Saturday, November 26, 2011

Ludwig van Beethoven visits the Hadassah Medical Center, Ein Kerem (Jerusalem) in the hope for a better diagnosis

The subject was the life and death of Ludwig van Beethoven (1770-1827) as seen through the eyes of four doctors and researchers of the Hadassah Medical Center Jerusalem. It was 1:00 on November 23rd and the auditorium of the Ein Kerem hospital was more than crowded with medical staff interested in the case history of a great composer. The event began with the opening bars of Beethoven’s Piano Sonata in A flat major opus 26 played by Dr. Ayelet Shower (Cardiology). Dr. Shower then proceeded to sketch in details of Beethoven’s life – that his father was an alcoholic and that he had lost three siblings, that he was single and alone and that his hearing had begun to deteriorate at age 26. She spoke of the many hearing devices Beethoven himself and his friend Maelzel (inventor of the metronome) had built in order to hear sound vibrations better, of his suicide wish at one stage, his liking of women and drink and of his many health issues. The long list of medical problems was compiled from his doctors’ reports and his own writings; to name some - headaches, fever, rheumatism, gout, back pain, eye problems and liver problems. He seems to have spent much of his 50’s in bed. Close to his death, Beethoven's appetite much diminished but suffering from constant thirst, his doctor prescribed a cocktail in an attempt to save him, but to no avail.

Next to talk was Professor Yaakov Naparstek, chairman of Hadassah University Hospital and professor of Medicine at the Hebrew University Hadassah School of Medicine (Internal Medicine, Clinical Immunology, Allergy). Professor Naparstek based his diagnosis on the writings of Beethoven’s last doctor, on Beethoven’s conversation books (used for communication), the Heiligenstadt Testament, etc. He spoke of the composer’s deafness and despair: “What humiliation when anyone beside me heard a flute in the far distance, and I heard nothing.” We viewed a picture of Beethoven bent over his piano, his ear actually resting on the wood! By 1801, Beethoven no longer heard high notes, yet he could not tolerate shouting. Naparstek mentioned the “Beethoven gene” and talked about research done on the composer’s skull. He rules out the possibility of Beethoven having suffered from Paget’s disease (a chronic bone condition) but not Cogan’s Syndrome (a rare rheumatic condition characterized by inflammation of ears and eyes).

Dr. Shower’s playing the opening of the “Moonlight” Sonata opus 27 no.2 provided some welcome relief prior to Professor Naparstek’s launching into a detailed discussion of Beethoven’s internal problems. He talked about research based on examination of Beethoven’s bones and hair and corrected some of the misinformation concerning the composer: Beethoven did not have syphilis; neither did he suffer from rheumatism (this Naparstek saw from pictures of the composer’s hands). Beethoven liked to drink, but he was not necessarily an alcoholic. He had intestinal problems. Did the composer suffer from lead poisoning as the result of his drinking from a goblet made partially from lead? Professor Naparstek claims that what is absolutely clear is that Beethoven died of liver malfunction.

Ear, Nose and Throat specialist Dr. Michal Kaufman-Yeheskeli imagined Beethoven navigating the corridors of the Hadassah Medical Center, carrying a bag with his various hearing aids. She diagnosed him as having inner ear problems and as suffering from tinnitus, driven mad by “rushing and roaring sounds” in his head. Today the Hadassah specialists would be able to improve the state of his hearing with a cochlear implant. Beethoven was obliged to leave the world of performing because of his deafness, investing his energy in composing.

Pathologist Dr. Karen Meir reinforced what had sadly become clear to all of us present – that Beethoven had suffered a lot. Lying on his deathbed, the composer requested the doctors carry out an autopsy on his body; Dr. Johann Wagner and Karl von Rokitansky performed it in Beethoven’s house and a detailed report was written. Dr. Meir suggests Beethoven might have suffered from a multi-system disease from a young age, but she emphasized that microscopic examinations were not carried out and that these would have produced clearer findings.

In a letter to his brothers, to be opened only after his death, Beethoven wrote:” Oh ye, who think or declare me to be hostile, morose or misanthropical, how unjust you are, and how little you know the secret cause of what appears to you….six years ago I was attacked by an incurable malady, aggravated by unskillful physicians, deluded from year to year, too, by the hope of relief, and, at length, forced to the conviction of a lasting affliction”. Poor Beethoven! His music has given so much interest, inspiration and joy to the world yet he, himself, was lonely and ill. On his deathbed he uttered “Applaud, my friends. The comedy is over…”

1 comment:

Yoel Donchin said...

שמי פרופ דונחין ואני האחראי על הדיון על בטהובן
כתבת יפה האם היית שם ואיך נוגע לךך האם את עובדת בהדסה
תודה בכל אופן