My disruptive and mysterious health issues

By Heather O’Donnell

I’d like to start a series of essays/interviews about performing artists’ career-impacting health issues. Eventually this will include interviews with other performing artists, but I’ll begin with my own history of ‘My disruptive and mysterious health issues’. I’m writing with the intention of speaking openly about injuries and illness, with the hope that such frank language may contribute to dismantling a tendency to engage in long-standing taboos in musicians’ cultures that conceal injuries and illnesses, hide unattractive aspects of reality, pathologize non-normative experiences, and hide behind self-created or market-demanded personas.

The everyday reality of musicians is often unflattering. For example: this my reality at this moment:

The history of my ‘disruptive and mysterious health issues’ runs almost parallel to my history as a pianist. I started playing the piano, like most professional pianists, at the age of five, and the first strange symptoms arrived in my teens. I was more prone to joint pain, anemia and struggles with depression than my peers. At 18, I was experiencing quite a lot of pain while playing which led to teachers mentioning disorders such as ‘repetitive strain syndrome’ or ‘tendonitis’, though my practicing habits at this point were not especially enthusiastic or vigorous, and should not have placed an extraordinary level of strain on my body.  

However, upon entering the conservatory, I discovered a means to distinguish myself from my peers: as an obsessive and almost self-punishing practicer. This could involve starting at 6 am and acquiring 11 or 12 hours of practice time before the day was over. I mention this with a wish to distinguish genuine commitment to an artistic undertaking from sheer stupidity. Unfortunately, my approach was mired much more in the latter than the former. It was also displaying socially avoidant behavior: the practice room was a more controlled and immediately gratifying environment than the unpredictable world outside. It was comforting to be inside the small room with the big piano and the music that so beautifully and gratifyingly reflected seemingly limitless aspects of human experience.

 I was rewarded for this approach, not so much in genuine progress at the instrument (this would have more likely occurred with a third of the practice hours, combined with explorations into other aspects of musicianship and developmental life experiences), but more in a social reward system from the conservatory community which cheered me on in my ostentatious displays of commitment and self-flagellations. I learned to practice over pain signals and to focus exclusively on herculean programming as a means of securing social standing in an environment in which there were few clear guidelines on how to enter professional life following studies. I developed a love for large-form and highly ambitious pieces which I maintain to this day (whether or not this is a psychologically healthy tendency is another question): the Liszt Sonata, Wanderer Fantasy, the Goldberg Variations, the Concord Sonata to name a few. The brush with heroicism in such pieces is habit-forming, and playing them is indeed a thrilling experience.

But heroicism/thrill-seeking lies often on the opposite side of the spectrum to longevity. Especially when one is overreaching their physical and psychic capacities. And, it’s important to mention- female bodies are not ideally fitted to modern piano design.

So, I won’t go into too much detail about the 15 or so years in which pain became chronified, and the symptoms became more pronounced and stranger. There were frequent visits to all sorts of medical and therapeutic practitioners. I found pianists who were specialized in rehabilitation after injury and worked for several years with them. I sought out a lot of help from physiotherapists, Feldenkrais teachers, a manual therapist, psychotherapists, among others, and these interventions were sometimes helpful but didn’t seem to be able to break the cycle of alarming symptoms, which eventually congealed into a triad of 1) chronic pain, 2) a lack of sensation in the fingers and 3) weakness/lack of control/trembling in some fingers. A story that illuminates this: at some point in the mid 2000s, I met with a good friend and confided to her what kinds of things I was experiencing. She looked down at my hand (at that point the left hand was particularly affected) and then impulsively reached out, holding onto my hand, saying in a shocked tone: “It looks like the hand of a dead person”.  There was a certain degree of muscle atrophy in the palm, and, of course, I was cradling the hand protectively most of the time, because the pain was disturbing and scary.

It wasn’t just the hands and arms that were presenting alarming symptoms: I was in poor health. I couldn’t go for more than two hours without needing to collapse into a deep nap, and when I’d stand up too quickly I’d lose my sight for about 4-10 seconds and feel dizzy. This was related to anemia which was connected with a lifelong bout with (until that point) undiagnosed celiac disease. In 2008, I was finally hospitalized for a week to run a battery of tests intended to identify the source of anemia. On the last day, before they were about to release me without an answer to the problem, a doctor ran a celiac test and the results were through the roof. Afterwards, I resorted to a logical fallacy: ‘Celiac was the cause of my health problems’. The reality was much more convoluted, and, as often happens in life, clear lines of causality cannot be drawn in real world problems which are protracted, messy and too old and entrenched to trace. Biological problems fuel psychological responses like stress reactions, and stress reactions can chronify and exacerbate biological problems. The biopsychosocial maelstrom of health disruption resists clear clinical diagnoses, and it is sometimes a psychologically healthier approach to learn to live with uncertainty and stop torturing oneself with questions like: “What caused this?”

 Even though I was able to treat Celiac disease, the hand/arm problems and chronic pain lingered and occasionally flared. It was simply a dreadful thing to be a pianist in this condition. I stopped.

Then began a fumbling attempt to identify who I was without the mantle of ‘pianist’, which I had worn since I was a kid. Should I go back to school and study something? If so, what? What am I interested in? What are my abilities? The answer to these questions at that point was usually: “I have no idea!” I landed on psychology, and managed to win a spot at the Freie Universität in Berlin. The next 5 years were engulfed by limping through an endless battery of statistics, experimental design, probability theory, and different approaches to clinical and experimental psychology. And most importantly, after struggling for years to successfully carry a pregnancy to term, I gave birth to a beautiful baby girl.

Now on the other side of training as a psychologist and specialist in musicians’ health and injury prevention, I have started to play again in the last couple of years. I’ve been enjoying going back to old pieces and finding, to my delight, that they’re still sitting in my system, waiting to be picked up and dusted off. We all love stories of triumph and overcoming crisis, but this isn’t one of those! This is, by all means, not a hero’s story. I walk (pianistically speaking) with a pronounced limp, and this is now part of me. I can’t practice more than 90 minutes - 2 hours per day without the pains and other symptoms returning. Maybe this will stay like that forever, maybe it will change, I’m not so concerned with putting a lot of mental energy into wondering about that.

If I can play the piano for a little bit today, well then, that’s nice!