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Hitting the right note: Exploring music and mental illness at dotMD

Dr Kogan, who is Clinical Professor of Psychiatry at Weill Cornell Medical College and Artistic Director of the Weill Cornell Music and Medicine Programme, has received much acclaim for his distinctive series of lectures and performances on the great composers. At these performances, Dr Kogan not only discusses the mental health issues faced by music giants such as Beethoven and Tchaikovsky, but also plays their compositions on piano.

The series began after he was asked to present a symposium on musical creativity and mental illness at the American Psychiatric Association. Dr Kogan was in an ideal position to present the symposium, having completed a double major in music and pre-medicine at Harvard, after which he studied psychiatry at Harvard Medical School. As a child, he had been enrolled in the Juilliard Pre-College, studying cello and piano, and had continued playing concerts alongside his medical career.

“I started reading biographies on composers whose music I had played all my life and in many cases I thought they sounded a lot like my patients,” Dr Kogan told the Medical Independent (MI).

 “I found many of them had mental illness, or if they didn’t have mental illness they at least had issues — the sort of issues that psychiatrists always deal with, and it made me really interested in the nature of creativity. I found it actually very valuable in my life as a physician because I started thinking about issues of creativity and also as a musician, because learning something of the lives of these musicians helped me play their music better, I think.”

His first lecture/recital was on the German composer Robert Schumann, who died in a psychiatric institution from self-imposed starvation. At the 2017 dotMED conference, the works of the American composer George Gershwin were discussed and performed. Gershwin, who was born in 1898, and with his brother Ira as lyrist, wrote many of the classics of what would come to be known as ‘the great American songbook’.

One of the most significant American composers of his age, he is perhaps best known for his orchestral work Rhapsody in Blue and Summertime from his opera Porgy and Bess. In his talk, Dr Kogan said that Gershwin frequently misbehaved as a youth and speculated he had what might now be diagnosed as Attention Deficit Hyperactivity Disorder (ADHD).

However, his behavioural problems subsided when he discovered and started playing music, which he grasped with an intuitive brilliance, leading to a dazzling career.

Talking to MI, Dr Kogan said his research into the mental lives of these composers has led him to recognise the importance of conflict in the creative musical mind.

“I think conflict is extremely important,” Dr Kogan said, “that people use artistic expression as a way to work through their own personal and emotional issues. It is extremely important. I have learned that music can be extremely curative, that it can be therapeutic. With Gershwin, he didn’t have music initially, he was just a ‘bad kid’ as a youngster. A quote from Gershwin is: ‘I spent my young years making a complete nuisance of myself.’ Studying the piano turned a ‘bad boy’ into a ‘good boy’. Music also unlocked this creative genius he had within him that nobody would have known that he had.

“I have learned something about how therapeutic the arts are and how important the humanities are to medicine, which is why I am so impressed and thrilled by this particular conference, which I think is extremely valuable for the medical community. I was delighted to come over to Ireland to be a part of it.”

Dr Kogan, who performed parts of Rhapsody in Blue and Porgy and Bess on piano, said it is interesting to think about whether Gershwin would have written his great works had he been prescribed Ritalin as a youngster. Ultimately, Dr Kogan believed that Gershwin, like the other composers he has talked about in his series, would have found a way to express his creativity.

 “One can only speculate on this question,” he said.

“This comes up all the time. I did a Tchaikovsky programme, and somebody said ‘would Tchaikovsky have written the Pathétique if he had been on Zoloft?’ My sense is that most of these great creators, I think they are so determined to create they won’t let anything we physicians do to them get in their way. If the medicine makes their mood more normal, but gets in the way of their creative drive, usually they just wouldn’t comply with their recommendations. Their creativity would still find expression.”

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