Hektoen International

A Journal of Medical Humanities

Sergei Rachmaninoff: The dichotomy of life and music

Michael Yafi
Chaden Yafi
Houston, Texas, United States

Rachmaninoff. Photo by Bain News Service. between ca. 1915 and ca. 1920. Library of Congress

Sergei Rachmaninoff (1873-1943), a Russian composer, was known for having very large hands. With a span that covered twelve white keys on the keyboard (the interval of a thirteenth), he could play a left-hand chord of C, E flat, G, C, and G.1 This has led some medical experts to speculate on potential medical diagnoses. One proposed diagnosis for Rachmaninoff’s congenital gift is Marfan syndrome.2 This would explain his extraordinary capability in playing some very wide piano chords without breaking them, as evident in the beginning of his second piano concerto. The “thumb sign,” one marker of Marfan syndrome, allows a person to flex his thumb and extend it below the other four fingers.3

Another suggested diagnosis is acromegaly,4 a condition which can be associated with melanoma, the cause of Rachmaninoff’s death. There is no historical or photographic evidence for any of these conditions, and it is possible that he just happened to have large hands.5

Another interesting medical aspect of the composer’s life was his diagnosis of depression after the failure of his first symphony and how his psychiatrist helped him recover. As a sign of recovery, Rachmaninoff wrote his famous second piano concerto and dedicated it to his psychiatrist, Dr. Dahl.6

Rachmaninoff’s music is often considered to be the epitome of melancholy and sadness. In his personal life, however, he enjoyed great wealth, had strong family ties, owned luxurious cars, and loved humor, even though Igor Stravinsky once famously described him as “six feet two inches of Russian gloom.” What was the source of the darkness, pain, pessimism, hopelessness, and sad minor tonalities that were pervasive in his works?

An important source of sorrow would have been his homesickness after leaving Russia. He loved his country and always dreamed about going back, even though he knew that he would never be able to live there. “I love my Russia, I adore it, but still I think I could never live there now.”7 When he came to the US he became a concert pianist when all he really wanted to do was to compose music. At the age of forty he had to learn a new piano repertoire for solo piano concerts. He practiced for hours on end, memorizing music by other composers such as Beethoven, Schumann, and Chopin that he had to include in his concerts.

Photo by Bain News Service. between ca. 1915 and ca. 1920. Library of Congress 

During his lifetime, Rachmaninoff never suffered financial hardship like Mozart and Schubert, did not have tumultuous love relationships like Chopin, was not unrecognized like Bach and Schubert, and did not have a troubled marriage like Mahler. He obtained enormous success, not only as a pianist but also as a composer and conductor. His concerts were resoundingly successful with audiences in the US, Canada, and Europe, and fans would follow him from town to town to attend. Admirers would wait all night in front of the box office to get tickets and in lines backstage to meet him after his performances.

This success led to financial wealth, which enabled him to enjoy a lavish lifestyle. He always lived in luxurious homes and would spend summers with his family in palatial houses in Europe, complete with a maid, babysitter, and driver. In 1932 he bought land on Lake Lucerne in Switzerland and built his permanent residence, Villa Senar, which resembled his family’s villa in Russia, Ivanovka. He loved cars and owned a fancy Lincoln (among others) that he would ship to Europe when he traveled. Boats were another luxury, and he owned two motorboats.8

Rachmaninoff’s wealth and fame never affected his loyalty to his family. He was happily married and had a great relationship with his daughters and adored his grandchildren. As a philanthropist, he was extremely generous to everyone in need, including many Russian starving artists and Russian musicians in exile. To accomplish this, he gave many benefit concerts and also sponsored many composers through US concert tours. One was for his Russian friend, Nikolai Medtner. He also sponsored Igor Sikorsky to build his first helicopter, who in return made Rachmaninoff the vice-president of his firm. The first helicopter prototypes were used to move Rachmaninoff’s piano to concert sites.9

Rachmaninoff had a great sense of humor and would always joke with his family and friends. When he had parties at home, he used to play four hands with his wife (also a pianist and a graduate from Moscow conservatory). They often played the Italian Polka, and he would start by telling their guests that this was the only piece his wife knew how to play.8

However, this happy and luxurious life was not apparent in his music. Many of his works are considered to be among the darkest, most pessimistic pages in classical music. Rachmaninoff was fascinated and somewhat obsessed with the grim and sinister Dies Irae plain-chant theme (The Day of Wrath), which is used frequently in requiems. He used this theme in his three symphonies, Isle to the Dead, Paganini Rhapsody, and in several piano works.

Perhaps Rachmaninoff’s sadness came from something beyond homesickness. In the Welsh language there is a word, hiraeth, which means a longing for a home that no longer exists. The composer seemed to have a foreboding glimpse of his future when at age nineteen he composed a song based on a poem by Pushkin:

Don’t sing for me again fair maiden,
Those sad Georgian songs;
They remind me
Of another life and a distant shore.

While Rachmaninoff spent his life in luxury, perhaps his soul remained captive on that “distant shore.”


  1. Erik Fokke, “On the Phenomenal Hands of Sergei Rachmaninoff”, https://www.rachmaninoff.org/articles/archive/30-on-the-phenomenal-hands-of-sergei-rachmaninoff
  2. D A B Young, “Rachmaninov and Marfan syndrome”, Br Med J (Clin Res Ed) 1986;293:1624 https://doi.org/10.1136/bmj.293.6562.1624
  3. Rodney H. Falk, M.D., “The “Thumb Sign” in Marfan’s Syndrome”, https://www.nejm.org/doi/full/10.1056/NEJM199508173330706
  4. Ramachandran M, Aronson J. The Diagnosis of Art: Rachmaninov’s Hand Span. J R Soc Med. 2006 Oct;99(10):529-30. doi: 10.1258/jrsm.99.10.529
  5. “Sergei Rachmaninov, the pianist with very big hands”, Hektoen International Journal https://hekint.org/2018/11/13/sergei-rachmaninov-the-pianist-with-very-big-hands/?highlight=Rachmaninoff%20marfan
  6. Garcia E. Rachmaninoff’s emotional collapse and recovery: the first symphony and its aftermath. Psychoanal Rev. 2004 Apr; 91(2):221-38. doi: 10.1521/prev.
  7. Swan, Katherine, and A. J. Swan. “Rachmaninoff: Personal Reminiscences–Part I.” The Musical Quarterly 30, no. 1 (1944): 1-19.
  8. Swan, K., & Swan, A. (1944). Rachmaninoff: Personal Reminiscences–Part II. The Musical Quarterly, 30(2), 174-191.
  9. “Igor Sikorsky and Sergei Rachmaninoff” Air&Space/Smithsonian, November, 2002 https://www.sikorskyarchives.com/Igor_Sikorsky_&_Sergei_Rachmaninoff.php

Additional references:

  1. Bazhanov, Nikolai. Rachmaninoff. Trans. Raduga publishers, Moscow 1983.
  2. Reither, Joseph. “Chronicle of Exile.” Tempo, no. 22 (1951): 29-36.

MICHAEL YAFI, M.D., is a Professor and Director for The Division of Pediatric Endocrinology at UTHealth, (The University of Texas Health Science Center at Houston).

CHADEN YAFI, DMA, earned her Doctor of Musical Arts degree from Boston University, College of Fine Arts where she was a recipient of the prestigious Dean’s Award Scholarship. She also holds a Master’s in Piano Performance, and a Graduate Performance Diploma, both from the Longy School of Music of Bared College, a Bachelor in Piano performance from the Higher Institute of Music in Damascus, and a Bachelor in Pharmacy and Pharmaceutical Chemistry from Damascus University. Dr. Yafi works as pianist and piano pedagogue in Houston. She worked previously as piano faculty at Tufts University and Brookline School of Music in Boston. She has published three books Music in Their Hearts: Introduction to Contemporary Music Education (Arabic), Musical Ramifications: Essays on the Aesthetics of Music, (Arabic), and Aesthetic in Graduate Music Schools: Bringing Philosophy to the Learning of Music (English).

Highlighted in Frontispiece Volume 13, Issue 2– Spring 2021

Fall 2020



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