Doctors with the opera bug find enthusiasm infectious; OperaDocs: The pathology of the performance draws fans dedicated to finding a germ of truth in the outlandish plots.


She faints. She coughs. She recovers.

She faints. She coughs. She dies.

Oh, and her frailty inspires lust in the man who revives her. They fall in love.

Her name is Mimi, and, as the heroine of "La Boheme" takes to the stage in the Baltimore Opera's performances of Puccini's 19th-century opera, some in the audience can't help but ask a few technical questions.

For instance, why is Rodolfo hanging around Mimi as she wastes away in the final death scene? Doesn't he realize she's contagious?

Call them OperaDocs, a club seeking serious explanations for what has long been recognized as the art form with the most inane plots. Their inaugural question -- put to the dean of the School of Hygiene and Public Heath at Johns Hopkins University at the Lyric last week:

What might have happened to Puccini's opera if Mimi had received a dose of INT -- the early treatment for tuberculosis?

It's a cliche in opera that heroines die of TB and women who appear pale and delicate are romantic. "They are pale, wan and sick people. Yet for some reason, men are attracted to them," says Allen Jensen, a well-known ophthamologist and founder of OperaDocs. The group gives opera lovers such as himself a chance to rewrite the plot. "It's a fun thing," he says.

In 1896, when Puccini wrote his opera, most people were, in fact, infected with tuberculosis, and 10 percent developed the disease. A quarter of all deaths in Europe were from TB, according to Alfred Sommer, the Hopkins dean.

Mimi was likely "pale from anemia, delicate from malnutrition, and radiant with flushed cheeks and bright, sparkling eyes from fever," he told 110 doctors and friends at the OperaDocs lecture.

"Coughing up blood must have been off-putting," Sommer says, "but occurs late in the disease -- and presumably in the romance."

At first, TB was thought to be related to squalor and malnutrition in overpopulated areas such as the Latin Quarter of Paris. Mimi was a poor seamstress whose illness was worsened by the cold in her drafty flat. TB also was considered a consequence of immoral behavior -- another famous TB patient is Violetta, the prostitute in "La Traviata." She, too, is attractively pale.

But 14 years before Puccini's opera, a German researcher discovered that TB was an infection passed from person to person.

There may have been some basis in reality for the image of a pale, delicate woman as a lover in opera, but operas often were written by men who had troubled relationships with women or whose maturity was restricted to their musical development. The characters are frequently one-dimensional and immature. Indeed, enjoying opera usually requires a leap of faith -- putting aside the story or not taking it seriously.

But to OperaDocs, it is the ultimate form of art -- music, drama, scenery, theater, plus illnesses that are very difficult to figure out. "It has a lot of people dying suddenly and other illnesses you can diagnose. It would be interesting to see 'what happened if ...' It's like a sport," says Mario Menendez, a Towson internist whose love for opera dates to his early childhood.

"This is a way to make it relevant to us, to what we are doing," he says. "The stories are so ridiculous, but the music is fascinating."

Otello's jealous rages may have been epileptic seizures, he suggests. Elektra, who plotted with her brother to murder their mother, "was so happy [when the plan was realized] she danced and died -- she probably had a heart attack," he says.

Of course, madness is a recurring operatic theme, as is amnesia -- people lose their memories, and regain them at the most opportune time, Menendez points out.

Operas lay out human relationships in a mythological way, but they do speak to dynamics in individuals and families, says Tim Allen, a Towson psychoanalyst who will be the OperaDocs guest speaker next year when the Baltimore Opera Company stages "Elektra." They may not get acted out nowadays in the same way, he adds. Instead of the usual Greek setting for the tragedy, "Elektra" is to be staged in an insane asylum -- the perfect opportunity to explore the kinds of psychoses that lead to matricide and patricide.

And while many opera stories are implausible, "La Boheme" is not one of them, notes Michael Harrison, general director of the Baltimore Opera. The characters are based on true renderings from Murger's collection of stories of Bohemian life in Paris at the time.

Analyzing operas for their germs is "hilarious," he says. "It could be a lot of fun and sparks a good deal of interest in the individual operas."

So, to return to Mimi, what might have happened to Puccini's plot had she been injected with a dose of INT? Perhaps only another remission and relapse, says Sommer. A multiple-drug treatment would be more effective, but if it had been given before she met Rodolfo, there would have been "no romance, no plot and therefore, no opera," he says.

"If not from TB, Mimi would have suffered from some other chronic, debilitating -- but alluring and uplifting -- fatal disease."

Diagnosis Opera

Match the opera to its illness, keeping in mind that tuberculosis was a very common affliction.

1. "La Boheme" A. Bubonic plague

2. "Oepidus Rex" B. Insanity

3. "Elektra" C. Tuberculosis

4. "La Traviata" D. Syphilis

5. "Parsifal" E. Cholera

6. "Death in Venice"

7. "The Tales of Hoffman"

Answer: 1-C, 2-A, 3-B, 4-C, 5-D, 6-E, 7-C

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