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. 2000 Feb 26;320(7234):575. doi: 10.1136/bmj.320.7234.575

Fascinating rhythm

David Cummins
PMCID: PMC1117607  PMID: 10688570

A pianist in the Bill Evans style, he is a respected figure on the London jazz scene. His earliest icon was George Shearing, whom he heard as a teenager, but among his strongest influences were Horace Silver and Thelonius Monk. Like many of his idols, rhythm is what drives him, especially the challenging and the complex. It was this that made his medical history so intriguing.

In his late 30s, when his style and technique were beginning to mature, he developed a persistent pulsating noise in his left ear. A Harley Street surgeon diagnosed otosclerosis. At first he found the noise intrusive, but after a while his jazz and his tinnitus began to live in harmony. When he was playing, the sound of his jazz masked the noise in his ear; when he was resting, the noise in his ear provided a convenient backing for mental extemporisation. Apart from the odd missed beat, it kept perfect time.

Many years later, however, when his creative powers were at their peak, the pulsation became periodically irregular. Initially these episodes were short lived, but over time they increased both in frequency and duration and became a source of considerable distress. During attacks the tempo of the pulse quickened, its rhythm became chaotic, and he felt in a state of continuous alert. His confidence suffered, his mental improvisations ceased, and the quality of his playing began to decline.

Why the attacks affected him so profoundly is uncertain. In the course of his career he has experienced a wide variety of rhythms, ranging from the basic to the extraordinarily complex. Rhythmic patterns that perturb the uninitiated—crossrhythm, polymetre, etc—are second nature to him. Moreover, one of his favourite techniques is to play “outside the pulse,” an aspect of the modern style in which, to use his words, “the pianist flirts with rhythmic disaster but never loses control.” Did he find “rhythmic disaster” harder to cope with, having spent much of his life trying to avoid it?

Last year a physician diagnosed paroxysmal atrial fibrillation and prescribed sotalol and amiodarone. His rhythm section is now beating regularly, and some say they have never heard him playing so well.

Footnotes

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