Opium: The Diary of a Cure (Jean Cocteau)

To begin with, I could not have been thoroughly cured the first time. Many courageous drug addicts do not know the pitfalls of being cured, they content merely to give up and emerge ravaged by a useless ordeal, cells weakened and further prevented from regaining their vitality through alcohol and sport.

Incredible phenomena are attached to the cure; medicine is powerless against them, beyond making the padded cell look like a hotel-room and demanding of the doctor or nurse patience, attendance and sensitivity. I shall explain later that the phenomena should be not those of an organism in a state of decomposition but on the contrary the symptoms of a baby at the breast and of vegetables in spring.

A tree must suffer from the rising of its sap and not feel the falling leaves.

“Le Sacre Du Printemps” orchestrates a cure with a precision of which Stravinsky is not even aware.

I therefore became an opium addict again because the doctors who cure―one should really say, quite simply, who purge―do not seek to cure the troubles which first cause the addiction; I had found an unbalanced state of mind; and I preferred an artificial equilibrium to no equilibrium at all. This moral disguise is more misleading than a disordered appearance; it is human, almost feminine, to have recourse to it.

I became addicted with caution and under medical supervision. There are doctors capable of pity. I never exceeded ten pipes. I smoked the rate of three in the morning (at nine o’clock), four in the afternoon (at five o’clock), three in the evening (at eleven o’clock). I believed that, in this way, I was reducing the chances of addiction. With opium I suckled cells, which were restored to the world after five months of abstinence, and I suckled them with countless unknown alkaloids, whereas a morphine addict, whose habits frighten me, fills his veins with a single known poison and surrenders himself far less to the unknown.

***
There is still no such thing as a scientific cure. No sooner are the alkaloids in the blood, than they fix upon certain tissues. Morphine becomes a phantom, a shadow, a fairy. One can imagine how the known and unknown alkaloids work, their Chinese invasion. To overcome them, one must have recourse to the methods of Moliere. One drains the patient, cleans him out, stirs up his bile and, whether one likes it or not, goes back to those tales according to which evil spirits were supposed to be chased out by herbs, charms. purges and emetics.

***

Do not expect me to be a traitor. Of course opium remains unique and the euphoria it induces is superior to that of health. l owe it my perfect hours. It is a pity that instead of perfecting curative techniques, medicine does not try render opium harmless.
But here we come back to the problem of progress. Is suffering a regulation or a lyrical interlude?
It seems to me that on an earth so old, so wrinkled, so painted, where so many compromises and laughable conventions are rife, opium (if its harmful effects could be eliminated) would soften people’s manners and cause more good than the fever of activity causes harm.

My nurse says to me; “You are the first patient whom I have seen writing the eighth day.”
I full realise that I am planting a spoon in the soft tapioca of my young cells, that I am delaying matters, but I am burning myself up and will always so. In two weeks, despite these notes, I shall no longer believe in what I experiencing now. One must leave behind a trace of this journey which memory forgets. One must, when this is impossible, write or draw without responding to the romantic solicitations of pain, without enjoying suffering music, tieing a pen to one’s foot if need be, helping the doctors who can learn nothing from laziness.

During an attack of neuritis one night, I asked B.: “You, who do not practise and are up to your eyes in work at the Salpetriere and are preparing your thesis, why do you attend me at my home day and night? I know doctors. You like me very much but you like medicine more.” He replied that he had at last found a patient who talked, that he learnt more because I was capable of describing my symptoms, than at the Salpetriere where the question: “Where does it hurt?” invariably brought the reply: “Don’t know, doctor.”

***

We are no longer, alas, a race of farmers and shepherds. The fact that we need another system of therapy to defend our over-worked nervous system cannot be questioned. For that reason it is imperative to discover some means of rendering harmless those beneficial substances which eliminates so unsatisfactorily, or of shielding the nerve cells.

***

Tell this obvious truth to a doctor and he will shrug his shoulders. He talks of literature, Utopia, and the obsessions of the drug addict.
Nevertheless, I contend that one day we shall use those soothing substances without danger, that we shall avoid habit-making, laugh at the bugaboo of the drug and that opium, once tamed, will assuage the evil of towns where trees die on their feet.

***

While I am drawing, E …, who is a replacement, is writing to her brother: “I’m taking advantage of the fact that my patient has found a pastime for the moment in writing to you.” ‘She pronounces the word Quies (ear-plugs called Quies) Cuisses (thighs). Mile d’A … would never have been able to go to sleep without putting her Cuisses in her ears.

Do not forget that no visitors are allowed, that a nervous case, a semi-lunatic who ought to be entertained, is shut up alone with his nurse for with months on end. The chief medical officer comes in for a minute. If the patient is all right, he stays longer. If the patient is not well, he beats a retreat. The psychiatrist attached to the establishment is young, agreeable and lively. He cannot help but be liked. If he is liked, a long visit vexes the chief medical officer, who is disliked. He stays ten minutes.
Any nurse is allotted to any patient. Yet the choice of nurse is of paramount importance for nervous cases. Smiles: “Ah! If we also had to worry about details like that … ” And the nervous patient is treated like an old dodderer. The composition of the medicines is kept hidden from him. Human contacts are avoided. The doctor must be inhuman. The doctor who talks and makes contact with the patient is never taken seriously.

“Yes, he’s a good talker, but if I were very ill I should send for someone else. ” Psychology is the enemy of medicine. Rather than tackle the question of opium with the patient who is obsessed by it, they avoid it. A real doctor does not stay long in the room, he conceals his tricks for lack of tricks. This method has corrupted the patients. They suspect the doctor listens to them, the human doctor. Dr. M. has killed all my family and treated my brother’s broken nose for erysipelas. His frock coat and bald pate were reassuring.

***

I wanted to take notes during my stay in the clinic and above all to contradict myself in order to follow the stages of the treatment. It was a question of talking about opium without embarrassment, without literature and without any medical knowledge. ‘

The specialists seem to be unaware of the world which separates the addict from the other victims of poisons, ‘the drug,’ and drugs. I am not trying to defend the drug; I am trying to see clearly in the dark, to make blunders and to come face to face with the problems which are always approached from the side.

I imagine that young doctors are beginning to shake off the yoke, to revolt against the ridiculous prejudices and follow new developments.

A strange thing. Our physical safety accepts doctors who correspond to artists whom our moral safety rejects. Imagine being cared for by someone like Ziem, Henner or Jean Aicard.

Will the young doctors discover either an active type of cure (the present method remains passive), or a regime which would enable us to withstand blessings of the poppy?

The medical faculty detests intuition or risks; it wants practitioners, forgetting that they only arise thanks to discoveries which in the first place come up against scepticism, one of the worst forms of comfort.

There will be objections―art and science follow different paths. This is not true.

***

After the cure. The worst moment, the worst danger. Health with this void and an immense sadness. The doctors honestly hand you over to suicide.

***

I was therefore eliminating through ink, and even after the official elimination there was an unofficial elimination with a flow which became solid through my desire to write and draw. I allowed these drawings or notes only the value of frankness, and they seemed to me to be a derivative, a discipline for the nerves, but they became the faithful graph of the last stage. Sweat and bile precede some phantom substance which would have dissolved, leaving no other trace behind except a deep depression, if a fountain pen had not given it a direction, relief and shape.

Waiting for a period of calm to write these notes was trying to relive a state which is inconceivable as soon as the organism is no longer in it. Since I have never granted the slightest importance to the setting and since I was using opium as a remedy, I was not unhappy at seeing my state disappear. Whatever one renounces is a dead letter for those who imagine that setting plays a part … I hope that this reportage finds a place among doctors’ pamphlets and the literature of opium; may it serve as a guide to the novices who do not recognise, beneath the slowness of opium, one of the most dangerous faces of speed.

Discussion Questions:
1. Does this piece alter the definition of “cure” for you? If so, how? Does this definition change depending on clinical setting and therapeutic goals?
2. Do you believe that any modern day principles of harm reduction can be applied to Cocteau’s hopes that doctors may develop “a regime which would enable us to withstand blessings of the poppy?”

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