Boston’s Symphony Hall is filled to capacity, but on stage, there is only a single chair. There is not even a music stand. It is an odd image—simple, daunting, magnetic. I have never seen anything quite like it. The hall lights flicker; then the house lights dim. Stragglers hurry in to claim their seats. And then, suddenly, we are all on our feet again.
The chair on stage is for Yo-Yo Ma, who will perform three of Bach’s six suites for solo cello. Ma comes onto the stage, bows a few times, takes his seat, and starts in on the fourth suite without hesitation. He seems free, on fire. His forehead glistens with sweat. Little drips fall down his temples and land on the fingerboard. His eyes are closed, and there is a smile, almost of discovery, on his face. Without an intermission, he brings the house to life with the fourth, fifth, and then the daunting sixth suite.
Since I was a child, Bach’s Suite No. 6 for solo cello has been my very favorite piece of music. It has six parts, each harder than the last. I have been playing cello and piano since I could walk, but I have never even attempted the sixth suite. So much of the suite involves rapid string crossings, double stops, and very high notes—way up on the A string in thumb position. I am just not good enough—yet. “Next year,” my teacher reassures me. Ma has recorded these works a few times, tracks I own in their entirety, but this is my first time having the honor to hear him perform in person. I am transfixed.
My husband and I spend a lot of time in Symphony Hall, but he does not share my passion for cello. It takes some convincing to get him to go to the Ma concert with me. By the time we reach the box office, only front row seats remain—one on stage left, one on stage right. Jon takes the right, and I the left.
I focus on Ma. His posture, where his left knee rests on the left corner of his instrument. Ma’s body and his cello undulate with the music, especially in the difficult passages. I study how he moves with his instrument, as though it is an extension of his body. I marvel at his mastery of the treble clef and higher positions, especially in the later movements. That face of wonderment.
On this night, as he delivers Bach’s sixth suite, I can feel the pulsations of the crowd. The rhythms, almost like heartbeats, move right through me. It is nearly too much.
***
A month after hearing Yo-Yo Ma play, I collapsed during a run one snowy morning. I had been an avid athlete all my life: Division I varsity college soccer, mountain climbing, skiing, distance running, swimming, more. I was training for my second Boston Marathon, but that aspect of my life ended abruptly.
My cardiovascular system had shorted out. A purely electrical problem: my heart muscle was good and strong, but the nerves were incompetent. I was quickly diagnosed and fitted with a combination pacemaker and implantable cardioverter defibrillator (ICD). My life depends on a non-rechargeable lithium ion battery implanted in my chest within a hermetically sealed device about the size of a deck of cards. Underneath the activity of the pacemaker, my heart is nothing. No rhythm. Sometimes I feel as if that makes me nothing, too.
My cardiac illness was in the making before the running collapse. In fact, I may have been born with some version of it, but it has gotten worse as I have aged. And it does not just involve my heart; my disease has spread out to my whole body. Over the last few years, a rare brain disorder called dysautonomia has led to the failure of the peripheral vascular nerves that strengthen the blood vessels. The result is failure of the vessels to pump the blood adequately. My grave cardiovascular and neurologic illnesses mean that even the slightest common ailment can cause severe hypotension.
A year after my collapse and ICD surgery, I discovered I was pregnant. It was with some hesitation that Jon and I had decided to try to conceive a baby, but both my cardiologist and our obstetrician gave us their blessings. After checking a pregnancy test early one morning, I returned to the master bed and whispered into my sleeping Jon’s ear, “I’m thirty today, and we’re pregnant!” He rolled onto his back, eyes still closed, and a wide smile spread across his face. He embraced me tightly and whispered back, “Oh, my. Oh, Elizabeth. This is good.” My pregnancy went remarkably smoothly. William was born via induction on his due date. His labor lasted only one hour. After birth, the doctors quickly checked his heart for any abnormalities, and found none. Jon and I felt like we had won the lottery.
Never did I tell anyone that during William’s pregnancy I rented a portable Doppler instrument off the internet so I could listen to his heartbeats anytime I wanted to. And I did, often. Unlike my own, William’s heart rhythms fluctuated with the vicissitudes of our shared lives—our adrenaline bursts and lulls, our moments of stress and contentment. I have never felt so alive as when pregnant. I treated myself beautifully—for William.
***
In the spring of 1815, a powerful volcano called Mount Tambora erupted in what is now Indonesia. Its aftermath clouded the atmosphere with ash for a long time, shrouding the South Pacific in a long bout of darkness and changing the weather over much of the world. Historical accounts suggest that this climatic disaster had major psychological consequences on the people of the time. Musicians like Beethoven and Schubert wrote some of their most masterful, soulful works during this time. Many European artists became captivated by the myth of Prometheus, giver of fire. Lord Byron left England shortly after Tambora’s blast. He soon met up with the great Romantic poet Percy Shelley and the soon-to-be Mary Shelley—Mary Godwin. They spent some time in Switzerland, still darkened by the aftermath of Mount Tambora’s eruption, and while there, they shared scary stories. It was at this time that Mary Shelley, in her young adulthood, created Frankenstein—a “modern Prometheus” who takes electricity and makes from it life.
In James Whale’s 1931 movie adaptation, the scientist Frankenstein waits for the worst lightning storm of the season to capture the most powerful electrical charge for his experiment and bring his creature to life. Despite the monster’s “abnormal” stolen brain, the scientist is determined. Just as lightning is about to strike, he hoists the monster to the top of a tower. The lightning hits, and it works: the monster moves his right forearm. Life achieved.
***
I take cello lessons from a substitute cellist for the Boston Pops and Symphony Orchestra, who is also the teacher of Pops conductor Keith Lockhart’s son. I cherish my lessons, though my experience of them is so different than before my heart’s decline. I can play music as always, but the pulsations of the rhythms escape me, even when listening to music played by others. I miss it.
In his book on the Bach cello suites, Eric Siblin describes the prelude to the sixth suite as “a bolt of lightning—searing, rhapsodic, and electrified with ecstasy.” He continues: “It harks back to the first suite with its undulating current, but five suites later is bursting its bounds with pyrotechnical energy. Here Bach is working with a large canvas. The trumpets blare, strings soar, drums roll. The composer pulls off the symphonic effect of a full orchestra with one bow and a handful of strings.” Part of the Prelude involves repeating exact notes on different strings in different positions, some open and some in fourth position, giving an electric then a muted sound to the note. It is so gratifying to me—or at least it used to be. I know there used to be more.
In the 1931 film as well as Mel Brooks’s later satire, Young Frankenstein, the monster becomes enamored with the violin; as a woman plays, the monster swoons. There is something about music that seems to make the monsters forget their violent tendencies and get caught up in the moment. At least, for a moment.
***
Percy Shelley drowned off the coast of Livorno in 1822, in a weather-related boating accident on his ship, Ariel. He was a month shy of his thirtieth birthday. At the poet’s cremation on the beach where his body was found, Edward Trelawney braved the funeral pyre’s flames to remove Percy’s heart from his burning chest. He gave it to a friend, Leigh Hunt, who ultimately gave it to Mary. Apparently, she kept her husband’s heart for the rest of her life, wrapped in a copy of his “Adonais.”
There is something magical about the heart. Throughout history, it has often been considered the soul of the body, the emotional core, the spirit. When mine malfunctioned, I felt as if a deep and meaningful part of me had died.
My Medtronic Evera XT ICD’s pacing system is programmed to give me a steady heart rate at baseline and to speed up with activity. My ICD’s rate responsiveness acts on an accelerometer, a tiny contraption within the device that senses foot strikes. (This differs from other brands of ICDs, which act, for example, on inotropy—heart contractility.) As I step more, my heart speeds up. My device is finely tuned to give me as much energy as possible, but the accelerometer is rather dumb. I cannot swim. I cannot ski. I cannot do yoga. I cannot walk up inclines. The list goes on from there. Another issue for me is that I am left-handed with a thin chest wall. Since my ICD is located in my left chest, this means that sometimes movements just from using my left side lead me into inappropriate tachycardias. Such is life, currently, and it is eerie.
Ever since my running collapse—sixteen years ago, now—I have felt as if I am living on borrowed time. It feels as if there is a beast living within me, controlling the very core of my being, my soul. I hate it—but also cherish it because it gives me the life I have to share with William and others.
William is now fourteen and a soccer star, just like I used to be. He recently ran three miles with his heavy eighth-grader backpack on, just to improve his fitness. What a nut. As William enters adolescence and gains perspective and empathy, he is becoming a wonderfully caring and concerned young man who caters to his mom’s needs and rarely pushes me too hard. That’s good, because as he is getting stronger, I am getting weaker. Recently, we had our first outdoor soccer workout of the spring. The field was half covered in snow, but this did not deter us. I was in goal, to minimize stress on my heart. My goalie gloves were strapped on tightly to protect my delicate cello hands, and William was practicing shooting drills on me. One shot came in so fast and hard that not only could I not catch or deflect it, but it smacked me square in the face, breaking my glasses.
“Mom, oh, Mom, are you OK?” William yelled, as he sprinted in my direction. “Mom, I’m so sorry! I’m stressed! Are you OK?” I reassured him that I was fine, I patched up my glasses, and the afternoon continued.
The first successful pacemaker recipient was a man named Arne Larsson, who got his first device in 1958, when he was forty-three. He lived to be eighty-six years old, and he died of malignant melanoma. He was an avid sailor. I can picture him on his sailboat, tapping his pacemaker for a faster heart rate, for more energy, as he hoists the mainsail or the jib. He had a total of twenty-six pacemakers throughout his life, and he found a calling campaigning for other patients needing such devices.
I have done the math again and again: a typical ICD lasts only about five years, due to battery depletion. Delivering approximately 120,000 heartbeats per day—a steady eighty beats per minute—takes its toll. I’m on my fourth device. How many pacemakers will this mean for my lifetime? Ten ICDs to make it to seventy? Will I make it to seventy?
***
I know what it feels like to drown, sort of. Every few months, when my cardiologist measures the function of my ICD, he has to check the lead wires that connect the machine to my heart muscle. My leads are sixteen years old now; eventually, they will need to be replaced, too. “OK, I’m ready,” I say to my cardiologist, and I rest my head back on the exam table.
“I’m dropping the atrial lead output now. Let’s see when we lose capture,” he says.
My heart beats along steadily, until it doesn’t. I know exactly when this happens. I sink down into the exam table, my whole body disappearing from the room, going down, down. And then: nothing. The rhythm of my pulse stops, and I quickly cease to be.
I go dead for a few seconds, then my cardiologist restarts my heart, electrically, and I come back to life. He tilts the Medtronic computer screen toward me, backs up the rhythm strip on the monitor, and shows me the event: flat line. No cardiac activity. “I guess we won’t be changing your atrial pacing settings!” he says, with that nervous smile he has perfected for this awkward routine.
***
In Whale’s 1931 film, there’s a scene where the monster and a young girl throw flowers into a pond. The flowers float; throwing them is a fun game. When they run out of flowers, the monster throws the girl into the pond; she, unfortunately, does not float.
In Young Frankenstein, there is also a scene with a girl and flowers. The girl is tossing the flowers, one petal at a time, into a well. The young monster observes her doing this, and when she runs out of flowers, he looks menacingly at her for a moment, but she proves to be the stronger one. She retreats to a seesaw and sits down on one end. She tells the monster to sit down. When he does not, she repeats herself, louder. Finally, the large monster obeys, and his weight catapults the girl through the air, through an open window, and into her bedroom. Her parents, searching frantically for her, enter the bedroom moments later and find her sleeping peacefully in her bed. I want to emulate this girl, her strength and command.
When I was three years old, my mother, older brother, and I fell off the wing of a fiery DC-10 aircraft. The rescue slide had broken, and we fell two stories down, through a giant hole at the top. My brother was dropped by my mother and landed on his feet, but she held on tight to me, chest to chest—heart to heart—as one holds a baby. We landed on our heads on the cement tarmac. We were both terribly injured. My mother hit her head on the jet engine on the way down, fractured her skull, and had seizures for decades. Later, I developed seizures, too. Another electrical storm in me. My heart and my brain. But I try to remind myself of the famous Beckett line: “I can’t go on. . . . I’ll go on.”
Every Thursday morning at ten, I share the psychotherapy waiting room with an older gentleman and his young assistant. Often, when getting up out of his chair in the waiting room, the man must take a few moments to find his rhythm, to get his steps going. It quickly became clear to me that this man suffers from Parkinson’s disease, which killed my grandfather. The man proceeds with his festinating gait and makes his way into his therapist’s office. Sometimes, he falls. My medical self wants to run to his aid, but Dr. Sommer, our therapist, says not to. It is a point of pride for him to get up on his own.
The winter when I first met this man, the Wellesley Symphony Orchestra played a children’s concert. I was a cellist in the orchestra at the time. Just before intermission, we played an Irish rhapsody. We played through it three times, while many children lined up and came onto the podium one by one. They each got to “conduct” the orchestra themselves for a moment. It is actually quite hard to play an orchestral piece without a real conductor. We had to rely on the principal violinist to set the pace and dynamics. I had to be careful with my bow hand so as not to poke any of the excited children making their way onstage. Halfway through the procession, I noticed my eyes moistening.
By then, my husband and I had parted ways. Owing to my ill health and its consequences, Jon was granted full physical custody of William, but knowing that a growing boy needs his Mom, I see him frequently. William has a bedroom in my new firehouse-turned-condominium home and sleeps there sometimes, but usually we have a mere several hours together, and then I hand him back to his father. Seeing all the children at the concert brought back a flood of emotions about times missed with William, times I have been in out-of-state therapy programs or in hospitals, getting intensive psychiatric and cardiac care.
At the end of the performance, we played some new music commissioned specifically for the Wellesley Symphony Orchestra. At the end of the concert, a young man came up to the microphone and told the audience a little about the music. He said, “We have the great honor and privilege of having the composer of these works in our presence tonight.”
An older man slowly made his way down the side aisle of the performance hall. As he got closer and came into sharp focus, I realized it was the man from the waiting room. He was struggling, but he made the long walk all the way down to the stage, unaided, and took a bow. By that point, the crowd and the orchestra members were all on their feet, clapping and cheering furiously. Tears streamed down my cheeks.
The next Thursday at ten, I saw the man and his assistant again. After five minutes of trying to get up the courage, I walked over to him, kneeled down to his level, and said, “Hello, I wanted to introduce myself. I’m Elizabeth Fortescue, and I play cello in the Wellesley Symphony. It was such a privilege to play your work and now to meet you.” A lovely smile came over the man’s face, and he held out his hand to greet me.
For the next several weeks, I missed therapy. I entered a terribly difficult period, in which I found myself struggling violently with my illness, wishing things were different. Here was this composer, limited in his motions and their rhythms by Parkinson’s but prodigious on the musical page, turning out beautiful songs. And here I was, playing the music but feeling rhythm-less and dead inside. I didn’t know which was worse. I took it out on myself and wound up locked in a mental ward for many weeks. Finally, the hospital staff decided I was safe enough to go home, and I resumed my work with my outpatient therapists. But my symphony days were over. Too many missed practices.
On my first Thursday back in the waiting room, the man invited me to call him by his first name and asked his assistant for his briefcase. He pulled out a wrinkled old envelope with no writing on it. I opened it up, and the note inside said: Dear Elizabeth, May I have the pleasure of having dinner with you at my home? I blushed, took his hand in mine, and thanked him for the invitation.
Just recently, I received an email. It was from Max Hobart, violinist for the Boston Symphony Orchestra for many years and now the Music Director of the Wellesley Symphony Orchestra. His email said: Dear Elizabeth, it would be my pleasure to have you back in the Wellesley Symphony. May I save a seat for you? Best wishes, Max. I don’t know how this came about, but I am ecstatic. Our first rehearsal is Wednesday.
***
But before all of this, as I sit on the edge of my seat, listening to Yo-Yo Ma play the last tones of the sixth Bach suite, I feel a brief moment of sadness. It is Valentine’s Day. There is snow everywhere, and it is cold out. I don’t know where Jon and I will meet up. He likes to make a quick escape from Symphony Hall, to beat the traffic and the crowds, but I am determined to stay for every standing ovation. To try to pry an encore out of Ma. I still want more.
Ma concludes, and the audience uproar is palpable. Like the others, I am on my feet instantly, cheering, “Bravo!” and clapping furiously. An elegant woman comes on stage and gives Ma a giant bouquet of red roses. He manages to accept them, his multi-million-dollar borrowed Stradivarius cello named the “Davidov” in one hand, his bow in the other, and the roses under one arm. As he bows to the applause and the cries for more playing, a rose comes loose from the bouquet. It falls onto the floor of the stage. Instead of exiting stage left as he appears to be intending to do, Ma picks up the rose and scans the audience. He walks over to the edge of the stage, and he hands the rose—handed the rose—to me.