avoiding consideration of his own emotions, that which he rejected or to which he had aversions, his urges and his sympathies, and sometimes his attraction.
These little medical writings are structured around the representation of illness, and a series of procedures to follow and their side effects. For them to have a reason to exist, they must be simple and reliable. This is how a pact forms between inquisitor and medical history: it demands facts, and writing without hidden traps, writing which puts up no façade. Medicine tends to bring everything it touches into line with its logic. Its power comes through its ability to reveal the causes of pain, but it quickly wearies and abandons that which, once it has been unravelled, seems to remain a mystery. The extent of its understanding often ends at the threshold of the most singular realities. Medical knowledge generally neglects this other, more complex and formless, zone, with which art, and more particularly literature, tends to be charged (in the electrical sense of the term): an active space never entirely unveiled. And if, according to Virginia Woolf, a simple flu can provides us an astonishing tale, I have noticed that the doctors who take interest in it are few.
In breaking with its witchy element, medicine has also rent itself of a powerfully troublesome weed: subjectivity. Subjectivity is not, as we well know, the self of psychology, or is so only in approximation. And that of patients is not simply emotion or anxiety, manifestations of which easily frustrate doctors, but a rift which opens up an illness, a crack that risks devouring the methods of Father Hippocrates – and which threatens, also, to reverberate through the fractures of the medical staff themselves. Subjectivity is the semi-consistent fog which awaits a listening ear, which hopes for encounter, which must extend for relationships to take form – even if they are to end in loss.
Medical histories bear the mark of this sacrosanct notion of therapeutic distance. To interpret symptoms in a scientific frame of mind is to take a step back, allowing for the most rational possible analyses and syntheses. However, what has appeared, from the beginning of my practice, damaging as a writer, and as an individual, is the way in which this distanced retelling overruns the field of thought, discrediting the imaginary which illness can cause to proliferate: giving us a glimpse of an evil moon, but obscuring its private face.
The kind of narration which is the foundation of medical writing is rarely the object of reflection. If, for my part, I was sensitive to it, it is because I was working under a literary pull. And because I felt inhabited by a formlessness which, since my adolescence, had demanded representation; because I sensed within myself that hidden face which I took care to delimit in my everyday professional activities, and so frequented, in parallel to the school which taught me my trade and responded to a confirmed vocation, another, wherein an understanding of human life was less precise and yet more powerful – this other, this folk-school, was literature.
In certain regions or from within certain pages, long seasons open out. The summer will always be, for me, not the sea or walks in the mountains, but a bedroom in which I lie, blinds half closed, or a deck chair in the shadow of a tree, bathed in the green and yellow light of epiphany – spaces which strongly recall the room of a patient or convalescent, where our eyes zip back and forth from a book to the spiralling path of a fly that circles above our head, where we follow the black mark of a little spider meandering across the ceiling: a truant space of the fleeting madness that is dreamy thinking.
Folk-school: at the beginning of the Reformation, in the first third of the XVI century, this was the name for the improvised classes which took place beyond the control of priests and official education, away from the churches, in the countryside – in the bushes. They were schools which, far from idleness, were first and foremost those of the margins, schools of contestation, and which, above all, made a return to the text. In order to listen to human beings, we must, without doubt, know how to listen to texts. And vice versa.
My folk-school was therefore a little underground. Modest and intimate, it tended to instruct me in more delicate and complex attentions. All the same, as I was already finding the hospital, as it is today, unbearable with its invasive and mutilating managerial logic, it was also a space of resistance. To protect what others may have identified as a crack, there were the authors with whom I came face to face. Not only so that I might grow in compassion and deepen my understanding, but that I might attempt to glimpse a poorly delineated psychic space, to unearth from within myself the possibilities of those muzzled emotions, not to imagine myself as preserved from evil, to believe myself “healthy”, but dare to embrace my moments of distress, to guard my faith in the power of what they revealed about who I was, revelations that none could have offered better.
If I were engaged in self-revitalisation through the refusal to separate myself from a fate shared, potentially, with certain patients, this personal development was left at the hospital door. I had to accommodate myself to the growing distance between modes of psychic life that seemed to rule one another out, and which I was unable to reconcile. What shook this division, and tentatively shifted its frontiers, was that I was learning how to write, and that writing was leading me along a tightrope toward a place from where one can see at least two ways at once: the lip of a volcano discovered in the bushes. It was a matter of rediscovering the fluidity which exists in the mind between thoughts that issue from logic and those that issue from reverie, or at least those in which logic is not manifest, whose structures do not follow a causal sequence but one more associative and dreamlike. It was wanting to write like a doctor but forgetting I was one.
To become this crucible of psychic reconciliation, it took me falling ill (with a cancer that initially condemned me), which is to say, doubting the tacit fidelity of my body, becoming a stranger to myself, and submitting to hands that considered me an object of investigation, of protocol and of care… »