Piano Men

Editorial September 2005

No material has been received or submitted for publication during the summer, so for our editorial at the end of the holiday season I offer a personal response to a psychiatric story covered by The Times; one which had a particular resonance for me, and that might connect with readers' experiences of 'mystery patients' who defied diagnosis?

Doctors who have browsed this website's sections down as far as Links and Downloads will have noted SCP's invitation to share hobbies and out-of-work interests, and discovered that SCPNET's present Editor has for many decades counteracted the stresses of psychiatry by playing and writing about music. Occasionally those interests have coincided, e.g. in writings about the artistic lives of hospitalised psychotic patients Adolph Wölfli in Berne and Ivor Gurney in Dartford.

An unknown man was reported as having been found on an isolated Kent beach in April, wet and with all labels removed from his smart suit. He was taken to hospital where he did not talk, and his identity was a mystery. Because he remained mute, he was transferred to psychiatric facilities in Dartford, where I had been a consultant psychiatrist long ago. There he spent time at the piano. Some believed he was a gifted pianist and the media dubbed  him "The Piano Man". He continued totally mute until the end of August, firing widespread speculation. [Picture: TheTimes]

Dartford's Piano Man brought to mind the mentally ill pianist David Helfgott, and he was thought to be, variously, a French busker and a Czech concert pianist. Finally, according to The Times, when a nurse asked once again "Are you going to speak to us today?" he answered to her astonishment, "Yes, I think I will"! It emerged that he had worked with mentally ill patients and, after a failed suicide attempt, was mimicking their symptoms.

With involvement of the German Embassy he was repatriated, and clinical confidence protected information about him to date, including his identity which had now become known. A hospital "insider" told The Times that the hospital had "got nowhere with him" and thought "he was going to be stuck with us for ever". "He had us all fooled for four months." Contrary to exaggerated reports of his musical prowess, it seems he might actually have "just kept tapping one key continuously".

That image brought to mind a unique and eccentric (posthumously world famous) Italian contemporary composer and poet, Giacinto Scelsi, whom I had been one of the first in UK to study and write about; DISCOVERING SCELSI (Piano Journal 7/21: 1986). When I visited Scelsi near the end of his life in order to discuss his piano music, he told me at his mansion overlooking the Rome Forum that he attributed his musical individuality and achievements to
1) having tolerant parents who allowed him as a child to experiment by improvising wildly and noisily instead of being constrained to learn to play 'properly'
and
2) a mental breakdown in adulthood when he spent a period as an inpatient obsessively sitting at the piano day after day, and playing again and again one and the same note.

He demonstrated that to us, playing a Bb for a minute or so, wanting us to concentrate on the sounds within the note. By doing so in the hospital, Scelsi believed he had 'cured himself' of his illness thereby, and his discovery of a universe within the single note determined the direction of his later music, its complexity necessitating abandonment of the piano, and influencing the later generation of spectralist composers.

Scelsi was no more forthcoming than Dartford's Piano Man may have become before departing to Germany. A spokesman for West Kent NHS and Social Care Trust said: “The patient dubbed Piano Man is no longer in our care. He has been discharged after a marked improvement in his condition.” *

Elective mutism is less common in adults than in children. It must be hoped that the Dartford psychiatric team will publish a case study on their efforts to treat this patient; perhaps a music therapist might have a contribution to offer?

*Sequel: Sunday Times 28 August 2005 - - British tabloids were bidding up to £50,000 to interview the Piano Man last week and a book could earn him more. "With clever PR and marketing it could be worth hundreds of thousands of pounds and potentially a nice film deal,” said Max Clifford, the publicist - -
The Times 30 August - - Why didn't the nursing home correct the nonsense about the Piano Man playing long beautiful sonatas, when it now turns out he could barely hit a note?

Maybe readers have had other 'mystery cases' they would like to tell us about (use the Feedback form)? SCPNET & the British Journal of Clinical & Social Psychiatry would welcome more papers, on these and other topics.

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Hospital doctors should keep an eye on the issues of abuse of power and disciplinary over-reaction, which have been a central concern of SCP for many years; there has been a disquieting surge of suspensions, with responses to 'whistleblowing' prominent amongst them.
PGW