فصل 13

CHAPTER 13

IN THE FIACRE on their way to the clinic later that day, Breuer raised the question of confidentiality, and proposed that Nietzsche might feel more comfortable being admitted under a pseudonym—specifically as Eckart Müller, the name he had used when discussing his patient with Freud.

“Eckart Müller, Eckkkkkkart Müuuller, Eckart Müuuuuuuller,” Nietzsche, obviously in high spirits, caroled the name to himself slowly in a soft whisper as if to discern its melody. “It’s as good a name as any other, I suppose. Does it have special significance? Perhaps,” he speculated mischievously, “it’s the name of some other notoriously obstinate patient?” “It’s simply a mnemonic,” Breuer said. “I form a pseudonym for a patient’s name by substituting for each initial the letter in the alphabet immediately preceding it. Thus, I got E.M. And Eckart Müller was simply the first E.M. that occurred to me.” Nietzsche smiled. “Perhaps, some medical historian will one day write a book on famous physicians of Vienna, and wonder why the distinguished Doctor Josef Breuer so often visited a certain Eckart Müller, a mysterious man without past or future.” It was the first time Breuer had seen Nietzsche being playful. It boded well for the future, and Breuer reciprocated. “And pity the philosophic biographers of the future when they attempt to trace the whereabouts of Professor Friedrich Nietzsche during the month of December in the year eighteen eighty-two.” A few minutes later, when he had thought more about it, Breuer began to regret having suggested a pseudonym. Having to address Nietzsche by a false name in the presence of the clinic staff imposed a wholly unnecessary subterfuge upon an already duplicitous situation. Why had he added to his burden? After all, Nietzsche did not need the protection of a pseudonym for the treatment of hemicrania, a straightforward medical condition. If anything, their present arrangement demanded that he, Breuer, take the risks, and hence, he, not Nietzsche, needed the sanctuary of confidentiality.

The fiacre entered the eighth district, known as Josefstadt, and stopped at the gates of the Lauzon Clinic. The gatekeeper, recognizing Fischmann, discreetly avoided peering into the cab and scurried to open the swinging iron gates. The fiacre lurched and bounced over the hundred-meter cobblestone driveway to the white-columned portico of the central building. The Lauzon Clinic, a handsome, four-story structure of white stone, housed forty neurological and psychiatric patients. When it was built three hundred years before as the city home of the Baron Friedrich Lauzon, it lay immediately outside the city walls of Vienna and was encircled by its own walls, along with stables, a coach house, servants’ cottages, and twenty acres of garden and orchard. Here, generation after generation of young Lauzons were born, reared, and sent out to hunt the great wild boar. Upon the death of the last Baron Lauzon and his family in the typhoid epidemic of 1858, the Lauzon estate had passed to Baron Wertheim, a distant, improvident cousin who rarely left his country estate in Bavaria.

Advised by the estate executives that he could divest himself of the burden of his inherited property only by transforming it into a public institution, Baron Wertheim decided that the building should become a convalescent hospital, with the stipulation that his family receive perpetual free medical care. A charity trust was established, and a board of trustees enlisted—the latter unusual for including not only several leading Viennese Catholic families but two Jewish philanthropic families, the Gomperzes and the Altmanns. Though the hospital, which had opened in 1860, ministered primarily to the wealthy, six of its forty beds were endowed and made available to poor, but clean patients.

It was one of these six beds that Breuer, who represented the Altmann family on the hospital board, commandeered for Nietzsche. Breuer’s influence at the Lauzon extended beyond his board membership; he was also the personal physician of the hospital director and several other members of the administration.

When Breuer and his new patient arrived at the clinic, they were greeted with great deference. All formal intake and registration procedures were waived, and the director and the chief nurse personally conducted doctor and patient on a tour of the available rooms.

“Too dark,” Breuer said about the first room. “Herr Müller needs light for reading and correspondence. Let’s look at something on the south side.”

The second room was small but bright, and Nietzsche commented, “This will do. The light is much better.”

But Breuer quickly overruled him. “Too small, no air. What else is free?”

Nietzsche also liked the third room. “Yes, this is entirely satisfactory.”

But Breuer again was not pleased. “Too public. Too noisy. Can you make something available farther from the nursing desk?”

When they entered the next room, Nietzsche did not wait for Breuer’s comment but immediately put his briefcase into the closet, took off his shoes, and lay down on the bed. There was no argument, since Breuer also approved of this bright, spacious third-floor corner room, with its large fireplace and excellent view of the gardens. Both men admired the large, slightly bald, but still regal salmon-and-blue Isfahan carpet, obviously a remnant of happier, healthier days at the Lauzon estate. Nietzsche nodded in appreciation of Breuer’s request that a writing table, a gas desk lamp, and a comfortable chair be placed in the room.

As soon as they were alone, Nietzsche acknowledged that he had gotten up too quickly from his last attack: he felt fatigued, and his head pain was returning. Without protest, he agreed to spend the next twenty-four hours resting quietly in bed. Breuer walked down the hall to the nursing desk to order medications: colchicine for pain, chloral hydrate for sleep. So heavily addicted was Nietzsche to chloral that withdrawal would require several weeks.

When Breuer leaned into Nietzsche’s room to take his leave, Nietzsche lifted his head from his pillow and, holding out the small glass of water by his bed, proposed a toast: “Until the official beginning of our project tomorrow! After a brief rest, I plan to spend the rest of the day developing a strategy for our philosophic counseling. Auf Wiedersehen, Doctor Breuer.” A strategy! Time, Breuer thought in the fiacre on the way home, time for me, too, to think about a strategy. So consumed had he been with ensnaring Nietzsche that he had given no thought whatsoever to how he was to tame his quarry, now in room 13 of the Lauzon Clinic. As the fiacre swayed and rattled, Breuer tried to concentrate on his own strategy. It all seemed a muddle, he had no real guidelines, no precedents. He would have to devise an entirely new treatment procedure. Best to discuss this with Sig; it was the kind of challenge he loved. Breuer told Fischmann to stop at the hospital and locate Doctor Freud.

The Allgemeine Krankenhaus, the Vienna General Hospital, where Freud, a clinical aspirant, was preparing himself for a career as a medical practitioner, was a small city unto itself. It housed two thousand patients and consisted of a dozen quadrangle buildings, each a separate department—each with its own courtyard and wall, each connected by a maze of subterranean tunnels to all the other quadrangular buildings. A four-meter stone wall separated the entire community from the outside world.

Fischmann, long familiar with the secrets of the maze, ran to fetch Freud from his medical ward. A few minutes later, he returned alone: “Doctor Freud’s not there. Doctor Hauser said he went to his Stammlokal an hour ago.” Freud’s coffeehouse, the Café Landtmann on Franzens-Ring, was only a few blocks from the hospital; and there Breuer found him, sitting alone, drinking coffee, and reading a French literary journal. The Café Landtmann was frequented by physicians, clinical aspirants, and medical students; and though far less fashionable than Breuer’s Cafe Griensteidl, it subscribed to over eighty periodicals, perhaps more than any other Vienna coffeehouse.

“Sig, let’s go to Demel’s for a pastry. I’ve got some interesting things to tell you about the case of the migrainous professor.”

Freud had his coat on in seconds. Though he loved Vienna’s premier pastry shop, he couldn’t afford to go except as someone’s guest. Ten minutes later, they were seated at a quiet corner table. Breuer ordered two coffees, a chocolate torte for himself, and a lemon torte mit Schlag for Freud, which he finished so quickly that Breuer persuaded his young friend to choose another from the three-tiered silver pastry wagon. When Freud had finished a chocolate custard mille-feuille and a second coffee, both men lit cigars. Then Breuer described in detail everything that had happened with his Herr Müller since their last talk: the professor’s refusal to enter psychological treatment, his angry departure, the middle-of-the-night migraine, the strange house call, his overdose and peculiar state of consciousness, the small, plaintive voice calling for help, and, finally, the remarkable bargain they had struck in Breuer’s office that morning.

Freud stared at Breuer with great intensity as he told this tale—a look Breuer knew. It was Freud’s total-recall look: he was not only contemplating and registering everything but recording it as well; six months hence, he would be able to repeat this conversation with perfect accuracy. But Freud’s demeanor changed abruptly when Breuer described his final proposal.

“Josef, you offered him WHAT? You are to treat this Herr Müller’s migraine, and he should treat your despair? You can’t be serious! What does this mean?”

“Sig, believe me, it was the only way. If I had tried anything else, poof!—he’d be on his way to Basel. Remember that excellent strategy we planned? To persuade him to investigate and reduce his life stress? He demolished that in minutes by utterly eulogizing stress. He sang rhapsodies about it. Whatsoever does not kill him, he claims, makes him stronger. But the more I listened and thought about his writings, the more I was convinced he fancies himself a physician—not a personal one but a physician to our entire culture.” “So,” Freud said, “you snared him by suggesting he begin to heal Western civilization by starting with a single specimen—you?”

“That’s true, Sig. But first he snared me! Or, that homunculus you claim is active in each of us snared me with his pitiful plea of ‘Help me, help me.’ That, Sig, was almost enough to make me a believer in your ideas about there being an unconscious part of the mind.” Freud smiled at Breuer and enjoyed a long draw on his cigar. “Well, now that you’ve snared him, what next?”

“The first thing we’ve got to do, Sig, is get rid of this term ‘snare.’ The idea of snaring Eckart Müller is incongruous—like catching a thousand-pound gorilla with a butterfly net.”

Freud smiled more broadly. “Yes, let’s drop ‘snare’ and just say that you’ve got him in the clinic and will see him daily. What’s your strategy? No doubt he’s busy designing a strategy to help you with your despair, starting tomorrow.” “Yes, that’s exactly what he said to me. He’s probably working on it this very moment. So it’s time for me to plan as well, and I hope you can help. I haven’t thought it through, but the strategy is clear. I must persuade him he is helping me—while I slowly, imperceptibly, switch roles with him until he becomes the patient and I, once again, the physician.” “Exactly,” Freud agreed. “That’s precisely what must be done.”

Breuer marveled at Freud’s ability always to sound so sure of himself, even in situations where there was no certainty whatsoever.

“He expects,” Freud continued, “to be your doctor of despair. And that expectation must be met. Let us lay plans—one step at a time. The first phase obviously will be to persuade him of your despair. Let’s plan this phase. What will you talk about?” “I have no concerns about it, Sig. I can imagine many things to discuss.”

“But really, Josef, how are you going to make that believable?”

Breuer hesitated, wondering how much of himself to reveal. Still, he answered, “Easy, Sig. All I have to do is tell the truth!”

Freud looked at Breuer in astonishment. “The truth? What do you mean, Josef? You have no despair, you have everything. You’re the envy of every doctor in Vienna—all Europe clamors for your services. Many excellent students, like the promising young Doctor Freud, cherish your every word. Your research is remarkable, your wife the most beautiful, sensitive woman in the empire. Despair? Why, Josef, you’re atop the very crest of life!” Breuer put his hand on Freud’s. “The crest of life! You’ve put it just right, Sig. The crest, the summit of the life climb! But the problem with crests is that they lead downhill. From the crest I can see all the rest of my years stretched out before me. And the view doesn’t please me. I see only aging, diminishment, fathering, grandfathering.” “But, Josef”—the alarm in Freud’s eyes was almost palpable—“how can you say that? I see success, not downhill! I see security, acclaim—your name attached in perpetuity to two major physiological discoveries!”

Breuer winced. How could he admit to having wagered his whole life only to find that the final prize was, after all, not to his liking? No, these things he must keep to himself. There are things you don’t tell the young ones.

“Let me just put it this way, Sig. One feels things about life at forty that one cannot know at twenty-five.”

“Twenty-six. On the far side of twenty-six.”

Breuer laughed. “Sorry, Sig, I don’t mean to be patronizing. But take my word that there are many private things I can discuss with Müller. For example, there are troubles in my marriage, troubles I’d prefer not to share with you, so you don’t have to keep things from Mathilde and hurt the closeness you two share. Just believe me: I shall find much to say to Herr Müller, and I can make it convincing by sticking largely to the truth. It’s the next step I worry about!” “You mean what happens after he turns to you as a source of help for his despair? What you can do to lessen his burden?”

Breuer nodded.

“Tell me, Josef, suppose you could design the next phase in any way you wish. What would you like to happen? What is it one person can offer another?”

“Good! Good! You prod my thinking. You’re magnificent at this, Sig!” Breuer reflected for several minutes. “Though my patient’s a man—and not, of course, a hysteric—still, I think I’d like him to do exactly what Bertha did.” “To chimneysweep?”

“Yes, to reveal everything to me. I’m convinced there’s something healing in unburdening. Look at the Catholics. The priests have been offering confessional relief for centuries.”

“I wonder,” said Freud, “whether the relief comes from the unburdening or from the belief in divine absolution?”

“I’ve had as patients agnostic Catholics who still benefited from going to confession. And on a couple of occasions in my own life, years ago, I experienced relief from confessing everything to a friend. How about you, Sig? Have you ever been relieved by confession? Ever unburdened yourself fully to anyone?” “Of course; my fiancee. I write Martha every day.”

“Come now, Sig.” Breuer smiled and put his hand on his friend’s shoulder. “You know there are things you can never tell Martha—especially Martha.”

“No, Josef, I tell her everything. What couldn’t I tell her?”

“When you’re in love with a woman, you want her to think well of you in all ways. Naturally, you’re going to keep things hidden about yourself—things that might present you in a bad light. Your sexual lusts, for example.” Breuer noted Freud’s deep blush. Never before had he and Freud had such a conversation. Probably Freud had never had one.

“But my sexual feelings involve only Martha. No other woman attracts me.”

“Then let’s say before Martha.”

“There was no ‘before Martha.’ She is the only woman I have ever craved.”

“But, Sig, there must have been others. Every medical student in Vienna keeps a Süssmädchen. Young Schnitzler seems to have a new one every week.”

“This is exactly the part of the world I want to shield Martha from. Schnitzler is dissolute—as everyone knows. I have no appetite for such dalliance. Nor time. Nor money—I need every florin for books.”

Best to leave this topic quickly, Breuer thought. I have learned something important, however: I now know the limits of what I can ever hope to share with Freud.

“Sig, I’ve gotten us off the track. Let’s go back five minutes. You asked what I want to happen. I’m saying that I hope Herr Müller will talk about his despair. I hope he’ll use me as a father confessor. Maybe that in itself will be healing, maybe bring him back into the human fold. He’s one of the most solitary creatures I’ve ever met. I doubt he’s ever revealed himself to anyone.” “But you told me he’s been betrayed by others. No doubt he trusted and revealed himself to them. Otherwise, there could be no betrayal.”

“Yes, you’re right. Betrayal is a big issue for him. In fact, I think that should be a basic principle, perhaps the fundamental principle, for my procedure: primum non nocere—do no harm, do nothing he could possibly interpret as betrayal.” Breuer thought about his words for a few moments and then added, “You know, Sig, I treat all patients this way, so this should pose no problem in my future work with Herr Müller. But there’s my past duplicity with him—that he might view as betrayal. Yet I can’t undo it. I wish I could cleanse myself and share everything with him—my meeting with Fräulein Salomé, the conspiracy among his friends to steer him to Vienna, and, above all, my pretense that it is I, myself, and not he who is the patient.” Freud shook his head vigorously. “Absolutely not! This cleansing, this confession, would be for your sake and not for his. No, I think if you really want to help your patient, you will have to live with the lie.”

Breuer nodded. He knew Freud was right. “All right, let’s take stock. What do we have so far?”

Freud responded quickly. He loved this type of intellectual exercise. “We have several steps. First, engage him by disclosing yourself. Second, reverse the roles. Third, help him disclose himself fully. And we have one fundamental principle: to retain his trust and avoid any semblance of betrayal. Now, what’s the next step? Suppose he does share his despair, then what?” “Maybe,” Breuer replied, “there doesn’t have to be a next step? Perhaps simply revealing himself would constitute such a major achievement, such a change in his way of life, that it would be in itself sufficient?”

“Simple confession isn’t that powerful, Josef. If it were, there’d be no neurotic Catholics!”

“Yes, I’m sure you’re right. But perhaps”—Breuer took out his watch—“this is as much as we can plan for now.” He signaled the waiter for the check.

“Josef, I’ve enjoyed this consultation. And I appreciate the way we confer—it’s a honor for me to have you take my suggestions seriously.”

“Actually, Sig, you’re very good at this. Together we make a good team. Yet I can’t imagine a great clamor for our new procedures. How often do patients come along who require such a Byzantine treatment plan? In fact, I’ve felt today that we were not so much devising a medical treatment as planning a conspiracy. You know whom I’d prefer as a patient? That other one—the one who called for help!” “You mean the unconscious consciousness trapped inside your patient.”

“Yes,” said Breuer, handing the waiter a florin note without checking the tally—he never did. “Yes, it’d be a lot simpler to work with him. You know, Sig, maybe that should be the goal of treatment—to liberate that hidden consciousness, to allow him to ask for help in the daylight.” “Yes, that’s good, Josef. But is ‘liberation’ the term? After all, he has no separate existence; he’s an unconscious part of Müller. Isn’t integration what we’re after?” Freud seemed impressed with his own idea and pounded his fist softly upon the marble table as he repeated, “Integration of the unconscious.” “Ach, Sig, that’s it!” The idea excited Breuer. “A major insight!” Leaving the waiter a few copper Kreuzer, he and Freud walked onto Michaelerplatz. “Yes, if my patient could integrate this other part of himself, that would be a real achievement. If he could learn how natural it is to crave comfort from another—surely that would be enough!” Walking down the Kohlmarkt, they reached the busy thoroughfare of the Graben and parted. Freud turned down Naglergasse toward the hospital, while Breuer strolled through Stephansplatz toward Backerstrasse 7, which lay just beyond the looming Romanesque towers of the Church of Saint Stephen. The talk with Sig had left him feeling more confident about meeting tomorrow morning with Nietzsche. Nonetheless, he had a worrisome premonition that all this elaborate preparation might be only illusion—that Nietzsche’s preparation, not his own, would govern their encounter.