Book Review

Asylum is novelist Nina Shope’s disturbing and complex story of how men control women’s bodies under the guise of scientific study. Shope approaches this topic with nuance, gravity, and clarity of expression. The author is fearless in her approach to the topic, graphically delving into the specifics of the exploitation of women. On a more hopeful note, Shope also explores the female body in connection to the expansion of life beyond the common categories of our lived experience, bridging the female body with a realm of mysticism and spiritual exploration.

Asylum charts the interactions of French neurologist J.M. Charcot and his most famous patient, Augustine, in a hospital for “hysterical women” in 1875 France. Charcot is both a medical researcher and showman, entertaining packed halls with exhibitions of hysterical women who display their symptoms in order to be cured by his treatments. Augustine is his most celebrated patient at an asylum that is less for the recuperation of the ill and more a museum, a collection of anatomical curiosities. The asylum removes “the hysterics and epileptics from the population . . . creating a new clinic of nervous disorders . . . a ‘new collection.’”

Hysteria was traditionally believed to be caused by the detachment of the uterus. Charcot insists that hysteria is not caused by “the uterus as an animated organ that must keep its place . . . ” The doctor, addressing a crowd, claims that the uterus is sedentary, so much so that “we can hold it in our fist.” He then picks up a curved metal brace, shaped “like the skeletal jaw of a mythical beast,” its tongue “a whorled screw that tightens as the bolt is turned, clamping down flesh and viscera.”

He explains to the audience that “we employ uterine compression” not to immobilize the womb, but to pause an “attack” with immobility. Charcot then lifts Augustine’s hips and slips “the metal mouth” in place. Then “she speaks in tongues . . . and shakes until her limbs are bruised. Until the belt bites down, preventing any movement. The women in the audience gasping. The men with their hats placed respectfully in their laps.” This, the first exhibition of Augustine, sets the tone for the rest of the novel. Charcot and his students view all women as inherently damaged, yet sexually charged. It is the job of medicine to heal women, or at least to render them obedient members of society.

But as we read, we learn that Augustine is not the helpless victim of Charcot. Augustine tells Charcot that she “improvises on stage to exceed your expectations, to make a name for myself.” Even though Augustine lives in captivity, “the air filled with the scent of women secreting, of bodies shifting under clamps, under braces. Of moist skin sticking to metal,” she has a sphere of influence that she exploits. She tells the reader that she has “earned my place inside this living museum, as the primary exhibit. . .” This position gives her power.

She uses her power to manipulate Charcot, who is not all he seems to be; the great scientist realizes he is physically weak when in Augustine’s presence: “he is painfully aware of the years elapsing. No longer a young man, he cannot help but note his declining physique—the decrease in muscle tone, the whitening hair.” Augustine, the patient with an “hysterical” illness, is in the bloom of rigor and health. At one point she refuses to cooperate with Charcot’s interns, revealing great strength as she refuses “to comply, clinging to the bedframe, digging my heels into the floor.”

She circumvents Charcot’s psychological control. When she is not the object of medical investigation, she is able to detach herself from her body. She explains: “When I am not looked at, I do not exist. When I am not touched, I am without a body.” This shift in perspective is the first step she takes away from Charcot’s attempts at dominance. Later in the novel, she is able to use this sense of incorporeality to her ultimate benefit.

Charcot employs photography to capture Augustine’s hysterical states in the hopes of creating a book that will be the definitive work on female madness. For the first picture of Augustine, a neutral pose, Charcot “envisions a series of photographic tableaux burgeoning . . . an array of seizures and poses branching onward like a complex genealogy—revealing the roots of hysteria, establishing a hierarchy of symptoms.” Charcot wants to fix Augustine in easy-to-digest diagnostic categories; to strip the individual woman of her unique essence. But this plan does not work to Charcot’s satisfaction. Augustine’s body will not obey his dictates. He is forced to pose her with straps and braces. He is afraid that his subterfuge will be discovered. And soon enough, an influential journal takes issues with the exhibitions of Charcot’s “star performer” saying:

. . . we can hardly believe that an attack is taking place, the straitjacket that appears in one photograph offers an indication that something is wrong. Even that she wears a whalebone corset, comporting herself so that we nearly forget to notice it. In light of these discrepancies, we must ask ourselves if the patient dissembles on stage, and if she has been schooled in the art of deception.

The journal is correct: Augustine is schooled in deception, but it is not all of Charcot’s making. Much of it is her own creation. Augustine may be a charlatan like Charcot, but this changes when Charcot tells her stories of “the great Christian mystics . . . women who held the image of the celestial spouse before them as a perpetual vision, a conjugal hallucination . . . saints in the throes of convulsions, breasts bared, devils tearing at the bedclothes.” For Charcot, religion is nothing but a form of hysteria, but as Augustine hears these stories, her hysterical experiences shift toward the mystical.  In her thinking, Charcot becomes Jesus, the celestial husband, she is the cosmic wife, and the visions induced by her “illness” are tokens of her divine calling. A spiritual/erotic relationship develops between Augustine and Charcot, but it is just one wrung on the ladder of Augustine’s journey. She is always shifting her relationship with the doctor, changing its parameters for her benefit. Augustine appears to start a romance with a woman named M, apparently another patient. Augustine relates:

I am in bed at night and M enters the room, enters my bed . . . and when M comes near, I ask, do you love me, M, do you love me, and M says yes, always yes, and holds me and presses against me . . .

M is the antithesis of Charcot. He causes Augustine pain, while M alleviates her pain. Augustine tells us that:

. . . M enters the studio surreptitiously, loosening the restraints, rubbing the redness from my skin. Together, we experiment with new positions. M stretches my legs, massaging the muscles to keep them limber, working the joining to improve flexibility and balance. . .

Charcot reacts with suspicion and jealously when Augustine tells him about M. He uses narcotics to lower Augustine’s defenses, to discover her lover’s name. His investigation, he tells Augustine, reveals that M is “just an illusion born of illness.”  But it is in Charcot’s best interest for M to be an illusion, as M is a source of warm human comfort, and Charcot of cold exploitation. Eventually, Augustine relates that “the first time before the crowd, you reach inside me—your arm plunging impossibly deep . . . like an old man intent on rebirth.” This abuse is a turning point. Augustine fully realizes the intensity of her predicament; and considers the flagrant violation of her most intimate parts a “horror.” The doctor has done this to her, Augustine correctly guesses, to “show me my place in this equation—as a void . . . an emptiness.” Her only choice is to escape, and her plan to leave the asylum hinges on the coupling of sex and power, and its capacity to both conceal and reveal how society treats male and female bodies.

Despite the mystical tendencies of Shope’s novel, which provide the one redeeming element of Augustine’s experience, the book mostly points out that a woman’s body is always a “problem” for men to solve—a riddle that must be understood, even if in the process of doing so, the female body is pathologized, abused, and placed in a category of a disease to be cured. Of course, this is all an illusion. There is no “cure” for a woman’s problems in a man’s world, because men have defined the problems. Shope’s disturbing novel eloquently demonstrates that men repeatedly use various methods to attempt to control women: religion, medical science, economics, art, and violence. Power over the female body is the ultimate goal, and Augustine’s fabricated disease and treatment are metaphors for the complex mechanisms pervading that power dynamic.