Recording of the Week: La Sonnambula

January 31, 2010

Sports is as much of a meritocracy as can be found. Opera, alas, does not come near to sports in using skill and ability as the determinant of success. If opera were anything close to a meritocracy Raúl Giménez would have sung more than just 11 performances at the Met – Almaviva in Rossini’s Barber in 1996 and Ramiro in the same composer’s Cenerentola in 2000. And Luba Orgonosova would be above zero at the same house. Fortunately the two got together for a concert performance of Bellini’s La Sonnambula with Amsterdam’s Concertgebouw Orchestra more than a dozen years ago. Naxos recorded the opera live and has it available at a much lower price than the competition.

Orgonosova, born in 1961 in Bratislava, has enjoyed considerable success in Europe. She is particularly known for her work in Mozart’s opera’s though she sings Bellini, Verdi, and Puccini as well. She has a beautiful lyric voice that handles coloratura passages with great ability.

Giménez is a decade older than the soprano. He was born in Buenos Aires in 1951. He is widely recognized as a bel canto specialist despite his brief New York career. You can put him on the list of outstanding tenors who made very little impact on the New York house. You can go back to the 20s when Aureliano Pertile sang only one season at the Met. Other fine tenors slighted by the Met include Salvatore Fisischella, Fernando de la Mora, and Bruce Ford – the last is returning to the Met this year as one of an army of tenors needed to help Renée Fleming get through Rossini’s Armida.

When you listen to the excerpt below you’ll be struck be the beauty of Giménez’s voice and the elegance of his vocal line. His younger South American coeval who has taken New York by storm may have a little more in the fireworks department, though not by very much, but he can’t match the Argentine’s legato. It’s a shame that American audiences didn’t get a chance to hear more from Giménez. At 59 his career is either over or soon will be

Here is the duet from Act 1 beginning Prendi: l’anel ti dono. The enthusiastic reception this singing elicits from the Dutch audience is obviously deserved. If you relish Bellini’s music you’ll definitely want this album. It will also help to remind that there’s more to operatic success than ability. In that regard, unlike athletics, it resembles life.

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Lucia in Miami

January 24, 2010

Eglise Gutiérrez

Florida Grand Opera’s Lucia Di Lammermoor had its season premiere last night (January 23, 2010) at the Ziff Ballet Opera House. Unfortunately it was not one of the company’s better efforts. Director Renaud Doucet and designer André Barbet set the action in what seemed to be the 1930’s. There were kilts mixed with dinner jackets though some of the hoi polloi were wearing pants. There was a single stone slab which served as the setting of all three acts. A fountain was hinted at in the first act, while a long table was used in the second.

In general, the staging was stiff and the acting board like. During the mad scene Lucia schlepped Arturo’s corpse onto the stage and then used it as a prop. There was a ghost that kept turning up like a ghoulish penny. In the opera’s final scene Lucia morphed into the ghost allowing her and Edgardo to walk of the stage arm in arm as the departing departed.

Lucia, of course is about singing. If you have the right soprano and tenor for the two leading roles the opera can’t miss. Without them it’s a dreary affair. Cuban-American soprano Egliese Gutiérrez was Lucia. She had a lot of well wishers in the audience who vigorously cheered her performance. She has a dark middle voice that shifts gears above the staff and turns into a sound more associated with Strauss or Mozart. She puts so much pressure on her top notes that her voice must eventually crack which it did – twice – during the mad scene. Her efforts were so focused on getting out the notes that she didn’t have much time left for drama. Lucia demands more than she could deliver.

But Ms Gutiérrez’ difficulties with Donizetti’s soaring vocal lines were slight compared to those encountered by tenor Israel Lozano. Lozano’s voice might be right for Almaviva in Rossini’s Barber, but Edgardo was too much for him. While a lyric tenor can sing the part, a tenorino cannot. Lozano had trouble with pitch; in one phrase he managed to be both sharp and flat. The ghost got in his way during the sextet causing him to lose his way near the piece’s end. He then finished off the great number with a shrieking high note of intermediate pitch.  Why can’t modern directors leave this great ensemble alone? It needs no help or embellishment.

Lozano’s worst trouble came in the opera’s final scene when he completely lost his voice. He managed to croak his way to the work’s end. It wasn’t pretty. The inadequacy of the two principals was enough to finish off the evening. But there were other performers.

Baritone Mark Walters was Enrico, Lucia’s evil sibling. Given to stock villain gestures he has a burly voice that is loud if not subtle. Bass Jordan Bisch was a wooden actor though he produced the evening’s best singing. His mellifluous voice was, however, light. Conductor Ramon Tebar gave a taut reading of Donizetti’s familiar score.

The production was full of silly touches. Both Enrico and Edgardo used pistols. The latter committed suicide by shooting himself. Unfortunately it was after rather than before losing his voice. Lucia’s mourners arrived at the graveyard toting umbrellas. If you were new to Lucia you might wonder why it’s been such a big hit for 175 years after seeing FGO’s weak effort.

This was my first time at Miami’s new music center. From the outside the two hall are gleaming white and very impressive. The opera house from the inside is austere and stark. It lacks the plush luxury one associates with a lyric theater. The acoustics, however, seemed bright and full, though I was only six rows from the stage. I can’t tell how the music sounds at the back of the fourth balcony.

In summary, FGO can and has done much better. When you charge more than $200 for the top ticket you have to do better than last night.

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Passionate Intensity 3

January 22, 2010

Chapter 3 is up

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Carmen in HD

January 17, 2010

Carmen is a daunting challenge for any singer, much less for a mezzo whose roles before taking on Bizet’s extra human gypsy have been focused on Mozart and Rossini. Singing the role for the first time at the Met super heats the this challenge. Elina Garanča more than met the role’s requirements; she triumphed.

Today (January 16,2010) the Metropolitan Opera broadcast Bizet’s final opera in HD. The new production was directed by Richard Eyre with sets and costumes by Rob Howell. The dancing, much more of it than customary, was choreographed by Christopher Wheeldon. Unlike the Met’s dreary Tosca and drab Hoffmann, both new productions, that were televised earlier this season, Carmen was a qualified success. The qualification was the first act. The time of the opera was ostensibly moved to the early Franco era, but the time shift was almost invisible and was likely ignored by virtually all the audience. The problem with the first act was plainness – no it was ugly. The cigarette girls came out of a hole in the ground and were dressed in schmattas.  They looked like they needed a bath. They were hardly “alluring and seductive”. Who would build a subterranean cigarette factory in Seville?

The remaining three acts were much better, not so much because the sets were flashy or eye catching – rather they didn’t get in the way of the action or the music. The orchestral introductions to acts 1 and 4 were concluded by a brief ballet that worked very well. The dancing set the mood for the drama to come. The two dancers, Maria Kowroski and Martin Harvey, realized these interpolations perfectly so that they seemed to always have been part of the opera. The same was true of the flamenco inspired dancing that was added to the beginning of the second act. Here some of the singers were also required to dance. They handled themselves with grace and aplomb.

The opera’s stark final scene, Carmen’s murder, was simply set allowing Carmen, José, and Bizet to supply all the effect needed for this gripping climax.

Elina Garanča who was originally scheduled to sing in the Met’s Hoffmann moved to Carmen as a replacement for Angela Gheorghiu. Garanča proved to be a brilliant choice. She’s very tall and embodies statuesque, voluptuous, and beautiful in ways that need to be seen rather than described. Her acting was earthy and seductive. She moved with leonine grace and tossed of her dance parts with appropriate grace. Her voice is dark, dramatic, and beautiful. Her tone was pure from top to bottom. There was not even the hint of a vocal problem. Hers was a Carmen that could stand comparison with any of her great predecessors at the Met. In a dark wig the naturally blond Latvian seemed the essence of Gypsy fire. Garanča’s Carmen was a proletarian earth goddess who only dies only for an instant. She will never really go away. In this regard, she was like the bull in a corrida. He dies only to be reborn. Garanča’s voice is so well placed and produced that she sounds as if she could sing anything she chooses.

Roberto Alagna was Don José. Why is the peasant corporal called “Don”? “Don” is an honorific reserved as a mark of esteem for a person of personal, social, or official distinction. Regardless, Alagna’s tenor is no longer the beautiful lyric instrument it once was. It’s mid range is dark and has a spinto sound. His top notes are strained. He elected to take the high B-flat at the end of the Flower Song piano rather than the usual forte. The result was a pathetic falsetto that robbed the aria of its power and poetry. The remainder of his performance was solid if not memorable. His acting was convincing. The death scene was acted passionately. The powerful acting of both Garanča and Alagna left the audience riveted as it’s supposed to be when this most dramatic of scenes is done right. Alagna’s manhandling of Carmen was so rough that it brought to mind Giuseppe Di Stefano’s Don José of more than 50 years ago. During the Met broadcast Carmen in 1956 he broke Risë Steven’s arm in the last scene of the opera.

Teddy Tehu Rhodes, a New Zealand born baritone, was a last minute replacement for Mariusz Kwiecien. The extremely tall and slim singer did well with the Toreador’s Song though his sound is a little hollow. Barbara Frittoli sang Michaela with a pure light soprano. She did her best to impersonate a peasant girl about 25 years younger than she is. Gary Halvorson’s closeups did not ease her task. Keith Miller was impressive both vocally and dramatically as Zuniga.

This production of Carmen was the Met debut of Canadian conductor Yannick Nézet-Séguin. The 34 year old maestro appears to be the picture of mildness, but he led the Met orchestra in a whiplash reading of Bizet’s great score that captured both its brilliance and lyricism. This was clearly the most successful HD broadcast of the season thanks to Garanča and Nézet-Séguin. The future looks grand for both these young artists.

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Mad Men Meet Mozart

January 11, 2010

The award winning TV series Mad Men had escaped my notice until a few days ago. Hearing a lot of good things about it I decided to watch a few episodes. After viewing the first three I’m mystified what the fuss is about. Set in 1960 it depicts the lives of a number of people connected with a Madison (hence one meaning of Mad Men) Ave advertising agency’s employees and their bosses. The series aims at verisimilitude trying to capture the feel of 1960 New York. It fails utterly. Everybody talks like an Ibsen epigone. They smoke so much that the HD resolution is obscured by fumes. I lived in New York in 1960. People smoked a lot back then, but not as much as on this program. They also didn’t do it looking like 11 year olds imitating their parents. The acting is as stiff as the dialogue. People never talked that way, certainly not in Manhattan. There wasn’t even a single button down shirt in sight. The show is a comic book version of the early sixties.

What’s any of this to do with medicine or opera? In the first episode a new secretary goes to a doctor to get a prescription for birth control pills. She gets it, but only after receiving a lecture from her male doctor on not abusing it by becoming the borough slut. She also gets a pelvic exam without a nurse in the room. Didn’t happen then, doesn’t happen now. Physicians dispensed contraceptives in New York during the 50s and 60s with as much aplomb as they wrote for Darvon.

The third episode depicts a Saturday afternoon birthday party for the protagonist’s daughter. We know is early March, 1960 because we’ve been told that Elvis just returned from Germany at the end of his military service. That was March 2, 1960. The radio is on at the birthday party and we hear that the Met is broadcasting The Marriage of Figaro (which is the title of this episode) starring Robert Merrill and Joan Sutherland. To begin with,the Met always calls Mozart’s opera by its Italian name – Le Nozze di Figaro. This is OK because the TV audience wouldn’t recognize it by that name. Figaro was broadcast in early 1960, but in January not March. Furthermore neither Merrill nor Sutherland ever sang in this opera during their long Met careers. And to cap the mishmash Sutherland didn’t make her first appearance at the Met until November of 1961. It took about a minute to check all this out. If verisimilitude was the goal the script writer easily could have done the same.

Of course, all of this would be irrelevant if the show were any good, but it’s not. That it’s won a lot of awards speaks tomes about the competition. Clumsy is the adjective the keeps coming to mind. I’ll go back to Uncle Miltie.

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Der Rosenkavalier in HD

January 9, 2010

Today’s performance of Strauss’ Der Rosenkavalier was broadcast live in HD from The Metropolitan Opera House. It was the 376th staging by the company of Strauss’ most popular opera. An impressive number, but far from La Boheme’s 1208 or Aida’s 1112. There’s a reason for the difference besides its being around for less time. It’s not as good as the other two. It does take a lot of resources to mount Rosenkavalier, but not more than Aida. The problem with the Strauss work is that it’s far too long. You could easily cut 45 minutes from the score without losing much. All of the third act up to the Marshallin’s entrance could easily go.Today’s performance clocked in at more than four and a half hours including the Met’s notoriously long intermissions.

Strauss just didn’t have the knack for slapstick comedy that makes up most of the third act. Much of Ochs’ carrying on in the first act could also be cut. Ochs is an obnoxious boor who can’t engage an audience’s sympathy.

So what’s it got going for itself? The Marshallin, one of opera’s great characters. Beautiful waltzes, magnificent orchestration, a final trio that’s one of music’s most inspired ensembles; it was exquisitely delivered this afternoon. Lots of other fine music and a story that’s appealing.

Renée Fleming has been singing the Marshallin at the Met for 10 years. She’s got the role down pat. She looks great (whoever did her cosmetic surgery is a master) and her voice is lustrous and silky from top to bottom. Even with video director Barbara Willis Sweete’s penchant for blemish revealing closeups you could still  believe that she was in her early to mid thirties. The Marshallin seems to suffer from bipolar disorder. Fleming portrayed her emotional volatility without overemphasizing it. What makes the character is the sensitive, probing, and beautiful music Strauss has given her.

Everybody loves the Marshallin, but think about what she does. Today, in some jurisdictions, she’d be in front of a judge rather than an audience. She’s having sex with a 17 year old boy. She’s also committing adultery. I wonder why and how she hooked up with a kid half her age. Something is seriously wrong with the lady. Talk about suspension of disbelief.

OK, let’s talk about it. Octavian, the 17 year old boy, was played by a 50 year old woman – Susan Graham. She’s good looking, is well preserved, and possess a beautiful voice. She can also act which is a good thing because for about half the opera she has to pretend to be a boy pretending to be a girl. She’s been singing this role at the Met since 1995. Her impersonation is as good as any I’ve heard since before she was born. The Marshallin realistically thinks Octavian will leave her soon – how could he not. Octavian is a typical teenager who confuses lust with love. He moves on to Sophie who is a dimwitted 15 year old. How long to you think it will take before Octavian finds another Marshallin? And how long before the Marshallin finds another Octavian? The whole plot is small beer.

Sophie was played by soprano Christine Schäfer. Her mind seemed to be someplace else as she gave a vocally satisfactory (aside from a small crack at the beginning of her part) performance that seemed disconnected from the action. She even seemed that way during her intermission interview. It’s hard to believe that this is a singer who scored a great success with Berg’s Lulu. There were times I thought she might fall asleep.

Baron Ochs was sung by Icelandic bass Kristinn Sigmundsson. He fits the requirement that the bass who sings Ochs be a reject from The Incredible Hulk. He did as much with the role as one can given the character’s repellent personality which is only partly offset by his great waltz tunes. His voice is solid in the middle but goes airy at its top and is weak at its bottom. German composers not named Mozart seem to be unable to do comedy that doesn’t have  at least a twinge of nastiness about it.

Eric Cutler gave a lovely reading of the Italian Singer’s aria. His voice is a slender instrument, though. Veteran Thomas Allen was an unctuous and confused Faninal. Nathaniel Merrill’s 40 year old production still looks splendid. The rest of the cast was up to Met’s high standard. Stage director Robin Guarino had a lot of people running all over the stage for much of the second and third acts for little reason. A little less hysteria would be welcome.

Dutch maestro Edo de Waart returned to the Met for this run of Rosenkavalier after an absence of 10 years. Strauss’ brilliant orchestra is as important a player in this opera as any of the singers. De Waart led his singers and orchestra with care and skill. A beautiful and sensitive reading of this dazzling score.

The Met’s subtitles gave up any attempt (except for an occasional “ain’t”) to translate the various forms of German that comprise Hofmannsthal’s libretto. The nobles speak an archaic high German, the commoners speak low class Viennese dialect, and the two Italians (Annina and Valzacchi) mouth broken German. But it’s hopeless to translate this for non-German speakers. Try translating Porgy and Bess into German.

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Is Isolated Chest Pain a Valid Indication for Coronary Angiography?

January 8, 2010

The high profile case of Rush Limbaugh’s chest pain raises a question that never seems to get a satisfactory answer. Is isolated chest pain an indication for a coronary angiogram? Lets use Mr Limbaugh’s case as an example. Since all I know about it is what he has said, I’ll make some assumptions for the sake of discussion.

A 59 year old man with no history of cardiovascular disease experiences severe chest pain highly suggestive of an acute coronary event. EMS is summoned, he receives emergency treatment, the pain subsides only to reoccur. By the time a physician arrives the second episode of chest pain has subsided. His evaluation is entirely negative. EKG is normal, cardiac enzymes are normal and remain so. Vital signs are normal. He is not diabetic and his blood lipid levels have always been normal. Nevertheless, he is taken to the cath lab and a coronary angiogram is performed which is also normal.

Was the angiogram indicated or was it a reflex conditioned by a combination of habit and defensive medicine? The fear of physicians when someone arrives in the emergency room with chest pain is that he is experiencing an heart attack – or an acute coronary syndrome a term now in vogue.

Below is a table taken from the American College of cardiology/American Heart Association Guidelines for Coronary Angiography. The entire report is here: ACC/AHA Guidelines for Coronary Angiography

Noninvasive Test Results Predicting High Risk for Adverse Outcome

1. Severe resting left ventricular dysfunction (LVEF<35%)
2. High-risk treadmill score (score-11)
3. Severe exercise left ventricular dysfunction (exercise LVEF<35%)
4. Stress-induced large perfusion defect (particularly if anterior)
5. Stress-induced moderate-size multiple perfusion defects
6. Large, fixed perfusion defect with left ventricular dilatation or increased lung uptake (201Tl)
7. Stress-induced moderate-size perfusion defect with left-ventricular dilatation or increased lung uptake (201Tl)
8. Echocardiographic wall motion abnormality (involving >2 segments) developing at low dose of dobutamine (10 mg · kg-1 · min-1) or at a low heart rate (<120 bpm)
9. Stress echocardiographic evidence of extensive ischemia

1 Greater than 3% annual mortality rate.
bpm indicates beats per minute.

Given that our patient is stable, has a normal EKG, and whose initial cardiac enzymes are normal. The next move should not be to take him to the cath lab. Less invasive tests as depicted on the table above should be performed; if they are normal and subsequent cardiac enzymes levels remain unchanged the likelihood of an acute coronary syndrome is just about zero. The patient should be discharged and followed as an outpatient.

Assuming that Mr Limbaugh’s case is as I have described it (a big assumption as I don’t have the details of his case) then his angiogram was unnecessary. So let’s focus on a patient who really does have all the characteristics I have just listed. He would still get a coronary angiogram in many medical centers. Why?

Medicine does not lack scientifically based guidelines for rational clinical practice. But they are commonly ignored. The evaluation and treatment of coronary artery disease is right at the top of diseases that have been exhaustively studied, that have sound diagnostic algorithms, that have effective treatments (both medical and surgical), that are diagnosed and treated on a seat of the pants basis rather than on the basis of medical science.

To a close observer who is not a cardiologist it seems that the diagnosis and treatment of coronary artery disease is like the cost of a flight on American Airlines – no two passengers have paid the same price for their ticket.

The aggressiveness with which one cardiologist approaches a patient with chest pain seems to depend in large part on his personality. Also, medical science is not as precise and clear cut as physics. There is a wide range of practice patterns that fall within the bounds of acceptability. The ultimate standard for the presence of absence of coronary artery disease is the coronary angiogram. So, many cardiologists don’t fool around with non-invasive tests when they have a patient whose story is typical of coronary disease. The patient goes to cath lab. Guidelines are just that – guidelines. They are not graven in marble, at least not yet. But a lot of unnecessary angiograms are performed.

The practice pattern is not likely to change, but coronary angiograms can go wrong. The complication risk from the procedure is low – around 1%. Serious complications are even less common, but they do occur. When you’ve seen a few you get a little less cavalier about sending low risk patients to the cath lab.

And finally, you don’t get sued for telling a patient he doesn’t have coronary artery disease when he doesn’t, but you do get sued for telling a patient he doesn’t have it when he does.

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