Adjusting the puckered leather stool to a comfortable distance, I began.
Almost as soon as I sounded the declarative octaves of the powerful melody, the familiar painful stiffness arrived. It came earlier than I had ever experienced it during private practice. My forearm felt as if I was trying to lift a dead weight, while my fingers tried to ignore what held them back. I played on, willing my arm to continue despite the slow icing-over that for the first time began to freeze the fourth and fifth fingers of my right hand.
To any rational pianist this creeping immobilisation would have signalled imminent disaster. In my mind’s eye I was only on the third page of seven, but it was obvious to everyone present that something was terribly wrong. The severity of the stiffness was making me botch notes I’d never missed before. Chopin’s étude, intended to help develop a pianist’s technique, had hastened the deterioration of mine.
In the sequence leading up to the second articulation of the melody, during which the hands race down the keyboard in parallel motion, my right hand stopped functioning. The fingers, now fused and curled in on themselves from the stiffness in my wrist, could no longer move independently of each other. My forearm was locked in paralysis too. But my useless claw didn’t stop moving: it skidded, taking my forearm with it, thundering across the treble keyboard in a hail of discordant notes.
Somehow I limped through the final bars. One still had to finish even if one were, in another sense, already finished. The silence in the Opera Theatre was cold and complete. I did not expect comfort from these strangers, but I wished the spotlights would go dark. The humiliation radiated from me so powerfully that it felt as if my freckles were burning. Glancing briefly through the dusty haze of the stage lights, I saw the shadowy outlines of the Conservatorium students hunched together, nudging each other with their elbows like the undulations of a piano accordion. At least they had the decency not to laugh out loud. I had to get out of there before their silence burst.
I closed my eyes as I dipped my head in mortified farewell. A few sympathetic members of the audience clapped to congratulate me for finishing. The rest were too appalled to respond.
It wasn’t until twenty years later, reading the story of Leon Fleisher for the first time in the neurologist Oliver Sacks’s Musicophilia, that I recognised my experience and learned its name: focal dystonia, commonly known as musician’s or writer’s cramp. Some neurologists believe that the localised paralysis is the result of over-practice, during which the brain distorts the mental representation of the fingers such that they overlap and can’t be controlled independently. Focal dystonia disproportionately affects musicians, most frequently pianists, violinists and guitarists, although it also strikes horn players’ embouchure. Instead of maintaining a reciprocal balance between agonist and antagonist muscles, relaxing and contracting in tandem, the muscles contract together. It’s as though the brain reaches a point, after countless repetitions of the fingers making the same movement, beyond which it can no longer differentiate the working of one finger from that of another on the same hand. If you think of a trill, in which two fingers manipulate two neighbouring keys at high speed; or the precise levering of the right hand required to play consecutive octaves, you can marvel at the brain’s capacity to engineer these dexterous feats while empathising with its occasional failure to distinguish one performing finger from another. Research has shown that when parts of the somatosensory cortex, the section of the brain responsible for the sense of touch, repeatedly receive signals extremely close together, they can blur, perceiving the signals as simultaneous.55 Fleisher believes that inappropriate practice techniques, rather than too much practice, are to blame for the task-specific paralysis. In any event, the debilitating cramp is a neurological more than a muscular affliction. The real problem wasn’t in the muscles of my right arm: it was in my brain.
In 1831, the year that Chopin composed the Revolutionary Study, Robert Schumann began to experience cramping in the middle finger of his right hand. At twenty-one he was considered one of Europe’s most promising virtuoso pianists. Terrified of what this inexplicable development meant for his performing career, Schumann turned in desperation to a finger-stretching device. Unfortunately his loss of motor control in the ‘bird’ finger became worse, and within two years he abandoned performing. Today Schumann is best known as one of the finest composers of the Romantic period. His Toccata is the only work of the virtuoso piano repertoire that has no use for the third finger of the right hand. Clara Schumann became the first, and foremost, interpreter of her husband’s works for piano.
Schumann’s is the first known case of focal dystonia—in his case, the loss of task-specific motor control in the middle finger of his right hand while playing. According to contemporary neurologists, dystonia affects approximately one per cent of professional musicians, and Schumann displayed several of the disorder’s primary risk factors: namely that he was a perfectionist, a man, and someone who was prone to anxiety and who practised for extended periods music that placed an extreme burden on the motor skills of the brain.56 The only risk factor I was missing was a penis.
Leon Fleisher tried everything from homeopathy to hypnosis to fix his disobedient right hand. Some doctors thought he had a pinched nerve and wanted to operate on his spine. Many suspected that the problem was psychological. Despite his dystonia, Fleisher’s devotion to the piano led him to become the world’s leading performer of the repertoire that exists for the left hand.
Paul Wittgenstein, brother of philosopher Ludwig, was a promising pianist from a wealthy family who lost his right arm during World War I. After the war he commissioned concertos for the left hand from composers including Ravel, Hindemith and
