Review: 'City of Incurable Women,' by Maud Casey

Incurable can be a fun hyperbolic adjective when used whimsically — for instance, an incurable romantic — but it becomes a chilling description when applied to actual medical conditions, fatalistic and revelatory of gaps in knowledge and the biases that exist within this supposedly objective field.

In her seventh book, "City of Incurable Women," Maud Casey explores these blind spots as they historically affected women suffering from mental illnesses and psychosomatic disorders that baffled their male doctors, men whose curiosity "often swerved into cruelty."

The author of six previous books, her most recent novel, "The Man Who Walked Away," was based on the real-life case history of Albert Dadas, a 19th-century psychiatric patient in the hospital of St. André in Bordeaux, prone to wandering in a trance-like state.

Here — through extensive research, archival documents and black-and-white photographs — Casey crafts a collection of linked narrative pieces inspired in part by Georges Didi-Huberman's book "The Invention of Hysteria: Charcot and the Photographic Iconography of the Salpêtrière," about Jean-Martin Charcot, a neurologist who coined the diagnosis of hysteria at the Salpêtrière Hospital in Paris where he worked between the 1860s and the 1890s.

Originally a gunpowder factory (hence the name) the Salpêtrière was converted to a hospice for poor women in 1656 and the vastness of the sprawling compound is what prompted Didi-Huberman to refer to it as a "city of incurable women," a concept Casey uses to contemplate the connections between physical and psychic spaces.

She quotes Charcot himself in his "Lectures on Diseases of the Nervous System" as noting that the massive asylum contained a population of over 5,000, "including a great number called incurables who are admitted for life," meaning that "In other words, we are in possession of a kind of living pathological museum, the resources of which were considerable."

Mixing truth and imagination, Casey reveals both the grim facts of the place — "one doctor for every five hundred patients. Three different kinds of diets: two meals, one meal, and starvation" — and the complexity of the women these doctors reduce to objects of study and repulsed fascination.

Casey conjures a collective voice for these so-called hysterics, writing of their lives "in the before" in a way that returns their subjectivity to them: "When we turned ten, it was time to learn the catechism, time for our First Communion. Some of us left school because of an infestation that destroyed the crops. Some of us took work behind the doors of the silk factory."

Elsewhere, she uses the first person to deliver monologues in the personae of individual patients, including Jane Avril, the famed can-can dancer from the Moulin Rouge, who spent time in the Salpêtrière as a teenager.

Casey's dedication reads "for my fellow incurables" and this short, enchantingly strange book feels animated by compassion. In the section on Geneviève Legrand, she writes, "Bodies, you think, are like haunted houses." These accounts haunt the reader with their subjects' strength of spirit, even amid their thwarted dreams and desires.

Kathleen Rooney is the author of "Lillian Boxfish Takes a Walk" and, most recently, "Cher Ami and Major Whittlesey."

City of Incurable Women
By: Maud Casey.
Publisher: Bellevue Literary Press, 128 pages, $16.99.