On 23 December 1888, after cutting off part of his ear and giving it to a prostitute in a fit of madness, Vincent was admitted to hospital in Arles. He was treated by Dr Félix Rey (1865–1932).
Vincent's mental state worsened in his first days in hospital, according to Rey’s report: he chased the duty nurse in his nightshirt, forbade anyone from coming near his bed and washed himself in the coal bucket. As a result, he was placed in isolation.
The doctor wanted him transferred to an asylum in Marseille or Aix-en-Provence where he could receive better care: the hospital in Arles was mainly treating his ear and was less able to address his mental problems. In early January, however, Vincent unexpectedly took a marked turn for the better, and on 4 January, he was allowed to go home for a few hours for the first time. He was discharged from hospital on 7 January. Two days later, Vincent wrote to his brother Theo:
As soon as he felt better, Vincent resumed painting, producing works including a portrait of Dr Rey, which he gave the doctor as a keepsake. Within a month, however, he had another attack: he was convinced he had been poisoned. He was readmitted to hospital on 7 February and again placed in isolation. Vincent wrote:
“Having nothing else to distract me – I’m even forbidden to smoke – which, however, the other patients are allowed to do. Having nothing else to do I think about all those I know all day and night long.” [[brief nr=750)
Vincent was allowed to go home on 17 February, but he was not there long. A week and a half later, he was taken back to hospital on the order of the chief of police. His neighbours on Place Lamartine considered Vincent a danger and had drawn up a petition in an effort to get rid of him. He was accused of offences including indecent behaviour; it was alleged that he had chased women into their houses. Once again, he was placed in isolation.
Vincent remained in hospital until early May. He experienced long periods of lucidity and was therefore given permission to paint outdoors, and he took full advantage of it. During his stay in hospital, he painted many landscapes, along with works like Ward in the Hospital and The Courtyard of the Hospital. He was sometimes allowed to go into town, for instance when his friend Paul Signac came to visit.
His illness had made Vincent anxious and insecure. He became convinced that it would be better for him and for others if he continued to live apart from society for a while. Thus, on 8 May 1889, he had himself committed to the Saint-Paul de Mausole asylum in Saint-Rémy de Provence.