Paul Klee and his illness, scleroderma Richard M. Silver, MD The author (AΩA, Vanderbilt University, 1975) is profes- sor of Medicine and Pediatrics and director of the Division of Rheumatology and Immunology at the Medical University of South Carolina. t has been said that the viewing and analyzing of fine art from a medical perspective increases one’s appreciation of the in- dividual’s suffering and teaches us an important lesson of the humanI aspects of medicine.1 It is likely that few artists suffered as greatly as did Paul Klee, one of the pioneers of modern art. Klee suffered personal loss, intellectual and political persecution, and, finally, a devastat- ing illness, scleroderma. Scleroderma (systemic sclerosis) is characterized by autoimmunity, microvascular injury, and an overproduction of collagen and other extracellular matrix components, often leading to profound changes in personal appearance, significant morbidity, and, in many cases, reduced survival. Despite his fatal illness, Klee’s adaptation and artistic productivity provide a window through which one can appreciate the indomitable spirit of human creativity. Paul Klee was born on December 18, 1879, in the small town of Münchenbuchsee near Bern, Switzerland.2,3 His mother, Ida Maria Frick, was a trained singer, and his father, Hans Klee, taught music for fifty years at the Cantonal School for Teachers near Bern.4 Both envisioned a musical career for Paul, who indeed was a talented violinist, earning a seat with the Bern City Orchestra. From a very early age, though, it was drawing and art that captured the imagination of Paul Klee, although music accompanied him throughout his life and in his art. Captive of art, not disease Fortuitous—Klee encounters Kandinsky At age eighteen, Klee moved to Munich to study art at the private painting school of Hermann Knirr, where he soon became one of Knirr’s best pupils. Klee found the atmosphere of Munich stimulating.4 Living a Bohemian life unlike that of his youth in Switzerland, Klee noted his en- joyment of the “free life, the international comradeships and the unusually good musical performances.” 5p5 Two years later, Klee felt compelled to enroll in the Paul Klee, first violin (far right), and friends playing a Schubert Munich Academy of Arts, fearing that to quintet at the Knirr School in Munich, 1900. do otherwise might disappoint his parents, who felt Reproduced with permission of George Braziller, Inc., New York. their son was not studying with sufficient serious- ness. There, he studied under Franz von Stuck. At this formative stage of development, Klee presaged his later fascination with color, complaining that von Stuck, although a good teacher of drawing, was “no good as a teacher of painting, for he never said a thing about color.” 5p5 It was here that Klee first encountered Wassily Kandinsky, who would later have a profound influence on Klee’s artistic devel- opment. It was here also that Klee met the girl who was to become his wife—Lily Stumpf, the daughter of a Munich doctor.4 Paul and Lily married when he was twenty- seven over the objection of Lily’s par- ents. Lily was active as a concert pianist and earned a living by giving music lessons, some of which she gave at home while Paul devoted his time to art in his kitchen studio. Between 1906 and 1914, Munich was a center of avant-garde art, and it was there that Klee joined a community of young artists beginning to explore new ways of artistic expression.1 In 1912, Klee was invited to take part in an exhibition of art by Blaue Reiter, a group that included Kandinsky, Franz Marc, August Macke, and Gabriele Münter. The group’s name came from the cover illustration of its exhibi- tion almanac, showing a horse with a rider in blue, repeating themes from Kandinsky’s earlier painting Southern (Tunisian) Gardens, 1919. Watercolor and india ink on paper. 9½ x 71∕3 inches. Klee was entranced by the sights and colors during a trip to North Africa in 1914, an experience that would have a lasting impact on the artist. © 2007 Artists Rights Society (ARS), New York/VG Bild-Kunst, Bonn. Photo of scleroderma hand courtesy of John Varga, MD, Gallagher Professor of Medicine, Northwestern University Feinberg School of Medicine. 18 The Pharos/Winter 2008 Der Blaue Reiter (The Blue Rider, 1903) and Marc’s painting Die the Bauhaus was devoted to uniting the fine and applied arts Grossen Blauen Pferde (The Large Blue Horses, 1911). and architecture in a manner fitting for an industrial age. Klee realized at once that this was an offer he could not refuse.4 At the Bauhaus, Klee taught the principles and practices of art and published one of his most influential works, Pädagogisches Skizzenbuch (Pedagogical Sketchbook, 1925). After five years Learning about color: “I am a painter” of vital and fruitful work in the Weimar Bauhaus, this happy time came to a sudden end when the first Nazi parliament of the State of Thuringia closed the school. The entire Bauhaus A pivotal point in Klee’s career occurred in 1914, when he moved to the up-and-coming city of Dessau. Soon thereafter, joined his artist friends Louis Moillet and August Macke on a feeling an urge for artistic freedom, Klee accepted an appoint- seventeen-day trip to Tunisia. This excursion proved to be an ment at the Art Academy in Düsseldorf. The early 1933 coming unforgettable experience for Klee, who was entranced by the to power of the Nazis soon proved fateful for the German cul- colors and sights of North Africa. Of color he wrote, “It holds ture, but Klee refused to be upset. In February 1933, he wrote me forever—I know that. That is the meaning of this happy to Lily saying, “Not since my return from Venice have I worked hour: color and I are one. I am a painter.” 5p132 He brought the way I have been doing these past two weeks. The number back to Munich the foundations for some of his greatest of paintings alone doesn’t tell the story, but the integrity and works of art. joy in the work that come every day for several hours.” 5p69 The outbreak of World War I put an end to the expression- ist Blaue Reiter group. Kandinsky and others were forced to flee, first to Switzerland and later to their homeland Russia. Klee’s close friends August Macke and Franz Marc were killed in action while serving in the German army. Klee’s father being 1933: a dramatically productive year a German national, Paul was drafted into the German army at the age of thirty-five, just one week after learning of the death of Felix Klee, Paul and Lily’s only son, lived in Düsseldorf his friend Marc. Lily argued to army officials that her husband’s at that time, and recorded that from March 1933, when the health was none too good. In his diary, dated July 20, 1916, Klee swastika flag was run up over the Academy, his father stayed commented on his physical weakness from strenuous marches away from his beloved studio.5 Klee withdrew to his home and, and exercises.5 He was never transferred to the front; ironically, as so often the case in difficult times, worked as if obsessed. part of his military service was spent at Schleissheim, where That year saw his greatest productivity to date, comprising 27 his duties included painting aircraft. He was discharged from oil paintings, 119 watercolors and 336 drawings. Paul and Lily military service in February 1919, forever changed. fled to Switzerland in December 1933; shortly thereafter many Klee’s artistic expression changed from mostly draw- ings to the addition of large numbers of oil paintings and watercolors.1,5 An exhibition of over three hundred of his works brought him his first international recognition in 1919. Klee was becoming fa- mous. Then, on November 25, 1920, a telegram arrived from Walter Gropius offering Klee an appointment to the Bauhaus in Weimar.4 Not an art school in the usual sense, Joseph Goebbels and Adolf Hitler view exhibit of Entartete Kunst (Degenerate Art) that included works by Paul Klee and other twentieth century artists. The Pharos/Winter 2008 19 Paul Klee in his studio in 1938 (left) and 1940 (right). Progression of scleroderma is evident in the later photograph showing taut skin with pigmentary changes, telangiectasiae and loss of the distal portion of two fingers. Reproduced with permission of Zentrum Paul Klee, Bern, Klee Family Donation (left) and Keystone Switzerland (right). years later, much of the “degenerate art” was burned in the courtyard of a Berlin fire Die Zwitscher-Maschine (Twittering Machine), 1922. Watercolor, and pen and ink on oil station, while other works were sold by the transfer drawing on cardboard. 25¼ x 19 inches. Painted during his Bauhaus years, Nazis at auction,6 including Klee’s emblem- Klee blends nature with the industrial world. atic Die Zwitscher-Maschine (Twittering © 2007 Artists Rights Society (ARS), New York/VG Bild-Kunst, Bonn. Digital image © The Museum of Modern Art/Licensed by SCALA/Art Resource, NY. Machine, 1922). After returning to Switzerland, Klee worked in an improvised studio in a small of his colleagues were forbidden to paint, while exit from apartment in Bern. His colors blossomed out and became Germany became more difficult. On the eve of his departure, stronger. A new style emerged that was different from the Klee wrote to Felix, “I have grown somewhat older these past rigidity of the Bauhaus period and different, too, from the few weeks.