Doctor's Review: Medicine on the Move

October 23, 2021
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Artfully insane

Vincent van Gogh was certainly skilled... and possibly a little psychotic too

It's been nearly 120 years since Vincent van Gogh painted his iconic Sunflower series. The canvases, reminiscent of the late days of summer, examine the blooms in various

stages of life and decay. The artist's revolutionary use of colour, yellow in particular, may be the defining feature of his life's work, though his ability to evoke intense emotion using the simplest of subjects is perhaps just as significant. Like his beloved blossoms, Van Gogh's mind was in a perpetual state of change.

Van Gogh once wrote, "the sunflower is mine in a way." If only he had felt so strongly about his ear, part of which he so famously lopped off after an argument with Gauguin in 1888. What would prompt someone to do such a thing? Since his death in 1890, literally hundreds of medical historians and psychiatrists have posited theories as to what drove the brilliant artist insane. Whatever it was that pushed him over the edge, Van Gogh has become the archetype for the mad artist, whose genius was too great for his mind to bear.


Vincent was born on March 30, 1853 to Anna Cornelia Carbentus and Reverend Theodorus van Gogh in Groot-Zundert, the Netherlands. Little is known about his interest in art or his propensity for painting as a child, but his first official foray into the art world occurred at the age of 16 when he was apprenticed at the Hague gallery run by the Paris-based international art dealers, Goupil & Cie. After being shuffled around to various galleries for the next seven years, Vincent finally decided to quit art sales and enter the clergy, motivated by his love of the Bible and his desire to do some good. However, his obsessive tendencies soon became clear; the young preacher was a bit too zealous, prematurely starting his own ministry, rejecting all worldly possessions and living like his poor parishioners. Eventually, he was fired by the church.

The year was 1881 and he was already 27 years old. With few employment prospects and encouraged by his brother and best friend Theo, who also worked for Goupil & Cie., Vincent decided to try his hand at art, despite his lack of formal training. He moved to Brussels and, supported by his family, began taking classes at the Royal Academy of Art. Their trust in him was soon rewarded: Vincent showed remarkable promise. He painted with an undeniably unique style, achieving striking effects from average subjects. He travelled some and found peasant life to be his greatest inspiration.

The Potato Eaters (1885) is universally acknowledged as his first major work, but at the time it wasn't exactly received as a success. In his personal life, too, the veneer was beginning to crack. Though always prone to drama and intensity, Vincent's behaviour became more and more erratic. He allegedly fathered a child or two with a notorious alcoholic prostitute and argued constantly with his parents (who were less than thrilled about the prospect of supporting his unseemly girlfriend and her illegitimate offspring). Eventually, Vincent left her and moved to Brabant in the Netherlands in 1883, where his parents were living. He became incredibly prolific during this time, churning out dozens of canvases and seemingly endless drawings and sketches.


A couple of years later Vincent moved to Antwerp in Belgium, where big city life lifted his spirits somewhat, but also introduced him to a new problem: absinthe. Van Gogh drank heavily during this time, smoked like a fiend and led a generally debauched lifestyle, enjoying the company of prostitutes and badly neglecting his health. Though in Antwerp he received inspiration and further training, his time in the city also left him with syphilis. In 1886, he moved to Paris to be with his brother. Guided by Theo, who tried to sell Van Gogh's canvases in his Montmartre gallery, Van Gogh began to leave the darker colours he favoured for the brighter hues of the popular Impressionists.

In Paris, he came into his own, developing his new palette, refining his personal style and technique, meeting friends like Gauguin and Toulouse-Lau¡trec, and painting many famous canvases, including his self-portraits. He moved to Arles in the south of France in 1888, hoping to establish an artists' community there. As a gift to welcome Gauguin, Van Gogh painted his Sunflowers to decorate his friend's bedroom. In Provence, Van Gogh produced some of his most beloved and brightest work. He painted obsessively for months on end, inspired by the light and beauty of the country.

His mind, however, was not as sharp as his artistic eye. Drinking and smoking incessantly, he began to experience delusions and seizures, in what many at the time attributed to epilepsy. His friendship with Gauguin ended on December 23, 1888 when Vincent threatened him with a knife, the culmination of months of arguing about art and Vincent's fears that Gauguin would abandon him, which he promptly did. Destitute and alone, Vincent sliced off part of his own left ear, wrapped it in newspaper and offered it as a macabre gift to a prostitute named Rachel. Pretty soon, Vincent was institutionalized back in Arles so his brother could keep a closer eye on him. He was plagued by manic episodes, disturbing visions and paranoia, believing he was being poisoned.


Van Gogh would be in and out of mental institutions for the rest of his life, alternating between bouts of psychosis and relative normalcy. In 1889, he committed himself to one such asylum in Saint Rémy, back in Provence. Here, he painted mostly in a very distinct swirling, tremulous style, one characterized by his masterpiece from this time, The Starry Night. He was permitted to use an empty cell as an atelier and painted what he could see out the window and what he could remember, sometimes copying other painters' works for lack of visual inspiration of his own. When he was well, he was allowed to walk the grounds and paint outside. At one time, however, after he tried to kill himself by eating paint, his doctors restricted him to drawing. Despite these adverse conditions, Van Gogh arguably created his best works at Saint Rémy.

Although he left the institution in 1890, he was obviously still not well. He entrusted himself to the care of a doctor in Auvers-sur-Oise recommended to him by Camille Pissarro, Dr Paul Gachet. Gachet was a bit of a lunatic and an ama¡teur painter himself, and despite the fact that Van Gogh cared for him deeply, the man was not able to do much to improve his patient's condition. During the two months he spent with the doctor and despite enjoying a brief period of calm, Van Gogh suffered from increasing alcoholism, depression and delusions.

Though he had lived and painted in relative poverty and obscurity for many years, Van Gogh's work was finally garnering serious attention. Monet himself praised him and several critics hailed him as a genius. But it was too little, too late. Of the 900 or so canvases (and 1100 drawings and sketches) he is known to have created, Van Gogh sold only one painting in his life -- The Red Vineyard -- even though his brother tried his best for years. It would have been enough to push a far lesser man over the edge.

One afternoon, Van Gogh walked into a field in Auvers-sur-Oise, shot himself in the chest and died two days later on July 29, 1890. He was only 37 years old and believed he was a failure as an artist and a man. The field was one he had painted earlier in the month in the foreboding Wheatfield with Crows, in which three separate paths diverge into the wheat under a sky of brooding black birds.


So many theories have been put forth to explain the madness of the man, including porphyria, schizophrenia, tertiary syphilis, lead poisoning from eating paint chips and that psychiatric catch-all, bipolar disorder. Of them, one of the favourites is absinthe toxicity since it could explain his predilection for yellow and his deteriorating mental state.

Absinthe, taken in great quantities (which was certainly the case with Van Gogh) may result in xanthopsia -- an optic condition which imparts a yellowish-greenish tinge to the vision. Xanthopsia is also caused by too much digitalis, the active ingredient in the digoxin Van Gogh may have been prescribed to treat his purported epilepsy.

Indeed, many believe that Van Gogh's physical and mental problems altered his perception and therefore were at least partially responsible for his painting style. The stylized rings and swirls characteristic of his technique in The Starry Night, for example, which he painted in 1889 while in Saint Rémy, could have been influenced by the visual halo effects of Van Gogh's drinking and drugging.

It is unlikely, though, that the exact nature of Van Gogh's madness will ever be known. He believed that without his work, he would have gone completely insane, having once said, "It is only too true that a lot of artists are mentally ill -- it's a life which, to put it mildly, makes one an outsider. I'm all right when I completely immerse myself in work, but I'll always remain half crazy." Thankfully, despite his colourful personality, the true legacy he leaves is on canvas.


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