FOUNDED BY NAPOLEON III in 1863 as an asylum, the Centre Hospitalier Sainte-Anne in rue Cabanis in the 14th arrondissement is now not only an official monument historique, it’s also a hospital specialising in psychiatry and neuroscience.
The origins of the hospital date back much further though.
On 7th July 1651, the governors of the Hôtel-Dieu and representatives of the Queen regent, Anne of Austria, signed a contract in which the Hôtel Dieu gave up buildings and land of the Maison de la Santé in Faubourg St Marcel in exchange for which the Queen regent gave twenty-one acres of land to establish a hospital. A condition was that the new hospital should take the name of the patron saint of the Queen regent, mother of Louis XIV: Saint Anne.
The hospital began as a farm, la ferme Sainte-Anne, which employed inmates from the nearby Asylum de Bicêtre, a notorious prison and lunatic asylum, but where in 1793, Superintendent Philippe Pinel is credited as being the first to introduce humane methods into the treatment of the mentally ill.
In 1863, Napoleon III decided to create a psychiatric hospital in Paris on the site of la ferme Sainte-Anne. The Centre Hospitalier Sainte-Anne was to be a clinical asylum marking a shift of emphasis from just the containment of the mentally ill towards research into and the treatment of mental illness.
The French architect Charles-Auguste Questel took charge of the project and work proceeded over a period of four years. The hospital was inaugurated on 1st January 1867 and the first patient was admitted on 1st May of the same year. Most of the original buildings still exist and are still in use.
The asylum in 1877: Revue générale de l’Architecture et des Travaux Publics, 1877, n°4 (volume 34ème)
Le pavillon Magnan de l’hôpital Sainte-Anne
In the years that followed, the Centre Hospitalier Sainte-Anne expanded its role beyond just the psychiatric treatment of its patients. Departments for general surgery and dental surgery were created to provide treatment for patients from all the asylums in the Département de la Seine along with an obstetric department and laboratories for radiology, microphotography and biology.
A major breakthrough occurred in 1920 when the French psychiatrist, Edouard Toulouse, set up the Comité d’hygiène mentale, a mental health committee designed to seek the most effective medical and social means for treating mental illness. In 1922 this resulted in the Centre for mental disease prevention, which aimed to improve the treatment of patients by developing outpatient as well as inpatient centres.
Another breakthrough came in 1952 when the French psychiatrist, neurologist, writer and member of the Académie française, Jean Delay, along with J. M. Harl and Pierre Deniker discovered that a high dose of chlorpromazine produced a considerable reduction in the agitation and aggression of those patients with symptoms of schizophrenia. Chlorpromazine was released onto the market in 1953 by Rhône-Poulenc and given the trade name Largactil and it’s still in use today.
Today, the Centre Hospitalier Sainte-Anne has seven adult psychiatric units, two child and adolescent psychiatric units as well as an addiction unit. It also has centres for neurology, neurosurgery, neuroradiology, neurophysiology, neuropathology, anaesthetics, dentistry, physical medicine and rehabilitation.
The hospital is also a teaching hospital for students of the faculty of medicine at the Université Paris Descartes.
I went to explore the Centre Hospitalier Sainte-Anne and discovered that the site covers thirteen hectares (32 acres), including seven hectares (17 acres) of protected green space. Some of this green space is reserved for patients but most of it is accessible to the public.
On one side of a staff car park close to the central pharmacy I discovered some sounds of summer.
Sounds of the Centre Hospitalier Sainte-Anne:
One of the modern additions to the hospital is the new home of the Clinique des Maladies Mentales et de l’Encéphale (CMME), a sixty bed psychiatric unit supervised by four university professors.
The unit specialises in four main areas; eating disorders, mood disorders (including recurrent depression resistant to treatment, seasonal affective disorder, attention deficit hyperactivity disorder and anxiety disorders), suicidal patients and addiction.
Clinique des Maladies Mentales et de l’Encéphale (CMME)
The CMME is one of several new developments at the hospital so as I walked past it I was not surprised to discover the sound of construction work pervading the air. I stopped to capture the sounds of nature and construction work competing with each other.
Centre Hospitalier Sainte-Anne – Outside CMME:
Walking around the grounds of the hospital looking at some of the original buildings I couldn’t help but imagine what this place must have been like when the treatment of mental illness was in its infancy, even though France was quite enlightened in its approach by the standards of the time.
In 1838 France enacted a law to regulate both the admissions into asylums and asylum services across the country allowing mentally ill patients to gain access to treatment for their disorders in specific and appropriate institutions. This law remained in force until as late as June 1990 when it was revised.
Outside the Centre Hospitalier Sainte-Anne in rue Cabanis stands the controversial Le plancher de Jeannot / Jeannot´s floor, a chilling reminder of the effect that mental illness can sometimes have.
Inside the three panels are sections of a fifteen square metre wooden floor engraved with a message of eighty lines by a young man named Jeannot.
Jeannot was born in 1939 in a small community in the Béarn department in the south of France where his parents owned a farmhouse and some forty hectares of land.
In 1959, Jeannot’s father committed suicide. Jeannot, one of his sisters and his mother continued to live in the house but the family gradually became more and more isolated. Jeannot began to exhibit paranoid behaviour and he was admitted to a psychiatric hospital but he reacted so violently that he was unable to be treated. When his mother died in 1971, Jeannot buried her in the house, under the staircase.
Over the next few months, using a hand drill to make small holes, which he then connected with lines cut out with a knife and a gouge, Jeannot composed a text on the wooden floor of the living room. In brief, the text says that religion is the cause of evil in society,
Soon after completing the text Jeannot died, probably starving himself to death. Together with his mother he was buried in the local cemetery. His sister continued living in the house, alone. She was found dead in 1993.
The house was sold but the brocanteur who dealt with the house clearance noticed the inscriptions on the floor. Finding this unusual, he made contact with a psychiatrist, Dr Guy Roux. Dr Roux bought the floor from the new owner of the house. He later sold it to the pharmaceutical company Bristol Meyer Squib.
Le plancher de Jeannot was exhibited for the first time in the year 2000 at an international psychiatric congress in Paris as part of an exposition entitled 50 ans d´expression en milieu psychiatrique. It was later exhibited in the Bibliothèque Nationale in Paris where it gave rise to a heated public debate around the question: is it acceptable to present as a work of art the expression of someone in such psychological distress?
In 2007, Jean Pierre Olié, professor of psychiatry and chief psychiatrist of the Centre Hospitalier Sainte-Anne became involved and it was arranged that the floor, cut into three parts, should be put on display outside the hospital in the rue Cabanis.
The complete text of Le plancher de Jeannot: Click to enlarge
“A sick thought can devour the body’s flesh more than fever or consumption.”
Guy de Maupassant : Le Horla et autres contes fantastiques
The days of ‘lunatics’ and ‘asylums’ may be gone but the shame and stigma surrounding mental illness still persists. It may be less now than in the past but it’s still there.
Institutions like the Centre Hospitalier Sainte-Anne have contributed significantly to the diagnosis and treatment of mental illness but it’s up to of the rest of us to come to terms with the fact that mental illness is exactly what it says, an illness – an illness that one in five of us will suffer from at some point in our lives.
“Mental illness is nothing to be ashamed of, but stigma and bias shames us all”.
SUZANNE CURCHOD (1737 – 1794) was a French-Swiss woman of letters and hostess of one of the most celebrated salons of the Ancien Régime. She was also the wife of Jacques Necker, Controller-General of Finances under Louis XVI.
After her husband’s fall from power in 1790, the Neckers left Paris and returned to Switzerland. Suzanne died in 1794 but not before she had founded a hospital in Paris that still bears her name, the Hôpital Necker.
Suzanne Curchod – Madame Necker
The Hôpital des Enfants Malades (hospital for sick children) was created by the Conseil général des Hospices in January 1801 on the site of a former hospice for abandoned children, the Maison Royale de l’Enfant Jesus. The newly formed hospital, believed to be the oldest children’s hospital in the world, opened in June 1802 catering for 149 boys and 92 girls aged from 2 to 14 years old housed in separate wings, each containing 30 to 40 beds.
On 1st January 1927 the Necker hospital for adults and the Hôpital des Enfants Malades were merged to become the Hôpital Necker – Enfants Malades, the name by which its still known today.
Hôpital Necker – Enfants Malade in Rue de Sèvres in 2015
Hôpital Necker in Rue de Sèvres in 1900 – Image courtesy of Paris en Images
Today, the Hôpital Necker – Enfants Malades is a university teaching hospital affiliated to the prestigious Université Paris Descartes and it’s part of the public hospital system, the Assistance Publique – Hôpitaux de Paris.
The Carré Necker
The hospital has 400 beds for children and 200 beds for adults. It is one of the world’s leading institutions for paediatric medicine and surgery and it’s a referral centre for some rare diseases and particularly complex conditions.
The Carré Necker
Over the years, many eminent physicians and surgeons have worked at the hospital but perhaps none more eminent than the French physician, René-Théophile-Hyacinthe Laennec (1781 – 1826). In 1816, while working at the hospital, Laennec invented the stethoscope and pioneered its use in diagnosing various chest conditions.
As well as having a plaque to mark his invention, Laennec has more recently been distinguished by having the new Pôle Mère-Enfant Laennec named after him. This 54,000 M2 facility was opened on 10th July 2013 by François Hollande, Président de la République.
Pôle Mère-Enfant Laennec
At a total cost of 215.4 million Euros, the Pôle Mère-Enfant Laennec caters for paediatric surgery, infant resuscitation, accident and emergency, paediatric imaging, cardiology, nephrology, gastroenterology, maternity and neonatology. It has been designed to centralise these paediatric specialities so as increase the efficiency of clinical care and to reduce the time required to get that care to patients. Special emphasis has also been put on the comfort of the patients and the parents with individual rooms designed on a parent-child-carer model.
On my visit to the Hôpital Necker – Enfants Malades I went into the reception area of the Pôle Mère-Enfant Laennec to record some of the atmosphere.
Inside the Pôle Mère-Enfant Laennec:
The reception area is spacious and well-lit with a cafeteria and bookstall, a gift shop, a reading room full of children’s books, a large children’s play area and a quiet room for mothers and children. Entry into the unit is via huge automatic glass doors that open and close with a gentle swish as people pass through. You can hear these swishing sounds in my recording. These sounds must surely be one of the defining sounds of this place although I suspect that those who come here with much more pressing things on their mind will scarcely be aware of them.
A clown entertaining children in the Hôpital Necker – Enfants Malades in 1945
Image courtesy of Paris en Images
I ALWAYS THINK it’s better to visit a hospital out of curiosity rather than out of necessity. The other day it was curiosity that led me to the Hôpital Lariboisière in the 10th arrondissement a short step away from the Gare du Nord.
The Hôpital Lariboisière was born out of the cholera epidemic that hit Paris in 1832. The Hôtel Dieu, the oldest hospital in Paris, took the brunt of the epidemic and it is said that by the end of March 1832 every admission to the Hôtel Dieu was for cholera and practically no one was discharged. Almost 20,000 souls died from the six-month epidemic.
L’Hôtel Dieu during the cholera epidemic 1832 – Painting by Alfred Johannot
Devastating though it was, the epidemic did produce some positive results. In the 19th century curing cholera was like clutching at straws so attention turned towards prevention rather than cure. Major steps were taken to improve the city’s hygiene and by the time Baron Haussmann began rebuilding Paris in 1853 the hygienist movement had become the major force in urban planning. Slums were demolished, streets widened, the sewage system improved and a new hospital was built to serve the inhabitants on the Right Bank – the Hôpital Lariboisière.
The French architect, Martin-Pierre Gauthier, designed the new hospital based on the hygienist principles of providing plenty of light and air, a free flow of water and pavilions separated by galleries to prevent cross infection. His design comprised six buildings arranged around a central courtyard connected by colonnaded walkways.
A bequest from Eliza Roy Comtesse de Lariboisière financed the building of the hospital. The Comtesse had no heirs and so she bequeathed her fortune to the City of Paris to create ‘un hospice pour les malades qui portera mon nom Hospice Lariboisière’. The Comtesse died on 27th December 1851 and on 29th July 1853 an Imperial decree confirmed that the hospital was to be named Hôpital Lariboisière, the name by which it’s still known today. The hospital was opened in 1854.
The tomb of the Comtesse de Lariboisière, designed by the Italian born French sculptor, Carlo Marochetti, rests in the hospital chapel.
Today, behind it’s 19th century façade, the Hôpital Lariboisière is a busy, modern hospital with around 1,000 beds. Together with two other hospitals very close by, Hôpital Saint-Louis and Hôpital Fernand Widal, the Hôpital Lariboisière is part of the Groupe Hospitalier Universitaire Saint-Louis, Lariboisière, Fernand Widal, which together offer a comprehensive range of medical services.
I went to explore the Hôpital Lariboisière. I wandered through the gardens outside and along the quadrangle of long corridors inside on the ground floor, the arteries that lead to the ars medicina beyond.
Here are some of the sights and sounds I discovered.
Hôpital Lariboisière – A Soundwalk:
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THE HÔTEL DIEU was founded in the middle of the 7th century, which makes it the oldest hospital in Paris. It sits on the Parvis du Notre Dame alongside its more prestigious neighbour, the Cathédrale Notre Dame de Paris, which was founded some four hundred years later.
Originally, the Hôtel Dieu was situated on the other side of the Parvis next to the river Seine. During the Middle Ages it grew in an unplanned and rather chaotic way and by the 17th century it had spilled over the river occupying two bridges and a parcel of land on the Left Bank.
Of course, to say that the Hôtel Dieu was founded as a hospital is not exactly true; there were no hospitals as such in the 7th century. It did cater for the sick after a fashion but it was founded more as a refuge for the poor and it continued to be a refuge for Parisians until the 17th century. By this time though it had gained a terrible reputation and by the time of the Revolution in 1789, a quarter of those admitted died often of diseases contracted within its walls.
It was only in the mid-19th century when the hospital moved to a new, purpose-built home on the other side of the Parvis, the home that it occupies today, that it began to shed its reputation as a disease trap and became a place where people might be treated and even cured.
Today, the Hôtel Dieu has 350 beds and it’s the primary casualty centre for emergency cases in the first nine arrondissements in Paris. It also specialises in research into and the treatment of diabetes and it has a major ophthalmology department, which caters for ophthalmic emergencies, surgery and research.
Recently, I went to have a look at the Hôtel Dieu. From both the outside and the inside it has the feel of rather a cold, unwelcoming place.
Like most 19th century hospitals its buildings are arranged around a central courtyard connected by colonnaded walkways.
Beneath these walkways are long, seemingly endless corridors, which have a rather haunting feel to them.
Whilst these long corridors have a curious haunting elegance about them and the hospital wards themselves are perfectly clean and functional, the spaces in between are rather shabby and have a run-down feel. The entrance to the ophthalmic emergency unit for example doesn’t really inspire confidence even though it’s a state-of-the-art facility.
Regular visitors to this blog will know that, whilst I have a passion for the city of Paris, I have an even greater passion for its sounds and I found the sounds inside the Hôtel Dieu simply fascinating.
To illustrate that, I offer you two sound pieces, both recorded inside the hospital but both recorded in different ways. Both illustrate how sound can describe the atmosphere a place and create images equally as powerful as words or pictures.
The first piece is a soundwalk inside the hospital. I simply recorded as I walked along the corridors and in and out of any door that would let me pass. I didn’t of course invade any private areas – the emergency room, the wards or the laboratories, I simply kept to the public spaces.
Hôtel Dieu – A Soundwalk:
In the first piece I walked through the hospital discovering the sounds. In the next piece, I sat in one place and let the hospital walk past me.
I sat on a long wooden bench in the seemingly endless corridor shown above, outside what I discovered was the bloc opératoire which to my ear at least sounds much more elegant than the operating theatres.
Hôtel Dieu – Outside the bloc opératoire:
If you listen carefully, amongst other things you can hear the soft tread of operating theatre staff dressed in hospital scrubs and white coats returning to work after lunch.
Both these sound pieces illustrate the everyday sounds of a busy hospital, sounds that would go largely unnoticed to the ordinary visitor or to someone with more important things on their mind.
People often ask me why I record sounds like these and my answer is always the same.
For most of our history we have used artefacts, architecture, pictures and words to create a vision of our past. It’s only in the last ten seconds or so on our historical clock that we’ve been able to capture and archive sound. Almost all our sonic heritage has passed by completely unrecorded.
In the 16th century this hospital catered for some 3,500 patients at a time often with four or more to a bed. In 1832 it was overwhelmed with victims of the great cholera outbreak. We have written and pictorial evidence of what the hospital was like during those times but we have none of its contemporary sounds to listen to. Sitting on my long wooden bench in a seemingly endless corridor I was not only able to listen to and record today’s sounds of this place but to create a record of these sounds for others, now and in the future, to explore. I think I may even have been able to hear faint echoes of this place’s past.
As a final note, I have to record that the Hôtel Dieu has an uncertain future.
Thanks to a restructuring of l’Assistance Publique Hôpiteaux de Paris, the body that oversees the hospital, changes are afoot. There are proposals to close the emergency department and to change the hospital into a Hôpital Universitaire de Santé Publique, in effect, a teaching hospital which will take walk-in patients without appointment. That’s why there are banners up on the hospital walls and why the CGT union were collecting signatures for a petition on the day I went.
If these changes come to pass then maybe the sounds I recorded in the Hôtel Dieu will become more important than I thought – a genuine piece of history captured before this hospital as we know it disappears.
I AM DELIGHTED TO present a new piece in my Paris – A Personal View series.
For each piece in the series I invite a guest who lives in Paris to visit one of their favourite places or a place in the city that has a special meaning for them. With access to a microphone and sound recorder the guest talks about the place and tells us why it’s special to them.
Today, my guest is Adam Roberts.
Photo courtesy of Adam Roberts
Adam is an Englishman who has lived in Paris for a little over fifteen years. As well as doing his demanding day job Adam finds time to write the very informative and popular Invisible Paris blog – a celebration of the parts of Paris that would be refused entry to the ville musée if they tried to get in today.
And Adam’s chosen place? The Hôpital Salpêtrière …
Adam Roberts at the Hôpital Salpêtrière:
Mur des Fermiers Généraux – The Farmers-General Wall
Former Women’s Prison Cells
Charcot’s Library – Photo courtesy of Adam Roberts
Bâtiment de la Force
I am very grateful to Adam for giving up his time to visit and talk about the Hôpital Salpêtrière.
Unlike other sounds on this blog, the sound piece ‘Adam Roberts at the Hôpital Salpêtrière’ is not covered by a Creative Commons license. The copyright for this piece rests jointly and exclusively with Adam Roberts and Des Coulam. It follows therefore that the downloading of this piece for any purpose is not permitted without the express permission of both Adam and Des. We have no wish to spoil your enjoyment of this piece but simply ask you to respect that the work is ours. Thanks for understanding.