Wednesday, May 20, 2009


Recently I was amazed by the speed and accuracy of a student zipping through the Finale of Mendelssohn's violin concerto. It also seemed extremely effortless. I had performed the same work in a pair of concerts a couple of months ago. In order for my old fingers to match the student tossing the work off I had to return to a drug which I was forced to use during my years of forced labor. My body has always responded to prednisone, a synthetic corticosteroid, in a way that makes it easy to understand why the headlines more than half a century ago read: Arthritis is a thing of the past. Just like heroin another five decades or so before had made pain miraculously disappear, this new hormone, hydrocortisone, made stiff joint flexible again. The lame were walking once more. It took time for people to understand why heroin was dangerous; it also was a while before the side effects of these steroids became known. But the substances have also become lifesavers in many critical conditions, something that wasn't obvious from the beginning.

In my case back then, I was feeling 250% better and once again could perform like I did as a youngster. Then I noticed a slow but steady gain in body weight, up to 35 pounds. The typical fat redistribution was evident and my face resembled a full moon. A visit to the eye doctor revealed a steroid-induced cataract, behind the lens. It was probably the most difficult decision in my life but I deemed it necessary to come off that miracle drug. Of course I couldn't do it cold turkey as I would have become one. With the introduction of artificial corticosteroids such as prednisone to the system, the production of cortisol by the adrenal cortex lessens and eventually disappears and the body has to be tricked back to starting its endocrine factory again. In my case, I remember it taking about six months. Every time I would lower my dosage even a tiny bit, life became hell. Finally I was at zero and the weight loss was rapid. Since then I have had to go back on the drug numerous times under stressful situations but always just for a short term. Even then coming off the wonder drug is a test of character. But the fat deposits are gone, I look like myself again and during my last eye exam the doctor couldn't find even a trace of the cataract that a previous eye surgeon had eagerly wanted to operate on.

Hormones are powerful chemicals indeed. My dad will be turning 98 in a month. The last four decades he has lived with prostate cancer which in this country would no doubt have been operated on or treated with radiation. He, however, has received tiny amounts of a hormone all this time and done well. Not everyone reacts to this form of treatment. My father's father died from the disease and my brother rushed to have his gland removed when there were signs of malignant cells in it.

Other hormones determine how we grow, metabolize sugars and fats, and how our internal clock ticks, among many other things. A pianist friend as a young woman was observed by her friends as playing her scales and everything else slower and slower. In her own view she was doing everything as usual, it was just that everyone else was acting manic. Someone got this woman to go visit a doctor (I believe she was in London at the time) and the lab results quickly showed that her thyroid was almost completely inactive. Synthetic hormones soon returned her life to normal, although the amount had to be carefully titrated, as is the case with insulin in diabetes. My own mother had the opposite problem when I was just three or four: she suffered from severe hyperthyroidism. Her gland was normal size and the doctors just called it 'toxic thyroid'. Medication to treat this condition was not yet available and the surgeon just decided to remove a half of her thyroid gland. It was kind of a radical approach but in her case it seemed to work, although we always wondered what effect it might have had for her numerous later health problems.

The hormones that most affect our daily lives don't often get any medical attention: our sex hormones. As important as they are for the continuity of the human species, they are also the source of much chaos and violence. Men with too high testosterone levels easily become sexual predators. This includes rapists and murderers, such as Ted Bundy, but also men who have managed to achieve the position of a boss or other forms of power. As such they are often shamelessly preying on the weaker ones. They may be CEOs, members of the clergy or law enforcement, or in my field, orchestra conductors, executive directors or even critics. Among conductors, it would be easier to name those who haven't used their position to demand sexual favors as this is considered 'normal' behavior. Their terrible deeds often remain hidden or are covered by other powerful people, although I do remember hearing about a case long ago where a 'done deal' quickly unraveled in Utah. The excess level of hormones was too much for the Mormons (hey, it rhymes!) once they learned the facts. Instead, a decent Mensch was elected to the post. Some baton wielders' actions become public knowledge in Wikipedia or gossip publications, others' adventures are suppressed with the help of people in high places, the same ones that make blog entries disappear from search engines. Someone with a sharp tongue once remarked (pardon the language) that such an oversexed macho man thinks hormones means and is spelled whore moans. This is another reason why all of us should be educated, even in the skill of spelling.

They may be tiny molecules but let us not belittle the mighty hormones. They can both help us live and make us die. They even seem to have a place in the arts, be it good or bad.