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The Incidence of “Brain Fever” in The Brothers Karamazov

November 13th, 2006 by David Kronemyer · 3 Comments

Dostoyevsky’s characters frequently suffer from something he calls “brain fever.” Pulcheria Alexandrovna Raskolnikova, Raskolnikov’s clueless mother, has it in Crime and Punishment; in fact she dies from it.  Arkady Makarovich Dolgoruky has it, for a while, in The Adolescent.  So does Nicolas Vsevolodovich Stavrogin, in The Possessed.  Then there is Rogojin, in The Idiot; not to mention Ivan in The Brothers Karamazov.

The purpose of this note is to analyze what Dostoyevsky means by brain fever; who ends up getting it; and why.  We will focus primarily on The Brothers Karamazov, where brain fever plays a critical role.

From a medical standpoint, when someone is talking about brain fever, they’re usually referring to meningitis: an infectious disease characterized by inflammation of the tissues surrounding the brain or spinal cord, usually caused by a bacterial infection, and often, fatal.  Dostoyevsky, however, uses the phrase more loosely.  There’s no evidence the brain fever afflicting his characters, has anything to do with meningitis.

Brain fever also must be distinguished from several other Dostoyevskyan maladies, including epilepsy and straight-up insanity.  In The Idiot, for example, Prince Myshkin has epilepsy; he in turn, on several occasions, characterizes Nastasia Philipovna as being “mentally ill;” and, in the end, it’s Rogojin who ends up killing her, a crime fortunately mitigated by the sudden onset of – that’s right – brain fever.

As a matter of biography, Dostoyevsky himself was an epileptic.  Nothing in The Idiot is more terrifying than Dostoyevsky’s descriptions of the onsets of Prince Myshkin’s epileptic fits, of which he suffers several during the course of the narrative.  Rogojin’s brain fever, on the other hand, is most unexpected and, frankly, is an unsatisfactory explanation for his killing Nastasia Philipovna.  Rogojin is complex, and there are several reasons why he might have wanted to see Nastasia Philipovna dead, none of which have anything to do with brain fever.  Seeing as how brain fever suddenly is introduced at the end of the book, it’s almost as though Dostoyevsky got tired of writing it.  Rather than engaging in a more satisfying, albeit more complex, explanation of Rogovin’s condition, he simply passes it off as brain fever.  This is an illustration of Dostoyevsky’s tendency to use “brain fever,” and other deus ex machina, as a convenient explanation for supervening phenomena, often psychological, as to which he doesn’t want to elaborate further.

A different dynamic is at work in The Brothers Karamazov.  In principle, all of the principal characters partake of some degree of derangement.  That being so, Smerdyakov is epileptic, and Ivan’s the one with brain fever.  Ivan’s brain fever reveals itself most floridly in his encounter with the Devil.  Dostoyevsky’s narrator states:

“Anticipating events I can say at least one thing: he was at that moment on the very eve of an attack of brain fever.  Though his health had long been affected, it had offered a stubborn resistance to the fever, which in the end gained complete mastery over it.  Though I know nothing of medicine, I venture to hazard the suggestion that he really had perhaps, by a terrible effort of will, succeeded in delaying the attack for a time, hoping, of course, to check it completely.  He knew that he was unwell, but he loathed the thought of being ill at that fatal time, at the approaching crisis in his life, when he needed to have all his wits about him, to say what he had to say boldly and resolutely and ‘to justify himself to himself.’

“He had, however, consulted the new doctor, who had been brought from Moscow by a fantastic notion of Katerina Ivanovna’s to which I have referred already.  After listening to him and examining him the doctor came to the conclusion that he was actually suffering from some disorder of the brain, and was not at all surprised by an admission which Ivan had reluctantly made him.  ‘Hallucinations are quite likely in your condition,’ the doctor opined, ‘though it would be better to verify them… you must take steps at once, without a moment’s delay, or things will go badly with you.’ But Ivan did not follow this judicious advice and did not take to his bed to be nursed.  ‘I am walking about, so I am strong enough, if I drop, it’ll be different then, anyone may nurse me who likes,’ he decided, dismissing the subject.”

There are several interesting facts about brain fever we can deduce from this passage.

1.  Although it may build up in your system for some time (“long been affected,” “stubborn resistance”), its onset is sudden (“eve of an attack”).

2.  Thereafter, it is highly debilitating (“gained complete mastery”) and affects your ability to think clearly (“have all his wits about him,” “Hallucinations are quite likely”).

3.  If you “think positively,” you might avert it for a while (“terrible effort of will,” “delaying the attack for a time,” “take to his bed to be nursed”).

4.  Will-power, though, will not alter its inevitable course (“check it completely”).

5.  One knows if one has it (“He knew that he was unwell”).

6.  It causes delusional thinking (“Ivan did not follow this judicious advice,” “I am walking about, so I am strong enough”).

When the doctor says, “or things will go badly with you,” presumably he is referring to the consequences set forth at point 2.  It’s impossible to decipher just what the doctor meant by “[al]though it would be better to verify them…,” where “them” clearly refers to the “hallucinations” of the previous phrase.  Does the doctor mean one should verify one is having hallucinations? This doesn’t seem to be particularly useful information, in and of itself.  A better reading of the doctor’s advice is, it would be better if one could discern the true state of affairs that would present itself, if one weren’t having the hallucination.

It’s also important to distinguish between having a hallucination, which is a transitory episode of auditory-ocular dissonance, as opposed to not being able to think clearly, which is one’s capacity to reason.  Using this distinction, one hypothesis might be to characterize Ivan’s encounter with the Devil, as a hallucination.  Whereas, his testimony at Dmitri’s trial is supposed to demonstrate he’s no longer in possession of his faculties, and brain fever in fact has set in:

“‘Are you in your right mind?’ broke involuntarily from the President.

“‘I should think I am in my right mind… in the same nasty mind as all of you… as all these… ugly faces.’  He turned suddenly to the audience.  ‘My father has been murdered and they pretend they are horrified,’ he snarled, with furious contempt.  ‘They keep up the sham with one another.  Liars!  They all desire the death of their fathers.  One reptile devours another….  If there hadn’t been a murder, they’d have been angry and gone home ill-humoured.  It’s a spectacle they want!  Panem et circenses.  Though I am one to talk!  Have you any water?  Give me a drink for Christ’s sake!’  He suddenly clutched his head.

“The usher at once approached him.  Alyosha jumped up and cried, ‘He is ill.  Don’t believe him: he has brain fever’” (emphasis added).

This outbreak from Ivan at Dmitri’s trial suggests there is a reason why Ivan didn’t follow the doctor’s earlier advice.  It is because of his brain fever; in other words, brain fever caused him to become so delusional, it affected his ability to comprehend and implement the doctor’s advice, to begin with (point 6).  Rather than “take steps at once, without a moment’s delay,” Ivan (erroneously) believed because he was “walking about,” he was “strong enough.”

This reading seems to contradict point 5, however, which suggests brain fever still leaves one in possession of one’s conscious faculties.  I suppose it could be argued Ivan didn’t yet really “have” brain fever, per se; rather, he was on the “eve of an attack.”  Prior to the inception of the attack itself, one still retains one’s ability to think; not so, however, thereafter.

The problem with this is, if Ivan simply is on the “eve” of an attack, but has yet to succumb, he still should be cognitive enough, to recognize the wisdom of the doctor’s advice, and do what the doctor says.  Which is the thinking behind point 5, to begin with.

Perhaps the best way to reconcile these conflicting symptoms is to conclude Ivan was in a perilous zone, where brain fever had built up a kind of critical mass, but he had yet completely to succumb.  This is consistent with point 4, which posits the disease’s inevitable course.  Point 5 also is necessary for the consistent integration of point 3; for it would not be possible to think happy thoughts, and attempt to avert it, if one wasn’t aware one had it, to begin with.

This hypothesis is confirmed by three other people: the amused narrator at Dmitri’s trial, who clearly was present as a spectator; the prosecutor, Ippolit Kirillovitch; and Dmitri’s lawyer, Fetyukovitch.  The narrator says:

“Yes, I think the ladies who came to see the spectacle must have been satisfied – the show had been a varied one.  Then I remember the Moscow doctor appeared on the scene.  I believe the President had previously sent the court usher to arrange for medical aid for Ivan.  The doctor announced to the court that the sick man was suffering from a dangerous attack of brain fever, and that he must be at once removed.  In answer to questions from the prosecutor and the counsel for the defence he said that the patient had come to him of his own accord the day before yesterday and that he had warned him that he had such an attack coming on, but he had not consented to be looked after.  ‘He was certainly not in a normal state of mind: he told me himself that he saw visions when he was awake, that he met several persons in the street, who were dead, and that Satan visited him every evening,’ said the doctor, in conclusion.  Having given his evidence, the celebrated doctor withdrew.”

Note how the doctor (a) distinguishes between hallucination, and a more profound condition of derangement; (b) supports our earlier theory that, when he first saw the doctor, Ivan only was on the brink of an attack (“he had such an attack coming on,” emphasis added); and (c) confirms that, sometime after his meeting with Ivan, but before what just happened at the trial, brain fever fully erupted (“the sick man was suffering from a dangerous attack of brain fever,” emphasis added).

Ippolit Kirillovitch and Fetyukovitch both second the doctor’s diagnosis of full-fledged brain fever, in their arguments to the jury.  Ippolit Kirillovitch: “The elder of these brothers expressed his suspicions only to-day, when he was undoubtedly suffering from brain fever.” Fetyukovitch: “Oh, I fully share the court’s and the prosecutor’s conviction that Ivan Karamazov is suffering from brain fever, that his statement may really be a desperate effort, planned in delirium, to save his brother by throwing the guilt on the dead man.”

This chronology leaves us with a significant problem, though.  Did Ivan have brain fever when he conversed with the Devil, or didn’t he? This is important, because, if he was under the influence of brain fever, the whole Devil episode merely becomes a hallucination.

The doctor says: “He was certainly not in a normal state of mind,” emphasis added, and then goes on to relate more details about Ivan’s chat with the Devil.  This clearly implies that, at least for the doctor, brain fever already had set in.  But, I think Dostoyevsky wants to elevate this encounter (i.e., the one between Ivan and the Devil) to something far more cognitive, really on par with Ivan’s earlier story of the Grand Inquisitor, when there was no suggestion of brain fever’s influence.  Ivan is a thinker, he’s intellectual, he even majored in philosophy.  It diminishes the importance of the conversation with the Devil (and therefore also inadvertently derogates from the Grand Inquisitor story) if Ivan then had brain fever.  Again, it’s difficult to reconcile these conflicting diagnoses, other than to say, although he was in possession of his faculties, Ivan was slipping into a condition of brain fever, when the Devil incident occurred.

But why then is it necessary, or appropriate, for Ivan to have brain fever at the trial?  A simple (but incorrect) answer would be, because that’s how Dostoyevsky wants to show how and why Ivan’s testimony was discredited, and why the jury didn’t buy his story about Smerdyakov committing the murder, producing the actual rubles, etc.  The reason why I think this interpretation is incorrect is because it’s too facile; it’s like saying the reason why Smerdyakov killed himself was because of his “consciousness of guilt,” when in fact that had nothing to do with it.

Rather, for Dostoyevsky, mental illness is a metaphor for a far more serious condition, that is, existential estrangement.  Consider, for example, the interactions between Ivan and Smerdyakov upon Ivan’s return from Moscow.  In the first and third interviews, Smerdyakov’s miserable; in the second, he’s happy.  This mirrors his perception of the status of his relationship with Ivan, upon whom he has modeled his life, and with whom (or so he thinks) he’s entered into a secret pact to kill old Karamazov.  On several occasions during the book, Smerdyakov refers to Ivan’s dictum: “All things are lawful.”

In much the same way, Ivan’s attack of brain fever is not for the purpose of suggesting his encounter with the Devil was a hallucination; nor is it for the purpose of discrediting his testimony at trial.  Rather, it’s a marker, or a sign-post, indicating the extent of his estrangement from his brother, Dmitri.

Ivan has an incredibly conflicted relationship with Dmitri.  For much of the book, he hates him; he certainly thinks he’s guilty, upon reading the letter Dmitri wrote to Katerina Ivanovna.  Yet, following his last interview with Smerdyakov, he finally realizes Smerdyakov thought he (i.e., Ivan) actually had “asked” him (i.e., Smerdyakov) to kill old Karamazov.  They had entered into a compact with each other.  It only is after this realization (a) he encounters the Devil; (b) Smerdyakov kills himself; and (c) Ivan resolves to testify at Dmitri’s trial.  As Ivan relates to Alyosha, the Devil told him (i.e., Ivan): “Oh, you are going to perform an act of heroic virtue: to confess you murdered your father, that the valet murdered him at your instigation.”

This raises the question of whether, at the trial, Ivan had brain fever, at all.  Even if we hypothesize the episode with the Devil was an hallucination, caused by brain fever, this doesn’t require us to commit to the conclusion his brain fever was ongoing, and affected him subsequently.  Indeed, the only person throughout the entire book who wouldn’t assent to the proposition Ivan has brain fever, is Ivan himself.  People think Ivan has brain fever; in fact, this is the only comprehensible reason for his bizarre tale about Smerdyakov.  However, the true fact of the matter may be that Ivan recovered from his brain fever (if he ever had it, to begin with) sometime after the encounter with the Devil, but before his testimony at trial.

Alyosha’s meeting with Ivan is crucial to this interpretation.

“He [i.e., Ivan] jumped up in a frenzy, flung off the towel, and fell to pacing up and down the room again.  Alyosha recalled what he had just said.  ‘I seem to be sleeping awake… I walk, I speak, I see, but I am asleep.’ It seemed to be just like that now.  Alyosha did not leave him.  The thought passed through his mind to run for a doctor, but he was afraid to leave his brother alone: there was no one to whom he could leave him.  By degrees Ivan lost consciousness completely at last.  He still went on talking, talking incessantly, but quite incoherently, and even articulated his words with difficulty.  Suddenly he staggered violently; but Alyosha was in time to support him.  Ivan let him lead him to his bed.  Alyosha undressed him somehow and put him to bed.  He sat watching over him for another two hours.  The sick man slept soundly, without stirring, breathing softly and evenly.  Alyosha took a pillow and lay down on the sofa, without undressing.”

In other words, at this point, there can be no question but that Ivan has brain fever.  But, Alyosha continues:

“As he [i.e., Alyosha] fell asleep he prayed for Mitya and Ivan.  He began to understand Ivan’s illness.  ‘The anguish of a proud determination.  An earnest conscience!’ God, in Whom he [i.e., Ivan] disbelieved, and His [i.e., God’s] truth were gaining mastery over his [i.e., Ivan’s] heart, which still refused to submit.  ‘Yes,’ the thought floated through Alyosha’s head as it lay on the pillow, ‘yes, if Smerdyakov is dead, no one will believe Ivan’s evidence; but he will go and give it.’ Alyosha smiled softly.  God will conquer!’ he thought.  ‘He [i.e., Ivan] will either rise up in the light of truth, or… he’ll perish in hate, revenging on himself and on every one his having served the cause he does not believe in,’ Alyosha added bitterly, and again he prayed for Ivan.”

In short, “God’s truth” in fact “gained mastery” over Ivan’s heart.  And, even though “no one will believe Ivan’s evidence,” “he will go and give it,” anyway.  God in fact conquers, and Ivan in fact rises up in the light of truth.  So, Alyosha’s prayer was efficacious; Ivan recovered from brain fever; and testified at trial.  The reason why Ivan recovered is because Alyosha drove away the Devil, and prayed for him.  In this manner, brain fever — understood as a metaphor for a kind of spiritual dissonance — became an occasion for revelation.

This interpretation of the text also is consistent with Dostoyevsky’s views on “psychology.”  As evidenced by his analysis of the “psychological” evidence at Dmitri’s trial, Dostoyevsky doesn’t put much credence in this new discipline.  This also is true, in The Idiot.  Of the numerous examples that come to mind, I’ll cite only two: Hippolyte’s hilarious rendition of “My Necessary Explanation,” which he characterizes as his last will and testament; and Evgenie Pavlovitch’s analysis of Prince Myshkin towards the end of the book, during the course of which Prince Myshkin comes to the incredible conclusion he loves both Nastasia Philipovna and Aglaya Ivanovna.

Evgenie Pavlovitch: “And are you assured, at the same time, that you love Aglaya too?”

Prince Myshkin: “Yes–yes–oh; yes!”

Evgenie Pavlovitch: “How so? Do you want to make out that you love them BOTH?”

Prince Myshkin: “Yes–yes–both! I do!”

And just think, this was way before the invention of modern porn.