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Health Care Cantata

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Tintoretto at the death bed of his daughter.

While reading Peter Roderick’s account of the dismantling of Britain’s National Health Service in the latest issue of the London Review of Books, I put on the relevant Bach cantata.

Bach has many lessons to teach us, though they are rarely for the faint-of-heart. Indeed, faintness of heart itself is one of his main themes. For Bach the weakness of the body is the central fact of earthly life, and the human propensity for moral and physical disease contaminates even the enjoyment of music itself. To listen to Bach is therefore to listen to a paradox: the pleasure to be had from his religious cantatas relies on bodily organs and inclinations prone to sin and degradation.

Bach’s own sensual appetites, not to say stamina, can be gauged by the sheer quantity of his (pro)creative (re)production over five decades: he fathered more than a thousand works (many of more than an hour’s duration) and some twenty children by two different women. More than half of these children died in infancy. Nothing specific is known about the medical measures taken on behalf of these infants, though my survey of a number of household instruction books from the period shows that many of the ills, both grave and merely inconvenient (e.g., hemorrhoids), were treated with a variety of seemingly benign herbal concoctions as well as with powerful chemical potions, including substances such as mercury. Then as now, what didn’t kill the patient tended to make him or her stronger.

Bach’s own medical travails over his relatively long life of sixty-five years are documented only near the end. Forensic historians generally believe diabetes was the chronic condition that eventually claimed him. Four months before his death in July of 1750, Bach was operated on in Leipzig by the English oculist, John Taylor, a womanizing ophthalmologist then traveling through Germany in his trademark coach painted with images of the eye. Taylor later had a go at the aged Handel’s eyes, and with a similarly disastrous results.

That the two greatest musical minds of the era ended their earthly days in total darkness did not prove to be useful to Taylor’s later reputation, though it has secured him infamous cameos in dozens of biographies of Bach and Handel. (Favoring the ploy of leaving town abruptly after operating on a single eye and before he had to face the direct results of his botched surgeries, Taylor spent his last several years blind himself, a bit of poetic justice that did not escape his numerous detractors’ notice. Samuel Johnson described Taylor as one of the best examples of “how far impudence could carry ignorance.”)

Burial sermons and obituaries of Bach’s time often detailed the last hours of earthly life of the deceased, and consistently included a line or two about the efforts of the family to secure the best possible medical care for the dying. This rhetorical gesture was intended to salve the family’s collective conscience and to inform congregations or newspaper readers that the survivors had done all they could by bringing in experts equipped with the most advanced-and often costly-medical knowledge. The physicians either unwittingly delivered the coup de grace in the form of some toxin or confirmed that further struggle was hopeless. So it is in Bach’s obituary: ” a few hours later he suffered a stroke; and this was followed by a raging fever, as a victim of which, despite every possible care given him by two of the most skillful physicians of Leipzig, on July 28, 1750, a little after a quarter past eight in the evening, in the sixty-sixth year of his life he quietly and peacefully, by the merit of his Redeemer, departed this life.”

In the midst of the most concerted creative outpouring in the history of Western music and still in the hearty haleness of mid-life, the forty-eight year-old Bach—one wife recently buried and several of children by his new young wife soon to die— produced a magnificent, if little-known, cantata Es ist nicht Gesundes an meinem Leibe (BWV 25) devoted to human illnesses of the mind and body. One is unlikely to hear this unrelenting work, the ultimate exercise in negative body imaging, in a chaste Pilates studio in your neighborhood. Hypochondriacs are advised to secure the music libraries of their iPhones against this potentially debilitating Bachian virus.

The work opens with a chorus to the text: “There is nothing healthy in the face of God’s threats, and there is no peace in my bones from my sin.” The cantata’s poetry is drawn from a collection published in 1720 by the Lutheran clergyman, Johann Rambach, who also a wrote a thick and explicit book on Christ’s crucifixion, a tome owned by Bach’s second wife, Anna Magdalena. The greatest master of Christian masochistic imagery before Mel Gibson, Rambach loved to write about pain and suffering, all the better to advertise the joys available in heaven.

Bach introduces the opening chorus with heavy-burdened sighs in the orchestra, then gives a slower version of this same figure to voices bewailing their mortal bodies. At dramatic moments in the course of this portentous musical discourse, Bach introduces a full texture of brass instruments playing the familiar tune of the Passion chorale, whose text would have been known to contemporary congregations: “My heart is filled with longing / To pass away in peace.” From the tribulations of the earthly body, escape comes only from the world itself; this shimmering hymn is the song of heaven, both harmonious with and independent from the tortured, serpentine counterpoint of the voices and other instruments.

A tenor recitative follows this chorus-like 18th-century operas, Bach’s cantatas generally alternate movements devoted to the quick delivery of large chunks of text (recitatives) with more static reflections using shorter poetic units and involving a great deal of textual repetition (arias). In twisted, pain-wracked melodic contours and pain-wracked chromatic harmonies, Bach lays out the central thesis of the work: “the whole world is a hospital, filled with countless people, even children in their cribs, stricken by illness.” One person suffers the fever of lust, another stinks with pride, a third (and here thinks of the Healthcare executives of our times) is tossed into a premature grave by the consumption of avarice. The leprosy of sin devastates the limbs of all people. “Who is my doctor?” asks the recitative rhetorically at its lonely conclusion. 

The answer is voiced only late in the subsequent bass aria in ecstatic arcs of soaring melody, all joyful hope in contrast to the pained introversion of the preceding recitative: “You are my doctor, Lord Jesus, only you know how to cure my soul.”

The sicknesses here cataloged are both metaphorical and real: sin is the cause of all suffering, but Bach’s musical depictions of a host of maladies in the bass aria alone are so detailed and evocative that they must have made his infirm and often sickly congregations uncomfortably conscious of their bodies and all the diseases and discomforts that attended them.

After the general cry for help that opens this bass aria, “leprosy” and “boils” are given to twisting, repeated figures that capture both the immediate pain and the relentless progress of disease. Later, ineffective “herbs” and “compresses” offer glimpsed hopes of comfort, but these quickly give way again to pain and despair, until the doctor Jesus makes his house call at the door of the soul. 

On volume 7 of Ton Koopman‘s complete set of Bach’s cantatas (available on the Antoine Marchand label), the great bass Klaus Mertens gives the definitive performance of this aria, as he subtly modulates his voice from the grim exhortations of the opening to the urgent anticipation of relief that momentarily beats back the pain of the body. Though composed before our antiseptic age, this aria offers an unforgettable evocation of the way the patient’s squirming and sweating in the waiting room gives way both to anticipation and \ dread as the door opens on to the bright white of the examination room. O ye infirm, put down your People magazines and listen to the music!

On the most obvious level, the cantata retails the scorn for earthly existence harbored by millenarians and political quietists: in a world of questionable medical procedures and menacing disease, the only hope is heaven. While the melodies, diseases, and medical practices may be mostly different, the song remains the same: for the religious and non-religious alike, death is the only real cure.

Bach’s gripping music captures the opposing forces of hope and futility felt by all patients, then as now. Even in its exacting representations of pain and suffering, the cantata soothes, partly by looking beyond its immediate circumstances and sorrows, while at the same time wallowing in them. One doesn’t have to be religious to recognize the weirdly ecstatic quality in the music and the complicated psychological state it represents. Dependent on the body to be sung, played and heard, the cantata paradoxically strives for the transcendence of the fragile physical condition of all humans. Does the music succeed? Even the good doctor Hippocrates himself had to admit Ars longa, vita brevis: Art is long, life is short.

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DAVID YEARSLEY is a long-time contributor to CounterPunch and the Anderson Valley Advertiser. His recording of J. S. Bach’s organ trio sonatas is available from Musica Omnia. He can be reached at  dgyearsley@gmail.com

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