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Glenn Gould as Patient

This paper was presented at the symposium and film festival "Glenn Gould: Variations on Musical Genius in our Time," November 18, 1995 at the Dolby Facilities in San Francisco.

Glenn Gould was surprisingly open in talking about his many symptoms. When I first met him in 1957 -- we were both in our twenties then -- he told me within the first half hour about pain and spasms he was having in his arms, about the physiotherapy treatment he was receiving in Toronto, and about various pills he had been taking for some time. The preceding year, on a vacation trip to the Bahamas, he had told perfect strangers about "this thing: It's bringing on a spastic stomach, diarrhea, and tightening of the throat. I've got three doctors treating me for it now."1 One of Glenn's most prominent complaints was a fear of being too cold. He constantly overdressed, wearing heavy sweaters, overcoats, woolen gloves, scarves, and caps even in the hot sweltering summers of Toronto. He always insisted that the temperature of a room be brought up to a level where he felt comfortable and others usually felt uncomfortable. His fear of cold and of catching cold was something his mother had installed in him when Glenn was a small boy. She told him "don't go outside in the fresh air, you might catch a germ." If anyone was the faintest bit sick, they were not allowed to be near him. His mother discouraged him from getting close to crowds. She urged him to keep away from the Canadian National Exhibition and other places where there are large numbers of people. Glenn with his vivid imagination amplified his mother's warnings to the point of absurdity.

He would do a lot of reading about infections, and he knew all about the latest antibiotics. He frequently consulted medical doctors, as well as chiropractors, usually to tell them how he wanted them to treat him. All of his doctors that I have interviewed describe Glenn as a difficult patient who had to have things his own way, who insisted on making appointments late in the day because he preferred staying in bed until noon or one o'clock, and who wanted to direct his own treatment. He refused common-sense advice regarding proper hygiene, diet, and physical exercise. One of his worst habits, in my opinion, was of not informing his doctors about who else was treating him and prescribing medication, thus causing confusion and probably over-medication. He had little respect for the side-effects of drugs.

Shortly after his sensational New York debut and his wildly successful recording of the Goldberg Variations at age 23, Glenn arranged to have a psychiatric consultation with one of the leading members of the psychiatric establishment in Montreal. In those days, psychiatry was considered more advanced in Montreal than it was in Toronto. The doctor gave him the names of one psychoanalyst and three general psychiatrists in Toronto, and Glenn began seeing one of the general psychiatrists who apparently chose not to use psychological approaches but to treat him primarily with medication. How long the treatment lasted, or how effective it was I have been unable to discover, but I suspect that Glenn's recent exposure to psychiatry was a factor in his positive feelings as well as his ambivalence toward me when we met two years later.

That was in 1957, the year Glenn was invited to give concerts in Moscow and Leningrad, a great boost to his career since no classical musician from the West had ever before performed behind the Iron Curtain. His manager Walter Homburger went along to help with arrangements for a European tour afterwards that included a concert with Karajan in Berlin, which, like the Russia concerts, was a huge success. But the following year Glenn ran into trouble in Europe. Despite his brilliant playing, fellow artists noticed his helplessness and neurotic behavior. Glenn was beginning to make remarks suggesting that audiences were basically hostile to artists and that it was dangerous for him to expose himself to the public. In Austria he developed an upper-respiratory infection and began canceling concerts. Subsequently he came down with what was diagnosed as a kidney infection for which he was told to eat a low-protein diet. He canceled more concerts and retreated to a hotel in Hamburg where he wrote his friends (including me) that "on the whole I study better and work easier in a climate of indifference such as hotels provide." His manager Mr. Homburger arrived in the nick of time to prevent Glenn from canceling a concert tour of Israel.

1959, when Glenn was 27 years old, turned out to be a year of great crisis for him. First, John Roberts and other friends in Toronto who were trying to get him to be more independent, got Glenn to move away from his home on 32 Southwood drive where he was still living with his parents. In an outburst of enthusiasm Glenn impulsively rented a large country estate called "Donchery." John Roberts helped him furnish the building, Glenn told people that he was planning to occupy one wing of the mansion, while the other wing was to be reserved for "his manager" -- it wasn't exactly clear who that was meant to be. Very quickly Glenn got cold feet and pulled out of the deal, at considerable expense. His friends helped him find a 6-room penthouse on St. Clair Avenue in Toronto, and he gradually became accustomed to living there. But John Roberts noticed some peculiar symptoms, for example complaints that pieces of furniture were looking at Glenn in on odd way and that he was hearing strange voices.

In November 1959 Gould came to San Francisco to perform the Goldberg Variations at the Curran Theater but told me he was too sick to play and would have to cancel. I sent him to Dr. Malcolm Watts, a Professor at UC Medical School, who gave Glenn a clean bill of health. He went ahead with the performance, but in the middle of the Bach he suddenly stopped playing and complained about a draft coming from an open door way up in the balcony. The door had to be closed for the concert to continue.

Upon returning to Toronto there was another crisis. Glenn called me to say that disturbing things were happening in his apartment. Some neighbors were spying on him from the roof, shining lights into his windows, making strange noises, and sending him coded messages. He found the whole thing more disconcerting than frightening. Something was going on that he couldn't understand or control. He wanted my advice: should he call the police or would it be better to deal with these people directly, invite them in, go to their place, or correspond with them? I wondered whether Glenn was in a drug delirium, or whether he was developing a paranoid episode? Over the phone and at such a distance there was no way to know for sure what was going on. I told him not to call the police and not to try to deal with the neighbors directly, but to get in touch with his doctor in Toronto for help. (At the time I didn't know that he had a psychiatrist there.) Several days later there arrived a letter from Glenn asking me to be his "conspirator." In essence what he wanted was for me to certify on a copy of his contract with his manager that he was too sick to be giving concerts and should be excused from further touring. In my answering letter I urged him not to do any further touring until his medical problems were under control and explained that it would be unethical for me to intervene with the manager since he was not actually my patient and I had never examined him.

At the some time I decided on a little conspiracy of my own. I had a good friend and psychiatric colleague, Dr. Joseph Stephens, living in Baltimore, Maryland, where Glenn was scheduled to give a concert with the Symphony Orchestra in March 1960. I called Dr. Stephens, told him what had been happening with Glenn recently, and urged him to go backstage after the concert to introduce himself to the pianist. That's exactly what happened, and fortunately the two men liked each other. "We began driving in the snow to my house," says Dr. Stephens. Glenn said "you understand nothing about how to drive in the snow. Let me drive. So I said "okay" and within a very few minutes he nearly ran into a car by going through an intersection and not watching where he was going, putting on the brakes and having the car skid." Gould was basically a good driver, but he was so easily distracted by music or topics of conversation that he would have accidents.

Fortunately Dr. Stephens' apartment was close to the concert hall. They arrived safely and "talked about music." Dr. Stephens has told me that "Glenn always did far more of the talking than I did, and he was always a monologist. There wasn't much two-way conversation, because it was always Glenn pontificating to anybody that wanted to listen. I liked him very much and wanted to listen. He seemed very warm, very natural, very unaffected, and for some reason he seemed to like me, because before the evening was over I was already invited to come to Canada to visit him."

Thus began one of Glenn's longest and most solid friendships. It lasted 17 years, during which they saw each other frequently or spoke by telephone two to three times a week. I think it was as close as Glenn ever got to having a psychotherapeutic relationship. Dr. Stephens always maintained clinical objectivity, never criticized, teased or belittled him in any way. Dr. Stephens is Professor of Psychiatry at Johns Hopkins and a world-famous researcher on schizophrenia. He is also a harpsichord and piano player of professional quality. Thus Gould found it possible to converse at length with Dr. Stephens on aspects of keyboard technique, and to improvise for him. "He was amazingly good at improvising," says Dr. Stephens. "Brahms, Schubert, Rachmaninoff -- you name the composer -- he improvised them all beautifully in their styles."

But their relationship had another side. As Dr. Stephens told me, "one of Glenn's attractions to me was the fact that I was a doctor, and that he was a super-hypochondriac." Indeed, the very first time they met, Glenn shared with Dr. Stephens a most disturbing medical problem he was then having. It had started a couple of months earlier, when Glenn was in New York visiting the Steinway Piano Company. There he had been having arguments with the chief technician, Mr. William Hupfer, about how far to go in modifying his piano. Glenn wanted the action to be lighter, which Hupfer in wanting to preserve "the true Steinway sound" strongly resisted. In the course of the afternoon, Hupfer, in what was probably meant as a gesture of reconciliation, slapped Glenn on the back. He immediately became upset, claiming that Hupfer had struck him so forcefully as to cause pain and produce a physical injury. He feared that he might never be able to play the piano again and that his career was ruined. He asked his lawyer to take action against Steinways for $300 000 in personal damages. The case was settled out of court for a lesser amount.

In the meantime it was obviously necessary to have Glenn examined by specialists. On February 4, 1960 he was seen by Dr. Morris D. Charendoff, one of Toronto's leading orthopedic surgeons, who reported that ever since that incident at Steinways, Gould "had been experiencing several rather vague complaints with reference to his left arm, consisting chiefly of a sense of fatigue, aching and a sense of incoordination in the left arm and especially the left hand. He had noticed the latter symptoms particularly in his attempts to play the piano. He had also been aware of attacks of numbness and tingling affecting the 4th and 5th digits so that he was unable to properly coordinate these fingers in difficult technical pieces on the piano and that the above problems had represented a disability to him."

I'd like to interject at this point that at the Health Program for Performing Artists in San Francisco we have seen many musicians with similar complaints, and we take them to be real, not imaginary. Often these symptoms turn out to be products of "overuse," a syndrome brought on by the incessant practicing and performing that musicians force themselves to engage in, sometimes under undesirable conditions of fatigue, competition, and stress.

What Dr. Charendoff concluded about Glenn Gould in 1960 was that was a result of the "injury" that Glenn was blaming on Steinways, "he could have suffered a minor traction injury to the various nerves entering his upper extremity and particularly the roots of the ulnar nerve. Such injuries are referred to as neuropraxia. They can usually last anywhere from 6-8 weeks, but do not lead to permanent disability." Glenn had daily treatment from a masseur and also took some cortisone, apparently with little relief. Because he continued to complain, Dr. Stephens took him to a Hopkins professor for a neurological examination. The neurologist commented on a "tic and marked asymmetry in (Gould's) face" (the tic we can seen in some of his films, especially the one he made with Yehudi Menuhin). The neurologist concluded that "there was absolutely nothing the matter with this man neurologically, the problem is in the field of psychiatry." Dr. Stephens felt that "actually, the concern about his shoulder was out of proportion to anything that made physiological sense and that it bordered on the delusional."

For several years, on the recommendation of the conductor Eugene Ormandy, Glenn received treatment for his ailing left shoulder from an orthopedist in Philadelphia. This doctor put Glenn's entire upper body into a plaster cast, hoping thus to bring parts of Glenn's left shoulder into a better alignment. Whether the treatment did much good is hard to say. By the summer of 1960 Gould was already back to giving concerts and making recordings and films. In 1962 he made his first radio documentary about a composer, Arnold Schoenberg, and I'm proud to say that I was one of the people he interviewed for this program.2 (I'd met Schoenberg and attended his classes at the Music Academy of the West.)

In 1964, at age 32, Glenn finally decided to honor his commitment not to give any more public concerts. He began working exclusively in the area of radio and film making.

Getting back to his health problems, Glenn was profoundly affected by the death of his 85-year old mother in 1975, when he was 43 years old. She had developed a massive stroke, and he was on the phone with Dr. Stephens for many hours trying to find out what could be done for her. Her death proved to be an enormous emotional loss which left Glenn bereft and in deep despair. Having never attached himself to any other woman, his mother had remained a tremendously important figure in his life. It was with her that he could share his joys and disappointments, his dreams, the reviews of his concerts, and other aspects of his career. After her death, Glenn became more introspective, more philosophical, and maybe even more reclusive. And his relationship with his elderly father changed. There was considerable bitterness when the older man wanted to remarry. Glenn was supposed to be the best man, but he absolutely refused to go to the wedding ceremony.

To make matters worse, only a year after his mother's death Dr. John Percival, whom Glenn had been consulting on a regular basis for years, found him to have a mildly elevated blood pressure. "It was 150 over 90," Dr. Percival told me. He tried to reassure Glenn by saying "it's elevated a little bit, but nothing to worry about. Don't give it a second thought." But Glenn become quite alarmed: "I disagree with you; that is quite wrong; my father has been battling high blood pressure for years." Unbeknownst to Dr. Percival, Glenn started consulting a nephrologist at the University of Toronto who put him on an antihypertensive regimen and vigorously treated other symptoms Glenn had been complaining of for years. Among Dr. Logan's prescriptions we find medication for gout (which Glenn never had), for Parkinsonism, and for anxiety. Vallium was dispensed by both Dr. Logan and Dr. Percival as well as other doctors, so Glenn had a steady supply of this tranquilizer and probably became addicted to it. Profound anxiety led him to check his blood pressure at frequent intervals during the day and the night, using both a German and a Japanese blood-pressure machine. There were a number of crises when his blood pressure rose precipitously, but for the most part the hypertension was well controlled with medication.

A new career opportunity opened up for Glenn when he was approached in 1971 by a film director to provide background music for the film Slaughterhouse-Five by Kurt Vonnegut. Glenn didn't like the film, but he spent a lot of time with the directors to finalize his contribution to it, less than 15 minutes of music by Bach. Three years later, Warner Brothers used excerpts from the Goldberg Variations for its film The Terminal Man. But it was not until Gould's last year, 1982, that he was asked to contribute some original music to a film called, The Wars, produced by Richard Nielsen. Gould liked the film, but he failed to seize on this opportunity to be the composer he always said he wanted to be, and instead merely assembled, very tastefully, music by Brahms, Strauss, and other composers, into a collage that worked very well as a sound track. The Wars was a success in Canada, but was never shown in the United States.

By now, Glenn was already a sick man, scarred by the effects of hypertension, weakened by self-neglect -- inadequate diet, lack of exercise, sleep, and fresh air -- and probably overmedicated. The author of The Wars visiting him for the first time, described Glenn as "really sick. He looked ill, because the colour of his skin was so alarming. And his hair looked dead … that awful look of someone who's been ill in a very major way so their hair dies..."3 Dr. Joseph Stephens and I were similarly shocked to observe his physical decline when we spent an evening with him in 1977 listening to his latest recordings. Glenn had always seemed amazingly youthful and energetic. Now we were in the presence of a man who seemed prematurely aged, terribly pale, with thinning hair, a stooped-over posture, and tense facial expression.

But he continued to have all sorts of projects, ambitions, and original ideas. Toward the end of his life Glenn made serious efforts to be a conductor. He had long ago changed managers, dropping Walter Homburger in favor of Ronald Wilford of Columbia Artists in New York who is an expert with conductors. In order to conduct, Glenn felt that he would have to give up piano-playing, because conducting activated muscles and movements of the back and shoulders that led to pain and stiffness when he returned to the keyboard. He wrote out a long list of favorite orchestral pieces that he wished to conduct, and began working secretively and at his own expense with members of the Hamilton Philharmonic. The results seem to have been encouraging, for in July 1982 Glenn was recording Wagner's Sigfried Idyll in a slow-paced performance emphasizing the work's contrapuntal structures.4 But since this is the chamber-music version employing only a small group of instruments, we cannot tell how Gould would have sounded conducting a full-fledged symphony orchestra.

In looking at his last-years' notes, one is struck by the enormous discrepancy between plans for various ambitions projects that would have taken years to complete, and his daily description of symptoms and suffering that would be consistent with someone in a nursing home -- "palpitations, heat in arms, indigestive-style pains in chest, wake-up pulse rate, dream episodes, high pulse diminishing with activity, freezing sensations, shivers top of nose, ankle-foot phenomenon, lower abdomen problem, liquid consumption triggers pockets of ulcer-like pains through to back, congestive sensation when bending over, bladder pressure, urination while asleep."5 These were the two Goulds, the courageous Canadian pioneer of the performing arts, and the abject victim of disease.

On the 27th of September 1982, two days after his 50th birthday Glenn woke up realizing there was something new the matter with him. He felt numbness down his left side and some weakness of the left arm, signs of what he suspected might be a stroke. He wanted one of his doctors to come over to examine him, which apparently was not possible. He resisted going to the hospital by ambulance and had to be driven there uncomfortably by car. On admission he was alert but showed slowed speech, left facial weakness, and other signs suggesting a left hemipleglia caused by infarction of the arteries in his left frontal brain -- what this means is that the arteries had clotted and blood was no longer flowing to the right side of the brain, resulting in paralysis on the left side. Within two days his condition had deteriorated to the point where he had to be transferred to Respiratory Intensive Care. By now he was comatose. Electroencephalographic studies showed massive destruction of the right brain hemisphere, and other tests revealed death of the medulla oblongata, the brain's central controlling mechanism of bodily functions. On October 4th, with his family's consent, he was taken off life-support systems and declared dead. An autopsy confirmed the diagnosis of massive right cerebral infarction and showed no pathology of Glenn's heart, prostate, stomach, and other organs about which he had been complaining so much for so many years.

In summary, I've presented the medical history of Glenn Gould in some detail in order to highlight the struggle he had throughout his career with physical and mental illness and to emphasize the serious problems likely to be encountered in the practice of performing arts medicine.

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References

1. Jock Carroll, Glenn Gould: Some Portraits of the Artist as a Young Man, Toronto: Stoddard, 1995, p. 14

2. "Arnold Schoenberg: The Man Who Changed Music," CBC Wednesday Night Radio Broadcast, August 8, 1962

3. Otto Friedrich, Glenn Gould: A Life and Variations, New York: Random House, 1989, p. 267

4. Sony Classical SMK 52 65o

5. Otto Friedrich, Glenn Gould: A Life and Variations, p. 317-318

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