Retrospective blues: Robert Johnson—an open letter to Eric ClaptonBMJ 2006; 333 doi: http://dx.doi.org/10.1136/bmj.333.7566.489 (Published 31 August 2006) Cite this as: BMJ 2006;333:489
Let us hope the medical profession can continue to learn from all the other worlds that surround it, and which it ultimately serves. Blues aficionados among you may have enjoyed Eric Clapton's Sessions for Robert J—a personal tribute to Robert Johnson, “the most important blues musician who ever lived.”
Session IV of the material featured marvellous acoustic playing by Clapton, emulating his favourite influence, and also his enlightening commentary regarding the difficulty of reproducing the material. The scene was carefully set up with the long familiar (to those of you in the know) photograph of Johnson in the background with his unnaturally long fingers clutching his guitar neck.
It dawned on me then that perhaps Johnson's guitar playing gift related to unfair advantage from this arachnodactyly. Eric pay heed.
So what else do I know? Closer inspection of his face revealed a slight left ptosis, and he was known to have “one bad eye”—a small cataract afflicted him from time to time, but later disappeared. Dislocated?
The film played on, recounting some events surrounding Johnson's premature death, at the early age of 27 years. What was the cause of his death way back then in the 1930s? His death certificate was displayed, revealing the cause of death as “No doctor.” Legend has it that he was poisoned by strychnine-laced whisky or succumbed to syphilis, but neither rang true. One account from the evening of his demise described him “on his hands and knees howling and barking like a dog.” Dissecting?
So it seems possible that this tall, slim, loose jointed guitar wizard with a history of “resolving cataract” and unexplained sudden death had Marfan's syndrome.
So what does looking back teach us? Now coming up to 20 years in general practice, I can reflect that in my personal experience I have seen Marfan's syndrome on four occasions, most recently, sadly, in retrospect, after the sudden premature death of one of our young patients.
And then it dawned on me; that in my 20 years of practice, to my knowledge I have seen only one death due to aortic dissection—on a cold dark winter night many years ago, “on her hands and knees howling like a dog.”