Are You a Doctor, Sir?
Rodney Graham
Oct 31 — Nov 18, 1989

The Or Gallery is proud to present Rodney Graham’s solo exhibition Are You a Doctor, Sir? The exhibition is constructed around a lecture on Sigmund Freud and pays tribute to the fiftieth anniversary of Freud’s death.

Catalogue Essay by Rodney Graham

Two Sources for a Possibly Fictional Element in Freud’s “Katharina” Case-study
R. Graham

In his case-study “Katharina” from Studies on Hysteria, Freud conducts an analysis of an 18-year-old patient suffering from ‘‘virginal’‘ anxiety.l In a single sessions he is able to relieve the girl of a complex of symptoms (vomitting, fainting spells, recurrent hallucinations) brought on by an attempted seduction by her uncle. The substance of the analysis is unremarkable, but its site is curious: a mountain-top in the Austrian Alps.

In the summer vacation the year 189- I made an excursion into the Hohe Tauern so that for a while I might forget medicine and, more particularly, the neuroses. I had almost succeeded in this when one day I turned aside from the main road to climb a mountain which lay somewhat apart and which was renowned for its views and for its well-run refugee hut. I had reached the top after a strenuous climb and, feeling refreshed and rested, was sitting deep in contemplation of the charm of the distant prospect. I was so lost in thought that at first I did not connect it with myself when these first words reached my ears: ‘Are you a doctor, sir?’ But the question was addressed to me and by the rather sulky-looking girl of perhaps 18 who had served by meal and who had been spoken to by the landlady as ‘Katharina’. To judge by her dress and her bearing, she could not be a servant, but a daughter or relative of the landlady’s.

Coming to myself I replied: “Yes I’m a doctor, but how did you know that?”

“You wrote your name in the Visitors’ Book, sir. And I though if you had a few minutes to spare… The truth is, sir, my nerves are bad. I went to see a doctor in L- for them and he gave me something for them; but I’m not well yet.”

So there I was with the neuroses once again – for nothing could very well be the matter with this strong, well-built girl with the unhappy look. I was interested to find that the neuroses could flourish in this way at a height of over 6,000 feet. I questioned her further.2

Freud alludes to the session in a letter to Fliess from the mountain resort of Reichenau, dated August 20, 1893. “Recently I was consulted by the daughter of an innkeeper on the Rax,” he writes, “lt was a nice case for me.“3 He does not elaborate on the analysis in the letter, but he does report what he calls a “piece of home psychology” containing a strange echo of the account of his surprize encounter with Katharina:

I spent the 18th and 19th on a complicated tour around and on Mount Rax with my friend Rie and yesterday sat in a cheerful mood in the new hut on the mountain when suddenly someone entered the room, completely flushed with the heat of the day, whom initially I stared at as an apparition and then had to recognize as my wife.4

It seems that Freud’s wife, Martha, not normally fond of climbing, had on this day followed her husband to the summit where her sudden and unexpected appearance caused him to experience a momentary feeling of disbelief. Such a feeling, the sensation that “What I see here is not real”, was later to be do-scribed by Freud as ‘derealization’ (Entremdugesfuhl). According to Freud, phenomena of derealization serve the agency of defence-repudiating or warding off a piece of reality to which the ego is hostile – by ‘falsifying’
the offending stimulus. In ‘“A Disturbance of Memory on the Acropolis”, the 1936 paper which theorizes the concept, Freud draws from his own experience -ironically, the fleeting sensation of unreality he experienced in Athens upon first sur veying the view from the summit of the

If Freud never ventured an interpretation of his earlier serialization at the top of Mount Rax, this may be due to the veil of discretion he invariably cast over his relations with Martha in his published writings.6 Yet, it is possible that unanalyzed material bearing on this incident found its way into the Katharina analysis, and that the case-study has been embroidered with a kind of
novelistic fiction based on Freud’s surprize encounter with his wife. Could it be that Freud found himself pursuing a literary by-path here, and that it is not a physician but a writer who speaks in the opening paragraphs of the “Katharina” case-study?

Katharina herself first appears as a disembodied voice, posing the question which shatters Freud’s poetical reverie and returns the vacationing physician to his calling: “Are you a doctor, sir?“7 Those familiar with Le Spleen de Paris may have already heard an echo of a question once directed, quite unequivocally, to a poet:

As I was nearing the edge of the suburb, walking under the gas lamps, I felt an arm being slipped into mine and I heard a voice in my ear say, “Are you a doctor, sir?”

I looked; it was a tall, robust young woman with very wide-open eyes, hardly any make-up, and long hair flying in the breeze with the strings of her bonnet.8

“No, I am not a doctor, so kindly let me go” replies the narrator of Charles Baudelaire’s 1867 prose poem “Madmoiselle Bistouri” (Miss Lancet). Nevertheless, motivated by the hidden promise of her invitation – she is evidently a prostitute – he follows the strange woman to her home to be pampered, offered drink and cigars, and shown portfolio illustrations and photographs of famous doctors.

“When we meet next time, you’ll give me a photograph too, won’t you darling?”

“But,” I said, also pursuing my idée fixe, “why do you think I am a doctor?”

“It’s because you’re so sweet and good to women.”

Mademoiselle Bistouri was a fictional version of a real, though somewhat older woman; a Parisian figure of the day dubbed ‘La Mère Bistouri’ by the doctors of the Hôtel Dieu where she was a regular fixture.9

It is his passionate love of mystery (for, he says, “I always hope to find the solution”) that directs Baudelaire to the origin of Mademoiselle Bistouri’s obsessive idea. I shall not be the first to note the uncanny anticipation of Freud’s therapeutic technique (precisely the cathartic method of the Studies) in the question Baudelaire finally asks of her: “Exactly when what it, how long ago, when you first felt this particular urge?” (italics mine).10 The poem ends, the analysis breaks off, with the silence which marks Mademoiselle Bistouri’s confrontation with what Freud will later call the resistances.

Freud often spoke of his literary precursors. Did he know this poem? I think it is likely. I find it likely as well that he was listening to Baudelaire’s voice when he composed the account of his meeting with Katharine. A speculation : does Freud’s literary fiction (and his erotic phantasy) super-impose two unexpected encounters – the doctor with his wife, the poet with the ‘prostitute’? And, does the path which carries Freud away from the main road suggest the destination to which perhaps all narratives lead, and the fulfillment of the promise which all narratives hold out – a seduction?

-Rodney Graham

Edited by William Wood
Published by the Or Galled Society with the financial assistance of The Canada Council
Vancouver 1990
ISBN 1-895006-00-0
Copyright @ 1990 Rodney Graham and the Or Gallery Society

1. Sigmund Freud, “Katharina——”, in Josef Breuer and Sigmund Freud, Studies on Hysteria, The Standard Edition of the Complete Psychological Works of Sigmund Freud, ed. and trans., James Strachey and Anna Freud (London: Hogarth Press and the Institute of Psycho-analysis, 1955), vol.II, 125-134. Hereafter cited as S.E.
2. Op. cit., 125.
3. Jeffrey Moussaieff Masson, ed. and trans., The Complete Letters of Sigmund Freud to Wilhelm Fliess (Cambridge, MA: The Belknap Press of Harvard University Press, l985), 54. Freud has transposed the setting of the analytic session from the Raxalpe near Reichenau, just southwest of the Vienna Woods, to a peak in the Hohe Tauern, a much higher mountain range in south-central Austria near the Italian border. For geographical specifics see Karl Baedeker, Austria, Together with Budapest, Prague, Karlsbad, Marienbad, 13th ed. (Leipzig: Karl Baedeker, 1929), 179 and 239.

A footnote added to the case-study by Freud in 1924 – which admits to a ‘discretionary’ falsification – is interesting in this regard: “I venture after the lapse of so many years to lift the veil of discretion and reveal the fact that Katharina was not the niece but the daughter of the landlady. The girl fell ill, therefore, as a result of sexual attempts on the part of her own father. Distortions like the one which I introduced in the present instance should be altogether avoided in reporting a case history. From the point of view of understanding the case, a distortion of this kind is not, of course, a matter of such indifference as would be shifting the scene from one mountain to another.” See S.E. II, 134.

4. Freud to Fliess, August 20, 1893, in Masson, page 53.
5. Sigmund Freud, “A Disturbance of Memory on the Acropolis: An Open Letter to Romain Rolland on the Occasion of His Seventieth Birthday”, trans., James Strachey, in James Strachey, ed., Sigmund Freud: Collected Papers (New York: Basic Books, 1959), vol. V, 303-312. Freud’s sensation of unreality was an act of unconscious filial ‘‘piety’‘ repudiating the fact that he had ‘gone further’ than his father by attaining Athens.
6. There is, however, additional material in Freud’s August 20th letter to Fliess that could, perhaps, form the basis for an interpretation of the incident. Freud introduces the story of his surprize encounter with his wife by way of introducing the reason for his cancellation of a planned “congress” with Fliess in Csorba. Martha, following a domestic upheaval, wanted to spend a few days with him on the mountain arid Fraud felt obliged to grant her this wish.

He rather stresses the sense of obligation and continues by reminding Fliess that he and Martha are living “in abstinence”, adding: “And you know the reasons for this.” These cryptic remarks suggest that affect-laden material bearing on his and his wife’s sexuality perhaps lay behind Freud’s derealization on the Rax. Here I am struck by the element of contrast in Freud’s description. Martha appears before him as vivid, sanguine (“flushed with the heat of the day”), yet is also ghost-like, unreal (“whom I initially stared at as an apparition”). Could it be that Freud’s observation regarding his wife’s sanguinary and his attendant judgement regarding her lack of reality betray a causal connection? Could it be that the judgement sought to ward off something which a flushed appearance often signifies – i.e. sexual excitement – and that what Freud’s derealization falsified was his wife’s desire?

7. It is in fact incorrect to speak of medicine as Freud’s calling since, by his own admission, he never felt any real vocation to medicine. In the 1926 “An Autobiographical Study” (commissioned for a series of accounts by prominent medical researchers), Freud describes medicine as part of a “life-long detour” through the physical sciences and away from the “great cultural issues” which fascinated him as a child (and to which psychoanalysis was to lead him back). In “An Autobiographical Study”, he attributed his decision to take up medicine as a career to the emotions aroused in him by a public reading of the essay “Fragments über die Natur“, inaccurately attributed to Goethe. This romantic, pantheistic essay describes a feminized nature, likening its revelation to the unveiling of Isis. Incidentally, it is curious to compare the noble sublimation of the essay to the ‘profane’ reflections on medicine found in Act 1, Scene IV of Goethe’s Faust – for Freud cites this, the so-called “Student Scene”, in the next paragraph of in “An Autobiographical Study”. In this scene, Mephistopheles, disguised in Faust’s professorial robes, dispenses advice to a wayward student; after successively rejecting careers in law, theology, natural science and metaphysics, the student becomes confirmed in his vocation only after Mephistopheles points out the sexual opportunities opened up by the career of a physician:

And give the women special care;
Their everlasting sighs and groans
In a thousand tones
Are cured at
one point everywhere.
And if you seem halfway discreet,
They will be lying at your feet.
First your degree inspires trust.
As if your art had scarcely any peers;
Right from the start, remove her clothes and touch her bust,
Things for which others wait for years and years.
Learn well the little pulse to squeeze,
And with a knowing glance you seize
Her freely round her slender waist
To see how tightly she is laced.

See Walter Kaufmann, Goethe’s “Faust”: The Original German and a New Translation (New York: Doubleday, 1961), lines 2021-2036, 205-207. The relevant passage of Freud’s “An Autobiographical Study” is S.E. XX, 8-9.
8. Translation by author from Anonyme roman, Jan Vercruysse, introduction, Spleen de Hambourg (Brussels: Yves Gevaert Éditeur, n-d. [1985]), unpaginated. See also, Y.-G. Le Dantec and Claude Pichois, eds., Baudelaire: Oeuvres complètes (Paris: Editions Gallimard, 1961), vol. 1, 300. Hereafter cited as O.C.
9. Robert Kopp, in his critical edition of Petit Plumes en Prose, quotes an article by Adrien Marx from L‘Époque of January 30, 1866, which describes “La Mère Bistouris”. See, Charles Baudelaire, Petit Poèmes en Prose, Robert Kopp, ed. (Paris: Librarie José Corti, 1969), 347-8.
10. “Peux-tu te souvenir de l‘époque et de l’occasion où est née en toi cette passion si particulère?O.C., 303. Kopp comments : “La psychanalyse freudienne ne cherce pas autre chose!“, op. cit., 349. See also Freud’s milder formulation in “Katharina”: “Frâulein Katharine, if you could remember now what was happening in you at the time, when you had your first attack, what you thought about it – it would help you.’ “ (S.E. II, 128), and the basic justification for the cathartic treatment of the Studies in Freud and Breuer’s “Preliminary Communication”: “For we found, to our great surprize at first, that each individual hysterical symptom immediately and permanently disappeared when we had succeeded in bringing to light the memory of the event memory by which it was provoked and in arousing its accompanying affect, and when the patient had described that event in the greatest possible detail and had put the affect into words.S.E. II, 6 (italics in original).

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