Book Review: Diagnosing genius: the life and death of Beethoven

The events of Beethoven's life have captured the popular imagination, making him the subject of innumerable biographies and at least two recent bio-pics. One question which has puzzled his biographers is how Beethoven could compose sublime music while labouring under ill health, particularly his deafness. Francois Mai, a professor of psychiatry at the University of Ottawa, offers some answers. Drawing on material from a wide range of sources, Mai makes good use of both primary and secondary works. Contemporary accounts of the composer's health are accessible in Beethoven's own writings, as well as those of his many physicians. To these Mai adds modern diagnostic tools, such as a toxicological analysis of a lock of Beethoven's hair. Despite the wide range of evidence presented, much of Mai's analysis is likely to frustrate the medical historian. In Diagnosing genius Mai is principally concerned with the description and interpretation of the medical evidence. Aiming at comprehensiveness, Mai endeavours to provide a more complete interpretation of the symptoms than has previously been achieved. He ranges over a wealth of conditions, from alcoholism, to syphilis, to lead poisoning, to assess the role each may have played in the cause of Beethoven's death. But such analysis cries out for historical contextualization. At several points throughout the book, for instance, Mai provides descriptions of Beethoven's relations with his many physicians. Famously irascible, Beethoven hired and fired physicians with an impressive regularity, largely depending on whether or not he approved of the treatment they prescribed. Yet Mai provides no discussion of the extensive historiography on the doctor–patient relationship—a central context for understanding Beethoven's behaviour. In his final chapter, Mai broadens his discussion to encompass the links between illness and creativity. Summarizing many of the insights of other authors on the subject, he systematically considers the effects that isolation, psychopathology, substance dependency and medical health problems may have on an individual's creativity. He suggests that conditions which Beethoven, and others, suffered may have fed their creativity, though the effect becomes deleterious if the illness is severe. Whilst careful in rehearsing the research of others, it is a pity that Mai seldom offers his own opinion. In the same chapter Mai asserts that though Beethoven was not a child prodigy like Mozart, he did display “exceptional talent” (p. 179). But this raises an interesting question, one which Mai does not address: to what extent is genius a social construction? In a fascinating aside, which sadly Mai does not capitalize upon, he reveals that the construction of the composer's reputation had a helping hand from his alcoholic father. Determined that his young son should be seen as a child prodigy, Beethoven's father concealed Beethoven's real birth date, putting it about that his son was two years younger than he actually was. This was a fact Beethoven himself only learned in his mid-forties, when circumstances required him to send for his birth certificate. But child prodigy or not, Mai's interpretation reveals a deep reverence for the composer, one which will brook no opposition to Beethoven's claims to eminence. Mai's careful research is a worthy addition to the genre of medical biography, a field of scholarship which seeks to establish what individuals “really” suffered from. For the medical historian, however, the value of the book is diminished by its emphasis on retrospective diagnosis and its disregard for contemporary historiography. Like its subject, Diagnosing genius displays a deafness of its own—a deafness to historical context.