Christian Sibelius: Finland’s first professor of psychiatry

Jonathan Davidson
Durham, North Carolina, United States

 

Christian Sibelius, a man in a suit
Photo of Christian Sibelius taken c. 1915–1920 by Atelier Nyblin. Via Wikimedia. Public domain.

When the name Sibelius is mentioned, most people will think of the famous Finnish composer, Jean. Outside of Scandinavia, few will know that Jean’s younger brother, Christian, achieved distinction in a very different field: psychiatry. Even less well-known is the multi-generational presence of physicians in Christian’s family, starting with his father and continuing through a daughter, grandson, and three great-grandchildren. In addition, most family members referred to in this account were (or are) gifted musicians, and Christian himself was an excellent cellist. Shadowing the medical and musical talents of the Sibelius family was the occurrence of psychiatric problems in some relatives, particularly Jean and Linda, including long-term psychiatric hospitalization, excessive alcohol intake, probable bipolar disorder, social anxiety, depression, suicide, and questionable spending habits leading to bankruptcy or serious debts.

This report focuses chiefly on Christian and his medical contributions, but will, to a limited extent, also describe the larger family picture.

 

Early years

Christian Sibelius was born on March 28, 1869 in Hämeenlinna, as the youngest of three children to Dr. Christian Gustaf Sibelius (1821–1868) and Maria Charlotta Borg Sibelius (1841–1897). Dr. Sibelius had practiced as a military doctor, and later was medical officer of health for the cities of Turku, Tampere, and Hämeenlinna and physician to the Hämeenlinna school of sharpshooters. He died from typhoid before Christian was born.

Christian’s older sister, Linda, was born in 1863 and died in 1932, and his brother, Jean, lived from 1865 to 1957. The siblings were close and often performed together as a duet or trio with Linda playing the piano, Jean the violin or piano, and Christian the cello. In the absence of a father and with a financially stressed mother, it is likely that the close bonds between the three children were important in their youth and when they encountered difficulties later in life. In 1902, at the age of thirty-nine, Linda experienced an acute episode of mental illness, which by today’s understanding is likely to have been bipolar or schizoaffective disorder. She was admitted to Lapinlahti Hospital, where her brother was medical director, and ultimately died in Nikkila Mental Hospital in 1932 after about thirty years in and out of hospital. Of interest is the fact that when Christian first learned of his sister’s indisposition, he diagnosed her as suffering from “melancholia hypochrondria” and opined that it would not recur. In this he was proved wrong.1

At birth, Christian’s older brother was given the name of Janne but as a young adult, following his uncle Janne, later changed his name to the French form, Jean, by which he is generally known. Jean had numerous psychiatric problems, the details of which are beyond the scope of this account, but appear to include significant misuse of alcohol, mood disturbance, performance anxiety, and frequent spending beyond his means, all of which created serious problems with his marriage.2 His brother Christian was as supportive as he could be and on occasion assisted with treatment, including the prescription of a sedative powder for tremor, which may have helped initially as a placebo but produced no long-term benefit.3

 

Medical career

Christian graduated with a medical degree in 18974 and shortly afterwards studied under Ernst Homen (1851–1926),5 who was a leader in the emerging field of neuropathology, professor of pathological anatomy at Helsinki University, and director of a clinical neurology ward modeled on that of Charcot in Paris. Homen supervised Sibelius’ doctoral thesis, which was highly acclaimed in the neurology community and lead to his being given a junior faculty position without even having to apply for the job. The thesis was entitled “A contribution to the subject of the knowledge of the histological changes in the spinal cord, the spinal roots and ganglia in progressive paralysis.” In the following years, from 1897 to 1905, Sibelius’ output continued with publications appearing in Finnish and German journals on spinal neuron changes following amputation, spinal ganglion alterations in hereditary-luetic malformations and normal newborns, and the cerebral effects of carbon monoxide poisoning.

In 1904, Sibelius’ career took a more administrative turn with his appointment as chief psychiatrist at Lapinlahti Hospital, which was associated with Helsinki University, and where medical students rotated. In 1906 he was appointed the first professorship in psychiatry in his country.6 At Lapinlahti, Sibelius introduced more humane conditions of treatment, removing restraints and other coercive measures such as induced emesis. In addition, he established a neuropathology laboratory and introduced psychometric assessments to strengthen the experimental and scientific basis of psychiatry. These measures included word association tests7 and the creation of a scale to assess the moral strengths and weaknesses of patients.8 In the opinion of this author, Sibelius was far ahead of his time in the creation of such a measure. Even as he ran the hospital, Sibelius undertook further training, spending time in 1906 at Emil Kraepelin’s (1856–1926) clinic in Germany, as well as in Denmark, where he learned about children’s institutions for those with developmental disorders. From his time with Kraepelin, and with his interest in forensic psychiatry, he established a department of forensic psychiatry at Lapinlahti, where he taught medical and law students the essentials of forensic psychiatric assessment. His students were inspired by Sibelius’ enthusiasm and professionalism, and his assessments were considered precise, consistent, and well-founded.9

Between 1898 and 1910, a substantial part of Sibelius’ time was spent in expanding the teaching of psychiatry to students and general practitioners. From being an optional activity, Sibelius was able to make psychiatry a compulsory activity for trainees, who by 1910 were taking a fourteen-week rotation in psychiatry. Sibelius was convinced of the need to teach students about all forms of psychopathology: psychosis, neurosis, borderline, and personality disorders.9

Other important accomplishments included his founding of the Finnish Psychiatric Association in 1913 and holding office as Chair of the Finnish Medical Society in 1909 and President of the Finnish Society of Sciences and Letters in 1921.10 At the time of his death, Sibelius was considered to be Finland’s leading psychiatrist.11

Sibelius’ later writings included the topics of hypnosis and suggestion in the production of ecstatic states arising in the followers of Maria Akerblom, a controversial cult leader in early twentieth-century Finland.12

At the height of his career, Christian Sibelius’ life was cut short by the development of pernicious anemia, and he died in 1922 at the age of fifty-one. His brother Jean was devastated by this loss. As Christian lay on his death bed, Jean played on the piano the elegy from his King Christian II suite.

 

Family and descendants

Sibelius was characterized by Streng as a warm-hearted and unusually lively character whose speech was fragmented and jumpy, yet at the same time a calm and critical scientist who was ideally suited to the profession of psychiatry. He was also described as gentle, companionable, and of the utmost integrity. On his grave was inscribed Horace’s epitaph: “integer vitae scelerisque purus.13 Sibelius was not shy to express his opinions, especially in the matter of politics. During the Finnish civil war of 1918–1919, he was quite outspoken about the Reds, who he claimed were all crazy. Such a denunciation could have put him in serious peril, and in fact, on February 14, 1918, Sibelius was arrested by the Red faction for a brief time before being released. It is said that he had been ordered by the Reds to reserve some beds for their combat cases, but this he failed to do, whether for reasons of truculence or because the hospital was full already, as he claimed.14

Christian married Nelma Swan (1878–1970), a writer of children’s stories and translator. The couple had four children, Kaarina (1981–1989), Johannes (Jussi) Christian (1904–1940), Riitta (1907–2004), and Harry Christian (1910–1951).

Riitta completed medical training and subsequently specialized in rheumatology; she was herself an accomplished violinist.15 She married Gustaf Adolf Wangel (1894–1973), a neurologist. Their son, Anders Gustaf (1934–2013), obtained medical degrees from Helsinki and Adelaide Universities, as well as three medical doctorates, one of which was on the topic of pernicious anemia, the disease from which his grandfather Christian had died. Anders married an Australian Olympic swimmer, Denise Norton, and they settled in Adelaide in the 1960s. In addition to his distinguished academic career, Professor Wangel was fluent in four languages, a world champion sailor, and talented cellist, playing in chamber groups for thirty years and serving as reserve cellist in the Adelaide Symphony Orchestra. All three of the Wangels’ children have become doctors, practicing respectively in family medicine, dermatology, and anesthesiology, and all have manifested the family musical talent. From Christian Gustaf Sibelius down to his present-day descendants, there is a 200-year unbroken chain of five generations of medical doctors, to which one could add their accompanying musical gifts. As to Christian’s musical activities, in 1888–1889 following graduation, he attended the Helsinki Music Academy, and with his friends founded the Jouhik Quartet, which continued to exist until Sibelius’ last days.13 (The word “jouhik” refers to a traditional Finnish lyre with horsehair strings, but it is not known whether such an instrument was in their quartet.) It seems likely that Sibelius could have been as successful a musician as he was a psychiatrist if he had chosen that path.

 

Acknowledgments

Acknowledgments are made to Sirpa Tuomainen for translation of some Finnish source documents, to Katharina Parhi for reviewing parts of the manuscript, and to Anki Geust for providing source information.

 

References

  1. Goss GD. Sibelius: A Composer’s Life and the Awakening of Finland. 2009. University of Chicago Press. Chicago, IL. http://sibelius.fi/suomi/erikoisaiheet/terveys/terv_03.htm. Accessed November 30, 2022.
  2. “Jean Sibelius.” Wikipedia. https://en.wikipedia.org/wiki/Jean_Sibelius. Accessed November 28, 2022.
  3. Siren V. “Sibeliuksen ja kymmenientuhansien suomalaisten vapinaan löytyi syy” (The cause of Sibelius’s tremors and tens of thousands of Finns was found). Helsingin Sanomat. January 28, 2012. Archived at: https://web.archive.org/web/20120503205515/https:/www.hs.fi/kulttuuri/Sibeliuksen+ja+kymmenientuhansien+suomalaisten+vapinaan+l%C3%B6ytyi+syy/a1305554379014/. Accessed Nov 10, 2022.
  4. “Christian Sibelius.” Wikipedia. https://en.wikipedia.org/wiki/Christian_Sibelius.
  5. Aarli JA, Stien R. “History of Neurology.” In Handbook of Clinical Neurology 2009. https://sciencedirect.com/science/article/abs/pii/S0072975208021416. Accessed November 23, 2022.
  6. Von Knorring L. Editorial. Nordic J Psychiatry 2002; 56(5): 317.
  7. Sibelius C. “Association trials in service of psychiatry.” Proc Finnish Medical Association 1910; 52(2): 1-29.
  8. Parhi K. “Sensitive, indifferent or labile: Psychopathy and emotions in Finnish forensic psychiatry 1900s-1960s.” Emotions: History, Culture, Society. 2022; 6: 26-45.
  9. Hirvonen H. “In search for the roots of the Finnish psychiatric science – Psychiatry as a science and practice between the 19th century and 1930.” University of Eastern Finland Dissertations in Social Sciences and Business Studies. No. 71. 2014.
  10. Elfving F. Finska Vetenskaps-Societetens historia 1838-1938, Commentationens Humanarum Litterarum, Tomus X, p. 292.
  11. Tawaststjerna E. Sibelius Volume III: 1914-1957. Translated by Robert Layton. London: Faber and Faber, 2009.
  12. Lauerma H. “Scientific hypnosis in Finland.” Tieteellienen Hypnoosi ry. https://tieteellinenhypnoosi.fi/scientific-hypnosis-in-finland/. Accessed November 28, 2022.
  13. Streng O. “Christian Sibelius.” Duodecim 1922; 8-9: 293-303.
  14. T-M Lehtonen. “Veli Christian vangittu – säveltäjä Jean Sibeliuksen päiväkirja 1918.” Yle. February 17, 2018. https://yle.fi/aihe/artikkeli/2018/02/17/veli-christian-vangittu-saveltaja-jean-sibeliuksen-paivakirja-1918. Accessed January 9, 2023.
  15. Texler K. “Sailor, cellist and man of medicine: Anders Gustaf Wangel (1934-2013).” medicSA. June 2013. https://amasahistoricalcommittee.files.wordpress.com/2018/09/ocr_wangel_anders_june_2013.pdf. Accessed November 27, 2022.

 


 

JONATHAN R.T. DAVIDSON, MB, BS, FRCPsych, received his medical training at University College Hospital, London, and his psychiatric residencies at Queen Elizabeth II Hospital, Welwyn Garden City, and the Royal Edinburgh Hospital, Edinburgh, Scotland. He spent over thirty years on the Duke University psychiatry faculty, where he is currently Professor Emeritus.

 

Winter 2023  |  Sections  |  Psychiatry & Psychology