For almost four years prior to his death, Gershwin had experienced a series of symptoms consistent with a slow-growing tumor: intense headaches, nausea, memory blocks and losses, some fainting, olfactory hallucinations (the smell of burning rubber and other unpleasant scents). For nearly 15 years, Gershwin had frequent gastrointestinal episodes he labeled “composer’s stomach” unalleviated by change in diet (he kept a diary of food intake) or lifestyle (he gave up tobacco). His composer’s stomach never disappeared but never grew worse, essentially ruling out a progressive gastrointestinal disease. This too could have been related to Gershwin’s still “indolent” tumor. But, Sloop says, all the above would have been inconsistent with the speedy growth and debilitation of a glioblastoma.
Manifestations of a physical disorder became more intense after Gershwin moved to California. In performance, he blacked out. He spilled food, couldn’t handle silverware properly. He stumbled on stairs, fell on the street and couldn’t get up. He smeared a box of chocolates over his body. He attacked his own valet/ chauffeur and tried to throw him out of the car.
A few years earlier, well before the most dramatic symptoms emerged, Gershwin, then living in New York, had consulted doctors, primarily about his gastrointestinal problems and headaches. For about a year and a half, he had been in analysis five times a week with a psychiatrist named Gregory Zilboorg. I'm a fan of psychiatry in general; but not Zilboorg, a charismatic, unscrupulous figure, who betrayed confidences in a circular round robin, had sex with at least one female patient, engaged in questionable financial arrangements, and undermined the self-esteem of some entrusted to his care as well as some chance acquaintances. See Lillian Hellman, Moss Hart, Kay Swift (Gershwin’s lover), James Warburg (Swift’s husband), Edward Warburg and Thomas Merton (yes, the Trappist monk!) Well, not at this moment perhaps.
Zilboorg had Gershwin convinced his problems were entirely psychosomatic, a view communicated to Gershwin's nearest and dearest, many of whom (though not all) went along with the diagnosis. Those who disagreed were not on the scene in California. As Sloop painstakingly delineates, such somatization was inconsistent with other well-established aspects of Gershwin's personality.
When Gershwin's symptoms worsened in California, Zilboorg's recommendation led to another psychiatrist, Ernest Simmel. Simmel brought in an internist and later a neurologist who encouraged Gershwin to enter the hospital for three days of tests. They turned up nothing. Gershwin, still believing there was no organic cause for his problems, refused a lumbar puncture (spinal tap) that would have revealed a brain tumor. Gershwin allegedly told Oscar Levant that a brain tumor had been “ruled out.” Composer Vernon Duke reported a slight variant of essentially the same story.
The spinal tap was administered only after Gershwin was brought to the hospital, unconscious, on July 9. The tumor was located via ventriculography just prior to surgery. Ventriculography was abandoned by 1971, after brain scans were developed.
Stick around for Gershwin's Death: Could Gershwin Have Survived, Part 3.