EDITORIAL
Art and Medicine
Colorectal Cancer and Famous Composers
As a colorectal surgeon and an opera lover, I was curious to find out which famous composers had been affected by colorectal cancer. After a brief investigation, I found four composers whose lives were cut short by this condition: Gioachino Rossini (1792–1868), Claude Debussy (1862– 1918), Edward Elgar (1857–1934), and Jules Massenet (1842–1912).
Gioachino Rossini (1792–1868)
Rossini, born in Pesaro and died in Paris, is one of the most prominent figures of operatic bel canto, along with Gaetano Donizetti (1797-1848) and Vincenzo Bellini (1801-1835). From a very young age, he was a prolific composer, writing 39 operas in just 19 years, between 1810 and 1839. This made him the most important Italian composer of the first half of the 19th century, especially for two of his comic operas: The Barber of Seville and Cinderella, a genre in which he was a leading specialist.
He retired from operatic composition at the age of 37, already enjoying a very comfortable financial situation. He died of rectal cancer at the age of 76.
It is presumed that multiple health conditions, both mental and physical, influenced his premature retirement. Among the mental health conditions, he suffered from severe de- pression and likely had obsessive-compulsive disorder (OCD). Among the physical health conditions, he had a urethral stricture due to chronic gonorrhea, which required continuous and painful dilations. He also had severe obesity. Following the death of his first wife in 1845, the Spanish mezzo-soprano Isabella Colbran (seven years his senior and the subject of many of his operas), Rossini married his mistress, Olympe Pélissier (1797-1878), in 1846. Pélissier was romantically involved with the novelist Honoré de Balzac (1799-1850), among other partners. In 1853, they settled permanently in Paris, where they maintained an active social life with their famous Soirées Musicales.
Pélissier was a devoted and faithful caretaker of Rossini, and after his death, he became a zealous guardian of his manuscripts and defender of his musical legacy.
In September 1868, following rectal discomfort, she con- sulted Dr. Vito Bonato, who initially suspected an anorectal fistula but soon recognized the presence of cancer, prompt- ing him to call Dr. Auguste Nélaton (1807-1873), creator of the Nelaton catheter. The latter performed a minimal reduc- tion of the tumor with chloroform due to the patient's ex- treme obesity and fragility. The procedure was performed on November 2 without aseptic precautions, and the patient's recovery was gradual.
Forty-eight hours later, Nélaton decided to perform another operation, but Rossini developed perineal sepsis, probably with necrotizing fasciitis, which led to his death on Novem- ber 13, 1868, despite his wife's care. His remains are buried next to those of Olympe, who survived him by ten years, in the church of Santa Croce in Florence. A portion of his wealth was dedicated to the establishment and maintenance of a home for retired opera singers.
Claude Debussy (1862–1918)
Music is the arithmetic of sounds… — Debussy.
Considered a revolutionary composer of the 20th century, Debussy stood out for his exploration of new harmonic currents, radically transforming the possibilities of the piano.
His music was classified as "impressionist" by analogy with the contemporary painting movement, inspired by Monet's painting Impression, Sunrise. Just as impressionist painting suggested spontaneity through short brushstrokes and pure colors, Debussy achieved musical color through lucid timbres and fluid piano techniques.
However, the term "impressionist" is not enough to describe his refined, technically sophisticated, evocative, and sensual music. Among his most notable works are the Prélude à l’après-midi d’un faune, the “symphonic sketches” La Mer (for piano), the Moonlight from the Suite Bergamasque, and the Arabesques.
Debussy was closely associated with Symbolism, a late 19th-century literary and artistic movement. He was friends with the French Symbolists Stéphane Mallarmé (1842– 1898) and Paul Verlaine (1844–1896). His only completed opera, Pelléas et Mélisande, is based on the work of Mau- rice Maeterlinck (1862–1949), a Symbolist poet who won the Nobel Prize in Literature in 1911. Considered one of the pinnacles of the 20th century, this opera features melodic recitative, in which the voice follows the natural rhythm of speech. It greatly influenced Fauré, Sibelius, and others.
Debussy married Emma Bardac for the second time. They had a daughter, Claude-Emma ("Chouchou"), whom he adored.
He started experiencing proctorrhagia in 1909, but he was not diagnosed with obstructive rectal cancer until November 1915. He underwent surgery on December 7, which includ- ed resection of the tumor and a colostomy. This required the use of rudimentary colostomy bags, which were probably made of animal skin.
His postoperative recovery was slow and debilitating. He used morphine for four months and then intermittently, which limited his creative activity.
In January 1916, he underwent an innovative treatment for the time: the insertion of radium pellets in unknown doses based on the Curies' studies in Paris. It is worth noting that radiotherapy did not become widespread until after World War II. Over the next few months, his health deteriorated. In June 1917, he expressed frustration at not having been informed about the potential incurability of his disease.
He spent his last days in March 1918 under the German bombing of Paris with his wife and daughter, who refused to leave him alone. He died on March 25, 1918, at the age of
55. He is buried in the Passy Cemetery next to his wife and Chouchou, who died of diphtheria just 16 months later.
Edward Elgar (1857–1934)
…The royal banner, and all quality, pride, pomp, and circumstance of glorious war! Othello, Act III, Scene 3 – William Shakespeare.
Elgar primarily composed orchestral works, including the well-known Enigma Variations, which portray his friends. He also wrote symphonies, concertos, and choral works, such as The Dream of Gerontius. His piano and violin piece, Salut d'Amour, dedicated to his wife, is widely known. He died before finishing his opera, The Spanish Lady.
His personality was shaped by his lower-middle-class origins and Catholic faith in predominantly Anglican Eng- land. His wife, Alice Roberts, who came from an aristocratic background, supported him greatly and helped him advance in his career, bringing him closer to royal circles. He be- came the official court composer and wrote overtures and marches, including the famous Pomp and Circumstance marches. The first march is now emblematic of Anglo-
Saxon graduation ceremonies. He received a knighthood and the Order of Merit.
Deeply affected by his wife's death in 1920, he retired to his hometown of Worcester, leaving behind several unfinished works.
He suffered from recurrent tonsillitis and corneal abrasions throughout his life. The tonsillitis caused deafness, and the abrasions caused eye pain. His multitude of symptoms and insecure personality fueled the impression that he was a hypochondriac.
In 1915, he underwent an emergency hemorrhoidectomy due to rectal bleeding. In 1933, he complained of left sciatic pain and obvious weight loss. A laparotomy was performed under local anesthesia and revealed intractable rectal cancer that had invaded the left sciatic roots. He was given mor- phine to control his pain until his death on February 23, 1934. He is buried next to his wife in St. Wulstan's Church in Worcestershire.
Jules Massenet (1842–1912)
Like Rossini, Massenet was a prolific opera composer rather than a composer of major musical innovations. His works were popular in his time for their melodic charm and senti- mentality, though these same features were also criticized. Understanding the tastes of the Belle Époque public, he wrote works with subtle eroticism and exotic motifs, as well as accessible plots similar to those of his Italian competitor, Giacomo Puccini.
His work capacity was impressive. He started his workday at 4:00 a.m., then continued in the afternoon with piano lessons for his students. He composed more than 30 operas, including Manon (1884), based on the work of Prévost, and Werther (1892), based on the work of Goethe. These operas are still frequently performed today. The intermezzo Medi- tation from Thais is often performed as a concert piece.
Following the success of Manon, he composed twenty additional operas in twenty-eight years, as well as ballets
and incidental music. He maintained close collaborations with the Opéra-Comique in Paris and, toward the end of his life, with the Monte Carlo Opera.
He published his autobiographical memoirs, including
Pensées posthumes, written a month before his death.
He was prone to developing pharyngitis, bronchitis, and “rheumatism”, which he often used as an excuse to avoid attending unwanted events, such as Verdi's funeral.
In 1910, he began to notice his health was deteriorating. He was admitted to the hospital under a pseudonym in August and subsequently underwent abdominal surgery for "cancer" and "to prevent peritonitis," which required a two-week recovery period. One year later, he reported suffering from a "cruel illness." The precise condition remains uncertain, but it is believed to be obstructive colon cancer, and the surgical intervention successfully prevented peritonitis.
He passed away on August 13, 1912. His death was peaceful and discreet, consistent with his life.
The New York Times headline the following day read: “The last of the great melody creators has departed.”
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