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Nice Berg
DISSECTING ROOM
LIFELINE Vicki Hunt Vicki Hunt has been a registered nurse in critical care and neurology for more than 30 years. She works in movement disorders research and outpatient management at Wake Forest University School of Medicine, in WinstonSalem, North Carolina. Although she works with patients with Parkinson’s disease, dystonia, and tremor, her time is devoted mainly to the care of people with Huntington’s disease. Which patient has had most effect on your work, and why? The first group of 12 Huntington’s research patients I met in 1987 taught me to face the unsolvable, make the best of bad days, and always have hope. What would be your advice to a newly qualified doctor? Read varied sources, be kind, take a stand, and learn to laugh with your patients. What is the best piece of advice you have received, and from whom? My hairdresser said that I should not take myself too seriously or see myself as indispensable. She said if I dropped dead tomorrow people would be sad but want an earlier appointment with someone else. What is your greatest regret? I should have eaten the chocolatenut sundae instead of being proper and saying, “no, thank you”. What alternative therapies have you tried? Did they work? My husband believes in vitamin C and I take it for him. Don’t know if it works, but I am healthy. Do you believe there is an afterlife? Oh yes, but not sure where. What is your greatest fear? Birds—and they know it. What do you think is the greatest political danger to the medical profession? Lack of competent care for the poor. If you had not entered your current profession, what would you have liked to do? To teach chemistry. Describe your ethical outlook. Consider all possibilities but use common sense in the final decision. Do you believe in monogamy? Yes, and my husband had better believe in it too.
1628
Nice Berg ne of the few pleasures of ageing is that, if you are lucky, there are a number of things you can look back on with pleasure or, even, look forward to because they are associated with something enjoyable in the past. Let me explain. I have just attended a performance of Berg’s Violin Concerto and I had been looking forward to it for weeks, because almost 30 years had passed since I last heard it live. It had stuck in my mind for a reason. I was a research student in Glasgow when I heard it played by Yehudi Menuhin (known affectionately there as Hughie MacEwen). I remember it vividly because it was the first time I had heard it, and I thought it was one of the weirdest pieces of music ever. On reflection, I should not have been too surprised because I did know that Berg was a pupil of Arnold Schoenberg, undoubtedly a key figure in 20th-century classical music, although still often regarded as box-office poison. Still, I came away that evening thinking that if a guy like Yehudi Menuhin thought is was good enough to play, then I should at least try to understand it a bit more. So I went out and bought a record of it. As a student, I was not earning enough money to afford a posh Menuhin recording and had to settle for one by some Hungarian guy I had never heard of. I listened to it regularly for about a year and, would you believe it, actually got to enjoy its lyrical quality, although I would be lying if I said I understood it. Although I love music, I have shied away from the theory because I want to feel it at a visceral level without trying to analyse it. I got to like this piece of music so much that it took a place in my heart alongside the great violin concertos of Tchaikovsky and Mendelssohn. So, you can imagine my excitement when I found out that there was going to be a live performance.
O
I warned my wife that she might not like it, but offered some consolation by telling her that the second half was Beethoven’s Eroica. Somewhat spookily, that had also been on the programme that night almost 30 years ago. Well, the evening was all I hoped for. The Berg was played by a talented young Canadian violinist. Her performance was only spoiled by a septuagenarian behind us who insisted on munching nuts throughout. The violin concerto, the story behind it, and Berg himself have a lot to interest the busy clinician. The concerto is subtitled “To the memory of an angel” because Berg decided to use this commission to commemorate the untimely death from tuberculosis, at 18, of Manon Gropius, the daughter of the celebrated architect Walter Gropius and Alma Mahler, widow of Gustav. It was Berg’s last completed work before he died suddenly, on Christmas Eve, 1935, of septicaemia after developing an abscess. Earlier that year, a young German girl, called Hildegard Domagk, had also contacted septicaemia after pricking her finger with a needle and was close to death. However, she was fortunate in that her father Dr Gerhard Domagk was the chief pharmacologist at I G Farben where he had been studying the action of a red dye, prontosil, on streptococcal infections induced in rats. It had proved extremely effective so Domagk decided to try it out on his daughter as a last resort. What was to be the first of the sulphur drugs saved her life and it would almost certainly have saved Berg too, but it did not become widely available until more than a year later. In everyday life, as in music, timing is everything. David Jack
THE LANCET • Vol 359 • May 4, 2002 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet publishing Group.
LIFELINE Vicki Hunt Vicki Hunt has been a registered nurse in critical care and neurology for more than 30 years. She works in movement disorders research and outpatient management at Wake Forest University School of Medicine, in WinstonSalem, North Carolina. Although she works with patients with Parkinson’s disease, dystonia, and tremor, her time is devoted mainly to the care of people with Huntington’s disease. Which patient has had most effect on your work, and why? The first group of 12 Huntington’s research patients I met in 1987 taught me to face the unsolvable, make the best of bad days, and always have hope. What would be your advice to a newly qualified doctor? Read varied sources, be kind, take a stand, and learn to laugh with your patients. What is the best piece of advice you have received, and from whom? My hairdresser said that I should not take myself too seriously or see myself as indispensable. She said if I dropped dead tomorrow people would be sad but want an earlier appointment with someone else. What is your greatest regret? I should have eaten the chocolatenut sundae instead of being proper and saying, “no, thank you”. What alternative therapies have you tried? Did they work? My husband believes in vitamin C and I take it for him. Don’t know if it works, but I am healthy. Do you believe there is an afterlife? Oh yes, but not sure where. What is your greatest fear? Birds—and they know it. What do you think is the greatest political danger to the medical profession? Lack of competent care for the poor. If you had not entered your current profession, what would you have liked to do? To teach chemistry. Describe your ethical outlook. Consider all possibilities but use common sense in the final decision. Do you believe in monogamy? Yes, and my husband had better believe in it too.
1628
Nice Berg ne of the few pleasures of ageing is that, if you are lucky, there are a number of things you can look back on with pleasure or, even, look forward to because they are associated with something enjoyable in the past. Let me explain. I have just attended a performance of Berg’s Violin Concerto and I had been looking forward to it for weeks, because almost 30 years had passed since I last heard it live. It had stuck in my mind for a reason. I was a research student in Glasgow when I heard it played by Yehudi Menuhin (known affectionately there as Hughie MacEwen). I remember it vividly because it was the first time I had heard it, and I thought it was one of the weirdest pieces of music ever. On reflection, I should not have been too surprised because I did know that Berg was a pupil of Arnold Schoenberg, undoubtedly a key figure in 20th-century classical music, although still often regarded as box-office poison. Still, I came away that evening thinking that if a guy like Yehudi Menuhin thought is was good enough to play, then I should at least try to understand it a bit more. So I went out and bought a record of it. As a student, I was not earning enough money to afford a posh Menuhin recording and had to settle for one by some Hungarian guy I had never heard of. I listened to it regularly for about a year and, would you believe it, actually got to enjoy its lyrical quality, although I would be lying if I said I understood it. Although I love music, I have shied away from the theory because I want to feel it at a visceral level without trying to analyse it. I got to like this piece of music so much that it took a place in my heart alongside the great violin concertos of Tchaikovsky and Mendelssohn. So, you can imagine my excitement when I found out that there was going to be a live performance.
O
I warned my wife that she might not like it, but offered some consolation by telling her that the second half was Beethoven’s Eroica. Somewhat spookily, that had also been on the programme that night almost 30 years ago. Well, the evening was all I hoped for. The Berg was played by a talented young Canadian violinist. Her performance was only spoiled by a septuagenarian behind us who insisted on munching nuts throughout. The violin concerto, the story behind it, and Berg himself have a lot to interest the busy clinician. The concerto is subtitled “To the memory of an angel” because Berg decided to use this commission to commemorate the untimely death from tuberculosis, at 18, of Manon Gropius, the daughter of the celebrated architect Walter Gropius and Alma Mahler, widow of Gustav. It was Berg’s last completed work before he died suddenly, on Christmas Eve, 1935, of septicaemia after developing an abscess. Earlier that year, a young German girl, called Hildegard Domagk, had also contacted septicaemia after pricking her finger with a needle and was close to death. However, she was fortunate in that her father Dr Gerhard Domagk was the chief pharmacologist at I G Farben where he had been studying the action of a red dye, prontosil, on streptococcal infections induced in rats. It had proved extremely effective so Domagk decided to try it out on his daughter as a last resort. What was to be the first of the sulphur drugs saved her life and it would almost certainly have saved Berg too, but it did not become widely available until more than a year later. In everyday life, as in music, timing is everything. David Jack
THE LANCET • Vol 359 • May 4, 2002 • www.thelancet.com
For personal use. Only reproduce with permission from The Lancet publishing Group.