Leon Fleisher was a 36-year-old pianist at the peak of his career when he first discovered a slight curling of the fourth and fifth fingers on his right hand. "Within 10 months my fingers had curved inwards until the tips pressed against the palms," he says. "I tried to play through the problem, which only made it worse." As frustrating as the strange spasm was the lack of understanding by the medical profession. Specialists told him it was a type of Parkinson's, it was a form of seizure, it was all in his head.
In fact, Fleisher was suffering from a chronic loss of muscle control known as focal dystonia, an incurable neurological condition — sometimes called musician's cramp or piper's palsy — that can end careers. Fleisher continued to perform by specializing in the piano repertoire written solely for the left hand. But in 2004 he astonished both the medical and musical worlds by making a recovery.
Fleisher's "miracle cure" was a pioneering course of treatment with botulinum toxin, or Botox. Long before Botox became common in beauty regimes, injections into Fleisher's fingers enabled the pianist to make Two Hands, his first conventional recording in more than 40 years.
Fleisher is far from alone. Research indicates that professional musicians are considerably more susceptible to back pain than the rest of the population, and that 52 percent of musicians who experience muscular discomfort will find the problem to be associated with intensive practice or the unusual posture of playing an instrument. Yet performance-related injury remains something of a taboo subject. Few musicians are prepared to admit that common aches and pains could become career-threatening; many orchestral players insure their instruments far more comprehensively than they insure themselves.
Musicians have always punished their bodies in pursuit of ever-higher technical standards. Perhaps the most notorious historical example of performance-related injury was the case of Robert Schumann, who sought to improve his piano technique with a device designed to separate the tendons of the third and fourth finger. Scholars have since doubted whether the "finger tormentor" was really attributable to Schumann's subsequent disability, yet throughout his career he attempted to resuscitate the use of his hand by soaking it in warm brandy, wrapping it in herbal compounds and even thrusting it into the carcasses of freshly slaughtered animals.
Schumann's determination to become a virtuoso may have been inspired by witnessing performances by Nicolo Paganini, whose extraordinary facility on the violin was possibly the result of a rare growth disorder. It has been suggested that Paganini, an uncommonly tall and sinuous man, suffered from Marfan's syndrome — a condition whose benefits (to violinists at least) include elongated fingers with hyper-elastic joints. If so, it would be a rare instance of a medical disorder actually enhancing performance.
The opposite might be the case of the Canadian pianist Glenn Gould, who grew up with a deformation of the spine exacerbated by his unusually hunched position over the keyboard. Experts also suggest that the pianist's famously eccentric behavior and uncanny focus on technical perfection may have been symptoms of Asperger's syndrome (a diagnosis that did not exist during Gould's lifetime); while film footage indicates that Gould's withdrawal from live performance may have been accelerated by a pronounced curling of the fourth and fifth fingers, similar to the dystonia that halted Fleisher's career.
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