Ultimately, it is clear that while Vincent was haunted by thoughts of death, he felt safe from them within the asylum, and instead came to associate thoughts of death with the outdoors. These disparate views of the asylum interior and the outdoors can be seen by comparing the interior gouache and its accompanying photograph with an analogous photograph and painting of the exterior of the asylum. An anonymous photograph entitled Garden and Entrance to the Men’s Ward of Saint-Paul-de-Mausole shows the entrance to the asylum with a number of small shrubs and a handful of trees in front of it. Van Gogh depicted this same scene in Trees in Front of the Entrance to the Asylum, painted in October of 1889, but it is hardly recognizable. The trees have grown in number and size in Van Gogh’s imagination. In the painting, they dwarf the façade of the asylum, reaching toward the sky in the same gesture as the cypress in The Starry Night. While Van Gogh was content to paint an accurate depiction of the visual reality of the interior of the asylum, he chose to alter his depiction of the outdoors in order to express the fear of death that he associated with the world outside the asylum. This may have been one of the stronger motivations that compelled him to commit himself to Saint-Paul-de-Mausole: an attempt to escape this haunting fear of death. After he left Saint-Rémy for Paris and then Auvers in May of 1890,Vincent likely continued to be haunted by the specter of death until his suicide two months later. He shot himself in the chest on the evening of July 27, 1890 out of doors, in a field in which he had been painting (Brooks).
It is fitting that Van Gogh chose to end his life outdoors, under the stars which had so fascinated and terrified him, and which he perhaps reached, as he had speculated to Theo he would the year before.