Bravissimo, Señor Carreras
Charles Parmiter, Reader's Digest, November 1989
Each song and every aria is a celebration of this courageous tenor's victory over cancer
He could barely drag himself out of bed. He was dizzy, and his teeth hurt. It was July 13, 1987, and José Carreras was in Paris to make a film of the opera La Bohéme. Perhaps it was the antibiotics he'd been taking for his toothache that made him feel so tired. Perhaps it was his hectic schedule-recording, filming, giving recitals and performing operatic roles to packed houses in Britain, France, Italy, Spain and the United States, all in the preceding four months.
I look like hell, he mused, examining his gaunt face in the mirror of his hotel suite. He decided to go into hospital for a thorough examination. The years had been kind to 40-year-old José Carreras. Early in his career he had been recognized as one of the world's top three tenors (along with Pavarotti and Domingo). His good looks and natural acting ability made him a favourite with opera-goers, and his cheerful personality endeared him to conductors and impresarios alike. He had fan clubs from Vienna to Tokyo. His records were bestsellers, and his annual income was well over half a million pounds.
Anxious. All that seemed far away as he lay in his hospital bed, awaiting the results of a sternal marrow puncture the doctors had ordered after seeing his blood tests. "This will hurt a little," the nurse had warned, before driving a needle deep into his breastbone to suck out marrow for testing. For Carreras, though, it was as if she were drilling a hole straight into his heart.
Professor Jean Bernard, the world-famous blood specialist who had taken charge of José's bone-marrow test, walked into the room. His announcement was crushing: "You have acute lymphoblastic leukaemia -and I'm afraid it's very serious."
He explained that in this disease the bone marrow, producer of blood cells, is invaded by cancer cells that inhibit the production of platelets that stop haemorrhaging, white cells that fight infection and red cells that help bring oxygen to the tissues. José had two counts against him. One was his age: in patients under 12, 70 per cent are curable with chemotherapy. But in older patients, the survival rate drops. Secondly, he had B-cell leukaemia, meaning the cancer was also attacking the cells that manufacture immunoglobulin, the basic stuff of the body's immune system.
"We are going to do our best to cure you," Professor Bernard continued. "French doctors have made amazing strides fighting leukaemia. But if you prefer to be treated at home in Barcelona, there is a good programme at the Hospital Clinico." What Professor Bernard, out of kindness, neglected to say was that even with the most aggressive treatment, José's chances of survival were slim.
Chemotherapy. Radiation. Bone-marrow transplant. The words coursed through his brain, but they failed to register. His head was reeling. Why me? he thought. Why now?
Determined. José's 49-year-old brother Alberto, who had driven up from Barcelona, visited him in hospital. They talked for hours about their lives as children. Finally José said, "Alberto, I'm going to fight this disease. And with God's help, I'm going to beat it. Let's go home to Barcelona and get cracking."
José CARRERAS' mother was his biggest fan. A hairdresser, married to a Barcelona policeman, she encouraged José's childhood fantasies of singing at Covent Garden, La Scala and the New York Metropolitan and paid for his first voice lessons out of her meagre income. But Antonia Coll de Carreras never heard her son sing on an opera stage. She died of cancer at 51, when he was 17. His mother's agonizing death was very much on José's mind as he underwent chemotherapy treatment at the Hospital Clinico. Isolated in a sterile room, he was fed a "cocktail" of six potent drugs, dripped slowly into a vein in his arm, three times a day for seven days. Another dose of drugs was injected directly into his spinal canal to kill any cancer cells that might have taken refuge there.
Despairing. The next three weeks were a living hell. His hair fell out in clumps, and he lost a lot of weight. But he was too ill to care. "It was different from the nausea you get when you've eaten something bad or drunk too much," he explains. "I felt sick from the top of my head to the soles of my feet. Even my fingertips were nauseous."
Around mid-August he went into a "first remission." He spent ten days at home before starting a new round of chemotherapy, a "consolidation course" of four equally toxic drugs. "They all made me feel sick," he says. "The important thing was that I always had loved ones around me. They comforted me and kept my courage up." His sister Maria Antonia, Alberta and other relatives and friends took turns visiting him. "It was a terrible time for José," Maria Antonia remembers, "but he never complained. Whenever I arrived, he would smile and give me the thumbs-up sign."
In autumn 1987, with Carreras in remission, his doctors decided to proceed to the next stage: a bone-marrow transplant. A small portion of marrow would be extracted from a donor with a genetically identical tissue type-Alberta, perhaps, or Maria Antonia-and infused into José's bloodstream to find its way back to his bones. There would be potentially fatal complications, but if it worked, the donor marrow would boost the singer's immune system, producing the tumour-killing cells he needed to survive.
But no donor could be found. Alberto's and Maria Antonia's tissue type were genetically identical-but to each other, not to José. The only alternative was an auto-transplant. José's own marrow would have to be removed, treated and frozen, later to be thawed and returned to his blood, a process even more risky than a regular transplant and carried out under general or spinal anaesthetic.
On November 1 José arrived at the Fred Hutchinson Cancer Research Centre in Seattle, world-renowned for its work on bone-marrow transplants for lymph cancer and leukaemia. Five days later, doctors began the two-hour procedure of removing enough of his bone marrow for an auto-transplant.
Opera singers, as a rule, are terrified of a general anaesthetic. It depresses the central nervous system and necessitates a breathing tube which, they fear, might damage the vocal cords. José was no exception, and opted for a spinal anaesthetic.
The result was that he was groggy but awake as doctors punctured his pelvic bone hundreds of times to remove a litre of marrow. The marrow was rushed to a laboratory, where red corpuscles and plasma were removed and monoclonal antibodies-laboratory-created "killer proteins" specifically designed to fight B-cell cancer-were added.
A catheter was inserted through a large vein in his chest and advanced directly into the right auricle of his heart. He would receive the bone marrow through the catheter, and for more than three months he would have blood drawn, be fed, be given medication and receive transfusions through this tube.
Next, José's leukaemic bone marrow had to be destroyed by radiation. This process also destroyed his remaining normal bone marrow. Three times a day for four days, he was wheeled into a room with an immense X-ray machine. There he stood motionless while technicians sent huge doses of radiation through his body for 20 minutes at a time.
Inner Strength. To José those sessions seemed an eternity. "I'd mentally sing a four-minute aria from one opera, a three-minute one from another, and so forth, until I knew the 20 minutes were up."
Finally, confined to another sterile room, he was given large doses of chemotherapy for two days. "After all that, the marrow transplant itself was practically an anticlimax," he recalls. The doctors arrived at his bedside with a plastic package that "looked like salami." Using a syringe to suck up the contents, they injected them into José's catheter.
By the beginning of December, he still needed transfusions, but his blood counts were rising, and the transplanted marrow was functioning well. Luciano Pavarotti telephoned several times from Italy. "Please get well soon," he joked, "because there's no competition without you." Placido Domingo came to visit. Standing outside the sterile room, he inserted his hand into a rubber glove-like contraption. José grasped it, and the two great tenors talked shop for more than an hour.
Just before Christmas, José was allowed to move into a Seattle apartment rented by Alberto and Maria Antonia. The doctors told him he could start eating solid food. But he couldn't keep anything down. Worse still, as a side-effect of the radiation and chemotherapy, he had developed ulcers of the oesophagus, and medicine he was given for the ulcers affected his bone marrow. His blood counts began to fall precipitously.
José was getting weaker by the day. Finally, an age-old remedy proved to be an effective balm for his ulcers: belladonna. In 24 hours it calmed his stomach. "It was like a miracle," he recalls. His first meal in months was chicken soup. Within a week his ulcers started to heal.
A brand-new drug called GM-CSF gave his bone marrow the final boost it needed. His blood counts began to climb again. One day in February, Alberto and Maria Antonia were listening to a recording of El Cid and were stunned to hear an unmistakable tenor voice join in. "I had not sung a note in seven months," says Carreras. "But somehow I always had the feeling that if I could just survive this thing, my voice would still be there. It was."
On February 27, 1988, José flew home to a hero's welcome. Banners at the airport read BARCELONA LOVES CARRERAS and YOU'RE THE BEST, JOSE.
José still had the catheter in his chest, and he would need transfusions for the next three months. But his hair was growing back, and he was regaining weight. He tried to explain how he felt. "It's as if I'd been in a prison cell and suddenly found myself on a boat with the sea breeze blowing in my face..." He faltered. "My thing is to sing, not to talk," he said. "And with God's help, I hope to do so very soon."
He spent the next few months training with a physiotherapist and working hard on his voice. "The vocal cords are muscles, and they need regular exercise," he explains. "I'd been away for so long that it was like starting all over again. The biggest problem was breath control. Without it, your voice gets tired and you have no force. But it takes hours and hours to get it right." From simple passages José gradually worked his way up to that most difficult of arias, "Celeste Aida." "When I could sing 'Celeste' again," he says, "I was ready for my first concert."
On July 21 he returned to the stage with a spectacular open-air recital. For an hour and a half, with only a piano for accompaniment, he sang in Spanish, Italian, French and Catalan-operatic arias, folk songs and old favourites like "Granada." The 150,000 spectators called him back for five encores. When he finally waved for the last time and walked off, exhausted but radiant, there was scarcely a dry eye in the audience.
The recital made a profit of over £190,000-all of which went to the José Carreras Foundation to aid leukaemia victims. "The Foundation is my way of saying thanks to God for saving my life," he explains. "I thought I should use whatever influence I have to help others. And it seemed to me that if people could see me and say, 'Look, after all that has happened to him, he's back singing,' this could give other leukaemia victims hope.
"The illness has changed me," he continues. "I no longer sing just for the sake of singing. Now, when I go on stage or into a recording session, it is a celebration of being alive."
This page was last updated on: May 17, 2005
