Artist Propulsion Lab - S1 E4 - Emi Ferguson I

Release Date: August 18, 2022

 

Let’s Talk About Syphilis

John Schaefer: I’m John Schaefer, and you’re listening to the Artist Propulsion Lab, WQXR’s incubator for emerging and mid-career artists. 

We’re changing things up a little this week. Starting today, and for the next few episodes, flute-player Emi Ferguson is exploring another side of classical music - the health lives of several composers, specifically their experiences with syphilis. Just a heads-up - this episode will go into details about some of the effects of syphilis, so if you get squeamish easily, this may not be something you’ll want to hear. 

CLIP: Sister Rosetta Tharpe - Alan Lomax announcement

Here’s Emi.

Intro

EMI: As an undergrad at Juilliard, I almost quit music to go into epidemiology full time. That didn’t happen, but I’ve always been fascinated by the impact disease has on people’s lives and on society as a whole, especially as it relates to music. Now I know we’ve all been thinking about disease and society for the past couple years, so when WQXR asked me what I wanted to work on this year, I said, let’s take a COVID-break… 

…and talk about syphilis.

CLIP (Cause for Alarm): “Part of the reason is that you and I are afraid to talk about syphilis. So let’s talk about it, shall we?”

Just among composers - Franz Schubert, Bedrich Smetana, Scott Joplin, Hugo Wolf, Gaetano Donizetti, and Frederick Delius all had syphilis, and even more are rumored to have had it, but remain contested. 

CLIP: (To the People 1944): “A couple of years ago I would have been embarrassed if anyone had mentioned syphilis in my presence…”

While the bacteria that causes syphilis poses its own problems, like so many sexually transmitted infections, people just don’t want to talk about it, which makes treatment and prevention even harder.

It might seem remarkable now, to think about (just) how many historical figures had syphilis, but until the antibiotic penicillin was widely available, what is really remarkable is how common the disease was. Just in the 19th century, it’s estimated that 10-20% of the population in Europe had syphilis. We just talk about the famous cases. 

CLIP: Fight Syphilis - 1942

Syphilis was so widespread, and so terrifying that it wormed its way into the imaginations of many artists, and even affected fictional composers. In Thomas Mann’s novel, Doktor Faustus, a composer intentionally contracts syphilis to help him compose a revolutionary new kind of music, which had a striking resemblance to something like this…

MUSIC - Schoenberg, String Quartet No. 4, 1st Movement

This is a piece by Austrian composer Arnold Schoenberg, famous for pioneering the 12 tone composition method. And it was this resemblance between the music of Schoenberg and that of Thomas Mann’s fictional composer which got Schoenberg all hot and bothered. It led to the following encounter in a Los Angeles grocery store with his acquaintance, Marta Feuchtwanger, which I first came across in Alex Ross’ book The Rest Is Noise.

MARTA FEUCHTWANGER “I went to the Brentwood market,” (continuing underneath Emi)

EMI: It’s a little hard to hear (the interview is from 1975), but she is describing how an agitated Schoenberg walks over to her in the Brentwood Country Mart, yelling, in German that–  

MARTA FEUCHTWANGER: “You have to know I have not syphilis!”

EMI: Schoenberg was yelling at her that he didn’t have syphilis. He was also upset that Mann had taken details of his 12-tone method and ascribed them to a fictional character — one who makes a deal with the devil in a very misguided attempt at musical genius. Schoenberg didn’t want all of his friends thinking that he had syphilis, too.

Music clip

EMI: This was the late 1940s, and even though Schoenberg did not have syphilis, for those who did, there was finally a treatment that was both effective and coming into wide use - penicillin, which is still used today. And, while that may treat the disease…

SHEILA LUKEHART: “There’s still a huge stigma and that’s part of the problem.”

EMI: That’s Dr. Sheila Lukehart -

SHEILA LUKEHART: “an emeritus professor in the division of infectious diseases, the departments of medicine and global health at the university of Washington. And I've worked on syphilis for over 40 years.”

EMI: In the 1940s, with effective treatments available, there were public health campaigns to combat the taboos and encourage people to get tested and treated. We’ll be hearing clips from some of the movies, PSA, and radio dramas that came out of those campaigns too.

CLIP (To the People 1944): Do You want the facts?

 It’s a complicated disease, and it’s also a complicated thing to talk about! 

CLIP: - “Syphilis! Say it! Syphilis!”

Now, syphilis has a long and mysterious history. Like many diseases, there have been a lot of myths and superstitions that have come up around syphilis over the centuries. We first start to see it in the European historical record in late 15th-century Europe, and it terrified people.

SHEILA LUKEHART: [this was a, this was a greatly feared disease. Before, before penicillin in particular, 

The Many Names of Syphilis

EMI: Over the years, syphilis has had a lot of names. Here’s singer and musician Sister Rosetta Tharpe…

CLIP - SISTER ROSETTA THARPE: “I am not ashamed to call that monster by its other names, Syphilis, The Pox. I’ll say it right out on the radio. We are not superstitious anymore, we are not afraid to speak. Syphilis hath taken so many lives, syphilis hath killed and maimed so many. Syphilis hath broken up homes and destroyed innocent children. Now we are going to turn around and run him right out of our country…” 

Throw to music

EMI: Syphilis has had a lot of names over the centuries, like the French disease, the Spanish disease, the British disease,

SHEILA LUKEHART: depending upon who, who the most recent enemy was, because it was a thought to be a, a negative thing to have syphilis and so you, you ascribed it to your enemies.”

EMI: But what about the name, syphilis, though? That name actually comes from a fictional Italian poem written in 1530 by Girolamo Frascatoro, in which an Italian shepherd, named, yup, Syphilus, angers Apollo, who in turn afflicts him with the disease that now bears his name. Syphilis, the disease also has its own Latin name,

SHEILA LUKEHART: “Lues Venerea,” which means Vener or sexually transmitted, uh, plague or pestilence and the, uh, license plate on my car is Lues L U E S. I wanted “chancre” and the state of Washington wouldn't let me have it.

EMI: We’ll talk about chancres in a moment, but suffice it’s an unusual request for a license plate.

 And I wanted “syphilis” and they wouldn't let me have that. And I went to Lues and I guess that was strange enough that they let me have it.

EMI: There’s one more Latin name that’s important to know when it comes to syphilis. The bacterium that causes it is called “Treponema Pallidum,” or “T. Pallidum,” for short, and it’s shaped like a corkscrew. The individual bacteria can be called “treponemes.”

Stages of Syphilis

EMI: Now that we have the names under our belt, let’s talk about transmission and symptoms. 

SHEILA LUKEHART: Syphilis is transmitted by direct contact with an infectious lesion. 

EMI: This contact usually happens during sex, but syphilis can also be passed from a pregnant person to a fetus.

And I'll describe the lesions again in a minute, but the organism, the bacterium can go through intact mucosal surfaces. It can go through microscopic abrasions in skin, and once it it's in the body, it begins to multiply locally at the site of contact. And then it also gets into the bloodstream and disseminates throughout the body, even before there are any clinical manifestations.

EMI: This leads to stage one - primary syphilis

SHEILA LUKEHART: And what you see first clinically is the development of an ulcer an ulcerative lesion at the site of contact. That's called a chancre and the chancre is open. 

So it's the most infectious, um, stage of syphilis. If you come in contact with that lesion, you have a 30% chance of, of, uh, getting syphilis. 

The chancre also is painless. It doesn't hurt.

And so that chancre persists for several weeks and then heals spontaneously due to the host immune response. And then the patient is likely to be asymptomatic for a period of time. 

EMI: So. Stage one, primary syphilis: a chancre, which is an open, painless ulcer.  

Then, stage two - secondary syphilis: which is a rash all over the torso.

SHEILA LUKEHART: It's not painful, it's not, uh, itchy. It's just little red lesions that appear on the trunk, on the arms, the legs, the palms of the hands, the soles of the feet. And that will persist for about one to two months.

And then it too heals spontaneously due to the host's immune response. And each of those little lesions is a focus of treponemes multiplying under the skin. 

EMI: Remember, treponemes are – 

CLIP: (FIGHT SYPHILIS) - “The germ that causes syphilis”

SHEILA LUKEHART: So there are lots of treponemes, uh, present during the time. But if the skin is intact, it's not as infectious as the, the primary chancre, which is an open ulcer.

EMI: After the rash heals, a patient enters the so-called "latent stage" where they might not present any outward symptoms for years.

SHEILA LUKEHART: You remain infected for the rest of your life if you're not treated, but you don't have further clinical manifestations.

And about two thirds of people with syphilis that go untreated end up in that category, they don't have, uh, further clinical manifestations.

EMI: But what about that other third? Well, left untreated, the other third of syphilis patients progress into its final stage, which can happen even more than a decade later - tertiary syphilis. And tertiary syphilis presents in a variety of unpleasant ways. Here’s some of them.

MUSIC

Some patients develop what are called “gummas,”

SHEILA LUKEHART: And these are destructive ulcers or destructive lesions that can affect bone cartilage or any organ like the liver or the brain. You can have a Gumma anywhere in the body. And this is what resulted when, when cartilage of the nose is affected, then the nose can collapse. 

EMI: That’s known as “saddle nose,” and in the 15, 16, and 1700s, people would hide this condition by wearing a fake metal nose.

Another form of tertiary syphilis is called cardiovascular syphilis. That  affects the heart – specifically the aorta, which delivers oxygenated blood to the rest of the body.

SHEILA LUKEHART:  And you can have an aortic aneurysm, which is like a weakened area in the wall of the aorta. And if that weakened area is put under too much pressure, it can burst and that can result in death.

EMI: And then there’s neurosyphilis, yet another kind of tertiary syphilis, which attacks the nervous system in various ways. 

SHEILA LUKEHART: There are two kinds of late neuro syphilis.

One is called tabes dorsalis, which involves the nerves of the spinal cord and it affects mostly the lower extremities, but it can cause a loss of sensation in the extremities, you don't know where your feet are because you can't sense where they are and you walk with a very odd, um, wide based gait called ataxia.

EMI: Neurosyphilis can also go after the brain itself.

And the manifestations of that can be depression, personality changes leading ultimately to insanity and, or, um, yeah, dementia and, um, If enough neurons are destroyed, you become paralyzed.

And ultimately it results in death. 

EMI: I should also mention that it’s possible to have more than one form of tertiary syphilis at the same time… So you could have symptoms of neurosyphilis and also of cardiovascular syphilis.

Thankfully, we have very effective treatments for syphilis today, which has made tertiary syphilis a much much rarer occurrence. But syphilis hasn’t disappeared, and rates of infection have been rising in recent years. So if you’re concerned that you might syphilis, or any sexually transmitted infection, don’t be afraid to go to a nearby sexual health clinic. You can find links to clinics here in new York city in the episode description and on the episode webpage. 

CLIP: Schoenberg Quartet No. 4, 1st Movement

So whatever happened with Schoenberg and Thomas Mann? Well, if you pick up a copy of Mann’s novel today, there’s an author’s note that he added after the initial publication, clarifying that all of the musical details for his fictional Doktor Faustus came from Arnold Schoenberg. But there’s no mention whatsoever that the character’s syphilis is entirely Mann’s invention. 

Next time (though), we’ll look at one composer who was affected by syphilis, from a time when people really didn’t like to talk about it – Franz Schubert. We’ll look at the treatments he took for syphilis, all while composing some of his most famous works.

But to close out today, let’s go back to the VD Radio Project. Here’s Sister Rosetta Tharpe, from the radio piece “We Are Not Ashamed.” 

John Schaefer: This episode was produced by Emi Ferguson and Max Fine, and edited by Matt Frassica. Additional production assistance from Hanako Yamaguchi and Jade Jiang. “We Are Not Ashamed,” featuring Sister Rosetta Tharpe, is from the Alan Lomax Collection at the American Folklife Center at the Library of Congress. Used courtesy of the Association for Cultural Equity.

Excerpts from "An emigré life" oral history by Marta Feuchtwanger provided by the Center for Oral History Research, Library Special Collections, Charles E. Young Research Library, UCLA.

Additional thanks to the NYC Municipal Archives, the National Archives, and the New York Public Radio Archives. I’m John Schaefer, thanks for listening. 

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