Neurological Disorders in Famous Artists - Part 4. Группа авторов

      The Neurologic War Wound

As a volunteer, Céline joined the 12th Cuirassier cavalry regiment in September 1912. His initiation to military life was harsh, in particular because he had to learn how to ride a horse. He was promoted to brigadier in August 1913 and to maréchal des logis in May 1914 (Fig. 1).

Fig. 1. Louis-Ferdinand Destouches in his full-dress uniform, 1914 (public domain).

      When the war broke out, Céline moved with his cavalry regiment to the Meuse sector, in north-eastern France. He discovered the terrifying effects of modern warfare on a battlefield overflowed by the river Meuse: “I dive back into the corpses, the mud, the rain. In the Meuse, how dirty the path to glory is” [letter of September 25th, 1914; Céline, 2009, p. 112]. He quickly understood that the cavalry with its heroic charges had become out of place in this war.

      In early October, the regiment was transferred to the front of Flanders in the “race to the sea.” On this new battlefield where the first trenches appeared, the cavalry regiment of Céline fought more and more on foot.

      On October 25th, near Poelkappelle, on the battlefield of Ypres, Céline spontaneously volunteered to maintain the liaison between two infantry regiments. His right arm was wounded at around 6 p.m. as he was out of the trenches to transmit a divisional order to an infantry colonel. A few days later, Céline was mentioned in the dispatches of the 7th cavalry division with other soldiers: “(They) maintained the liaison between the 66th and the 125th infantry regiments in particularly dangerous circumstances. They came back to the regiment with the following citation by the head of the 66th: ‘They behaved as heroes’” [Archives de Paris, 1914].

      After his injury, Céline walked 7 km to the rear of the battlefield to find a first aid post. He was admitted on October 26th at the ambulance 3/9 set up in Ypres in Belgian infantry barracks [Service des archives médicales hospitalière des armées]. There, the fracture was reduced and Céline boarded a train destined to a military hospital in Dunkirk. However, because of violent pain in his arm, he got off the train at Hazebrouck station and was sent to the hôpital auxiliaire No. 6, set up in the Collège Saint-Jacques, where he was admitted on October 27th. Gabriel Sénellart (1880–1946), the civilian chief doctor of the hospital, performed surgery and removed the bullet from Céline’s arm. For this procedure, Céline refused anaesthesia because he was afraid of being amputated against his will. The bullet which hit him had been damaged and flattened by a first impact. This ricocheting bullet created a broad lesion in Céline’s arm [letter from Ferdinand Destouches of November 5th, 1914; Céline, 2009, p. 120].

      Paralysis of the forearm extensor muscles was confirmed by Dr. Sénellart. Over the following days, Céline started to complain of hyperesthesia in the radial nerve sensitive territory: “The bullet shattered the bone on 4 to 5 centimeters. However, it’s starting to heal. However, the nerves have been painfully affected” [letter of November 20th, 1914; Céline, 2009, p. 126].

      An evacuation towards a Dunkirk military hospital was planned but Céline’s father managed to organise a transfer towards a Parisian hospital for an electric treatment of the radial nerve paralysis. At the end of November 1914, after 1 month of convalescence in the hospital of Hazebrouck, Céline was transferred to the military hospital of the Val-de-Grâce in Paris. Céline’s uncle, Georges Destouches, the General Secretary of the Faculty of Medicine of Paris, was very helpful in this transfer.

      Céline was admitted into the department of Adolphe Jalaguier (1853–1924), one of the most famous surgeons of this time. He described Jalaguier in laudative terms: “Jalaguier with his beard, obviously an authority and a learned man! How many owe him their lives! Saved at the last minute… Particularly gentle with us, and such dexterity, such boldness […] We won’t see another hand like this one” [Céline, 1974, p. 913].

In the Val-de-Grâce hospital, Céline met the sergeant Albert Milon (1890–1947), who was suffering from a severe chest wound (Fig. 2). They established a close friendship. Milon was a model for Brandelore in Voyage au bout de la nuit (Journey to the End of the Night). During his stay in Val-de-Grâce, Céline received the Médaille militaire.

      The Radial Nerve Surgery

      According to a letter written by one of his Hazebrouck hospital nurses, Alice David (1874–1943), with whom he had an intimate relationship, Céline should have been operated for his radial paralysis at the Val-de-Grâce hospital [letter from Alice David of December 29th, 1914; Céline, 2009, p. 130]. He refused the procedure, probably fearing an amputation.

Fig. 2. Louis-Ferdinand Destouches (with his Médaille militaire) with Albert Milon (with crutches) in the Val-de-Grâce Hospital (Paris), December 1914 (public domain).

On December 27th, 1914, Céline was transferred from the Val-de-Grâce hospital to the hôpital auxiliaire 47 located on boulevard Raspail in Paris, where he refused again the surgical procedure suggested by Doctor Édouard Le Bec (1851–1941) [Gibault, 1985, pp. 157–164]. He was then rapidly sent to Paul-Brousse Hospital in Villejuif on December 31st. Albert Milon made the same journey and was admitted with Céline in Paul-Brousse Hospital (Fig. 3).

      There, Prof. Gustave Roussy (1874–1948) convinced Céline to accept the operation. He underwent surgery on January 19th, 1915 [Archives du Service de santé des armées, 1915]. The surgical procedure was performed by the renowned Prof. Antonin Gosset (1872–1944): “The exploration of the area was done through an oblique incision on the dorsal side of the arm. The section of the radial nerve was confirmed. Both sectioned ends were located in the tissues. There was a neuroma on the upper end. Both ends were dissected and a suture was performed. A large callus was removed and a muscle flap was inserted between the nerve and the humerus” [Ducourneau, 1966; Gibault, 1985, pp. 157–164].

Fig. 3. Louis Destouches and Albert Milon appear in the records of Paul-Brousse Hospital, held by Prof. Gustave Roussy (Archives du Service de Santé des Armées, Val-de-Grâce, Paris).

      The operation did not seem to produce the expected results. The nurse Alice David wrote 3 weeks after the surgery: “I wish had received better news. I hoped the intervention would have better results! But I do not lose faith, and I will pray for it” [letter from Alice David of February 9th, 1915; Céline, 2009, p. 134].

      On February 22nd, 1915, Céline left the Paul-Brousse Hospital. Roussy’s medical report specified: “Extension of the hand and first phalanges is nonexistent as well as extension and abduction of the thumb. There is a slight forearm atrophy and the landmark of the brachioradialis muscle is missing” [Ducourneau, 1966; Gibault, 1985, pp. 157–164].

      Céline needed electrical treatment to stimulate the recovery of his right radial nerve. He was sent to the Hôpital Michelet in Vanves, where he underwent this treatment in February and March 1915. The report of the electrical exploration carried out on March 16th, 1915, showed the absence of electrical excitability for the extensor digitorum and pollicis muscles and a reduced excitability for the triceps brachialis and brachio-radialis muscles. The conclusion suggested that some galvanic shock sessions were still necessary [Institut Mémoire de l’Édition Contemporaine, 2009].

      In March 1915, Céline received a convalescence leave. In May 1915, his new affectation