I have a hole in my head. Should I be practicing?
Last week, I wrote about poet Tomas Tranströmer and how he seemingly presaged his own 1990 stroke in his 1974 poem, “Baltics.” In turn, I might have been presaging my own neurological condition: I have a hole in my head.
A week ago, I was diagnosed with a cerebrospinal fluid (CSF) leak. There’s an encephalocele in my left temporal lobe: a 6 mm hole in my skull base, through which my temporal lobe is extending into my left sphenoid sinus. CSF fluid is leaking through that hole. It drips out through my left nostril: enough so that any gauze or cloth I put up to it is soaked through in a matter of minutes.
I first noticed the leak on Inauguration Day. I cried Inauguration Tears when Kamala Harris was sworn in, but I noticed that sometimes, a tear was escaping my nostril, too. Nose tears kept coming on Thursday. I was at home dismantling a bed frame. I’d bend over and fit the power driver into the screw head. The screws would rise from the planks and dangle on the magnetic tip of the drill bit.
Plop, plop, plop, came the nose-tears.
I googled “clear fluid runs out of my nose when I bend over” and read alarming results like “Arizona Woman Nearly Dies as Brain Fluid Leaks Out Nose.” I’m skeptical about Dr. Google and his diagnoses, but the symptoms of CSF leaks in reputable sources matched enough of my own to cause me concern.
I spent Friday trying not to get nervous. I kept dripping. On Saturday morning I collected a specimen of the drip in a glass jam jar. I rook it to the local clinic, where a long line of people stood waiting for their Covid tests. “I have a brain leak,” I said. The doctor was condescending: “In other words…a runny nose.” I showed him the liquid in the jam jar. “That’s not mucous at all,” he marveled.
I asked him to test it with a glucose strip (CSF has glucose, and tears do not). “Hmm. That’s a good idea.” He marveled as the strip turned a bright emerald. “That’s green!” he pronounced, “and it’s only going to get greener.” He wheeled around to address his assistant. “Write her up a letter for the Emergency Department. Tell them it’s glucose positive.” Peering over the assistant’s shoulder, he said, “Add another plus sign. G Plus plus plus.”
There are no windows at the NYU Langone Emergency Department. I came to accept that I would be here for some time. “This is what I do now,” I said, out loud.
The jar was a sensation. The attending physician took a picture of it with her iPhone.
I was eventually diagnosed with the CSF leak, skull defect, an encephalocele. The neurosurgical resident told me the injury might be from trauma, or it might be from something called Pseudotumor cerebri (a name I prefer to its alternate, Idiopathic Intracranial Hypertension) where increased pressure wears away at the skull and the dura, the membrane that covers the brain. Maybe it’s both.
I met with a neurosurgeon and an ENT surgeon later that week, and together they decided I’ll have endoscopic transnasal surgery to repair the defect. They’re going to go in through my right nostril across to my left sinus, nudge my brain back through the skull base, and patch up the hole with allografts and surgical glue. I should be out of the hospital the next day.
The first surgeon was optimistic. “I’m 70% confident I can repair it endoscopically.”
The second scoffed when I reported the number to him.
“No, more like 90, 95%”
“One thing,” the second surgeon said offhandedly, “in order to access the hole I’m going to have to cut the nerve that runs through here.” He touched the circle on the scan that showed the conduit for the nerve that controls tears in my left eye. “After the surgery. you won’t be able to cry out of that eye.”
Other than that detail, I mostly feel okay. This could be so much worse.
I mention all this because I promised to document my renewal of my relationship to the viola in this newsletter—in other words, I promised I would practice—and it’s already February and I have not yet started. And it’s unlikely I’ll start until after I recover from surgery, in March.
I’ve got these questions rattling around in my head.
What makes me a musician, if I am not making music?
If I never played music again, would I still be a musician? Under what circumstances might I cease to be a musician?
What, properly, should this newsletter be for?
How I know I’m a musician when not making music
There are a few points of friction that tell me I’m still a musician.
(a) Identity. I have a long history with music. Many decades of many hours a day spent in musical work. When I made a list of people to be notified, in case of emergency, most of them were musicians.
(b) Timekeeping. I had a particularly long MRI at NYU Langone. The technicians wedged earplugs in my ears, and headphones over the earplugs. “Are you claustrophobic?” they asked, as they snapped my head into a plastic coil that immobilized it. (The question, clearly, was not meant literally. It had a different, social, function—what linguists call phatic communication.)
They said the exam would take about an hour. They asked me what music I’d like to hear. I asked for Glenn Gould’s 1981 recording of the Goldberg Variations. I know it well. His measured, introspective tempi and judicious repeats make the entire performance clock in around 51 minutes.
The music they played was from YouTube—periodically punctuated by ads. They played Gould’s 1955 recording. No repeats, blistering tempi, detached staccatissimo, 38 minutes. When the Aria da capo ended, I wondered what would come next. There was a brief pause, another ad, followed the Bach Violin Concert No. 1 in A minor. That was followed by the Violin Concerto No. 2 in E Major. These are pieces I’ve played on the inside and outside: as a child, as an adult, as a violinist, as a violist.
So I’m hearing all of those parts of my life in counterpoint with the intermittent WHAM-WHAM-WHAM-WHAM-WHAM and the tik-tik-tik-tik-tik-tik-tik-tik-tik of the machine. During the periods of banging, clicking, whirring, clanging, and beeping, I was okay. I could admit the MRI as a bizarre new entry to the basso continuo, and enjoy its absurd counterpoint. I could place my awareness anywhere in the orchestra. I could shove my hands inside the gloves of Glenn Gould and double him.
This is what I did each time the wave of anxiety hit me. I issued myself an imperative (“Do NOT allow yourself to think about the fact that your head is trapped inside a coil inside a giant magnet” and “Breathe out your anxieties, push them out through your toes”) and then I took a seat in the band.
(c) Complaining. In the MRI, I marked time with music. I did the math (1955 Goldberg + 1 Violin Concerto = about 53 minutes) and made calming calculations, like, “Each one of these concertos is about 15 minutes long. When the E Major ends, I should be done”.) Except the MRI didn’t end after the E Major concerto. It went onto G Minor Concerto, which I don’t know as well.
“Seriously,” I thought, “are there to be no breaks on this gig?” It went on further still, through the Adagio and the first movements of the first of the Sonatas and Partitas, which could potentially go on for another two hours. I was in there for over an hour and a half.
It will be some time before I can listen to Bach again.
(d) Fear. I‘ve found myself not-yet-almost-nearly ready to admit that it pains me to face a future where I don’t play music. When the neurosurgeon was presenting my surgical options (roughly: endoscopy v. craniotomy) he said something about how the risk of damage to the temporal lobe wasn’t really that big, and that in any case there were relatively few “really essential” things going on in that part of the brain.
I prefer to assume that he was being hyper-specific about exactly which part of the temporal lobe would risk being impacted, like the particular 6mm of my temporal lobe that’s pushed through the dehiscence in my skull, because in a general sense, what goes through my head when I think “temporal lobe” is “language and music processing,” which I deem as essential as it gets. Even though the likelihood of something going wrong in surgery is very small, 47 years of music-making means music is tied deeply into my brain resources at many levels.
For the past 30 years, almost every choice I’ve made touched on musical performance in some fashion. What would I be without that?
Should I be making something of this time?
Ever since I got out of the Emergency Department, I’ve had to lay back at a 45 degree angle. If I sit up, I leak. If I stand up, I leak. I leak if I turn my head to the side. I leak if I bend over. So I don’t. I talk on the phone to friends. I sleep. I try to get up every so often.
It’s been two weeks of reclining. I have two weeks more to go before my surgery, and I’m battling the idea that I should be making something of this time. I think about holding the viola while I’m propped up in bed. I could be doing left hand drills, trills, silent thirds and octaves, vibrato.
Why isn't it enough that I just get through this?
A common cultural stereotype in music is the performer who overcomes disability, injury, or poverty to thrive in performance: Itzakh Perelman (polio); Beethoven (deaf); Stevie Wonder (blind); all the one-handed classical pianists (Tranströmer included); Susan Boyle (Aspergers Syndrome); David Helfgott (schizoaffective disorder); Michel Petrucciani (osteogenesis imperfecta) and the various rags-to-riches stories (Louis Armstrong, Jewel, Dolly Parton, Ed Sheerhan, Celine Dion.)
I admire artists who play through struggles. But it’s equally important that we hear stories that diverge from these pervasive, triumphant tales of overcoming. Stories of individual triumph often mask significant social injustice and systemic failures. The object lesson is that we should work harder, complain less, and be grateful—unrealistic standards to which few of us can adhere.
The late Australian disability activist Stella Young coined the term Inspiration Porn to expose the forms of Ableism in play when people with disabilities are portrayed as inspirational in part or solely because they are disabled. They ultimately serve to affirm non-disabled people, who can feel good about their unbroken, able bodies.
The Japanese Art of Kintsugi Won’t Save Us
There’s something similar at play in the musical aesthetic of Covid inspiration.
I’ve come to see the husband-and-wife songwriting team Abigail and Shaun Bengson as litmus test. The thing is, I can’t say for what, but people love the Bengsons and I don’t. (They made an off-Broadway musical that’s like a performed version of a New York Times wedding announcement.) Their latest venture, “The Keep Going On Song,” is a 50-minute streaming performance from quarantine in Shaun’s parents’ house in Dayton.
“The Keep Going On Song” is also the title track, and when Abigail sings “you are welcome in our home / We’re in Dayton, Ohio! / We’re at Shaun’s parents’ house.” it makes me want to drive over there and knock on the door and present myself and ask, “Did you really mean that?” But by the time she sphrechstimmes, “Are you okay? Are you alright? / Are you okay? Are you alright?" with her forehead furrowed in deep concern, I know she doesn’t mean it. It’s a performance of meaning.
I know people love them, and I don’t mean to take away anyone’s love. But it’s not for me.
The problem I have is that the shallow, saccharine, sentimentality crowds out all subtlety. Instead of describing complicated struggles and vivid personal experience, we get phatic art: art that neither seeks nor offers information of intrinsic value, but instead signals its willingness to conform to conventions, expectations, and values of the dominant power systems.
The pandemic falls on those least able to bear its burden. “The black-white economic divide is as wide as it was in 1968,” reports The Washington Post: you would have to combine the net worth of 11.5 Black households to arrive at the net worth of a single white household. With far less financial resources to carry them through the economic fallout of the pandemic: lost jobs, furloughs and pay cuts; trouble paying bills, rent, and health care expenses; losing health instance, and more (see this from the Pew Research Center). According to the Centers for Disease Control, Black people are 3.7 times more likely to be hospitalized and 2.8 times more likely to die from Covid-19 compared to white people.
We are approaching 500,000 Covid-19 deaths in the United States. One month ago yesterday, the nation’s capital was stormed by violent domestic terrorists, spurred on by the sitting President. The panic buttons had been removed from Ayanna Pressley’s office. Alexandria Ocasio-Cortez hid in her office bathroom as a hostile Capitol police officer broke in and asked, "Where is she?"
There is no silver lining to a terrorist coup and a public health disaster with massive casualties. It’s not your personal growth opportunity.
I don’t have much mental focus now. It’s taken me many hours to write this. I’m hovering around 50% brain power.
I can’t really do anything these days except recline and wait for brain surgery. I have a bed and these little rooms; health insurance and enough to eat; my careful choice of surgeons; a job I can still do while dripping; the support of a truly good partner. I don’t like not being able to take care of things for myself. I hate not being able to think clearly. I’m scared of the surgery.
It’s been liberating to inventory the things I thought I had to do, and didn’t need to do. The things I thought I was supposed to believe mattered, that don’t. Since I’ve been tiptoeing around in the silent mysteries of my brain, I feel a deepening commitment to my own memory.
Remembering like a political act, one upon which our survival depends. I don’t want to do anything else but remember my memories of this time, and not anyone else’s. (See Lucille Clifton’s epigrammatic “why some people be mad at me sometimes.”)
I’m not going to to Keep Going. I’m going to Keep Dripping. I don’t need to make anything out of this time. I just need to make it.
Practice as memory
I’m warming up to an idea of a discipline of practice as one of remembering.
I’m warming to the idea that it might be nice—really nice—to play the viola the way Tranströmer played the piano. Which is to say for me. Which is to say as I am, and not at the end of some hashtagged hundred-day challenge that seeks to erase everything broken in me, and everything that happened before.
When I say “hashtagged hundred-day challenge” I am referring only glancingly to the annual Instagram campaign by violinist Hilary Hahn. I like her commitment to practice for process, rather than results. I like how she uses “muscle health” and “mental health” in the same sentence.
I like her unpretentious, nuts-and-bolts approach: starting 2021 with the first of Carl Flesch’s Urstudien, which asks the violinist to contort three of the left hand’s fingers to hold down their positions on three separate strings while a fourth taps a fourth string with clear articulation. It’s like some awful game of fingerboard Twister.
I like how she doesn’t dwell on how hard it is, but she doesn’t cover it up, either. I like how she keeps coming back.
I imagine at least part of the reason why so many people follow her is because she’s a World-Class Musician (WCM), and eventually, she’ll be back on the road practicing from hotel rooms and green rooms in the glittering capitals of the world and if they practice like her then some of that glamour will rub off on them. I just like her for who she is in these few posts. She’s just coaxing her muscles to come back to life, and shining a little light for others.
Of course this guy posted this comment to one of her first posts of the year (proving, yet again, that Canadians can be assholes, too).
I don’t know Richard Reed Parry, but I know something of his career, and I know something of the way in which some successful musicians valorize struggle because they have a limited experience of it. If your career unfolds like an endless boulevard of green lights, a little struggle spice lends depth and credibility.
(Once, a friend, straight-faced, explained to me that composer Caroline Shaw—the youngest person to ever win the Pulitzer Prize—could not be critiqued for cultural appropriation because “she was homeless when she started at Princeton.” Another friend told me that Claire Chase—who got the MacArthur not for her exceptional work as a flutist, but as an entrepreneur—slept in her mobile catering van while she was writing the 45 grants that failed before she got the one that launched the International Contemporary Ensemble. Both accounts were related to me in a breathless tone of wonder. Both are apocryphal.)
The context of American life in which all of this unfolds—my brain surgery, the MacArthur, practicing or not practicing, the January 6 coup, the steep injustices of Covid-19—is shared by neoliberalism. Neoliberalism, simply put, is an ideology that suggests human well-being is best advanced by the fair actions of a “free market.” It casts inequity as a virtue: if the system is free and fair, then those who reap its rewards do so on the basis of their merits.
In system like this, words and memory lose their meaning. Music becomes meaningless, too.
What I’m trying to set up in these conversations is a context that is alive to the unequal world that makes not practicing (or failing to emerge from the pandemic a “better” musician, or pausing or quitting altogether) a reasonable choice. When I look it that way, it makes sense why I haven’t wanted to practice: where practice is an automatic good; where the logical outcome is to stage yet another comeback—against all odds, better than ever; when to “Keep Going” means to Keep Quiet about music’s harms (instruments and young bodies freighted with judgment, shaming, punishment, mockery).
What I want to do for myself, and for anyone reading these posts, is to create a context that is alive to the unequal world in which we live: the one that shapes our choices to practice or not practice. I want to make a space that allows us to reclaim our choices in a positive light, and to reclaim our instruments, our memories, and our music.
P.S. My surgery is February 18. Send me your good thoughts, please.