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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020
| Contributor Information
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Johann Sebastian Bach: "Hammered" the Organ
In July 1949, the skeleton of Johann Sebastian Bach (1685-1750) was recovered from a Leipzig, Germany, church that had been destroyed in World War II. Before the remains were transferred to a new resting place, Berlin surgeon Wolfgang Rosenthal had the opportunity to inspect them.
"I perceived multiple exostoses in the pelvic girdle, on the lumbar vertebrae, and at the calcaneus," he reported. In addition, he found the muscle attachment sites at the upper arms and forearms to be "strikingly prominent." Rosenthal deduced that this was due to repetitive strain brought on by "hammering" the organ, which was hard work in his time. Similar bone changes were noted on the arms and legs of passionate equestrians as well as soldiers and athletes ("horseback rider and military drill bones," or myositis ossificans).
Bach's medical history and that of 99 other well-known people are described in my book, Der prominente Patient (The Illustrious Patient). This slideshow presents a selection of prominent artists.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Charles Baudelaire: A Poet Without Words
At age 45, the French poet Charles Baudelaire (1821-1867) suffered a stroke. The man known as the poète maudit (accursed poet), whose subversive writing and free-spending lifestyle encompassed all that was seen as bohemian at the time, lived for another year and a half with chronic aphasia.
He repeatedly called out, "Cré nom!" or "Pas! Pas! Sacré nom!", most likely meaning "Sacré nom de Dieu" (which translates to "holy name of God" but was commonly used as a curse). These were the only syllables he could still pronounce, and he used them to express all of his thoughts and feelings: joy, sadness, anger, impatience. He quickly became enraged if others failed to understand him. Today, neurologists believe that Baudelaire suffered from anosognosia, an unawareness of his own condition. In other words, he couldn't tell how disordered his speech was or that he was cursing.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Ludwig van Beethoven: Deaf and "Lionesque"
The composer Ludwig van Beethoven (1770-1827) probably suffered from Paget disease, a progressive disease that causes bone remodeling. In cases where the skull is affected, up to half of patients become hard of hearing due to ankylosis of the ear ossicles and/or compression of the vestibulocochlear nerve.
Beethoven started to lose his hearing at the early age of 26 and within about 10 years was completely deaf. His autopsy also revealed an exceptionally dense and thick calvaria.
A mask created in 1821 to depict the then 51-year-old Beethoven shows a pronounced forehead, and a photograph of the exhumed skull, taken in 1863, shows irregular and large zygomatic bones, contributing to his "lionesque" appearance.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Humphrey Bogart: Cool to the Bitter End
Hollywood icon Humphrey Bogart (1899-1957) played the "tough guy," even privately, until he died of esophageal cancer, probably linked to the excessive smoking and drinking so common in that era. Bogart had avoided hospitalizations all his life until worsening problems with swallowing and coughing fits forced him to undergo a 9½-hour operation in which surgeons removed a tumor in his esophagus and several lymph nodes. This was followed by chemotherapy.
Bogart initially recovered but relapsed 6 months later. "Why is everybody whispering? I have cancer, not an STD, for crying out loud!" he barked at visiting friends. Two weeks before he died, he weighed only 80 pounds. But when a society journalist stopped by, he insisted that she report this quote from him: "I'm doing great!"
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Bertolt Brecht: Not Neurotic After All
German playwright Bertolt Brecht (1898-1956) complained about heart problems all his life, but his doctors dismissed him as being neurotic. In 2010, however, Brecht scholar Stephen Parker discovered a note revealing that Brecht had been diagnosed with cardiomegaly at a young age.
Given that his friends said he had a nervous twitch in the left side of his face, it is reasonable to believe that Brecht suffered from rheumatic fever as a child, which caused chorea minor. This was followed by arrhythmia, an enlarged heart with dyspnea on exertion, and physical weakness. Contrary to many reports, Brecht didn't die of a heart attack but probably of pericarditis due to urosepsis, as indicated by the kidney stones, prostatitis, and urethral stricture that plagued him much of his adult life.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Charles Bukowski: Shunned Like a Leper
Cult author Charles (real name Heinrich Karl) Bukowski (1920-1994) had a difficult childhood and suffered greatly from severe acne. In his book Ham on Rye, his alter ego Henry "Hank" Chinaski is described as having pimples on his face and body that were "large as walnuts," filled with yellow pus that splattered the mirror. His father tortured and humiliated him with an aggressive chemical peel.
A doctor at Los Angeles County General Hospital described Bukowski's as the worst case of acne he ever encountered, no doubt acne conglobata. Writing about it helped Bukowski overcome his life as an outsider and the pain it caused. "Words are the magic potion that saves us from suicide."
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Johann Wolfgang von Goethe: Stricken by Infection
Johann Wolfgang von Goethe (1749-1832) almost didn't finish writing Faust. Bullous erysipelas, usually brought on by Streptococcus bacteria, came close to killing him. Then 51, he was struck by catarrh in 1801 that evolved into a purulent inflammation of his face that disfigured him for weeks.
The infection spread to his palate, throat, and larynx, accompanied by a violent cough and bouts of suffocation. At times, Goethe was dazed or delirious. This state of affairs lasted for 9 days and then slowly improved. It took months for Goethe to fully recover.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Rita Hayworth: Her Brain Confounded Doctors
For a long time, movie diva Rita Hayworth's (1918-1987) eccentric behavior was attributed to her drinking. It took almost a decade for the true diagnosis to emerge. Her case, which led to a rediscovery of Alzheimer's disease, gave dementia research a huge boost that is still felt today.
In the early 1970s, Hayworth (in her 50s) started to have increasing difficulty remembering her lines and dance steps. In what would be her last movie —The Wrath of God, released in 1972 — she had to memorize her lines one by one or read them off of a board. Her bouts of great excitability unnerved friends and the public. Only after New York psychiatrist Ronald Fieve took her on as a patient was she diagnosed with Alzheimer's disease in 1979.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Friedrich Hölderlin: "Taming the Manicus"
In 1806, poet Friedrich Hölderlin (1770-1843), who was probably suffering from psychosis, was brought to the new university hospital in Tübingen, Germany, where head doctor Johann Autenrieth proceeded to treat him. Little is known about the 231 days that followed, but clues can be found in the teachings on "madness" that Autenrieth delivered to students at the university.
He believed that insanity was caused by a "pathic substance" that led patients to have "nonsensical visions, urges, and thoughts." In order to rid their bodies of this substance, patients were forced to take medications that brought on dramatic bouts of diarrhea, rectal bleeding, vomiting of blood, and violent pains. The objective: to tame the "manicus" like a wild animal.
Treatments also included beatings, gagging, starvation, and withholding fluids. Belladonna and opium were given to keep patients calm. After his "therapy," Hölderlin was declared "incurable" and released into the care of a carpenter family living in a tower next to the Neckar river, where he resided for the next 36 years.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Bob Marley: Malignant Melanoma on the Big Toe
In 1977, reggae musician Bob Marley (1945-1981) went to see a doctor for a soccer injury and was diagnosed with a malignant melanoma on the big toe of his right foot. The musician refused to have the toe amputated, opting instead for the nail and nail bed to be removed and the site covered by a small piece of skin that was transplanted from his thigh.
Presumably it was acral lentiginous melanoma, although it's unclear who made that diagnosis. Only 4% of melanoma patients suffer from this subtype. Four years later, Marley collapsed during a run in New York's Central Park. Doctors found metastases in his liver, lungs, and brain. Shortly thereafter, he performed his last concert and traveled to Germany, where he spent 6 months being treated by the controversial "faith healer" Dr Josef Issels. Marley never made it home; he died during a stopover in Florida.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Steve McQueen: The King of Cool Trusted Charlatans
Hollywood star Steve McQueen's (1930-1980) trademark was his nonchalance, but that trait would prove difficult to maintain. In 1978 he was diagnosed with pleural mesothelioma, a rare cancer that has been linked to asbestos exposure in 80%-90% of cases. For McQueen, this could have happened during his time in the US Marine Corps or when he participated in motorcycle races and wore fire-protection suits.
McQueen tried to hide the diagnosis, seeking out unorthodox treatments involving vitamins, minerals, and coffee enemas. He solicited help from a dubious US doctor in Mexico who claimed that cancerous tumors could be "digested" with the help of pancreatic enzymes, a strict diet, and other techniques. After 6 weeks of treatment, the tumors were said to have shrunk up to 75%. A final attempt at surgery in Juarez City revealed that the tumor in his right lung had spread to the diaphragm and left lung; 24 hours later, McQueen was dead. Official cause: a heart attack.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Pierre-Auguste Renoir: Ball Games to Fight Rheumatism
It's impossible to tell which paintings Pierre-Auguste Renoir (1841-1919) created with his right hand or his left hand, or even with a hand so severely crippled by disease that he was almost completely unable to move it. Around age 50, the painter began to develop symptoms of rheumatoid arthritis, which would confine him to a wheelchair for the last 7 years of his life. Almost immobilized by the disease, suffering from cachexia, and tortured by pain and decubitus ulcers, he nevertheless kept creating large-format paintings with the help of various tools.
Initially, he fought his progressive loss of movement by juggling leather balls, billiard balls, or shuttlecocks as well as by playing bilboquet, a game of skill involving a cup and ball. This led German rheumatologist Henning Zeidler to call Renoir "the inventor of ergotherapy." On what would be the last day of his life, Renoir painted some anemones that the maid had picked for him. "I think I'm getting the hang of this," he is reported to have said.
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Famous Patients: From Goethe to Beethoven, Marley to Bogart
Thomas Meissner, MD | October 16, 2020 | Contributor Information
Andy Warhol: A Stranger on Planet Earth
Andy Warhol's (1928-1987) eccentric behavior and art have been linked to Asperger syndrome. His monosyllabic interviews are legendary; he answered inappropriately like a child and often seemed stumped by questions. On the other hand, people with Asperger's are often savants.
Warhol's talent was graphic art. His Pop Art portraits of celebrities like Marilyn Monroe and Elvis Presley are iconic, as is Campbell's Soup Cans, a series of 32 almost-identical cans representing the varieties of Campbell's soup available at that time. Warhol was shy and awkward in the company of others and he was obsessed with his work. He died in 1987, probably from complications of gallbladder surgery.
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Disclosure: Thomas Meissner, MD, has disclosed no relevant financial relationships.
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