In the life of Malte, afflicted by mental problems, a dramatic event was his visit to a doctor at the famous hospital of the Salpetrière in the 13th arrondissement of Paris, which looks like this today:
My doctor didn't understand me. Not in any way whatsoever. It was indeed difficult finding the right words. They wanted to try electric shock treatment. Fine. I was given a note: I was to be at the Salpetrière at one o'clock. I was there.
But then everything went quiet and in the quietness a superior self-satisfied voice that I thought I knew said: 'Riez! ' A pause. 'Riez. Mais riez, riez. '  I was already laughing. It was inexplicable why the man in there didn't want to laugh. A machine started rattling and immediately fell silent; words were exchanged, then again the same energetic voice made itself heard and commanded: 'Dites-nous le mot: avant.' Spelling it out: ' a-v-a-n-t '  . Silence. 'On n'entend rien. Encore une fois...'  And then, while the warm and squishy babbling continued on the other side, there, for the first time in many many years it was there again. That: the Big Thing, which had shocked me with my first deep horror when I was a child lying in bed with a fever. Yes, that's what I had always called it whenever they were all standing round my bed, feeling my pulse, and asking me what had scared me: the Big Thing. And whenever they sent for the doctor and he came and persuaded me to tell him, I would simply beg him to do everything he could so that the Big Thing went away, nothing else mattered. But he was like the others. He couldn't take it away, though I was small then and it would have been easy to help me. And now it was here again. Later on it had simply failed to appear, it hadn't come back not even during nights when I'd had fever, but it was here now and I didn't have a fever. Now it was here. Now it was growing out of me like a tumour, like a second head, and was a part of me although it couldn't belong to me since it was so big. It was there like a big dead animal that at one time, when it was still living, had been my my hand or my arm. And my blood flowed through me and through it, as through one and the same body. And my heart must have been under a great strain pumping blood into the Big One; there was hardly enough blood. And the blood, against its own will, entered the Big Thing and came back sick and corrupted. But the Big Thing swelled and grew before my face like a warm bluish boil and grew before my mouth and across my remaining eye ran the edge of its shadow. I can't remember how I found my way through so many yards. It was evening and I'd become lost in an unfamiliar neighbourhood. I walked in one direction up boulevards that had wall after wall and when I could see no end to them I walked back down in the opposite direction as far as some square or other. There I began to walk along one street and passed other streets that I'd never seen before, and still more of them. Sometimes electric trams with their lights too bright raced up raced past amid a harsh clanging of bells. But their destination signs carried names I didn't know. I didn't know what city I was in or whether I lived hereabouts, or what I had to do so that I wouldn't have to do any more walking.
 stylish shiny top-hat
 Laugh! . . . laugh. Come on laugh, laugh.
 Say the word 'before' for us.
 We can't hear. Say it again.