Showing posts with label stroke. Show all posts
Showing posts with label stroke. Show all posts

Thursday, September 18, 2008

Mendelssohn’s Premature Death

Felix Mendelssohn
The medical basis for Felix Mendelssohn’s death at age 37 of a stroke—only a few months after his sister Fanny’s death of a stroke—has not to date been adequately described in the journal literature. But in recent years there has been intensive research on mutations of the NOTCH3 gene on chromosome 19. Might a NOTCH3 mutation have been the cause of Mendelssohn’s dying? We do not know. But the facts and family history are highly suggestive. NOTCH3 mutations give rise to a variety of hereditary abnormalities including stroke at an early age. Previously termed Familial Stroke Syndrome, CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy) is associated with NOTCH3 mutation. And within the past several years there is also now a commercial laboratory offering genomic testing for NOTCH3 variants. You may like to have a look at the sources below—especially if you have a family history anything like Mendelssohn’s?

Or not (as your own preferences and insurance coverage considerations suggest to you is best), inasmuch as there is presently no cure for the NOTCH3-related disorders. But knowing that you have a NOTCH3 point mutation may at least help as regards proper care in dosing with aspirin and other anticoagulants (“blood thinners”) either in surgery or on a chronic basis. And, since the condition is autosomal dominant (AD), knowing that you have it is very important for family planning and parent-child communication.

The person [electing to undertake voluntary genomic testing or screening] may benefit in the long run from making preventive lifestyle choices that will help counteract the biological risk [that is associated with the genotype that they have inherited].”
  —  Personalized Medicine, U.S. News & World Report, 23-APR-2008.
Chromosome 19



Friday, March 14, 2008

Horn Trio: Ian Dakin and Brahms’s Fractured Family, Fractured Idea of Requiem

 Johannes Brahms, Christiane’s son
H  orn: the perfect emblem of distance and disembodiment.”
  —  John Daverio.
Ian Dakin (French horn), Elaine Clark (violin), and David Clark (piano) will perform horn trios by Brahms and Wood on Sunday, 30-MAR, at 12:00 noon at Hugh Lane Gallery in Dublin. The Brahms Horn Trio in particular merits more frequent performance than it receives. And it merits more analysis too, I think, along the lines Daverio pursues in his recent book.

Brahms’s Horn Trio Op. 40 in E-flat major (1865) was composed in memory of Brahms’ mother. She had been an older mom: at her death following a stroke in January, he was 32; she was 76.

As a child, Johannes had spent lots of time with his mother. Too much probably, to the exclusion of his developing other social skills and relationships. The maternal bond was maybe excessive: Christiane obsessed over him, broke into tears when reading newspaper accounts of his successes, and eventually despaired of the idiosyncrasies of her husband, Jakob, 17 years her junior. Jakob and Christiane separated in mid-1864, and Johannes got his father to move in with him. Try as he might, Johannes was unable to patch up his parents’ relationship. Christiane died 18 months later.

Brahms wrote the Trio for natural horn rather than valve horn despite the fact that the modern valve horn was already common. The natural horn has a frailer personality more given to intimating mourning: it lends a darker timbre than could reasonably be achieved with a valve horn. Of course! Natural horn: perfect choice!

But timbre was not the only reason. As a child Brahms had learned natural horn from his father. In view of the associations of the horn with his early life, Brahms’s choice of this instrumentation for the Horn Trio is symbolic as an autobiographical elegy for a mother by her son. It is also uniquely evocative in view of what is known of their relationship—and the disparity between their temperaments (her kindness, admixed with Lutheran piety, simplicity and logorhea; his sensitivity, admixed with a bit too much intellect and reticence; his father’s impulsiveness and incontinence, running roughshod over everything and everyone).

The work’s four movements:
  • Andante
  • Scherzo (Allegro)
  • Adagio mesto
  • Allegro con brio
carry the constitutional earnestness and cheerfulness of the tonic E-flat. But Brahms dispenses with sonata form and substitutes rhapsodic essay sections. Brahms also uses Early Baroque ‘church’ [chiesa] sonata form with the movements sequenced slow-fast-slow-fast. To me, this alternation has a gestural automaticity or reflexive ‘masking’ quality, like the ‘going-through-the-motions’ dynamic of one who has lost a loved one and is distracted by interior thoughts about that person and who manages to get through the passing days by putting on a stoic ‘front’ and going about the daily routine, no matter how incongruous the somber thoughts and the cheerful tempo might be.

 John Daverio, Crossing Paths
Or maybe the interpolation of the disparate tempi is an ‘unpacking’ of Brahms’s pent-up feelings about the disparities between himself and Christiane—her cloying, kind-but-obsessive ways; her focus on superficialities and her inability to comprehend what really made him ‘tick’—disparities that were now things of the past, to be sorted and registered as part of his life’s experience and to be honored in memory.

The Scherzo is contemplative but still cheerful, in the way that E-flat characteristically is. Do we hear Kübler-Ross’s stages of mourning embodied in these four movements? Only as refracted by family dynamics!

The playfulness of the Scherzo tempo is maybe the most schizoid, mendacious, dissembling part of this Trio. Or, no, it’s the Adagio mesto, which opens with four measures of solo piano in the low register. Solemn, yes, as the violin and horn guilefully confirm. The Adagio: impassioned and genuine, but as if at arms’ length—as if Brahms is idealizing or mythologizing something that was never quite so, not really; brooding: as if he is still resisting the mother’s overt efforts to control his identity, to say through her praise and fawning what he was and what he was not. The Finale, incarnate in E-flat major, again up-tempo. Strange for a Requiem! The Finale—exuberant, joyful E-flat—gives us acceptance, the End of Mourning? Or is it instead the end of a life of masked conflict between pious mother and diverging son: an inescapable incompatibility of temperaments chronically collided under the compulsion of 19th-Century familial sense of duty, now finally over?

Fascinating drama. We look forward to Ian Dakin’s and the Clarks’ account of this beautiful, mysterious Trio-Riddle later this month.

[FYI, Kourakata and colleagues at Niigata University published an interesting paper in 2001 about dynamic perioral muscle biomechanics in French horn players. The lip valve function was studied by measuring contact pressure at the teeth-buccal interface during playing. Elite players used the depressor angulioris and levator angulioris muscles extensively, especially for high notes. The contraction of these muscles achieves smaller lip aperture, facilitating accuracy in high-register passages and enabling greater endurance control during long performances.]