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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
What did the 16th President of the United States, Abraham Lincoln, suffer from? What were the illusions that tormented the Polish-French composer Frédéric Chopin? And how can the symptoms of the Dutch painter Vincent van Gogh be interpreted from today's perspective?
The physician and author Thomas Meissner describes medical histories of 99 well-known people from all over the world in his book The Illustrious Patient (Springer, 2019). The book details the fates and tragedies behind the shiny facades of famous people from science and culture. The author describes which diseases shaped the life of these people, ended their career, or led to their death.
Here is a selection of illustrious authors, musicians, physicians, and politicians.
This has been translated from German and edited for clarity.
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Frédéric Chopin: Creatures Coming Out of the Piano
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Frédéric Chopin: Creatures Coming Out of the Piano
There has been a lot of speculation about the cause for the lung disease of Frédéric Chopin (1810-1849). One fact that was regularly overlooked, although Chopin himself and those surrounding him had reported it, was fits of visual hallucinations and experiencing (unknown to others) feelings of alienation toward familiar people or familiar surroundings.
During a private concert in 1848 in Manchester, Chopin abruptly stopped his performance in the middle of his Sonata No. 2, Op. 35 and left the room. Soon thereafter, he came back and continued the concert without any comment. This abrupt interruption occurred because he saw creatures emerging from the piano that frightened him, and this wasn't the first time; he had already repeatedly experienced something similar in Valldemossa on Mallorca. There, he suddenly stopped playing the piano and screamed, briefly made a confused and fearful impression, but then calmed down relatively quickly. Another time, while lying in bed with a fever and weak from bloody cough, he hallucinated that someone was knocking on the door and soon saw Death standing by his bed.
These were dreamlike states — imagination and reality merged. Chopin was partially aware of the unreality of these fits. The episodes were not accompanied by neurologic deficits. Some of the visual hallucinations apparently were Lilliputian perceptions — when things in one's surroundings look smaller than they actually are (micropsia). The diagnosis of temporal lobe epilepsy is considered the most likely cause for Chopin's sudden fits.
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George Gershwin: Abrupt End for an Exceptional Musician
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
George Gershwin: Abrupt End for an Exceptional Musician
On February 11, 1937, George Gershwin (1898-1937) performed his piano concerto in F major with the Los Angeles Philharmonic Orchestra, when he skipped a few passages during an absence lasting only a few seconds; the audience did not notice anything. He had already almost fallen from the podium during a rehearsal on the day prior. Two months later, he lost consciousness at his barber for about 30 seconds.
The composer described these episodes as "blackouts" to psychiatrist Gregory Zilboorg. They were preceded by the perception of the smell of burned rubber. Later, Gershwin increasingly suffered from migraine-like headaches. Among others, Gershwin was also examined by the German psychoanalyst Ernst Simmel, who had emigrated to the United States a few years earlier. Simmel suspected an organic cause but was not able to name it.
Gershwin kept having olfactory hallucinations, headaches, and dizziness. He eventually also suffered from motor dysfunctions that impaired his piano playing.
On July 9, 1937, Gershwin was taken unconscious to the Cedars of Lebanon Hospital; his blood pressure was massively elevated. During the trepanation the next day, physicians diagnosed a brain tumor that turned out to be glioblastoma multiforme. Five hours after the surgery, Gershwin was dead.
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Vincent van Gogh: Brush Licker and Lamp Oil Drinker
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Vincent van Gogh: Brush Licker and Lamp Oil Drinker
Vincent van Gogh's (1853-1890) eccentric personality is legendary and the cause for dozens of postmortem diagnoses. His significant lead exposure must thereby not be disregarded. The heavy metal could be found everywhere in daily life at that time: Wine was beautified with white lead and lead acetate. Lead was also a component of paints, drugs, tobacco, coal dust, and water that came out of lead pipes.
Van Gogh, however, did something that harmed him further: He ate lead. He did that deliberately by consuming the lead-containing paints he used, for example, by sharpening the brush bristles with his lips or by holding the handle of paint-covered brushes in his mouth. He licked his paint-covered hands and drank lamp oil too, as contemporary witnesses have confirmed. It can therefore be assumed that many of his physical symptoms can be attributed to chronic lead intoxication.
Furthermore, he was poor, often went hungry, and was malnourished. He probably had iron deficiency (anemia). Many patients with iron deficiency develop a pica syndrome, which is an eating disorder involving the consumption of inedible substances.
The continuous accumulation of lead in the body finally led to peripheral neuropathy, likely with paralysis of the radial nerve. Holding the brush became a problem for the artist, and the reduced visual motor coordination may explain the changed brush stroke and other characteristics in Van Gogh's later paintings compared with his earlier works.
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Ernest Hemingway: Depression Was in the Family
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Ernest Hemingway: Depression Was in the Family
Deep physical and mental wounds that increased with his age led to Ernest Hemingway's (1899-1961) dramatic end, which was in sharp contrast to his open personality and success as an author.
There were many risk factors for suicide in his family. Hemingway's strict father suffered from severe mood swings and he shot himself with a pistol in 1928. His sister Ursula and brother Leicester also committed suicide. The older sister Marcelline was supposedly depressed, and his relationship with his dominant mother was difficult and defined later in his life by anger, hate, and feelings of guilt.
Hemingway had an ambitious character; he was an impulsive person who often behaved in a childlike and egocentric manner. At the same time, he felt inadequate and was dissatisfied with himself.
The endearing and likeable Hemingway could become suddenly aggressive. It is presumed that he suffered from borderline personality disorder with affect regulation disturbance. In addition, he had alcoholism and later developed delusions.
In April 1961, he attempted to commit suicide three times within 4 days. After an unsuccessful treatment at the Mayo Clinic in Rochester, Minnesota in June 1961 and a 5-day drive home to Ketchum, Idaho, he shot himself with a rifle just a few weeks before his 62nd birthday.
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Frida Kahlo: Painted Suffering and Mental Torment
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Frida Kahlo: Painted Suffering and Mental Torment
There are hardly any other distinguished artists whose creations were influenced by physical suffering, mental torment, and disease to the extent of German-Mexican painter Frida Kahlo (1907-1954).
Perhaps she never would have painted at all if she had not been in a serious bus accident as an 18-year-old student. An iron handlebar pierced Kahlo's left hip and exited at her perineum. She lost a lot of blood and barely survived; there was even doubt about whether she would ever walk again. Her lower spine was fractured in three places; physicians found 11 fractures in her right leg; her right foot was luxated and crushed; and her pubic bone was fractured three times. In addition, she had one collarbone fracture, two rib fractures, and one luxation of the left shoulder.
Her right leg had already been permanently weakened because of poliomyelitis at the age of 6, and she later had several miscarriages, presumably owing to the accident. Kahlo was almost completely encased in plaster after the accident and remained in the hospital like that for 4 weeks. She suffered from the effects of the accident for the rest of her life and still had to spend weeks and months in bed or wear corsets made from plaster, leather, or steel.
The bedridden Kahlo started to paint owing to pure boredom. Her mother had a special easel made that allowed her to paint while lying down. She remained an autodidact her entire life, even if she may have learned some things from her partner and husband, painter Diego Rivera. In her creations, mostly self-portraits, she often confronted pain, fragility, and death.
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Herman Melville: Writing in a State of Ecstasy
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Herman Melville: Writing in a State of Ecstasy
The novel Moby Dick, about Captain Ahab's vengeance-driven hunt for a white sperm whale, is one of the most important works of world literature. While Herman Melville (1819-1891) was alive, it sold rather poorly; he and his family could not live on his writing.
After the publication of Moby Dick in 1851, Melville developed a number of mental and physical symptoms that some biographers dismiss as psychosomatic and others as an expression of mental illness.
When he worked on a novel, at least in his younger years, it was in a state of ecstasy lasting for hours and up to total exhaustion. He wrote in a state of "morbid nervousness," it was said. There are some indications that he went through alternating phases of hypomania and depression within the sense of a bipolar disorder.
In addition, he complained about severe headaches, back pain, and aching limbs. Passport applications stating his height show that Melville got shorter by approximately 3.5 cm (1.37 in) between 1849 and 1856. In addition, he had flares of eye pain and photophobia. Therefore, there are some indications that Melville had ankylosing spondylitis (Bechterew's disease).
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George Orwell: Wrote 1984 While Coughing Blood
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
George Orwell: Wrote 1984 While Coughing Blood
George Orwell (Eric Arthur Blair, 1903-1950) had his breakthrough with Animal Farm; 1984 became his legacy, which he wrote under already alarming conditions in terms of his health.
Orwell had suffered from bronchitis and chronic cough since childhood. He may have been infected with Mycobacterium tuberculosis in his youth; the often-malnourished chain smoker who lived in poor conditions repeatedly had pneumonia. In the Spanish Civil War, he survived a bullet wound in the neck only through luck.
In 1945, he went to Paris as a war correspondent. When his wife unexpectedly died shortly thereafter, he withdrew to the lonesome Scottish Hebridean island of Jura in 1946 for 18 months, already in weakened condition. In the cold and damp climate, he had to manage without electricity and warm water. There, while coughing blood, often feverish, and losing more and more weight, Orwell wrote his gloomy vision of the future of a totalitarian police state: 1984.
The long-existing suspicion of tuberculosis was not confirmed until 1947. The new cavern was in the left lower pulmonary lobe. A "collapse therapy" was performed with disconnection of the left phrenic nerve. The physicians' goal was to paralyze the left diaphragm to make the pulmonary lobe collapse. Weekly air injections in the underlying abdomen were supposed to support this. Later, Orwell received the then-novel streptomycin. However, the treatment had to be discontinued after 50 days because of Lyell syndrome.
In 1948, Orwell returned to Jura to write the final version of 1984. The novel was published in the summer of 1949 and was immediately a big success. The writer died 6 months later.
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Marcel Proust: When Asthma Was Considered a Neurosis
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Marcel Proust: When Asthma Was Considered a Neurosis
The French writer Marcel Proust (1871-1922) suffered from bronchial asthma, a disease that was thought to be of a "nervous" nature at that time, since childhood. Therefore, he preferably sought help from neurologists.
Maybe that also had something to do with his father, professor and epidemiologist Adrien Proust, who was well-known at the Faculty of Medicine in Paris and a neurologist himself. Adrien Proust considered that a bad upbringing and an overprotective mother to be causes of the neurasthenia. Asthma was thought to be an expression of it. Consequently, Proust thought of himself as a "nervous" personality.
He treated himself with various drugs and diets. These included anti-asthma powders, anti-asthma cigarettes, ether, balsams, opium derivatives, barbiturates, chloral hydrate, adrenaline, the alkaloid sparteine (lupinidine), acetylsalicylic acid, and other substances — in all possible combinations.
Later, he wanted to undergo a 3-month "isolation treatment" in a Parisian clinic — the treating physician had promised him that he would be healed afterward. Finally, Proust tried a shorter isolation treatment at a different clinic; he left that hospital sicker than when he went in.
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John Wayne: Cancer? I Beat It!
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
John Wayne: Cancer? I Beat It!
"Sure, I licked the big C." The still-bedridden John Wayne (1907-1979) casually dictated that Hollywood columnist James Bacon write this in his notebook. "I know the man upstairs will pull the plug when he wants to, but I don't want to end my life being sick, I want to go out on two feet, in action."
Contrary to the recommendations of the people surrounding him, Wayne did not keep his cancer diagnosis a secret: His left pulmonary lobe, as well as four ribs, were removed in 1964 because of a tumor the size of a golf ball. He survived the disease for 15 years.
His second serious health problem was an insufficient mitral valve, which he had replaced in 1978 with an open-heart surgery. Only a few months later, in January 1979, he was admitted to the hospital in an emaciated state because of abdominal pain. Under the assumption that it was a gallbladder problem, he underwent surgery. This turned into a 9-hour procedure with total gastrectomy because of stomach cancer that had spread to his lymphatic system. Later, Wayne additionally received radiotherapy, interferon, as well as newly developed immunologic vaccines, but none of it helped him.
Despite the medical defeat, Wayne's children donated a large amount of money to the UCLA Medical Center in Los Angeles. Today, the John Wayne Cancer Institute in California is one of the most renowned cancer research centers of the world.
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Oscar Wilde: Ear Surgery in the Hotel Room
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Oscar Wilde: Ear Surgery in the Hotel Room
The early death of the Irish playwright, writer, and journalist Oscar Wilde (1854-1900) has long been attributed to his sex life and alleged syphilis. However, the final diagnosis of meningoencephalitis was completely separate from the speculation that his death was a result of his sex life.
During his imprisonment because of "sexual offenses" from 1895 until 1897, he suffered from increasing deafness with recurrent discharge from the right ear. Finally, he was almost completely deaf in the right ear because an abscess had perforated the eardrum. The condition improved with daily flushing with carbolic acid. Later, Wilde apparently developed a cholesteatoma, a benign but expansively and destructively growing tumor at the eardrum with progressive bone destruction and chronic otitis media.
At the end of September 1900, Wilde was housed and cared for at the Parisian Hôtel d'Alsace, despite his destitution. In the following weeks, he was visited 68 times by the ears, nose, and throat specialist Maurice a'Court Tucker from the British embassy. The chronic otitis media was acutely exacerbated and had spread to Wilde's mastoid.
His physician considered surgery to be his last chance, which was performed on October 10, 1900, in the hotel room, under anesthesia, with chloroform. Unfortunately, no details have been passed on, but this was likely a radical mastoidectomy, a procedure that had just recently been described by German otologists Emanuel Zaufal and Ludwig Stacke.
A large wound remained that had to be attended to daily — there were no antibiotics yet. The infection came back and brought with it a high fever. Wilde died 10 weeks after his admittance to the hotel of secondary meningoencephalitis.
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Sigmund Freud: Living with Oral Cancer for 16 Years
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Sigmund Freud: Living with Oral Cancer for 16 Years
It is astonishing from today's perspective that the father of psychoanalysis, Sigmund Freud (1856-1939), survived with oral cancer for 16 years. Despite severe illness and great agony, he kept working and seeing patients past his 80th year of life.
The extensive cigar smoker went to the outpatient center a Vienna clinic in April 1923 to have a "painful swelling of the gums" removed. He believed that he could go back home right afterward. But that did not work out because in reality, this was an advanced squamous cell carcinoma.
While Freud was under intravenous sedation, dentist and maxillofacial surgeon Hans Pichler removed major parts of the right maxilla, mandible, and a few months later, major parts of the right soft palate and of the buccal and oral mucosa as well. Freud was fitted with a large oral prosthesis that he could put in only with external help. Eating and talking were possible only with great effort, as was the smoking of his beloved cigars.
In the summer of 1936, when Freud was 80 years old, a recurring tumor and parts of the underlying bone were removed. He almost constantly had painful wounds in the mouth and nose area. Consistent relapses could barely be reached with surgery anymore, and radiotherapy had no effect.
After Freud's emigration in 1938, Pichler even flew to London to operate on his patient there once more. After his condition had become unbearable and he was severely emaciated, Freud had his befriended physician Max Schur inject him with a high dose of morphine, as already discussed years before, and died in early morning hours of September 23, 1939.
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Friedrich Nietzsche: Signs of Mitochondriopathies
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Friedrich Nietzsche: Signs of Mitochondriopathies
The suspected diagnoses that were meant to explain Friedrich Nietzsche's (1844-1900) longtime suffering ranged from having brain cancer to dementia to neurosyphilis.
A more recent analysis of the findings, however, suggests mitochondrial encephalopathy — a syndrome called MELAS (mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes). Mutations of the mitochondrial DNA inherited only via the mother thereby lead to a clinically very heterogenous picture of progressive neurodegeneration that is triggered by the reduced energy supply for the cells.
At the age of 4, Nietzsche was already diagnosed with anisocoria as well as differing vision of his eyes. From the age of 11 and on, he suffered from paroxysmal headaches with vomiting as well as muscle pain as signs of myopathy. Later examinations revealed pigment changes in the retina, internal strabismus, as well as extreme myopia in the right eye and severe myopia in the left eye.
From the age of 31 and on, Nietzsche's abdominal problems intensified, with pain, constipation, and loss of appetite. His headaches and eye pain worsened too. In addition, he had severe back pain, speech impairment, disturbed consciousness, dizzy spells, signs of paralysis, and gait disorders. Sometimes, Nietzsche was agitated, disoriented, or euphoric; other times, he was aggressive and delusional. Intermittently, his mind was fully clear.
The glance at the family history is important: Nietzsche's mother also had anisocoria. Several family members on his mother's side suffered from migraines and psychiatric or neurologic diseases. At the end of his life, Nietzsche was paralyzed, demented, and probably blind. The early onset of disease, high likelihood of a hereditary nature of the disease, symptoms, and complications Nietzsche suffered speak for MELAS.
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Abraham Lincoln: Suffering From Smallpox in Gettysburg
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The Illustrious Patient — Diseases of Famous People
Thomas Meissner, MD | February 7, 2022 | Contributor Information
Abraham Lincoln: Suffering From Smallpox in Gettysburg
It started the day before president Abraham Lincoln (1809-1865) was going to give the most famous speech in US history: the Gettysburg Address at the military cemetery on the battlefield of Gettysburg.
The 54-year-old already felt weak and unwell during the train ride from Washington, DC on November 18, 1863. Nevertheless, he made it through the ceremony lasting several hours and held his speech of a bit more than 2 minutes that is still deemed a rhetorical masterpiece today.
On the return trip, Lincoln was feverish, faint, and exhausted, and he complained about dizziness and severe headache. The fever rose. After 3 days, the bedridden patient developed a scarlet skin rash, followed by blistering skin phenomena.
It is not unlikely that Lincoln's 10-year-old son Tad had been the vector. He recently had to spend several weeks in bed with a feverish disease and skin rash, but he had recovered. Another indication for smallpox is the fact that Lincoln's servant, William H. Johnson, who cared for the president for the entire duration of the disease, got ill in January 1864 and died.
The mortality rate of smallpox was about 30% at that time. Lincoln survived, which essentially contributed to the end of the Civil War and the end of slavery in the United States.
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Disclosure: Thomas Meissner, MD, has disclosed no relevant financial relationships.
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Meissner T. The Illustrious Patient. Springer-Verlag, GmbH; 2019.
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