Hektoen International

A Journal of Medical Humanities

Arnold Schoenberg’s String Trio Op. 45: Notes on “My Fatality”

James L. Franklin
Chicago, Illinois, United States

Arnold Schoenberg (Schönberg). Photo by Florence Homolka, 1947. Arnold Schönberg Center Image Archive. 

On August 2, 1946, the Austrian-born composer Arnold Schoenberg suffered a near fatal heart attack at his home in Los Angeles. Despite the fragile state of his health, on August 20th he was able to resume work on a string trio that had been commissioned by Harvard University. Schoenberg confided in a number of friends that the experience of his illness, both medically and emotionally, was the secret program behind the work, a fact he did not make known to the public. It is rare that a composer turns to music to express his feelings about a medical illness, especially when it is his own illness. For example, in an article published in Hektoen International,1 I discussed a composition by the French viola d’gambist Marin Marais (1656–1728), Tableau de l’Opération de la Taille, depicting the composer’s horrific experiences while undergoing the surgical removal of a urinary bladder stone. I referenced two other musical examples, Bedřich Smetana’s representation of tinnitus through a sustained high “E” played by the first violin in the last movement of his string quartet in E minor “From My Life,” and Mahler’s possible representation of his irregular heartbeat (atrial fibrillation related to mitral valvular heart disease secondary to rheumatic fever) in the opening measures of his Ninth Symphony. According to Schoenberg biographer Malcolm MacDonald, the “String Trio, Op. 45 is one of the most expressive and most concentrated of all his works, and one which in some way reflects his grim experience.”2

Since Schoenberg seems to have regarded the trio as a portrait of his illness in music, we might begin by reconstructing the composer’s medical history. To aid in this task, Schoenberg has provided several accounts of his medical illnesses. Our sources come from the composer himself and the observations of family and friends in material written over a period of years. It will come as no surprise that these accounts vary in certain details. In his writings, the composer found time to direct some humor into the encounters he had with members of the medical profession.

At the time of his heart attack, Arnold Schoenberg was seventy-one years old. He had emigrated from Germany to the United States in 1933, becoming an American citizen in 1941. Schoenberg was born on September 13, 1874 in the Leopoldstadt district of Vienna, and ironically—given his lifelong triskaidekaphobia—died on Friday, July 13, 1951 in Los Angeles. As a child, he was often ill, suffering from the effects of scarlet fever and also from breathing difficulties, perhaps inherited from his father who was asthmatic. Writing in 1950, Schoenberg recalled that he suffered from recurrent inflammation of the eardrum, supposedly a consequence of scarlet fever. He also recalled having to hold his arms up to facilitate breathing and noted that his father had died in 1890 during a “tremendous influenza epidemic” in Europe. His father was a heavy smoker and drinker. Schoenberg recalls that he himself “suffered every year from heavy attacks of influenza” and describes himself also as a “heavy drinker and smoker.” During World War I, he served in the Austrian army but was discharged because of his asthma. As a consequence of the “Spanish Grippe,” he was afflicted nightly with breathlessness and coughing. He was examined by the “renowned Viennese Professor Chvostek who could not determine any constitutional disease and denied that smoking and drinking of alcohol could cause my trouble.” His account goes on to mention that at several times in his life, he would stop smoking and drinking and his symptoms would abate, only to reoccur when he his willpower failed him. He mentions that in “1923/24 . . . I was drinking again and inhaling 60 cigarettes every day.” Also, “every day 3 liters of strong coffee.” It was not until 1944 that he finally abandoned smoking and restricted his drinking to an occasional glass of whiskey or cognac. On more than one occasion, he makes the point that “he never ceased to exercise his body by swimming, rowing, jumping, playing tennis, Ping-Pong and other games.”3

Gaze (or The Red Gaze). Arnold Schönberg. Oil on cardboard, May 1910. Arnold Schönberg Center Image Archive. 

In 1944 his health began to deteriorate; he was treated for diabetes for two years before “deciding on my own to leave off insulin injections.” He suffered from “attacks of giddiness and fainting [along with asthma] and something was also apparently wrong with my heart [an arrythmia].”

With the ascension of the Nazi Party to power in Germany, Schoenberg learned that the prestigious lifetime appointment as director of composition at the Prussian Academy of Arts in Berlin, which he had held for almost a decade, would be terminated. He promptly resigned and, failing to secure a position in England, emigrated with his family to the United States, disembarking in New York on October 31, 1933. He had accepted an unsatisfactory teaching position at Malkin Conservatory in Boston and an adjunct teaching position in Manhattan at the Juilliard School of Music. The strenuous commuting and winter climate on the East Coast proved very damaging to the then sixty-year-old composer’s health. By September 1934, he made the decision to move to Los Angeles. Within a short time, he was writing ecstatically about the beauty of his surroundings and that there was “scarcely a day, apparently even in winter, without sun.” He recovered his health and was able to indulge his desire to play tennis, including regular matches with his neighbor and polar opposite, a man in his thirties, the composer George Gershwin. By 1935, his teaching assistant Leonard Stein recalled that he was “fit and roly-poly” and full of vitality.4 Sabine Feisst, in a chapter from her book Schoenberg’s New World, “Rethinking Schoenberg’s American Years,” points out that Schoenberg spent twelve of the eighteen American years of his life in relatively good health and happiness. He raised his second family in America. After the death of his first wife in 1923, he married Gertrud Kolisch, the sister of the violinist Rudolf Kolisch.5 They had three children: Nuria, who was born Europe in 1932; and two sons who were born in California, Ronald in 1937 and Lawrence in 1941.

For a decade, Schoenberg prospered in Southern California though he struggled to gain acceptance of his music. To support his growing family, he secured a teaching position in the music department at UCLA and gave private lessons in music theory and composition. Compounding his financial difficulties, in 1944, on his seventieth birthday, he was forced by law to retire from the university on a pension of $38 per month. Feisst dispels a myth about financial misery by converting his earnings from commissions and teaching into adjusted current monetary values. In 1937, he was able to purchase a Spanish Colonial house in a fancy neighborhood, Brentwood Park, which he bought for $18,000.6

In March and April 1946, though he was still experiencing “fainting attacks every day,” he went to the University of Chicago as a visiting professor for one month, somehow managing to maintain all his lectures and classes. He notes being examined by several doctors: “None could detect the real cause and thought me clearly hysterical . . .” He referred to his myocardial infarction as Mein Todesfall, “my fatality,” and rendered this description of his illness:

On August 2 (1946), our house-doctor tried a new medication for my asthma: benzidrine. An hour or two later during the midday meal, I suddenly felt sleepy and went to bed, very unusual for me. At about ten o’clock in the evening I woke up, jumped out of bed and ran to a chair which I had been using during asthma attacks. I began to feel fierce pains throughout the body particularly in the chest and around the heart . . .

In one account, he identified the “house-doctor” as Dr. Waitzfelder who provided something new, “Benzydrin,” for his asthma. In the evening when he awakened with pain, he and his wife were unable to locate a doctor. He contacted his colleague, the composer Leonard Stein, who came to their house bringing Dr. Owen Lloyd-Jones. In the composer’s own words:

Dr. Lloyd-Jones, our present house doctor, who then saved my life. He gave me an injection of Dilaudid, to reduce the pains. This immediately helped; but ten minutes later I lost consciousness, and my heart-beat and pulse stopped. In other words, I was practically dead. I have never been told how long it lasted. All I was told was that Dr. Jones made an injection directly into my heart. It was three weeks before I recovered. I had about 160 penicillin injections; my heart and lungs were examined, X-rays were taken, and there were sometimes three or four doctors discussing my case. . .7

After being unconscious possibly for several hours, “the first thing I remember was that a man with coal-black hair was bending over me and making every effort to feed me something. […] It was Gene, the male nurse. An enormous person, a former boxer, who could pick me up and put me down again like a sofa cushion.”8

By August 20, 1946, Schoenberg had recovered sufficiently that he was able to resume work on the string trio that would eventually become his Op. 45. Working between a chair and his bed, he completed the trio on September 23, 1946. The string trio had been commissioned by A. Tillman Merritt of Harvard University for a fee of $750, and before his heart attack, Schoenberg had made only a few sketches. As he recovered, the final character of the work became a response to the severe illness he had suffered.

In writing the story of his novel Doctor Faustus, the exiled German author and neighbor Thomas Mann wrote: “We had Schoenberg to our house one evening . . . He told me of the new trio he had just completed and about the experiences he had secretly woven into the composition . . . He had represented his illness and the medical treatment he had received in the music including the male nurses and other oddities of American hospitals.” Schoenberg went on to note that it was extremely difficult to play, “almost impossible, but rewarding.” Mann seized on “impossible, but rewarding,” and worked it into a chapter on his fictitious hero, the composer Leverkühn’s chamber music.9

Schoenberg’s String Trio Op. 45 is scored for violin, viola, and violincello. Venerable examples of the string trio can be found in the classical era in Mozart’s Divertimento K. 563 and Beethoven’s trio Op. 3, his Serenade Op. 8, and the three trios of his Op. 9. Schoenberg’s trio is a twelve-tone work cast in five “movements,” three sections separated by two episodes, and lasts about eighteen minutes. While the composer told many friends and visitors he had depicted his medical illness, including his near-death experience with a hypodermic needle being plunged into his heart represented by unusual chords, the music is not programmatic but seeks to represent musically the delirium, agitation, and suffering experienced by the composer.

Performance of the trio is unusually challenging and requires artists of extraordinary virtuosic skill. Technically it features advanced string effects including challenging double and triple stops, harmonics, glissandi, and unusual bowing techniques. Harvey Sacks, the author of Schoenberg: Why He Matters, cautions “readers who are not familiar with Schoenberg’s twelve-tone idiom . . . this trio may not captivate them on a first or perhaps even a second or third listening. But it is worthwhile whatever effort is put into it.”10 Sacks further recommends that those who are musically literate will learn a lot from following the music with a score. Readers interested in a more complete analysis of the music may wish to consult books by Harvey Sacks, Malcom MacDonald, and Allen Shawn.11 The trio received its world premiere by members of the Walden Quartet as part of a symposium on music criticism at Harvard University in May 1947. Schoenberg lived to attend the West Coast premiere of the trio by the Koldofsky Trio in Los Angeles in 1948 and was pleased with their performance. In 1949 Alfred Koldofsky commissioned a Phantasy for Violin with Piano Accompaniment, Op. 47, which would be Schoenberg’s final chamber music composition.

One year after suffering his heart attack, a commission from the Koussevitzky Music Foundation of Boston led to the composition of A Survivor from Warsaw, Op. 46 and dedicated to the memory of Natalie Koussevitzky. The piece is scored for narrator, male choir, and orchestra. It is a highly personal work for which Schoenberg wrote the libretto, which includes German, Hebrew, and English text. His eyesight had steadily deteriorated to the point that he could only complete the work on specially ordered music paper with wide staves in a “short score form.” Under his supervision, the French conductor René Leibowitz prepared the full score. Leibowitz conducted the first European performance in Paris in December 1948. The world premiere was given by the Albuquerque Civic Orchestra with an amateur male chorus made up of farmers from Estancia, a town sixty miles from Albuquerque, on September 4, 1948. The seven-minute work was so enthusiastically applauded that a repeat performance was encored.

In July of 1950, the musician Robert Craft, a student and biographer of Igor Stravinsky, recorded a visit to the Schoenberg residence:

He is stooped and wizened, but sun-tanned like an athlete. He seems thinner than last time – that pained, too sensitive face difficult to look into and impossible not to look into – and the bulging veins in the right temple are more prominent. . . he seems smaller, and older than his years . . .12

Arnold Schönberg’s death mask by sculptor Anna Mahler, daughter of composer Gustav Mahler. Arnold Schönberg Center Image Archive. 

His ill-health over his final years had taken their toll. As Malcolm MacDonald notes, “the last photograph taken before his death is almost shocking: the once round face hollow-cheeked and skull-like, the skin taut and shrunken. He resembles the emaciated, unreal being in his painting Red Gaze. . .” He grew progressively weaker, and as Friday, July 13, 1951 approached, fearing the worst, he sunk into a deep depression. On that most unlucky day of the month, he took to bed and slept most of the day. He awoke at 11:45 PM hopeful that the day would pass but “shortly afterwards murmured ‘Harmony, harmony’ and died; thirteen minutes before midnight . . .”13

Igor Stravinsky, who lived but a few miles from the Schoenbergs but had not spoken to him since 1912, learned of the composer’s death the next morning. He immediately drafted a telegram of condolence, the first received by Mrs. Schoenberg. Five days later, Stravinsky visited the home of Alma Mahler-Werfel and was the first person to see Schoenberg’s death mask, still not dry, that had been made by Gustav Mahler’s daughter, the sculptor Anna Mahler. In the early years of the century, her father had generously promoted Schoenberg’s music. Schoenberg’s death certificate listed his occupation as composer of modern music. Gertrud Schoenberg died sixteen years later in February 1967. Their ashes were interred in Vienna’s Zentralfriedhof (Central Cemetery) as we might imagine, not far from the graves of Beethoven, Schubert, and Brahms.


  1. James L. Franklin, Surgery, note by note: Marin Marais, “Tableau de l’Operation de la Laille,” Hektoen International, Music Box, Summer 2013. https://hekint.org/2017/01/30/surgery-note-by-note-marin-marais-tableau-de-loperation-de-la-taille/
  2. Malcolm MacDonald, Schoenberg, Oxford University Press, 2008, p. 84.
  3. Joseph Auner, A Schoenberg Reader, Yale University Press, 2003. Chapter VII “Final Years Los Angeles, 1944-1951,” 7.28 On His Health from Childhood to 1950, pp. 346-349
  4. Dorthy Lamb Crawford, Arnold Schoenberg in Los Angeles, The Musical Quarterly 86(1), Spring 2002, pp. 6-48.
  5. Rudolf Kolisch was both a composition student of Arnold Schoenberg, his brother-in-law and the leader of the Kolisch Quartet founded in Europe and the Pro Arte Quartet founded in the United States.
  6. Sabine Feisst, Schoenberg’s New World: The American Years, Oxford University Press, 2011. Capter 1. “Rethinking Myth’s of Schoenberg’s American Years.
  7. Willi Reich (translated by Leo Black), Schoenberg: A Critical Biography, Da Capo Press, 1981, p. 218.
  8. Ibid Joseph Auner, A Schoenberg Reader, Chapter VII Final Years in Los Angeles, 1944-1951, 7.4 “My Fatality;” 1949, pp. 313-4.
  9. Thomas Mann, The Story of a Novel: The Genesis of Doctor Faustus, Alfred A. Knopf, 1961, p. 217.
  10. Harvey Sacks, Schoenberg: Why He Matters, Liveright Publishing Corporation, W.W. Norton & Company, 2024, p. 191.
  11. Allen Shawn, Arold Schoenberg’s Journey, Farrar, Straus and Giroux, New York, 2002, p. 271.
  12. Ibid Sacks, p. 191.
  13. Ibid MacDonald, p. 87.

JAMES L. FRANKLIN is a gastroenterologist and associate professor emeritus at Rush University Medical Center. He also serves on the editorial board of Hektoen International and as the president of Hektoen’s Society of Medical History & Humanities.

Spring 2024



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