"No one has yet proved that there is a definite link between rapid, repetitive muscular movement and dystonia," he says. "Yet bagpipe technique requires even greater malleability of the mouth and lips than say, a clarinet or horn. The research has some way to go; it will be very significant if there is a connection."
There is still much about musicians' maladies that remains imperfectly understood. The New Zealand pianist Michael Houstoun recently described his attempts to keep playing by using splints, rubber bands and even learning the Braille alphabet — remedies that seem no more sophisticated than Schumann's contraption.
As for Berque, his condition was misdiagnosed and untreated for so long that it ruled out any return to a playing career. His clinical work at least offers some compensation. "It keeps me in touch with other musicians, and I still feel part of the musical scene," he says. "Obviously, I wish I could still play. But helping others to keep playing is a fair reward."
The British Association for Performing Arts Medicine Web site is at www.bapam.org.uk
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