It’s time to let Schumann and his demons rest in peace
How accurately can you diagnose the mental state of someone who is dead? That was the question posed by Phil Hebblethwaite in The Many Diagnoses of Robert Schumann (Radio 3, Sunday). As you might expect from Radio 3, this was a programme with a musical heart, and Schumann’s exquisite music was threaded throughout. But it was also a multifaceted documentary about the history of psychiatry, and how one man’s death has been concealed, speculated over and politicised ever since his body was laid to rest.
So what are the facts? The German composer Robert Schumann, one of the shining lights of the Romantic era, tried to kill himself in the Rhine in 1854. He survived, but was voluntarily admitted to a mental asylum shortly afterwards and died two years later at the age of 46. His death was not suicide. He suffered a catalogue of symptoms including visual and auditory hallucinations.
At first he was thought to have suffered from melancholia, but in the years after his death, as psychiatry developed rapidly as a medical discipline, Schumann’s ill health became repeatedly debated. As Hebblethwaite pointed out, Schumann soon became a musical legend and a medical case study, but was not treated very much like a real human being.
Experts continue to disagree over what caused his death. Dr Richard Kogan, pianist and psychiatrist, argued that Carnaval, with its broad range of emotion from the manic to the sorrowful, is a piece that “stands as practically a catalogue of bipolar symptoms… I’m convinced that piece could not have been written by somebody who did not have bipolar disorder”.
Schumann’s biographer, Judith Chernaik, took a different view. She noted that general paralysis, a diagnosis made in the medical notes of the doctors who treated him in his final days, was a common way of diagnosing tertiary syphilis at the time.
Hebblethwaite even related how Schumann’s mental state caused problems for the Nazis, who were keen to elevate him as a great example of German musical genius. But the Nazis murdered or sterilised those whom they deemed to have heritable mental disorders, and so they took pains to posthumously diagnose Schumann as having suffered from the physiological disease of vascular dementia.
Hebblethwaite treated his subject with real sensitivity, in contrast to some of those across history who have obsessed ghoulishly over what may have caused Schumann’s distress. And Hebblethwaite ended on the right note: Schumann’s music, which, whether because of his mental illness or in spite of it, encompassed an amazingly broad range of beauty, pain and joy.
Also on the subject of mental distress, The Delirium Wards
(Radio 4, Monday) explored a terrifying symptom of Covid-19. It’s relatively common for extremely ill patients in hospital intensive care units to suffer from delirium. The presenter, journalist David Aaronovitch, experienced this himself in the ICU 10 years ago with a severe infection, and he shared his own memories of the horrifying delusions he experienced.
But the programme’s focus wasn’t on Aaronovitch’s experiences. Instead it was a report on the increase in cases of ICU delirium among Covid patients. Medical practitioners estimated that, before the pandemic, about half of patients intubated in ICUS might experience delirium, but during Covid, instances have risen to around 90 per cent. They speculated that it could be because Covid patients don’t have the familiarity of visits from loved ones, and wards are much busier, much more frightening places for patients who are already ill and confused.
The programme included contributions from recovered patients who recalled with intensity the delirium they had experienced. Robin Hanbury-tenison, an adventurous international explorer in his 80s who didn’t sound faint of heart, vividly hallucinated being surrounded by jungle animals he could feel and touch. Zara Slattery, a mother of young children, believed that she had committed murder and the nurses were punishing her. When she was close to death, her children were at last able to visit her and touch her, and slowly she was brought back to reality.
For all the patients who contributed, the things they believed in their delirium felt unforgettable and at least as terrifying as the possibility of death itself. This was an important window into a little-discussed experience of Covid survivors who have been extremely ill, and a reminder that we are still learning about all the many ravages of this disease.