Neurological Disease in Great Composers

Portrait of the Composer George Gershwin sitting at a piano
George Gershwin, who died from a brain tumor. Heritage Images/Getty Images / Getty Images

Neurological illness has existed throughout time.  Even the greatest minds are not immune.  In some cases, though, the disease itself may have helped create greatness, such as been inferred regarding the bombastic notes of Beethoven or the obsessive repetitiveness of Ravel's Bolero.  

Ludvig Von Beethoven

Beethoven’s is among the best known in classical music, and his neurological disorder is among the most famous in musical history.

  Born in Bonn, Beethoven lived in a time of musical greats such as Mozart, Haydn, and Schubert.  He composed nine symphonies, five piano concertos, 32 piano sonatas and 16 string quartets, as well as several musical works.  Incredibly, he did much of this work without being able to hear the music he composed.

Beethoven’s hearing loss began at about age 26 or 27, described as “ difficulty with conversation” and “Humming… that continues day and night without ceasing.”  By the age of 37 he used ear trumpets to help his hearing.  He composed his fifth symphony at the age of 48, though just a year later he would be described as “stone deaf.”   He died of liver failure in Vienna at age 57.

People have speculated on the cause of the great master’s deafness for years.  Other unusual features may be helpful.  Beethoven also had gastrointestinal problems and headaches.  Furthermore, he was described as having an unusual appearance, having been described as “leonine” or possessing a “simian ugliness.”

The great composer’s remains have been exhumed twice for autopsy, the first time 36 years and then 61 years after his death. The examiners noted that his external ears were irregularly formed, but that the auditory nerves were shriveled. His facial nerves, however, were described as unusually thick.

His brain was thought to have more wrinkles than normal, and his skull was unusually thick.

Several possible explanations were mentioned, including lupus or syphilis, though neither of these diagnoses seemed to fit. The most compelling diagnosis was named after a boy who was just 13 years of age at the time of Beethoven’s death in 1827. Sir James Paget would go on to become a physician who described a disease that would cause the same kind of gradual deafness, headaches, unusual appearance, and thickened skull of Beethoven.

Robert Schumann

Schumann was born in 1810. He had intended to be a concert pianist, but had a problem in his right hand. The composer further led a tumultuous life. By age 17 he was concerned he was losing his mind, and by age 20 had alcoholic binges and described a desire to throw himself into the Rhine river. The following year he wrote about a penile sore. By age 33 he had a persistent nervousness, with fits of shivering and apprehension of death. He had some improvement but again suffered a breakdown at age 42.

But not all was dire-- Schumann also experienced bouts of euphoria and high productivity.

On February 27th, 1854, Robert Schuman walked to the nearby Rhine River and threw himself into the frigid water. He was rescued by fisherman and was shortly thereafter interned in an asylum for the insane, where he died in 1856.

In retrospect, Schumann may have lived with bipolar illness, and he almost certainly died of neurosyphilis.

Maurice Ravel

Maurice Ravel was born in France. He was perfectionistic in his musical writing, but also focused on the need for music to entertain. By the age of 37, Ravel began to experience feelings of exhaustion. A few years later he began having poor appetite and insomnia. This insomnia would become more pronounced in 1929 when he wrote “Bolero.”  By 1933 He had difficulty with swimming and had his final public performance. In 1936, he was described as having difficulty speaking (aphasia), as well as clumsiness (apraxia). In late stages of his disease, he had memory problems and memory problems. Most authorities believe he suffered from familial frontotemporal dementia.

Dmitri Shostakovich

Dimitri Shostakovich was a child prodigy in music who would go on to compose several symphonies and concertos, as well as a successful opera. He nevertheless suffered bad health through his life, including childhood tuberculosis. Weakness prevented him from playing the piano well with his right hand. He was confirmed to have a paralytic disorder in 1973 and went on to have problems speaking and swallowing.  He died in 1975, due to what most experts have determined was amyotrophic lateral sclerosis.

Cole Porter

Cole Porter demonstrated early musical talent, and published his first musical piece “Song of the Birds,” at age 10. He had a very successful musical career, shaping American music, writing words and music for 12 Broadway shows and 11 movies. In 1937, his legs were severely damaged in a horseback riding accident. He suffered multiple fractures and nerve injuries. This led to severe pain and depression, as well as addictions to alcohol and medications. His legs required over 30 different surgeries, and ultimately his right leg was amputated. Nevertheless, Cole Porter complained about pain in his missing leg. This phantom pain continued until he passed away in 1964.

George Gershwin

George Gershwin also showed interest in music from an early age. He had a string of musical successes including Rhapsody in Blue and Porgy and Bess. In 1936, however, he became more depressed, in contrast to his previously outgoing personality. The following year, he smelled burnt rubber and had a mental lapse during a concert performance, which led to an uncharacteristic mistake. His physician initially diagnosed him with a psychosomatic disorder, as he had similar episodes. The smell of burnt rubber also became accompanied by dizzy spells. In 1937, his family members also noticed strange behavior changes, such as rubbing chocolate over his body and attempting to throw his driver out of a moving car. He began dropping objects from his right hand. In the morning of July 9th, 1937, Gershwin was able to play the piano—by the evening, he was in a coma. A neurological examination suggested the presence of a tumor, and he underwent urgent surgery—however, he died hours afterwards. A tumor was confirmed in his temporal lobe. Lesions in this area commonly known to cause seizures, which may sometimes cause unusual smells or dizziness. The tumor was originally thought to be a glioblastoma multiforme, a very aggressive tumor. Later reviews, however, suggested a less aggressive astrocytoma, raising the haunting possibility that with earlier diagnosis, George Gershwin may have been saved.

Source

Philip L Pearl, MD,  Professor of Neurology, Harvard Medical School Boston. Breaking Barriers in Neuro-Mythology: Beethoven’s Deafness, Schumann’s Madness, Gershwin’s Uncinate Seizures.  American Academy of Neurology Annual Conference 2015

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