Correspondence

The Neurologic Illness of Eugene O'Neill

N Engl J Med 2000; 343:741-742September 7, 2000

Article

To the Editor:

In their article on Eugene O'Neill (April 13 issue),1 Price and Richardson incorrectly claim that “existing biographies of O'Neill have displayed considerable uncertainty about the details” of the “ultimately lethal neurodegenerative disease” that crippled O'Neill during the final years of his life. Price and Richardson go on to say — also inaccurately — that “the results of the autopsy were not released” and that the diagnosis of Parkinson's disease that O'Neill's doctors had made during his lifetime “can now be refuted on the basis of clinical and anatomical findings.”

In our biography, O'Neill,2 first published in 1962 and continuously in print for the next 30 years, we discuss the playwright's illness in some detail. In the first chapter, for instance, we state, “Toward the end of 1937, [O'Neill] began to suffer from an illness diagnosed at first as Parkinson's disease and later as a rarer disease, whose nature could not be completely ascertained but which most specialists considered degenerative.” We go on to describe the symptoms of the illness at considerable length. In the final chapter, we make it clear that our information came from the autopsy report requested by O'Neill's widow, Carlotta Monterey O'Neill (and given to us in 1960, seven years after O'Neill's death). Although Price and Richardson list our biography (among other sources) among their references, they appear not to have read it.

The technical details of O'Neill's illness, minutely described by Price and Richardson on the basis of their scientific study, are undoubtedly of medical value. But their effort to place this clinical information in the context of O'Neill's life often misfires. Their biographical research appears to have been somewhat casual, and as a result the information that they offer is apt to be misleading.

To cite just a few examples: the authors state that O'Neill “began reading extensively” for “the first time” when he was confined to a tuberculosis sanitarium. O'Neill was then 25 years old and had, in fact, been reading precociously and exhaustively from the time he was 7. They further mistakenly write that O'Neill completed “his first play in 1914 at the age of 26,” when in fact he completed three one-act plays in 1913, when he was 25. To bolster their theory of the “possibility of an autosomal dominant or autosomal recessive inheritance pattern within O'Neill's family,” Price and Richardson cite the “premature death of [O'Neill's] two brothers” — ostensibly equating the death of James O'Neill, Jr., at 45, from alcoholism, with the death of the infant Edmund O'Neill, at the age of 1 1/2, from measles.

Perhaps the most egregious of the authors' misstatements is that “Eugene contracted syphilis but was treated and did not relapse.” In our many years of intensive research, we have nowhere found any evidence that O'Neill ever had syphilis, and we have asked Dr. Price to give us his source for that statement. To date, he has been unable to do so.

Arthur Gelb
Barbara Gelb
1841 Broadway, New York, NY 10023

2 References

1
Price BH, Richardson EP Jr. The neurologic illness of Eugene O'Neill -- a clinicopathological report. N Engl J Med 2000;342:1126-1133
Full Text | Web of Science | Medline

2
Gelb A, Gelb B. O'Neill. New York: Harper and Row, 1962.

To the Editor:

The publication of the results of the postmortem examination of Eugene O'Neill and an analysis of the findings is a welcome event, at last dispelling misconceptions about the playwright's final illness and inability to write in his final years. I carried out extensive interviews with his widow, Carlotta Monterey O'Neill, for more than a year, in connection with a research project on the playwright's creativity.1 In contradistinction to the claim of Price and Richardson that her husband abstained from alcohol during the last eight years of his life, Mrs. O'Neill told me emphatically that he engaged in periodic alcoholic binges until the time of his death. As is well known, the O'Neills lived in virtual seclusion during those final years, and his widow would clearly be the most reliable source of this type of information.

Some omissions in the report are also important. The authors refer to the suicides and possible bipolar illnesses of O'Neill's two sons, but they neglect to make clear that his first son, Eugene O'Neill, Jr., was the issue of a one-night stand with the woman who became his first wife, Kathleen Pitt-Smith, and that this son was raised entirely by his mother.2 Shane, his second, was his son by his second wife, Agnes Boulton, who was herself addicted to drugs and is not mentioned in the article at all. The offsprings' illnesses cannot be considered to have been derived from Eugene O'Neill alone.

Albert Rothenberg, M.D.
Harvard Medical School, Boston, MA 02115

2 References

1
Rothenberg A. The iceman changeth: toward an empirical approach to creativity. J Am Psychoanal Assoc 1969;17:549-607
CrossRef | Web of Science | Medline

2
Rothenberg A. Autobiographical drama: Strindberg and O'Neill. Lit Psychol 1967;17:95-114

Author/Editor Response

Dr. Price replies:

To the Editor: While writing the clinicopathological report on Eugene O'Neill, Richardson and I did not fully appreciate the intense, and at times contentious, interest in his extraordinary life. Well over 1000 books, articles, and chapters are devoted to his life, as are the Eugene O'Neill Foundation Tao House, the Eugene O'Neill Society, and a Web site (http://www.eoneill.com). One new book and an extensive revision of an older book have been published since we submitted our article.1,2

As journalists, not physicians, the Gelbs fail to understand the unique concept of a clinicopathological report. In O'Neill's case, it consisted of our reexamination of the microscopical slides of brain tissue and publication of the photomicrographs (which required permission from the O'Neill family); mapping of the specific areas of damage; a review of his and other family members' medical records; charting of his clinical course, including that documented by illustrative handwriting samples; and application of advances in the neurosciences since his death in 1953.

When asked why they recently chose to revise and expand their biography on O'Neill, which was first published in 1962, the Gelbs stated that they had a “deeper understanding now,” had lacked the analytic acumen previously, and had found new material, and most important, that “a giant of the theater like O'Neill, whose plays are revived constantly, deserved to be reexamined and reevaluated in the light of the ever changing cultural climate.”3 This is precisely what we attempted to do with regard to O'Neill's neurologic illness. I hope that the Gelbs, like all the O'Neill scholars who have responded favorably to this report, will eventually appreciate its merit.

Regarding documentation of O'Neill's relative, then complete, abstinence from alcohol in his later life, we relied on several authoritative references, which are listed in our original article. Our information that O'Neill first began reading extensively when confined to a tuberculosis sanitarium came from a noted O'Neill scholar4; the year during which his first play was published came from another source.5 Regarding familial transmission of his disease, we raised the possibility that had O'Neill's immediate family members lived long enough, they might have later had a similar disease. To the best of our knowledge, no other descendant of Eugene O'Neill has had cerebellar degeneration.

Bruce H. Price, M.D.
McLean Hospital, Belmont, MA 02178

5 References

1
Black SA. Eugene O'Neill: beyond mourning and tragedy. New Haven, Conn.: Yale University Press, 1999.

2
Gelb A, Gelb B. O'Neill: life with Monte Cristo. New York: Applause Books, 2000.

3
Peters M. A giant of the theatre. New York Times Book Review. June 4, 2000:32.

4
Brustein R. Journeying to the past: extracts from Robert Brustein's essay on Eugene O'Neill in the Theatre of Revolt. Am Repertory Theatre News 1996;17:7-9