Anatomy of an Illness as Perceived by the Patient (6 page)

Don Pablo brightened. “Yes, of course,” he said, “it will be good to see them again.”

As before, he stretched his arms in front of him and extended his fingers. Then the spine straightened and he stood up and went to his cello. He began to play. His fingers, hands, and arms were in sublime coordination as they responded to the demands of his brain for the controlled beauty of movement and tone. Any cellist thirty years his junior would have been proud to have such extraordinary physical command.

Twice in one day I had seen the miracle. A man almost ninety, beset with the infirmities of old age, was able to cast off his afflictions, at least temporarily, because he knew he had something of overriding importance to do. There was no mystery about the way it worked, for it happened every day. Creativity for Pablo Casals was the source of his own cortisone. It is doubtful whether any antiinflammatory medication he would have taken would have been as powerful or as safe as the substances produced by the interaction of his mind and body.

The process is not strange. If he had been caught up in an emotional storm, the effects would have been manifested in an increased flow of hydrochloric acid to the stomach, in an upsurge of adrenal activity, in the production of corticoids, in the increase of blood pressure, and a faster heart beat.

But he was caught up in something else. He was caught up in his own creativity, in his own desire to accomplish a specific purpose, and the effect was both genuine and observable. And the effects on his body chemistry were no less pronounced—albeit in a positive way—than they would have been if he had been through an emotional wringer.

Don Pablo, though delicately built, almost frail, was a giant among men in spirit and creative stature. He was buoyantly sympathetic in manner, managing to involve himself very quickly in the concerns or problems of his friends or visitors. His responses were unhurried, genuine, full. He showed me some of his original Bach manuscripts, and he remarked that Bach meant more to him than any other composer.

This was only one of several things he had in common with Schweitzer, I remarked.

“My good friend Albert Schweitzer shares with me the belief that Bach is the greatest of all composers,” Don Pablo said, “but we like Bach for entirely different reasons. Schweitzer sees Bach in complex architectural terms; he acclaims him as a master who reigns supreme over the great and diverse realm of music. I see Bach as a great romantic. His music stirs me, helps me to feel fully alive. When I wake up each morning I can hardly wait to play Bach. What a wonderful way to start the day.”

If Bach was his favorite composer, what was his favorite composition?

“The piece that means the most to me was written not by Bach but by Brahms,” he said. “Here, let me show it to you. I have the original manuscript.”

He took down from the wall, where it had been framed behind glass, one of the most valuable music manuscripts in the world now in private hands—Brahms's B-flat Quartet.

“Interesting, how I happened to acquire it,” he said. “Many years ago I knew a man who was head of the Friends of Music in Vienna. His name was Wilhelm Kuchs. One night in Vienna—this was before the war—he invited several of his friends for dinner, myself included. He had what I believe may have been the finest private collection of original music manuscripts in the world. He also owned an impressive collection of fine musical instruments—violins by Stradivarius and Guarneri among them. He was wealthy, very wealthy, but he was a simple man and a very accessible one.

“Then the war came. He was in his eighties. He had no intention of spending the rest of his old age under Nazism. He moved to Switzerland. He was then more than ninety. I was eager to pay my respects. Just seeing him again, this wonderful old friend who had done so much for music, was to me a very moving experience. I think we both wept on each other's shoulder. Then I told him how concerned I had been over this collection of manuscripts. I had been terribly apprehensive that he might not have been able to keep his collection from falling into Nazi hands.

“My friend told me there was nothing to worry about; he had managed to save the entire collection. Then he went and got some items from the collection—some chamber music by Schubert and Mozart to begin with. Then he placed on the table before me the original manuscript of the Brahms B-flat Quartet. I could hardly believe my eyes. I stood transfixed. I suppose every musician feels that there is one piece that speaks to him alone, one which he feels seems to involve every molecule of his being. This was the way I had felt about the B-flat Quartet ever since I played it for the first time. And always I felt it was mine.

“Mr. Kuchs could see that when I held the B-flat Quartet manuscript in my hands it was a very special and powerful emotional experience.

“‘It is
your
quartet in every way,' Mr. Kuchs said. ‘It would make me happy if you would let me give it to you.' And he did.

“I couldn't thank him adequately then, but I did write him a long letter telling him of the great pride and joy his gift had brought to my life. When Mr. Kuchs replied, he told me many things about the history of the B-flat Quartet I had not known before. One fact in particular stood out. It is that Brahms began to write the quartet just nine months before I was born. It took him nine months to complete it. We both came into the world on exactly the same day, the same month, the same year.”

As Don Pablo spoke, he seemed to relive the experience. His features, unmarred by any hard lines, were so expressive that his words seemed merely to confirm the image. Indeed, his face had the dramatic power of a full Ibsen cast.

I asked Don Pablo whether any other individual compositions had special meaning for him.

“Many pieces,” he said, “but none that I felt owned me and expressed me as much as the B-flat Quartet. Yet, when I get up in the morning, I can think only of Bach. I have the feeling that the world is being reborn. Nature always seems more in evidence to me in the morning.

“There is one other piece I must tell you about. This one, too, has special meaning. I think it is the piece I would like most to hear again during my last moments on earth. How lovely and moving it is, the second movement of Mozart's Clarinet Quintet.”

Don Pablo played it. His fingers were thin and the skin was pale but they belonged to the most extraordinary hands I had ever seen. They seemed to have a wisdom and a grace of their own. When he played Mozart, he was clearly the interpreter and not just the performer; yet it was difficult to imagine how the piece could be played in any other way.

After he got up from the piano he apologized for having taken up so much time in our talk with music, instead of discussing the affairs of the world. I told him I had the impression that what he had been saying and doing were most relevant in terms of the world's affairs. In the discussion that followed there seemed to be agreement on the proposition that the most serious part of the problem of world peace was that the individual felt helpless.

“The answer to helplessness is not so very complicated,” Don Pablo said. “A man can do something for peace without having to jump into politics. Each man has inside him a basic decency and goodness. If he listens to it and acts on it, he is giving a great deal of what it is the world needs most. It is not complicated but it takes courage. It takes courage for a man to listen to his own goodness and act on it. Do we dare to be ourselves? This is the question that counts.”

The decency and goodness within Don Pablo were clearly evident. But there were other resources—purpose, the will to live, faith, and good humor—that enabled him to cope with his infirmities and to perform as cellist and conductor well into his nineties.

Albert Schweitzer always believed that the best medicine for any illness he might have was the knowledge that he had a job to do, plus a good sense of humor. He once said that disease tended to leave him rather rapidly because it found so little hospitality inside his body.

The essence of Dr. Schweitzer was purpose and creativity. All his multiple skills and interests were energized by a torrential drive to use his mind and body. To observe him at work at his hospital in Lambarene was to see human purpose bordering on the supernatural. During an average day at the hospital, even after he turned ninety, he would attend to his duties at the clinic and make his rounds, do strenuous carpentry, move heavy crates of medicine, work on his correspondence (innumerable letters each day), give time to his unfinished manuscripts, and play the piano.

“I have no intention of dying,” he once told his staff, “so long as I can do things. And if I do things, there is no need to die. So I will live a long, long time.”

And he did—until he was ninety-five.

Like his friend Pablo Casals, Albert Schweitzer would not allow a single day to pass without playing Bach. His favorite piece was the Toccata and Fugue in D Minor. The piece was written for the organ. But there were no organs in Lambarene. There were two pianos, both uprights, both ancient. The one in the staff dining room was the more battered of the two. The equatorial climate, with its saturating humidity, had vanquished it almost beyond recognition. Some of the keys had no ivories; others were yellowed and cracked. The felt on the hammers had worn thin and produced harsh, twanging sounds. The instrument hadn't been tuned in years; even if it had been, the improvement would have been short-lived. On my first visit to the hospital, I wandered into the dining room, sat down to play, then drew back abruptly at the caricatured tones. Yet the amazing thing was that Schweitzer could play hymns on it at dinnertime each evening and the piano somehow lost its poverty in his hands.

The other piano was in his bungalow. It was in far better shape than the one in the dining room but it was hardly what one would call playable for a performer of Schweitzer's worldwide reputation. It had an organ footboard attachment that was engineered into the hammer action, but this footboard had the infuriating habit of becoming detached in the middle of critical passages. Even a phantom footboard, however, provided him with an opportunity to work his feet.

In an earlier book, I wrote about my experience at the Lambarene hospital when, one night, long after most of the oil lamps had been turned out, I walked down toward the river. It was a sticky night and I couldn't sleep. As I passed the compound near Dr. Schweitzer's quarters, I could hear the rapid piano movement of a Bach toccata.

I approached the doctor's bungalow and stood for perhaps five minutes outside the latticed window, through which I could see his silhouette at the piano in the dimly lit room. His powerful hands were in total control of the composition and he met Bach's demands for complete definition of each note—each with its own weight and value, yet all of them intimately interlaced to create an ordered whole.

I had a stronger sense of listening to a great console than if I had been in the world's largest cathedral. The yearning for an architectured beauty in music; the disciplined artistry and the palpable desire to keep alive a towering part of his past; the need for outpouring and catharsis—all these things inside Albert Schweitzer spoke in his playing.

And when he was through he sat with his hands resting lightly on the keys, his great head bent forward as though to catch the lingering echoes. Johann Sebastian Bach had made it possible for him to free himself of the pressures and tensions of the hospital, with its forms to fill out in triplicate. He was now restored to the world of creative and ordered splendor that he had always found in music.

The effect of the music was much the same on Schweitzer as it had been on Casals. He felt restored, regenerated, enhanced. When he stood up, there was no trace of a stoop. Music was his medicine.

But not the only medicine. There was also humor.

Albert Schweitzer employed humor as a form of equatorial therapy, a way of reducing the temperatures and the humidity and the tensions. His use of humor, in fact, was so artistic that one had the feeling he almost regarded it as a musical instrument.

Life for the young doctors and nurses was not easy at the Schweitzer Hospital. Dr. Schweitzer knew it and gave himself the task of supplying nutrients for their spirits. At mealtimes, when the staff came together, Schweitzer always had an amusing story or two to go with the meal. Laughter at the dinner hour was probably the most important course. It was fascinating to see the way the staff members seemed to be rejuvenated by the wryness of his humor. At one meal, for example, Dr. Schweitzer reported to the staff that, “as everyone knows, there are only two automobiles within seventy-five miles of the hospital. This afternoon, the inevitable happened; the cars collided. We have treated the drivers for their superficial wounds. Anyone who has reverence for machines may treat the cars.”

The next evening, he passed along the news that six baby chicks had been born to Edna the hen, who made her home near the dock. “It was a great surprise to me,” he said solemnly, “I didn't even know she was that way.”

One night at the dinner table, after a particularly trying day, he related to the staff an account of his visit to the Royal Palace in Copenhagen some years earlier. The invitation was for dinner, the first course of which was Danish herring. Schweitzer didn't happen to like herring. When no one was looking he deftly slipped the herring off the plate and into his jacket pocket. The next day, one of the local newspapers, reporting on the life at the Royal Palace, told of the visit of the jungle doctor and of the strange eating habits he had picked up in Africa. Not only did Dr. Schweitzer eat the meat of the fish, the newspaper reported; he ate the bones, head, eyes and all.

I noticed that when the young doctors and nurses got up from the table that evening, they were in a fine mood, refreshed as much by the spirit of the occasion as by the food. Dr. Schweitzer's fatigue, so palpable when he first came into the dining room, now gave way to anticipations of things that had to be done. Humor at Lambarene was vital nourishment.