Disentangling facts and opinions about what diseases have wrought on composers' creation of their music. That is the task the authors set for themselves: debunking myths and seeking truths. The book is brimming with musical analyses by musicologist Yves Knockaert and medical bulletins. The latter come from Frieda Matthys, em. prof. dr. psychiatry and psychology VUB. Take Beethoven, for instance. What happens when his ability to listen to what he writes diminishes?

That's what the first chapter is about. It's immediately a bull's-eye: how did Beethoven cope with his deafness? The authors compile the facts and opinions they know about composers who must contend with illnesses during their careers that do more than just hinder their profession. Should the listener worry about that mental and physical health? Can you see or hear anything in Beethoven's oeuvre, and in his behavior, of how he deals with that increasing deafness? Is there resistance against that fate, does he want to be the hero who fights it? Only later does acceptance come for him; he stops performing as a soloist and composes less for piano. "But how does someone manage to write complex compositions without being able to test them aurally?" It remains an unanswered question. His last works? Pure brainwork, some say, perhaps too cerebral. Beethoven himself: "Haven't I always been a sick person?" We learn that several other well-known (Gabriel Fauré, Ralph Vaughan Williams) and lesser-known composers also struggled with deafness.

But of course there are other ailments that can cross a composer's path. And you read this book naturally to learn more about those few great names who dealt with it without you already knowing. Take Bach and Handel's declining eyesight: cataracts. Both were operated on at the end of their lives by the same traveling quack "eye surgeon" John Taylor and yet both died blind. Another great name takes up a large part of the chapter on syphilis: Franz Schubert. He contracted the disease in 1823 but remains "inhumanly diligent" because, as he himself writes, "pain sharpens the mind and strengthens the spirit." And in that pain arose a slew of dark masterpieces: his Der Tod und das Mädchen, his Winterreise, his ninth symphony, his last piano sonatas. Yet his sudden cause of death turned out to be typhoid fever, due to a salmonella bacterium. Other syphilis sufferers included Niccolò Paganini, possibly poisoned by the then mercury treatment for syphilis, Gaetano Donizetti, who despite the disease managed to write 65 operas, including the mad scene from Lucia di Lammermoor...

Each little chapter begins, by the way, with a clear explanation of all those diseases composers suffered from. Similarly with tuberculosis, which until the early 20th century was responsible for 25% of deaths in Europe. You naturally think of Chopin. He had airway problems from a young age, but science still dares not attribute his death to tuberculosis today. A persistently weak constitution, that much is certain. Often despondent, almost always catching cold and coughing, but he remained productive. George Sand on his compositions: "it was the most painful labor I ever witnessed." Purcell, Pergolesi, Boccherini, Carl Maria von Weber, and Szymanowski actually died of tuberculosis.

It is somewhat sad to read that list of ailments. But on the other hand, it makes us realize that the artist's life is not always a bed of roses and it also commands respect for their perseverance. Mahler, with his heart disease, always carried a pedometer (!) in his pocket! Knockaert analyzes sharply how Mahler dealt with the word "heart" whenever he came across it, for example when setting Das Lied von der Erde. Bellini wrote his Casta Diva in the hellish pain of his persistent intestinal disease. Lili Boulanger, also suffering from intestinal disease, wrote the song Dans l'immense tristesse in 1916. Two years later she dies.

There are also those who simply grow old and develop dementia, Papa Haydn for instance. Ravel too had neurological problems, underwent brain surgery but that turned out fatally. Was it too much vodka and cigarettes for Shostakovich? Lung cancer in any case, but perhaps also ALS in the end? Alcohol and other intoxicants we see in "café pianist" Satie and also Sibelius "Can I give up drinking? It remains a pious hope." Yet he lived to 91. Knockaert: "The list of composers who drank (too) much alcohol is endless." The authors also discuss mood disorders. Who doesn't have them? Well, Schumann certainly did. Was Wagner bipolar and did Mozart have ADHD?

Yet despite the many uncertain medical bulletins from back then, all those ailments do not necessarily prevent the magnificence and productivity of their compositions. So the book contains not just sadness; on the contrary, it is a pleasure to read all those anecdotal details about composers and their times. And also because of the many sometimes extensive analyses that Knockaert writes about how and what they compose during their illness. And all of this seasoned with contemporary and modern medical insights that coauthor Frieda Matthys shares with us. The entire book is actually a tribute to the work ethic and resilience of all those composers who might have lived different lives had they been treated with the knowledge of modern medical science. Sick and sighing, composers: they remain a tough breed.

ISBN 978 94 6371 595 9