10.31.2014

PRIMUM NON NOCERE! (FIRST OF ALL, DO NO HARM!)

"All happy families are alike; each unhappy family is unhappy in its own way."  This is how Tolstoy begins Anna Karenina, one of the greatest novels of all time.  I am not sure whether that statement is universally true; I am sure, however, that it is universally true that nobody should make families unhappier by separating parents from their children unnecessarily. Keeping families together should be a commonplace; yet the opposite takes place far too commonly to be an exception to what should be a golden rule  I will give an example from our pediatric practice.

Not every parent interacts well with his or her child at our office.  (An example: one mother tried to text someone while I was about to give her frightened four-year-old vaccinations.)  Most, however, are caring; the parents I will now describe were very caring indeed.

They were obviously different.  The man wore the earrings; each had long hair of equal length; none of the socks or shoes matched, etc.  I remember asking them, "Whatever you smoke, do you ever smoke it in front of the kids?" You get the idea.

They were, however,  model parents.  They explained everything I was going to do, and comforted their two little sons admirably.  Their jeans might have been torn, their shoes might have been worn, but no matter--their children were very lucky to have such parents.

I was surprised that they didn't keep the next appointment, since they never missed appointments in the past. The following month, however, the children did come to the clinic--this time accompanied by foster parents.  Both boys looked miserable.  You could see that their world had fallen apart.  They were glum and taciturn, the direct opposite of their usual behavior.  The foster parents informed me that the boys now attended  daycare, since both adults worked.  They were decent people, but not very affectionate; each one sat silently while I examined two equally silent kids.

What had happened?  The foster parents told me that dad and mom had been caught smoking pot and that the children were removed from the home for that reason.  Soon after the visit,  I received a phone call from the mother; she was so very concerned about how the children were doing.  Both parents were in jail.

It is possible that there is more to this story.  Perhaps the parents had been caught selling drugs; the biological mother, however, denied that they had done so.

If their sole crime had been possession of a small amount of pot, it certainly wouldn't have been the first time that a family has been split up without good cause.  America's incarceration rate is the world's highest; 50% of state  inmates and 90% of federal inmates are serving time for non-violent drug-related crimes.  In addition, sentences for the same crime often result in years behind bars in America, in contrast with months behind bars in Europe. Punishment for possession of crack--even small amounts of which are equated with much larger amounts cocaine--is especially unfair and especially hard on the poor and minorities. (African Americans constitute 15% of the general population and 30% of those incarcerated.)

What about the children of those sentenced--sometimes for years--for such "crimes"? The statistics are disheartening. For instance, one in four children of poor African-American parents has had a parent serving time in jail during crucial years of child development.  Inmates are able to provide neither emotional nor economic support for their families; it is a real problem, especially for their children. Nor has mass incarceration made neighborhoods safer; there is, in fact, evidence to the contrary. In addition, too many families are the victims of what one reporter calls "poverty capitalism."  This occurs when local communities depend on fines to balance their budgets and thus tend to ticket people--especially poor people--more than necessary.  Inability to pay these fines and missed court appearances often result in jail time.

Many of those serving time lose precious time raising their children. You don't have to be a pediatrician to know that a child's perception and interpretation of separation can be very different from that of an adult--What seems like a small amount of time to a judge can seem like an eternity to a child; what might damage an adult for years might damage a child for life.

I later found out that the two boys had been placed permanently with their paternal grandmother in Wyoming.  I never heard from them or their parents again.

"Breakin' up is hard to do," is a rock 'n' roll classic that everyone was singing in the 60s.  "Breakin' up families must be exceedingly hard to do"--I doubt there will ever be a hit with that title, but I hope that that title will someday hit home.

Note: Details have been changed to protect the privacy of those involved.

This article appeared on page 7 of the Mid-Atlantic Ethics Committee newsletter, Fall 2014, published by The Law and Health Care Program of the University of Maryland.

10.25.2014

AN ANALYSIS OF TWO SCHUBERT LIEDER

I recently taught a four-week course on Goethe's Faust at the Osher Institute of Towson University. There was so much to cover in so little time!  I wanted to play recordings  and analyze  two Schubert songs with texts by Goethe, but couldn't, due to time constraints.  This essay, however, will do just that.  It is made available for anyone with an interest in music and in literature.

First Lied: Gretchen am Spinnrade (Gretchen at the Spinning Wheel), by Schubert with a Text by Goethe


Let's begin with a few words about the poem.  Gretchen recites (or sings) the words while she spins fiber into yarn at a spinning wheel.  The intensity of her love for Faust has destroyed her ability to live any longer within the confines she had known all her life.  She is young, inexperienced and has fallen, as they say, madly in love.  She has not yet had sex with Faust; he will soon give her a sleeping potion for her mother, so he can seduce her at home.  (Her mother will never wake up.)


The poem is written in Knittelvers; each pair of two lines has four strong beats, with a varying number of syllables occurring before each beat, usually one, two or three.  The very regular beats throughout the poem suggest the constant spinning of the wheel.


The poem is a masterpiece.  I know of no other poem that depicts sexual obsession as eloquently.  Gretchen's entire world has been reduced to one man; there is room for nothing else.  She is losing her grip on reality and she knows it.


Goethe's original version is followed by my translation:


Meine Ruh' ist hin,

Mein Herz ist schwer,
Ich finde sie nimmer
Und nimmermehr.

Wo ich ihn nicht hab

Ist mir das Grab,
Die ganze Welt
Ist mir vergällt.

Mein armer Kopf

Ist mir verrückt,
Mein armer Sinn 
Ist mir zerstückt.

Meine Ruh' ist hin,

Mein Herz ist schwer,
Ich finde sie nimmer
Und nimmermehr.





Nach ihm nur schau ich

Zum Fenster hinaus,
Nach ihm nur geh ich
Aus dem Haus.

Sein hoher Gang,

Sine edle Gestalt,
Seines Mundes Lächeln,
Seiner Augen Gewalt,

Und seiner Rede

Zauberfluss,
Sein Händedruck,
Und ach! sein Kuss--

Meine Ruh' ist hin,

Mein Herz ist schwer,
Ich finde sie nimmer
Und nimmermehr.

Mein Busen drängt sich

Nach ihm hin,
Ach, dürft ich fassen
Und halten ihn,

Und küssen ihn,

Ganz wie ich wollt,
An seinen Küssen
Vergehen sollt!




Prose translation:

My peace is gone,
My heart is sore,
I'll never have peace,
Again, nevermore.

It's like a grave
When I'm not with him;
The entire world
Is spoiled for me.

My poor head
Is going mad;
My poor mind
Has gone to pieces.

My peace is gone,
My heart is sore,
I'll never have peace
Again, nevermore.

When I look out the window
I'm looking for him;
To find him is the sole reason
I'd leave my house;

His noble gait,
His noble form,
The way he laughs,
The power of his eyes,

And the magical flow
Of his speech--
The touch of his hand,
And ah! his kiss--

My peace is gone,
My heart is sore,
I'll never have peace
Again, nevermore.

My heart is yearning,
Yearning for him--
Oh if I could embrace
And hold onto him

And kiss him
As much as I'd like--
From his kisses
To fade from sight!

Schubert put the poem to music in 1814; it is his Opus 2 and his first successful lied.  He was only sixteen years old at the time!  The song is a miracle.  It depicts Gretchen's distress and sexual obsession brilliantly and poignantly.  What other composer or writer has ever begun his career fully mature at such a young age?  Schubert went on to write many great compositions, some of which equal this one, but none surpassed it.  In comparison, Mozart, the very paradigm of prodigy, only began writing masterpieces in his early twenties.

The accompaniment is ingenious.  Schubert uses a pedal tone and two eighth notes followed by an eighth note rest in the bass to indicate Gretchen's foot on the pedal as it drives the wheel.  The constant spinning of the wheel is beautifully depicted by groups of sixteenth notes, 12 per measure, in the treble.  (The composition, as one might expect, is an a minor key.) The meter is 6/8, which is heard by the ear as two strong beats per measure of 6 sixteenth notes each, thus indicating the monotony of the endless spinning.   

Schubert's music is, however, never monotonous.  He changes the dynamics and the harmony to fit the increasing emotional intensity.  The poem was well suited for the composer.  The constant rhythmic pattern of the piece anchored Schubert's mind, as it were, which had the tendency to float away in any direction his invention decided to take him.  (We will hear an example of this in Prometheus.)

The key very effectively turns--albeit briefly--to major as she thinks of Faust's handsome qualities.  The true touch of genius, however, is the high point of the piece, where Gretchen imagines Faust kissing her.  She is so moved that she takes her foot off the pedal and the spinning stops, to great effect.

After this, the spinning begins with the return of the rondo-like stanza of "My peace is gone."  But it is really gone now--A crescendo begins, evoking increasing emotional distress, which culminates in an almost unbearable intensity with the repetition of "Oh if I could embrace..."


The poem ends at this point, but the music would seem very incomplete if it ended here  Schubert wisely has Gretchen return to her quiet spinning wheel-despair with a repeat of the rondo stanza.


Even if Schubert had been older at the time of this composition, the only proper reaction to this lied is awe


Now let's turn to a recording:








This is a recording of the lied sung by Kiri Te Kanawa, accompanied by Richard Amner on the piano.  I begin with this since it provides the musical notation.  Te Kanawa has a beautiful voice and does indeed sing in a very pleasing manner.  But this text demands a lot more than beautiful singing.  It is a rather bloodless and passionless performance.  The pianist's performance is too perfunctory.  Neither of them understand the text, or at the very least, choose not to understand it.

Now let's turn to another performance of this lied, sung by Renee Fleming accompanied by Christoph Eschenbach:




What a masterful performance by both singer and pianist!  Both performers give a highly emotional rendering--without ever overdoing it--just as the text demands.  You can hear the anxiety in Fleming's voice from the very beginning.  The performance by Eschenbach is every bit as impressive--what a team!  I'm going to emphasize only one thing--the high point of the piece, the G natural above middle C of "Kuss" ("Kiss")  Te Kanawa sings the note beautifully and gently, with an operatic fade in dynamics at the end.  Beautiful, but totally inappropriate, in my opinion.  In contrast, Fleming attacks the G with force, indicating the height of Gretchen's distress--it is quite riveting.  I think Schubert would have loved this performance.

One more recording, Evgeny Kissen playing the Schubert/Liszt piano transcription.  If you want to hear great technique, exquisite phrasing along with intensely emotional playing, Kissen is the pianist for you. His Gretchen begins with a more quiet despair than Fleming's does; the emotion, however, increases and increases--and increases.  He understands the text perfectly; he knows how to build up the emotion until a climax which leaves one almost breathless. What can I say?  This performance makes my hair stand on end, it is that intense.  Kissen performed this when he was about 18!--Now I can understand the sixteen year old Schubert a little better--but only a little!






Note: For those of you who are aficianados of this type of music, I suggest that you listen to Yuja Wang's interpretation of the same piece, the Schubert/Liszt Gretchen am Spinnrade, which is available on YouTube.  In which version does Gretchen's personality become passionately and musically alive?  Although Wang is an accomplished pianist, compared to Kissen, she is just playing notes.

One might want to read my essay,  Wanderers Nachtlied ll (by googling that title and adding Thomasdorsett) in which I compare the Wanderers Nachtlied by Schubert with the lied by Carl Loewe (1796-1869), to the same text, perhaps the most famous of all Goethe's poems.  Although Loewe was much less gifted than Schubert, I contend that he understood this text better and composed a very effective lied.  I also invite you to listen to his Gretchen am Spinnrade, sung by Brigitte Fassbaender, which is available on YouTube.  Notice that Loewe composes "Nach ihm nur geh' ich aus dem Haus" in a major key, as if it were something positive that Gretchen enjoyed doing--the feeling of an all-inclusive obsession is lacking totally. Not so in Schubert's vastly superior version, in which Gretchen's angst is readily apparent.


Second Lied: Prometheus, by Schubert with a Text by Goethe






I have analyzed this poem (google: Thomasdorsett Goethe's Prometheus) and invite readers to refer to it.  Here I will only present the poem and my English translation:





PROMETHEUS


Bedecke deinen Himmel, Zeus,

Mit Wolkendunst
Und übe, dem Knaben gleich,
Der Disteln köpft,
An Eichen dich und Bergeshöhn;
Musst mir meine Erde
Doch lassen stehn
Und meine Hütte, die du nicht gebaut,
Und meinen Herd,
Um dessen Glut
Du mich beneidest.

Ich kenne nichts Ärmeres

Unter der Sonn als euch, Götter!
Ihr nähret kümmerlich
Von Opfersteuern
Und Gebetshauch
Eure Majestät
Und darbtet, wären
Nicht Kinder und Bettler
Hoffnungsvolle Toren.

Da ich ein Kind war,

Nicht wusste, wo aus noch ein,
Kehrt ich mein verirrtes Auge
Zur Sonne, als wenn drüber wär
Ein Ohr, zu hören meine Klage,
Ein Herz wie meins,
Sich des Bedrängten zu erbarmen.

Wer half mir

Wider der Titanen Übermut?
Wer rettete vom Tode mich,
Von Sklaverei?
Hast du nicht alles selbst vollendet,
Heilig glühend Herz?
Und glühtest jung und gut,
Betrogen, Rettungsdank
Dem Schlafenden da droben?

Ich dich ehren? Wofür?

Hast du die Schmerzen gelindert
Je des Beladenen?
Hast du die Tränen gestillet
Je des Geängsteten?
Hat nicht mich zum Manne geschmiedet
Die allmächtige Zeit
Und das ewige Schicksal,
Meine Herrn und deine?

Wähntest du etwa,

Ich sollte das Leben hassen,
In Wüsten fliehen,
Weil nicht alle
Blütenträume reiften?

Hier sitz ich, forme Menschen

Nach meinem Bilde,
Ein Geschlecht, das mir gleich sei,
Zu leiden, zu weinen,
Zu geniessen und zu freuen sich,
Und dein nicht zu achten,
Wie ich!

PROMETHEUS


Conceal your heaven in mist, Zeus,

and practice on oaks and mountaintops
like a little boy who beheads thistles;
my earth, however, you must leave intact,
along with my hut which you didn't build,
and my hearth, the flame of which
provokes your envy.

I know nothing more destitute

under the sun than you gods!
Your majesty wretchedly gets by
with offerings and the breaths of prayer;
you would starve to death
if beggars and children
weren't hopeful fools. 

When I was an ignorant child,

my mistaken eyes turned
to the sun, as if there were
an ear up there to witness
my lament, or a heart like mine
to pity those in distress.

Who helped me when I opposed

the rashness of the Titans?
Who saved me from death and slavery?
Wasn't it you, my holy, fiery heart,
who accomplished it all by yourself?
And once, young and decent, didn't you radiate
thanks of deliverance 
toward Him who sleeps above?

Why should I honor you?

Have you ever 
eased the pain of the troubled?
Have you ever 
stilled the tears of the anguished?
Haven't eternal destiny
--your master and mine--
and all-powerful time
forged the man I've become?

Do you really believe

that I should detest life
and flee to the wilderness
just because many dreams 
bloom and don't survive?

I'm seated here, form human beings

according to my image,
a race that will follow my lead,
to suffer, to cry,
to enjoy, to rejoice,
and to ignore you completely,
just like me.

                 --Translated by Thomas Dorsett

Here is a recording of Schubert's lied, as sung by Dietrich Fischer-Dieskau, accompanied by Dietrich Henschel:










This is not one of Schubert's most successful lieder. It is a very angry poem, and the expression of anger was not one of Schubert's strong points. (He excelled in portraying--exquisitely--both youthful despair and youthful exuberance. Beethoven expressed anger very well, of which the "Ha, Welch' ein Augenblick" aria from Fidelio is an outstanding example.) Schubert's attempt at anger here--a rather pompous beginning along with subsequent tremulos in the bass--is not very convincing. Notice that he leaves anger behind beginning with "Ich kenne nichts Aermeres.." ("I know nothing more destitute"), although he returns to this emotion briefly later on in the lied.

The real problem for Schubert here is the irregular, changing meter of the poem As mentioned earlier, Schubert loved regular meters in poetry, which "anchored" him and gave him the opportunity to balance the regularity with astonishing melodies and harmonies. Schubert is best, of course, at melodies--he was one of the greatest melodists in the history of music--he was much less inclined toward dramatic declaration. The non-melodic declarative sections of this lied do not work very well. (This is not to say that Schubert lacked a sense of drama--Many of his lieder are replete with dramatic intensity e.g., Gretchen am Spinnrade, but he is best at moving the drama along via melody.


This might be C plus Schubert in comparison with the A plus Schubert of the first lied, but it is still Schubert; Prometheus is not without lovely moments. I think the ending is very beautiful, although the emotion expressed is, I think, very different from the intent of the poem. It is not anger with which the lied terminates, but with a religious solemnity, indicating the grandeur and dignity of mankind standing up on its own without an imagined crutch.


As an addendum, I would like to end with a twentieth-century version of this poem by Hugo Wolf. Here melody is subordinated to dramatic intensity; the accompaniment tells the drama, and has an even more important role than the singer--which almost never occurs with Schubert! A fierce anger informs the entire composition (--perhaps a little too much anger?--I leave that up to you!)  Since melody is not emphasized here, Wolf has no problem with the changes of rhythm of this free verse-like poem. Prometheus's anger is palpable throughout. Wolf's version is much more in accord with the poem--perhaps it is more angry than Goethe's poem, but it is a very valid interpretation. 





I have no objection if you still prefer Schubert's version--Grade C Schubert is still Grade A when compared to most composers! I just wanted to point out why his Prometheus is not among his best lieder.


I would like to summarize by stating the obvious: Goethe's poem Gretchen am Spinnrade is a very great poem. Astonishingly, however, a sixteen year old unknown composer wrote a lied to this text that is every bit as great as the poem. What a combination!


Addendum: Goethe Essays by Thomas Dorsett (They can be accessed on the Internet by googling the title along with Thomasdorsett.)

1. Goethe's Prometheus
2. Wanderers Nachtlied ll
3. Who Never Ate His Bread in Tears
4. Goethe's Wanderers Nachtlied und ein Einfacheres
5. A Fictional NDE-like Experience from Goethe's Faust Part 2
6. An Analysis of Two Schubert/Goethe Lieder

10.16.2014

STAND UP FOR YOURSELF

1.
This is indeed a self-help article, but it is not a riff on Bob Marley's immortal song, Stand Up for Your Rights; it is, rather, advice that might keep you exuberantly vertical, instead of eternally horizontal, for many years to come.

Lewis Carroll said it best: Don't just do something, stand there. Research has convincingly shown that, while standing might not be particularly good for bunions and soles, it happens to be very good for bodies and souls.

Here are some of the benefits of standing, according to scientific research:


  •  "Sitting is the new smoking"--Sitting for most of the day is associated with increased rates of obesity, diabetes, high blood pressure, heart disease, cancer and, you guessed it, The Big One.
  •   It has been determined that the negative effects of sitting for most of the day cannot be countered by even a daily trip to the gym.
  •   According to a British expert, the health benefits of standing for three hours every day is equivalent to participating in ten marathons a year!
  •  A recent Swedish study revealed that DNA telomeres remain intact longer in those who sit less.  (Telomeres are the ends of DNA strands the fraying of which is associated with aging.) Reducing sitting protects telomeres even better than exercise.
  • Standing, like exercise, improves mood. (In moderation of course--Cashiers at WalMart, some of whom are not young, are forced to stand for hours.  By the look on their faces and their responses when I asked whether standing up all day is difficult, I realized that a little sitting is not a dangerous thing.) 
  • On German trams there used to be a Schaffner, who punched or sold the tickets, and a Fahrer, who drove the tram.  You guessed it, research proved that Schaffners lived longer.  (These days, it's all automated and on the honor system--that is, you cancel your own ticket at a machine on the tram. Imagine that in New York!) 

The facts are in, and it's good news.   Even better news: you don't have to sweat the big stuff.  No need to suffer while juggling kettlebells or attending boot camp at a local gym.  As Kitty Kallen  sang in a song from the 1950s--yes, I remember it well--Little Things Mean A Lot.  (Kallen is still alive and nearly 100 years old.) Little things, in addition to standing and regular moderate exercise, might include taking the stairs instead of the elevator, parking farther away from the grocery store, etc.  If you work at an office where you sit all day, utilizing a standing desk for part of that time, or simply standing at your desk for a while, is an excellent and increasingly popular way to improve your health. The Aristotelian mean will keep you lean!

2.

I worked at a clinic for several years with a colleague, an internist, who was quite obese.  (Gone are the days of paper medical records; younger physicians will soon find it quaint that there was a time when physicians didn't sit at a computer.)  You didn't have to recognize his handwriting to know whether this doctor had entered something in a patient's chart; the inevitable cheese doodle stains on the page were enough to reveal whose fat fingers had manned the pen. Yes, he was quite obese, and yes, he lectured his patients about the benefits of exercise, good nutrition and the maintenance of  a healthy weight.  When a patient's eyes revealed the patient's thought--namely, how dare a big blimp advise a little blimp to skimp?-- he always replied, "Do as I say, not as I do."

That is not my philosophy.

I will finish this little heuristic article by revealing some of the ways I have incorporated standing up for myself.  (What works for me might work for you.)


  • I've bought a portable podium; I stand before it and do at least an hour's worth of reading and writing every day.  (In preparation for lectures I recently gave, I put my podium in my yard and lectured to the birds.  I was encouraged by the many tweets I received.)
  •  I watch about 4 or 5 hours of TV per week.  (While standing, of course.)  My wife, Nirmala, sits  while I stand, which is fine--she gets at least three hours a day of standing at her office.
  •  I walk a lot--to the bank, to the store, etc.  I notice that most people drive--even for a short distance.  (Recently, after I had escorted a woman to her car after a night of dancing, she offered to drive me back to the club.  She had parked across the street!)

The best friend I ever had, Walter Wilczewski, died a little over thirty-eight years ago--as I wrote in a poem, he was the same age as Schubert was at the time of his death--only 31, alas!  My friend died of multiple congenital aneurysms in his brain, standing would have done him absolutely no good.  One day, he told me that he had begun a poem.  The first line--Nirmala and I still recall it well--was, "I ate my breakfast standing up."  Walter was sometimes ahead of his time, albeit in strange ways.  I'm sure my he would be pleased to know that I am following his advice, albeit in my own, less odd way: in order to have a good time, I will continue to eat my meals while sitting; in order to have more time to be good, however, I will also continue to feast my eyes while I stand.

Addendum 10/18/2014

Last night while standing during a televised broadcast of Porgy and Bess, I coined a word (during the intermission) which expresses my ongoing enthusiasm for standing. It is stehtoll, which may be translated as "mad about standing."  (In German it is perfectly permissible to coin new words, usually consisting of two or more common words:  "Steh, " as a word meaning "stand" is used in such combinations as "Stehlampe," meaning a "standing lamp"  or "Stehpult" meaning a "standing desk." Toll means "crazy"--or, among other things, "wildly enthusiastic.")  I have become quite stehtoll, I admit. it.  One of the refreshing benefits of my Stehtollheit is that I now sleep entirely through the night--I had often been waking up four hours after retiring.  I thought some of you with sleep problems might try becoming stehtoll--Standing for at least three hours a day is ideal. If you do try it, I'd appreciate hearing from you in the comment box.