City of Incurable Women

by Maud Casey

“Where are the hysterics, those magnificent women of former times?” wrote Jacques Lacan. Long history’s ghosts, marginalized and dispossessed due to their gender and class, they are reimagined by Maud Casey as complex, flesh-and-blood people with stories to tell. These linked, evocative prose portraits, accompanied by period photographs and medical documents both authentic and invented, poignantly restore the humanity to the nineteenth-century female psychiatric patients confined in Paris’s Salpêtrière hospital and reduced to specimens for study by the celebrated neurologist Jean-Martin Charcot and his male colleagues.

Genres: Historical Fiction, Fiction, Short Stories, Historical, Feminism, Audiobook, Literary Fiction

128 pages, Paperback

First published February 22, 2022

About the author

Maud Casey lives in Washington, D.C. She is an Associate Professor of English and teaches in the MFA Creative Writing Program at the University of Maryland. She also teaches in the low-residency MFA Program at Warren Wilson and was a faculty member at the Breadloaf Writers Conference in 2009.

She has received the Italo Calvino Prize (2008), the St. Francis College Literary Prize, a Guggenheim Fellowship, a 2008-2009 DC Commission on the Arts and Humanities Fellowship, and international fellowships from the Fundacion Valparaiso and the Hawthornden International Retreat for Writers.

Her essays and book reviews have appeared in The New York Times Book Review, Washington Post Book World, Salon, Poets and Writers, A Public Space and Literary Imagination.

Reviews

[Adrienne Blaine · Rating 3 out of 5]

I appreciate what the author was trying to do here in giving voices to the women who were locked up as hysterics in a Parisian mental hospital. But in blurring the lines between historical fiction and poet fabrication, I felt a little too lost to fully empathize. I love poetic prose, but the portraits of each woman were not distinct enough for me to be able to see them as individuals. I know that at times the author may have been trying to draw a red thread through the narratives, but for me it had the effect of flattening the experiences of these women into a single voice. It’s an interesting read and the photos and documents show the depth of the author’s research, but I think I personally would have preferred a non-fiction approach in this case.

[Sunny Lu · Rating 4 out of 5]

Feminist historical reimaginings in novellas are so important to me

[Nancy · Rating 5 out of 5]

There’s the story of your life and then there are the parts no one can ever know. Not even you.
from City of Incurable Women by Maud Casey

The hospital was a city unto itself, the largest asylum in Europe, comprised of women diagnosed as ‘incurable’ hysterics. The medical professionals took advantage of this endless supply of powerless women, conducting experiments, which they photographed. They had their ‘favorite’ women who could hold a pose for the required length of time to expose the photographic plate, some patients becoming actresses to obtain attention and preferential treatment.

Each woman was photographed at admittance, a card created describing her physically and her ailment.

The doctors experiments were bizarre. They inscribed words and dates upon their skin and photographed the raised lesions. They set the women in a bed and photographed them in ‘ecstasy.’

The effects of poverty, tragedy, and trauma were diagnosed as hysteria. Ovarian compression was one treatment. After all, female hormones were the cause of hysteria.

I read Maud Casey’s The City of Incurable Women in one sitting. Casey has given voices and stories to the women in the photographs, unforgettably haunting and poetic. The photographic images of the women, their records, and paintings depicting the doctors studying the women, remind that this may be fiction, but these were women and girls who lived and suffered. Girls born in poverty, girls who were sexually assaulted, orphans.

In the before, we were all kinds of girls. A daughter, for example, who missed 150 days of school because of bad reading habits[…]one of the twenty-one moral causes of death, alongside nostalgia, misery, love, and joy.

from City of Incurable Women by Maud Casey
Casey reminds us of centuries of women who were treated without compassion. “We were saints. We were witches. We were burned at the stake. We are on fire still,” she concludes. It sends shivers up my spine.

I have chosen female doctors for thirty-five years. I can only imagine how the treatment of female patients would have been different had more women been allowed to practice in the 19th c. And, although important advances did come out of this hospital, science–even faulty theories–compressed compassion and skirted psychological insight. These women were human Guinea pigs and valued only as test subjects.

This beautifully written, haunting novel gives voice to a few women of the millions throughout history who were marginalized and shut away. It is staggering to consider.

I received an ARC from the publisher. My review is fair and unbiased.

[Irmak ☾ · Rating 2 out of 5]

interesting concept but didn't captivate me enough.

[BAM doesn’t answer to her real name · Rating 3 out of 5]

I'm not really sure what I think about this book?

[Kathleen · Rating 4 out of 5]

My review for the Minneapolis Star Tribune: https://www.startribune.com/review-ci...

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.

[Trista · Rating 2 out of 5]

2.5 stars. Okay… where to start… Despite my rating, I actually did kind of like this book. The prose was actually excellent. I found the writing to be very thought provoking and powerful. My gripe happens to be with the length, the structure and the overall flow of the piece. The novel doesn’t have one specific narrator. It’s supposed to be about all women that have suffered at the hands of these French women’s asylums throughout history (or so I’ve surmised).

The POV bounces from narrator to narrator. Most of them are the women. A few are doctors or various other predatory people involved. Some of these stories are told in third and even second person, but most are told in first person with very little in the way of transition so everything kind of blends together. The individual womens’ stories kind of start blending together too, which I could argue was intentional(?) albeit not very impactful from the storytelling perspective. That was kind of the main issue. Nothing really stood out. The narrative had no buildups, peaks or valleys. It was all just a bunch or terrible trauma and neglect and sexual abuse dumped out into a huge pile for the reader to sort through. No one particular story stood out. The women also seemed to also state their unfortunate circumstances in really alarmingly nonchalant ways. It was all trauma and beautiful imagery and nonchalance. It was too heavy-handed and lacked the impact it was seeking to impart.

I feel the spirit of this story would have been better represented in a short story instead of a novella. It seemed like the author was literally just trying to cram in everything she’d learned from her research and had so much great writing (prose-wise) that she couldn’t kill any of her darlings. If this piece were edited well and had more of a cohesive, decisive feel, with more emotional dynamics rather than that of just trauma, it would have helped to illicit the sincere longing of the women in institutionalized peril and what they’d endured. We get to know what happened to them, but we hardly get to know who they are or what they felt. It was like trying to glean a picture from a negative. The details were there, but the viewer doesn’t perceive the impact of them.

[Scarlett Readz and Runz....Through Novel Time & Distance · Rating 4 out of 5]

Oh, the fallacies of women's hysteria!
Quite an interesting read that delves into the medical field at its emergence of psychology through documenting cases of women during tests, trials and captivity in facilities. Alluding to more sinister practices and the inexplicable, perplexity of female creatures aflicted on the not so domestic side of life with some eccentricities, they endure constant societal judgement and so forth. There isn't a climax to this story but it is told from a fictional character's pov and her experiences through youth while offering her mind to the reader in a world where her family doesn't want her anymore, stirred up with her keen observations of the men in the medical field, as she navigates the path of least resistance and isn't the least unaware of how she is being taken advantage of.

Nove and quick read!

[saflori · Rating 3 out of 5]

This book consists of short stories of famous ‘hysterics’ (as these women were called) written in a style that makes it as though the information expressed is from their personal accounts. This made the reading experience more emotive and anguished. The strength of the book didn’t come from the writing style for me, as I was more so fascinated and taken by the history and truth of these women rather than the rhetoric. The book lacked context in places, as it could have included footnotes about these women or the places they were in or captions underneath the images.

[Corrie · Rating 5 out of 5]

I both listened and read City of Incurable Women by Maud Casey on Scribd (both versions are available) to get the best experience as the book contains photographs and records you would otherwise miss. The narration of Hope Newhouse (her flawless French made my jaw drop) is such a treat. She gave an utterly brilliant performance.

This novella is part fiction and part fact as it explores a world inspired by 19th-century female psychiatric patients who, diagnosed with ‘incurable’ hysteria, were confined in Paris’ Salpêtrière hospital. These women and girls were reduced to specimens for study by the celebrated neurologist Jean-Martin Charcot and his male colleagues.

What was said about the book:

“In exquisite prose, Maud Casey has built a city inside a book, a city that is a hospital, a museum, a dance, a body in ecstasy just outside the frame. On every page of this achingly beautiful book, Casey brings a wise and feral attention to the so-called incurables of the ‘era of soul science’—Augustine, Louise, Marie, Geneviève, and a chorus of nameless others singing their private beginnings and public ends.”

“Lyrical. . . . Through thorough research and a cutting pen, Casey elevates these women back to their deserved place in history, bringing to life those who were reduced to mere photographs.”

5 Stars

[Zen · Rating 4 out of 5]

This was interesting, humanizing the stories in these pictures and medical records shown in this novel.

[Kathleen · Rating 2 out of 5]

Disappointing. I had high expectations based on several reviews. "The Woman They Could Not Silence" was non-fiction, more readable, and more enlightening on the treatment of women in asylums.

[Ms. Dana · Rating 3 out of 5]

I read this one a little bit at a time. I like what the author was trying to do but I didn't love it. Using photographs and records from a Paris asylum, Casey built stories around each woman who was locked up for "hysteria". It was definitely dark, but so was the material she was pulling from. I think I would have enjoyed it more had it been more of a concrete story, and I didn't really care for the poetic / stream of consciousness style.

To note: I can see why the author chose this style, because each individual story became one story, illustrating how all women had experienced this as a collective, and how little the doctors of the time concerned themselves with their experiences.

[Annie · Rating 3 out of 5]

Maud Casey’s The City of Incurable Women brings me back to an old fascination of mine: the women incarcerated at the Pitié-Salpêtrière Hospital after being diagnosed with hysteria and other related maladies. Casey’s unusual book blends contemporary photos and doctors’ notes with fictional passages that give voice to women who bore their society’s expectations of their gender and their projected fears of women who broke those expectations. This is not an easy book to read—due to the subject matter and the experimental writing style—but I found it fascinating...

Read the rest of my review at A Bookish Type. I received a free copy of this book from the publisher via Edelweiss, for review consideration.

[Jennifer]

I liked the premise of this book and the addition of pictures and clippings, but the stories were unremarkable and forgettable. It is a short book and I gave up half way because I didn't remember any of the previous stories.

[Adhima Ratnaningtyas · Rating 3 out of 5]

The writing was so so so beautiful, but I think this book lacked focus on what it wanted to deliver, so everything felt less impactful for me. 3 stars!

[Liz Mc2 · Rating 4 out of 5]

For Freud, the hysteric's symptoms were a form of indirect expression of the unconscious, and Casey's book (a novel? a series of short meditations?) also struck me as indirect. The narrators, 19th century patients in Paris' Salpetriere, often speak through images, allusions, repetitions. It's a dreamy, lyrical book, far from a straightforward historical (I first typed hysterical, surely a Freudian slip of the fingers) narrative, despite the real and fictional documents and images in these pages. What emerges is both the women's helplessness--they are subject to their symptoms, to abuse by men in their lives "before" the hospital, and to abuse of various kinds by doctors--and the power they gain from their incurable symptoms. The "best" girls learn to make their illness and their bodies speak in the way the doctors desire, get special privileges, "perform" in the amphitheatre. They are more or less imprisoned, but they have also escaped the hardships of their working class lives and written a new story for themselves. They have learned, perhaps, to "enjoy your symptom!" Enjoy Your Symptom!: Jacques Lacan in Hollywood and OutI found this book fascinating, but I'm not sure what I would have made of it if I hadn't read a fair amount of psychoanalytic theory in grad school. (Many years ago and I'm no expert, but still).

[Jim · Rating 4 out of 5]

Depending on my mood, this book could have been 5 stars or just 2, maybe a DNF, so I can understand the divided opinions. I though the layout was awkward. I do love old pictures, and old documents, though their interweaving here lacked aesthetics. Silly complaint, but one all the same. The writing is wonderfully emotive, and dreamlike in places, in others the narrative shifts to a more modern aspect which increases the intensity and focus powerfully. The fictions take on their own lives, never losing their timeliness, but still reaching and hoping, which for women knows no place or time. Yes, men still feel the need to control women in all aspects of their being, sadly, this has not changed at all. Casey brings that to the fore repeatedly, but with such skillful use of language, cadence, and repetition as to make it sing with joy and desire and want. A beautiful creation that speaks volumes, even in so few pages.

[Dana Grimes · Rating 3 out of 5]

I read this one a little bit at a time. I like what the author was trying to do but I didn't love it. Using photographs and records from a Paris asylum, Casey built stories around each woman who was locked up for "hysteria". It was definitely dark, but so was the material she was pulling from. I think I would have enjoyed it more had it been more of a concrete story, and I didn't really care for the poetic / stream of consciousness style.

To note: I can see why the author chose this style, because each individual story became one story, illustrating how all women had experienced this as a collective, and how little the doctors of the time concerned themselves with their experiences.

[Sarah W. · Rating 3 out of 5]

*I received this book through LibraryThing Early Reviewers.*

This brief volume is centered around the fictionalized women who were psychiatric patients at the Salpetriere hospital in Paris. One of the most interesting things included in this book are the 19th-century photographs and snippets of documents which add layers to the stories and a visual sense of what the world was like for the women depicted. I can't say I really liked this book, but it did provide insight into a world I had rarely encountered previously.

[Ella · Rating 5 out of 5]

The before, the just before, and the centuries of just before. A door swings open. We were saints. We were witches. We were burned at the stake. We are on fire still.

I see Maud Casey is definitely up on her Luce Irigaray. It’s like someone turned the La Mystérique into a prose poetic novella.

[Skailer · Rating 3 out of 5]

Conceptually I really like this collection, and there were pieces of it that felt deeply spiritual and moving. However, as a whole, without additional historical information, I personally struggled to connect these written portraits with the actual experiences of these women (and the experiences these women were based on).

[Emma · Rating 2 out of 5]

I liked the content and idea behind this book but the execution and writing style weren't for me. I found it tedious and confusing. I understand what the author was trying to accomplish but in my opinion she didn't execute it all that well.

[Elena · Rating 3 out of 5]

I’ll read anything sigrid nunez tells me to but this got a little too abstract at times for me to follow individuals. disturbing history overall though

[JP · Rating 2 out of 5]

Meh barely scratching the surface of interesting. Potential lost.

[Connie · Rating 4 out of 5]

Fascinating. Lyrical, dreamy prose invites the reader to feel as these women feel. More questions than answers. Jane Avril rising from the ashes. For me, a blending of Alias Grace by Margaret Atwood and Asylum from American Horror Story and my own forgotten great aunt.

[Pat · Rating 3 out of 5]

This small unique book recounts some of the tragic stories of marginalized women committed to Paris' Salpetriere insane asylum in the 19th century. Through medical documents and photographs, their histories unfolded as male doctors treated them in unconventional, bizarre ways. One treatment was ovarian compression, hailed, unbelievably, as innovative and effective. Many of these patients were orphans or products of a dysfunctional, poverty-stricken home life. Some had been sexually assaulted and others were incarcerated for seemingly innocuous reasons like bad reading habits.

Although fictionalized, Maud Casey has cast a light on an unimaginable period in mental health history. The stories are haunting and profound. My thanks to LibraryThing and the publisher for the opportunity to read this book, which I may have overlooked and serves as a poignant reminder of how far the treatment of real mental illness has come.

[Eavan · Rating 4 out of 5]

"The luxurious pain of a body in the throes of its symptoms has been likened to a dance, and when she, a dancer, was a body in pain, it was something to behold."

I’ve written and re-written this review too many times for what it’s worth. I’ll keep it like this:

Maud Casey writes a compelling and emotional look at the lives of women diagnosed with hysteria who passed through the gates of the Salpêtrière hospital. Casey and I have obviously read Charcot's original publications and its interpretations by Didi-Huberman, seen the sometimes horrific, sometimes beautiful images of the women, and we've come to almost the same conclusion: these women were trying to survive trauma and retraumatization every single day.

Casey writes the story through a very thoughtful stream of consciousness. She brings us into the tattered and disjointed mind of a sufferer, shows us the attempt to articulate the depths of pain, and soaks its entirety in anger. The author heightens this sense of internal mess with photographs, case notes, and an array of medical quotes on the matter, and it is brilliant. Maud, I say you have it down.

Why? Well, I know I’ve spent the last few years trying to articulate what happened to me, and I still haven't figured it out. Maybe I never fully will. All I know was that I was diagnosed with conversion disorder after having episodes similar to some described by Charcot in his case notes. I've seen the early photos of these women—the really horrible ones that are not posed before Londe was able to put his damned studio inside—and it's like a mirror. It is terror, pain, anger, disgust, shame—It is not understanding why your brain is melting and you can no longer control your body. It is red. Blood red. (And there's always a doctor around, and he never knows what's really going on.)

I appreciated immensely Casey's ability to discern the layered acting that I believe occurred in the hospital, and to treat it kindly. In City of Incurable Women, the hysterics know they have to put on a show sometimes. They are put in front of important men and expensive cameras and learn very quickly the way psychiatric hospitals operate (hint: they are a lot like prisons). These wards are an internal city built by intricate networks of prestige and privileges, and the women of the Salpêtrière were no different.

What I am intrigued by more than anything, and what I wish the author would have discussed, is what exactly that line was. Patients came in with somatic symptoms and obviously kept having them—the things needed to heal were not easy to acquire there. Things like physical and emotional safety, cognitive behavioral therapy, and fuck, even some lithium from time to time just weren't happening. You stick a bunch of girls with PTSD or epilepsy or psychosis in a room, let male doctors touch them wherever they want whenever they want, barely feed them, barely let them outside, and at some point, it is simply a testament to survival.

Anyways, I loved this little thing, and it's helped me figure out how I can write again after being so sick. Stuff like this warps the head and makes you realize a lot of stuff you thought mattered really doesn't. Maud Casey understands that. I like that.

[heptagrammaton · Rating 5 out of 5]

Indefatigable. Mind-burrowing, slippery as a maggot in the flesh and hard as a drill boring through a skull. Full of melancholy as a kind of retrospective dread, the helpless recognition; the object of the female body bent to breaking as a rafter to support the world, vivid and aching, half history and half that-which-could-never-be-history-because-it-is-not-written.

In other words; this fucked me up in the best ways. The faceless old woman in my head, who sits on an iron-hot stove and subsists only on moldy archival paper, approves heartily.

[Gwyneth · Rating 5 out of 5]

Filled with the feelings and emotions of being woman and sharing the female identity with all women. Poetically beautiful prose in many voices that all feel personal and coming from inside myself.