When Nietzsche Wept

The novel opens in Vienna at the end of the nineteenth century. A young Russian woman named Lou Salomé goes to see a highly respected physician, Dr. Josef Breuer. She has a delicate mission: to ask him to treat a friend, the philosopher Friedrich Nietzsche, who is said to be sunk in despair and on the verge of taking his own life.

The problem is that Nietzsche hates doctors and accepts help from no one. So Lou proposes a disguise: Breuer should treat the philosopher's terrible migraines, which are real, and, beneath that pretext, try to heal his soul. None of this can be said openly.

The reader is thrown into this game of masks right away. We know there is an illness of the body, another of the soul, and a third layer of well-meaning lies. It is the spring that drives the plot and raises the book's central question: is it possible to help someone who won't admit they need it?

Breuer is forty, a famous, wealthy doctor, married with a family. He has a full practice, important friends, and the admiration of his colleagues. On the outside, he looks like a man who has made it. On the inside, he is restless, unable to say exactly what he lacks.

Nietzsche is the apparent opposite. He is thirty-seven, lives alone, sick, with no steady job, full of ideas that almost no one reads. He has moved from city to city many times, suffers from headaches and vision problems, and takes pride in his solitude the way someone puts on armor.

Both men really existed, but the story of their meeting is the author's invention. Yalom notes at the end that it is historical fiction: the background facts are real, the conversations are not. That lets the novel imagine what each could have given the other.

To bring Nietzsche to the clinic, Breuer sets up a strategy. Instead of offering himself as a doctor, he lets the philosopher play the part of someone with migraines who agrees to be admitted for tests. Inside the clinic, he will try to build intimacy little by little, without forcing a confession.

But Nietzsche is a sharp reader of people. He sees the maneuver, distrusts the kindness, and answers with irony and distance. To him, agreeing to be treated is the same as admitting weakness. His resistance is so intense that no technique works, and the doctor slowly loses patience.

That's where the book's most ingenious idea appears. Breuer decides to flip the game: instead of offering help, he will ask for it. He pretends to have a personal problem, hoping that Nietzsche, feeling useful, will lower his guard. Someone who refuses to receive sometimes only accepts once he discovers he has something to give too.