Title: The Alienist

Author: Machado de Assis

First published: 1881, in the journal A Estação

Page count: 86

First line: The chronicles of Itaguai relate that in remote times a certain physician of noble birth, Simão Bacamarte, lived there and that he was one of the greatest doctors in all Brazil, Portugal and the Spains.

Hmm, a third novella in a row that treats madness in some form or other. The previous two (Maupassant’s The Horla and Eliot’s The Lifted Veil) approached the subject from the inside, giving first person accounts of traumatic and fantastical events that the reader is invited to read double, as it were: both as genuine testaments of the strangeness of the world, and as unknowing self-descriptions of a diseased mind or soul – the horla doesn’t really exist, Latimer doesn’t really have second sight. It is up to you, the reader, to interpret and choose between them, or to carry the ambiguity right through to the bitter end.

In either case, and in both books, all the talk of madness and derangement reflected just as much on the human condition in general; what we like to call madness is just an extreme version of what we all experience to various degrees and at various times in our lives. This is obviously still the case, albeit the terminology has changed. Nobody is ‘mad’ anymore – we talk of mental illness, syndromes and disorders, but the mania (ha!) for scientific classification hasn’t scared off literature. Our novels and memoirs are just as full of those syndromes and disorders as they once were of plain old madness. We still look to the extremes to learn about the centre, and to reassure ourselves that the centre is where we live, even when we do so by incorporating parts of the extreme into it.

Both the previous two books were very good at this. This third ‘madness’ novella, written in Portuguese and translated by William L. Grossman, is rather different. It doesn’t explore madness from the inside, but from the outside. It’s about madness, and the treatment of madness, as a social and medical phenomenon.

As such, it fits neatly into the genre of para-psychiatric fiction – which, if it wasn’t a genre before, well it is now. Examples: Rivka Galchen’s Atmospheric Disturbances, One Flew over the Cuckoo’s Nest, Fight Club, Pat Barker’s Regeneration trilogy, The Bell Jar, One Flew Over the Cuckoo’s Nest, a fair amount of Will Self (The Quantity Theory of Insanity, Dr Mukti, Great Apes) and probably too many others to mention.

Generally, this genre take a sceptical or satiric view of the discipline or profession – as why should it not, seeing as this modern branch of medicine could be seen to be encroaching on turf long held by literature to be its own domain: the secular hermeneutics of the human mind.

The alienist of Machado’s book is Simão Bacamarte… and in fact, let’s stop for a moment, before we get to the book, to consider the title. It’s a great title, isn’t it?  It might actually be a better title today, for its strangeness, than it was on publication, 130 years ago. My OED has ‘alienist’ (from the French, alieniste), meaning mad-doctor – in today’s parlance, psychiatrist – with its earliest example coming from 1864, though the usage of ‘mental alienation’ to mean mental illness goes back centuries before that.

Simão Bacamarte, then, is an eminent scientist who sets up as a “psychopathologist” in his native town of Itaguai, in Brazil, west of Rio de Janeiro. He convinces the town council to fund an asylum for the treatment and study of the mentally ill and ‘the Green House’ is opened. “Some patients had already been admitted,” notes the narrator, “and their relatives took advantage of this opportunity to observe the paternal care and Christian charity with which they were treated.”

Nothing changes in that: Bacamarte is a kindly doctor to the end; it’s just, he’s a little too conscientious in his diagnoses. His stated intention in opening the asylum is to

study insanity in depth, to learn its various gradations, to classify the various cases, and finally to discover the cause of the phenomenon and its remedy.

Which, of course, sounds like a recipe for insanity itself. It sounds, in fact, like Robert Burton’s plan for his monstrous Anatomy of Melancholy, a book that manages to take the idea of the Enlightenment, of rational enquiry into the ills of the world, and inflate it and inflate it until it pretty well explodes. In fact again, melancholy, in Burton’s book, is more or less a synonym of madness, and the lesson of that book is that, as with dirt in a house, once you start looking for it, you will never stop finding it, for dirt – and madness – will reveal itself in ever finer gradations as your eye becomes trained to see it, and as you eradicate the big, easy stuff.

Thus the gag of The Alienist: that, once Bacamarte has got all the obviously mad people of the region under lock and key, he expands his parameters, and starts incarcerating anyone who deviates even minimally from what he considers normal. A rich man who gave away everything he owned? Mad. That man’s cousin, who comes to intercede with the doctor, on his behalf? Clearly delusional. The head of the town council, Bacamarte’s best friend, even his wife: all mad, all committed. There are shades of Catch-22 here: denial of insanity becomes its proof.

An aside: If you haven’t read Will Self’s excellent short story, ‘The Quantity Theory of Insanity’ (it’s in his US Selected Stories, the clangingly mis-titled The Undivided Self) then I recommend it thoroughly. Its  wonderfully Foucaultian premise: that psychiatrists have discovered that the insanity levels of any given population operate on a quota level – it goes down over here, it must go up over there:

i)                    If you decrease the number of social class 2 anorexics you necessarily increase the number of valium abusers in social class 4.

ii)                  If you have provide efficient medication for manic depressives in the Fens, there are perceptible variations in the numbers of agoraphobics on the South Coast.

I’ll leave the end of Machado’s book unspoiled (though suffice it to say it follows perfectly the formal logic of its madness) and turn briefly to the style, which is stuffy to the point of irony. In fact, it is so embedded in a very 19^th Century stuffiness that it’s rather difficult, at this distance, to see quite where the demonstration of stuffiness ends and its ironisation begins.

That’s the problem with irony. It is always obviously the other thing, but it’s always that thing, too. It relies on a tacit understanding between author and reader as to how far the display of a thing is also criticism of that thing. Take, for instance, the book’s insistence on “the chronicles of Itaguai” and “the chroniclers” themselves: “The chroniclers relate…”; “The chroniclers all agree that Mrs Soares found great comfort in the nobility of her husband…” and so on. This idea, that the chroniclers are to be trusted utterly and implicitly, is one that seems, to me, loaded with irony, but I can’t be sure; and I can’t be sure, too, that that irony isn’t also a gesture of approbation. The chroniclers and their chronicles are to be laughed at, but they are a good and serious thing, too. (Though they are also to be laughed at.) Sometimes, at this distance, we can only stand and stare. A very modern tale, and an utterly alien one, both. Definition of a novella: small enough to be taken in as a unified whole; big enough to make you stand and stare.