Narrow streets, old buildings, and small shops were in sight as I walked with a group of my friends towards the renowned Vincent Van Gogh Café. We were in Arles, a city in the south of France where the Dutch painter Van Gogh lived for more than a year and created some of his best work. Once we reached the square, a yellow café was to our right, and in blue writing “Le Café La Nuit” and “Vincent Van Gogh Café” were spelled out. Red couches and vases of yellow sunflowers lined the walls. People were rushing in and out, and tourists were taking pictures.
The image of Vincent Van Gogh Café in 2019 compared to Van Gogh’s painting in 1888.
This café, once a place where Van Gogh spent his time painting, now differed from the one depicted in his painting. Chairs were replaced by couches, empty stores fronts were changed to buzzing restaurants and hotels, a few circular tables were swapped for large rectangular tables. Intrigued, we did not stop there. Our next stop was the hospital ward courtyard, where Van Gogh was admitted twice, and created three known paintings.
The courtyard of the hospital ward in Arles (2019), with a replica of Van Gogh’s painting in the foreground.
You might be confused right now if you have not heard about Van Gogh’s story. Hospital ward? Twice? Van Gogh left Paris for Arles because of his mental health. However, after a few months in Arles, his mental health deteriorated. A razor covered with blood in hand, Van Gogh had maimed his ear, after arguing with his house guest (Khoshbin and Katz, 2015). At Hotel Dieu Hospital, Dr. Felix Rey treated Van Gogh, bandaged his ear, and diagnosed him with epilepsy. In a letter Dr. Rey wrote, there were times when Van Gogh “loses his train of thought and speaks nothing but disjointed words… he went to lie down in another patient’s bed and would not leave it… he chased the sister on duty… he went to wash in the coal-box” (Van Gogh Museum). He was then transferred to the asylum Saint-Remy-de-Provence, where Dr. Theophile Peyron, recorded Van Gogh’s medical condition as having “suffered an attack of acute mania with visual and auditory hallucinations that led him to mutilate himself by cutting off his ear” (Van Gogh Museum). So, was Van Gogh certainly epileptic? Or did he suffer from another neurological disorder?
Epilepsy is a neurological condition that is defined by recurrent seizures and can affect people of all ages. Van Gogh was described by doctors as having seizures, which is the reason for the primary diagnosis of epilepsy. However, the best method for diagnosis is through the use of an electroencephalography (EEG), a machine that records the electrical activity of the brain (Guerreiro, 2016). Epileptic patients have unusual activity in their brain cells(neurons), which makes an EEG a good tool to detect epilepsy. However, in 1889, when Van Gogh was diagnosed, the EEG had not yet been discovered. Thus, with no scans to look at, this brings to question whether the diagnosis of Van Gogh was accurate.
EEG image of a normal (seizure-free) brain compared to an EEG image of the brain of an epileptic patient (Ebrahimpour et al. 2012).
Another study revealed that auras are important in diagnosing patients as epileptic (Liu et al., 2017). An aura consists of all the sensations that a patient experiences prior to a seizure. The type of aura the patient experiences conveys what part of the cerebral cortex, outermost region of the brain responsible for decision making and speech, is affected (Liu et al., 2017). Epileptic patients could have sensory (related to the senses) or cognitive auras (related to thoughts), as well as unspeakable feelings (Liu et al., 2017). These characteristics were evident in Van Gogh, since he had auditory and visual hallucinations and he was unable to express his thoughts. However, the findings do not explain the depressive symptoms and the urge to commit suicide that Van Gogh experienced.
The more I look at the symptoms described by the doctors, the more I realize that Van Gogh was more likely a schizophrenic. Schizophrenia is a brain disorder that encompasses hallucinations, delusional thinking and cognitive problems (Seidman and Mirsky, 2017). One study examined the effects of depression and cognitive impairment on adults with schizophrenia (Raykeer et al., 2019). Patients who had schizophrenia had increased depression and cognitive impairments, which they measured through “quality of life exams,” a common well-known method. Both depression and cognitive impairments were observed in Van Gogh, according to the medical records written by Dr. Peyron. Further, individuals with schizophrenia lack empathy, are unable to understand what other people are feeling based on gestures, and have poor problem-solving skills (Couture et al., 2006). All of these symptoms were manifested by Van Gogh. Therefore, it is likely that he may have been schizophrenic, although there is no conclusive evidence to determine his neurological condition.
Now, as I continue walking towards the river in Arles, I see a replica painting of Van Gogh’s “Starry Night, 1889,” outside a gallery. This was a painting he made through his window when he was institutionalized at Saint Remy Asylum. Some people say that it was a visual hallucination because Van Gogh’s room did not have a view of the city and the trees were not shaped like flames, nor did the stars whirl as they appear in his painting. So, what was Van Gogh’s medical condition? The question remains unanswered, but if you asked me, I would say all signs point to schizophrenia.
Image of Van Gogh’s Starry Night 1889 painting.
References:
Couture, S. M., Penn, D. L., & Roberts, D. L. (2006). The functional significance of social cognition in schizophrenia: a review. Schizophrenia bulletin, 32(suppl_1), S44-S63.
Ebrahimpour, R., Babakhan, K., Arani, S. A. A. A., & Masoudnia, S. (2012). Epileptic seizure detection using a neural network ensemble method and wavelet transform. Neural Network World, 22(3), 291.
Guerreiro, C. (2016). Epilepsy: Is there hope? Indian Journal Of Medical Research, 144(5), 657.
Khoshbin, S., & Katz, J. (2015). Van Gogh’s Physician. Open Forum Infectious Diseases, 2(3), ofv088.
Liu, Y., Guo, X. M., Wu, X., Li, P., & Wang, W. W. (2017). Clinical Analysis of Partial Epilepsy with Auras. Chinese medical journal, 130(3), 318.
Pascal de Raykeer R, e. (2019). Effects of depression and cognitive impairment on quality of life in older adults with schizophrenia spectrum disorder: Results from a multicenter study. J Affect Disord. 256, 164-175.
Seidman, L. J., & Mirsky, A. F. (2017). Evolving notions of schizophrenia as a developmental neurocognitive disorder. Journal of the International Neuropsychological Society, 23(9-10), 881-892.
Van Gogh Museum. (2009, October). Vincent Van Gogh The Letters. Van Gogh Museum. Retrieved from http://vangoghletters.org/vg/letters.html
Paintings from:
Van Gogh V. (1889). The Starry Night. Retrieved from
https://www.vincentvangogh.org/starry-night.jsp
Van Gogh V. (1888). Café at Night. Retrieved from
https://www.vincentvangogh.org/cafe-at-night.jsp