Hektoen International

A Journal of Medical Humanities

The musical and medical journey of Jean Sibelius

Michael Yafi
Chaden Yafi

Houston, Texas, United States

Jean Sibelius, 1939. Via Wikimedia. 

The Finnish composer Jean Sibelius (1865–1957), one of the twentieth century’s greatest composers, was known for his ability to capture the stark beauty of his country’s landscapes through his unique, austere musical style. Born into a family with diverse talents, his father, Christian Gustaf, served as a municipal and military doctor,1 while his younger brother, Christian, became Finland’s first professor of psychiatry, playing a significant role in the establishment of psychiatry in the country. Christian Gustaf, an accomplished cellist himself, passed on his passion for music to his family. Despite the family’s impressive medical and musical lineage, they grappled with many psychiatric challenges, including Jean’s own struggles with addiction and depression. Other family members were diagnosed with bipolar disorder, social anxiety, and depression.2

As a child, Sibelius received piano lessons from his grandmother, demonstrating remarkable talent from an early age. At just ten years old, he composed his first piece, a piano trio he entitled “Water Droplets.” However, it was his uncle, Pehr Ferdinand Sibelius, an accomplished amateur violinist, who profoundly influenced him. Under his uncle’s guidance, Sibelius began taking violin lessons and quickly developed a preference for the instrument, famously stating that the piano lacked the ability to sing. His aspiration to become a virtuoso violinist was abruptly challenged at the age of thirteen when he suffered a broken arm, which posed a significant obstacle to his ambitions. Despite this setback, he persevered and later attempted to join the Vienna Philharmonic Orchestra,3 only to be thwarted by his injury, compounded by his innate shyness and severe stage fright. By the age of twenty-five, Sibelius’s focus shifted from aspiring to be a violinist to pursuing a career as a composer, although the desire to excel on the violin lingered. As he approached his fortieth birthday, he confided, “There is still a part of me that wishes to be a violinist, and this part of me manifests itself in an unusual way.”4

Despite his shift towards composing, Sibelius’s love for the violin remained steadfast, as evidenced by his decision to write only one concerto in his lifetime, specifically for the violin. However, alongside his musical pursuits, Sibelius struggled with personal challenges, notably his heavy smoking and drinking habits. In 1901, he developed a disease of the ear that could have led to deafness, but fortunately it was treated successfully.5

In a revealing letter to his brother Christian in 1903, Sibelius acknowledged his struggles with alcohol, admitting, “There is much in my make-up that is weak… when I am standing in front of a grand orchestra and have drunk half a bottle of champagne, then I conduct like a young god. Otherwise, I am nervous and tremble, feel unsure of myself, and everything is lost.”6 This candid admission highlights the destructive influence of alcohol on his life, affecting not only his personal confidence but also his financial stability. Despite his acknowledgment of the issue, Sibelius found it challenging to overcome his drinking habits, recognizing the deep-rooted and perilous nature of his addiction.

In 1908, his lifestyle caught up with him when he was diagnosed with throat cancer. He underwent thirteen operations to remove the cancerous growth.7 Despite this brush with mortality, Sibelius continued to produce profound works, exemplified by his fourth symphony in A minor, composed between 1909 and 1911. This symphony stands out for its somber and melancholic tone, punctuated by fleeting moments of hope. Unlike the trend towards longer and more expansive symphonies since Beethoven, Sibelius’s fourth symphony demonstrates a departure from convention, with fewer grand orchestral tutti passages and a more restrained use of musical material, drawing comparisons to the subtlety of Debussy rather than the bombast of Mahler or Tchaikovsky. This work encapsulates Sibelius’s stylistic trademarks while also reflecting influences from other composers. Despite his awareness of avant-garde movements and the music of Schoenberg, Sibelius remained steadfast in his loyalty to tonal music, opting to eschew the experimental trends of his time.

As Sibelius matured as a composer, he gradually distanced himself from his earlier preoccupation with nationalistic themes, legends, and myths. Instead, he turned his attention towards the symphonic tradition, following in the footsteps of masters like Beethoven, Tchaikovsky, and Strauss. However, Sibelius forged his own unique path within this tradition, characterized by a more austere style. While he sought to express his Finnish identity through his music, he was careful not to be perceived as overly nationalistic. This shift in focus is evident in his sixth symphony, where Sibelius famously remarked, “Whereas most other modern composers are engaged in manufacturing cocktails of every hue and description, I offer the public pure cold water.”8 This statement reflects Sibelius’s commitment to clarity, simplicity, and sincerity in his compositions, eschewing the flamboyance and excesses of contemporary musical trends in favor of a more restrained and authentic artistic expression.

Despite his acclaim in Finland, Sibelius faced financial difficulties stemming from his extravagant lifestyle. He had a penchant for throwing lavish parties and indulging in fine dining, often spending exorbitant amounts equivalent to 200 euros per day on restaurant dinners. His love for extravagance and good food often left him in dire financial straits.

Throughout his life, Sibelius battled recurring bouts of depression, exacerbated by his struggles with alcoholism and the political turmoil in his homeland. In a poignant entry in his diary from 1927, he lamented, “Isolation and loneliness are driving me to despair… In order to survive, I have to have alcohol… Am abused, alone, and all my real friends are dead. My prestige here at present is rock-bottom. Impossible to work. If only there were a way out.”9 This candid expression of despair reflects the profound emotional turmoil that Sibelius endured, grappling with personal demons and a sense of disillusionment.

In the latter years of his life, Sibelius’s output as a composer dwindled significantly, with a marked decrease in major works over his last three decades, partly motivated by a desire for early retirement. His declining health also played a role, exacerbated by his longstanding struggle with essential tremors in his hands, which were further aggravated by his alcohol consumption. He spent his time walking in the forests, visiting local pubs, and gardening. He did not allow visitors and avoided discussing music.10 In a moment of despair and perhaps symbolic resignation, Sibelius undertook a drastic act in 1940, burning a collection of manuscripts in a laundry basket during a self-described “auto-da-fé.”11

One poignant anecdote from 1956, a year before his death, illustrates the enduring legacy of Sibelius’s musical career. While attending a concert in Stalingrad, USSR, the conductor performed one of his works and announced the presence of the composer in the audience. In response to a thunderous applause, the ninety-one-year-old Sibelius took to the stage and addressed the audience with poignant simplicity, declaring, “When I was young, my family wanted me to become a doctor, but I became a composer instead.” This humble yet profound statement encapsulates the essence of Sibelius’s lifelong commitment to his craft and the enduring impact of his music on generations of listeners.

During his lifetime, Sibelius was honored with a government-issued stamp featuring his likeness, symbolizing his cultural significance to Finland. However, when the government proposed erecting a statue in his honor, Sibelius declined. Despite his prominence as a composer, he remained modest, preferring to focus on his music rather than personal accolades. His rejection of the statue reflects his humility and dedication to his craft.

It is worth noting the profound influence of the Finnish poet Johan Ludwig Runeberg on Sibelius’s artistic journey. Runeberg, hailed as the poet who christened Finland as “the land of a thousand lakes,” provided fertile inspiration for Sibelius. Among the many poems Sibelius set to music, “Tanke, se hur fågeln svingar” (“Thought, see how the bird swoops”) stands out. This evocative poem, with lines such as

Thought, see how the bird swoops
Light and free beneath the cloud;
You too have your wings
And your space in which to fly

captures the essence of Sibelius’s connection to Finnish nature and culture. Through his musical interpretation of Runeberg’s verses, Sibelius not only immortalized the beauty of Finnish landscapes, but also celebrated the resilience and freedom inherent in the human spirit.


  1. Murtomaki, Veijo, and translated by Fletcher Roderick. “Sibelius, Jean.” Henkilohistoria: National Biography of Finland. https://kansallisbiografia.fi/nglish/person/3630.
  2. Davidson, Jonathan. “Christian Sibelius: Finland’s first professor of psychiatry.” Hektoen International Winter 2023. https://hekint.org/2023/01/10/christian-sibelius-finlands-first-professor-of-psychiatry/
  3. Nicholas, Jeremy. The Great Composers (Quercus Publishing Plc, 2007): 201.
  4. Mariinsky Theatre. Jean Sibelius Violin Concerto playbill. https://www.mariinsky.ru/en/playbill/playbill/2011/11/29/2_1900/
  5. Nicholas, The Great Composers, 202.
  6. Nicholas, The Great Composers, 201.
  7. Nicholas, The Great Composers, 202.
  8. Kjemtrup, Inge. “A Personal Look at Sibelius’ Sixth Symphony, a Paean to the Natural World That Debuted 100 Years Ago.” Strings magazine, May-June 2023. https://stringsmagazine.com/a-personal-look-at-sibelius-sixth-symphony-a-paean-to-the-natural-world-that-debuted-100-years-ago/.
  9. Ross, Alex. “Apparition in the Woods.” The New Yorker, July 2, 2007. https://www.newyorker.com/magazine/2007/07/09/apparition-in-the-woods
  10. 10. Nicholas, The Great Composers, 203.
  11. Chipman, A. “Janácek and Sibelius: the antithetical fates of creativity in late adulthood.” Psychoanal Rev. 87, no. 3, June 2000:429-54. PMID: 10967789.

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

DR. CHADEN YAFI holds degrees from Boston University’s College of Fine Arts (PhD, Musical Arts), Longy School of Music (MA, Piano Performance, Graduate Performance Diploma), and Damascus University (BA, Pharmacy). She has worked at the University of Houston, Tufts University, and Boston University, and has also lectured at Dartmouth College and the Jung Center in Houston. She has published several research articles in music, as well as three books.

Winter 2024



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