Ferdinand opens a medical practice in La Garenne-Rancy

Ferdinand opens a medical practice in La Garenne-Rancy after years of working and studying, turning a return from America into a modest attempt to establish himself. The achievement is real, but its setting defines its limits: he arrives without ambition or confidence, in a poor suburb where even a verified medical diploma cannot guarantee patients or security.

From America to Medical School

After returning from America, Ferdinand spends weeks and months around Place Clichy and the Batignolles, the districts where he had begun, taking whatever odd jobs he can find. He describes the days as precarious and miserable, with work continuing in both rain and summer heat. In his spare time, largely alone, he reflects on books, newspapers, and what he has seen, and resumes his medical studies while earning his living.

The qualification takes five or six years of academic effort. Ferdinand presents the Faculty of Medicine as a guarded institution, a place in which knowledge is difficult to obtain and the eventual degree is a high-sounding document. He nevertheless passes his examinations and earns that degree, a substantial personal achievement following years of unstable work.

Establishing a Practice

Ferdinand opens his practice in La Garenne-Rancy, just beyond Porte Brancion on the way out of Paris. He puts his nameplate over the door and waits for patients. His motive is deliberately modest: he has little ambition and no great opinion of himself; he wants the chance to breathe and eat somewhat better.

The residents do not simply accept the nameplate as proof of his standing. They eye it suspiciously and go to the police station to ask whether he is really a doctor. The authorities confirm that Ferdinand has filed his diploma and is qualified. Word spreads through Rancy that a genuine doctor has opened another practice, but confirmation of his credentials does not resolve the more practical question of whether he can make a living. His concierge predicts that he will fail because too many doctors are already established in the area, and Ferdinand acknowledges that she is right.

The Practice and Its Neighborhood

The conditions surrounding the new practice make clear what kind of professional foothold Ferdinand has gained. At dawn, streetcars clatter down Boulevard Minotaure carrying crowds of dazed people to work. The young commuters appear cheerful, a contrast to Ferdinand’s bleak assessment of the district. He describes the houses as prisonlike, with their interiors neglected and their ownership represented by absent landlords and agents.

Rancy’s smoky sky recalls Detroit, and its cast-off buildings sit in blackened surroundings. The resemblance connects the suburb to the industrial environment Ferdinand has left behind: opening a practice has brought him back to France and into work as a doctor, but not out of urban poverty or alienation. His medical degree secures a recognized professional identity; the neighborhood’s conditions and crowded market place a sharp limit on what that identity can provide.

A Doctor Among Institutions

Ferdinand’s later work at the rest home in Vigny shows another setting in which his medical knowledge is used under institutional demands. In the evenings, staff conduct lengthy roll calls and make rounds of the patients’ rooms. Ferdinand recalls monitoring patients’ behavior before visiting days and administering an anti-masturbation syrup that he had previously used in connection with Bébert. The work is presented as routine management within the establishment, not as an extension of the independent practice he opened in Rancy.

Across these settings, Ferdinand’s credentials do not amount to professional freedom. In the factory, an examiner tells him that his health is unimportant for the work and warns that his education will not be useful there; at the rest home, his medical role includes carrying out institutional routines. The contrast helps define the Rancy opening: after precarious labor and years of study, Ferdinand has a diploma and a door bearing his name, but his working life remains shaped by poverty, institutions, and limited control over his circumstances.