Almost every night before bed, Alex Klein, one of the world’s most famous oboe players and a principal in the Chicago Symphony Orchestra, goes through the same routine. He begins by leaning his left side against a living room wall in his Riverside condo, his left arm stretched out behind him. He stays like this for 30 seconds before turning around and repeating the same movement with his right arm. When finished, he reaches both arms in front of him. With his right hand, he pulls down on his left fingers as a group, then works them one at a time, tugging hard, as though he were trying to yank them from their joints. 

After that, Klein moves to the kitchen for phase two. He gathers ice cubes from the freezer and neatly folds a small pile into a washcloth. Sitting at a table cluttered with papers and mail, he drapes the washcloth over his left wrist and keeps it there for about five minutes. 

On particularly grueling days, Klein also performs a kind of do-it-yourself electrotherapy. He spreads a gel on his left arm, then attaches two square white pads. These pads connect to a small black box, about the size of a tinderbox, ominously called a transcutaneous electrical nerve stimulation device. It shoots electrical pulses to arouse the nerves and activate the muscles. Klein generally sets the machine for 30 minutes, during which he relaxes—often to the point of sleeping—as his fingers twitch relentlessly from the pulses.

This is Klein’s reality now, the reality of living with a rare neurological and movement disorder known as focal dystonia. The condition limits his control over his left hand, leaving two of his fingers misshapen, a particularly cruel twist for someone who makes his living with those fingers. It also leaves him in chronic, intense pain—a side effect of torturing his body to get it to perform the way he needs it to.

The goal of his nightly routine isn’t to eliminate the pain—pain is a permanent part of his life now. He’s learned to accept that. His goal is just to moderate it enough to get through rehearsal the next day.

There was a time, a little more than 15 years ago, when Klein would wake up each morning eager to get to work. As an oboist, he was special. His stunning technical prowess pushed past what others had ever done with the instrument. His tone was so unique and beautiful that musicians from around the globe would flock to Symphony Center to hear him play. An oboe would sell at a premium simply because he had played it. He wasn’t just the CSO’s principal oboist. He was Alex Klein. 

But that was before the focal dystonia. Before he was forced to leave the orchestra for 12 years, under the assumption his career was finished. Before he gave up the oboe almost entirely. Before he spiraled into a depression so deep he contemplated suicide. And before, in the most surprising development of all, he clawed his way back to the CSO just last summer.

He’s a different person than he was the first time around—no longer a confident young virtuoso, but rather a twice-married 52-year-old scarred by his fall from classical music’s greatest heights and summoning the strength to stage a second act. 

To understand what having the oboe taken from him meant to Alex Klein, you have to understand his childhood in Curitiba, Brazil. Growing up in the 1970s, Klein struggled in school. He was bright—he could read books by age 4—but suffered from severe attention deficit disorder. He was so disruptive in class that in third grade the principal threatened to expel him.

Klein’s father, a civil engineer, had a different idea: He enrolled his son in music classes, figuring they might help center him. The boy already knew the instrument he wanted to learn. His father had once taken him to an orchestra concert, and he was mesmerized by the oboe players—the way they could work such a loud, crisp sound from such a small instrument.

Finding an oboe, however, wasn’t easy. Brazil was under a military dictatorship at the time, which made it difficult to import items from Europe. But Klein’s father saved three months of his salary and gave it to a music teacher he knew who often traveled back to his native Germany. It was on one of those trips that the teacher hid an oboe for the 9-year-old in a package he mailed to the Goethe-Institut’s Brazil outpost.

The boy’s talent was immediately obvious. By 11, he was selected for a professional chamber orchestra in Curitiba. At 13, he began touring Brazil as a soloist with internationally renowned conductors, including Olivier Toni and Eleazar de Carvalho. Even his performance in school improved. “Oboe was my savior,” Klein says. “Everything started working better in life.”

Klein left Brazil for the United States in 1984 to attend Oberlin Conservatory in Ohio. As a senior, he took first prize in an international oboe competition in New York, beating out some of the world’s most famous oboists. Over the next decade, he traveled around the globe playing competitions (he won three more), landed teaching gigs at Oberlin and the University of Washington, and released his first album, a recording of Vivaldi’s oboe concertos. Then, at 30, in a star-making turn, Klein was hired as principal oboist of the Chicago Symphony Orchestra—one of the most prestigious orchestral jobs in the world.

By 2001, six years into his tenure there, his career was peaking. He had recorded a Strauss concerto with the CSO that would later win a Grammy, and his performances were being heralded for their Dionysian beauty. “He had an energy and eagerness and a certain joie de vivre,” recalls Bill Buchman, the CSO’s assistant principal bassoonist and a longtime friend of Klein. “He was at the absolute top of his artistry.”

That March, Klein traveled to Brazil to perform Mozart’s oboe concerto, a buoyant, gleeful piece, with the São Paulo Symphony Orchestra. But a few days before the concert, as he began rehearsing, he found it difficult to move the fingers on his left hand. It took all his concentration and energy to play the right notes. 

When Klein returned to Chicago, he mentioned this to the CSO’s doctor, who was concerned. Klein underwent tests at Rush University Medical Center to see if a brain tumor was to blame. That ruled out, he saw a physician who specialized in working with performance artists: Alice Brandfonbrener at Northwestern. She diagnosed the focal dystonia. At first, Klein was relieved: “When she didn’t mention tendinitis, I thought, Whatever it is, I can deal with it. At least I don’t have to stop playing.” 

But Brandfonbrener painted a sobering picture for Klein: She told him that the condition was irreversible—that, in fact, tension in his body would only build—and predicted that within three years he would quit the orchestra out of frustration. 

In the medical field, dystonia is something of a mystery. For more than half a century, it was considered a psychological disorder rather than a neurological and physical one. Neurologists now know that dystonia involves the basal ganglia, a tiny area inside the brain that controls movement. Misfiring neurons there send the body conflicting messages, resulting in a variety of problems, including tremors, contorted muscles, and the inability to control certain muscles. In the case of focal dystonia, the mouth and fingers are mostly affected, which for a musician can make performing a familiar task, such as playing the oboe, incredibly arduous and painful. 

There are a few hypotheses for what causes dystonia. One is that it is genetic. Another is that simple overuse is to blame, which would help explain why dystonia afflicts musicians in disproportionately high numbers. “They train and train and abuse their muscles and their brain,” says Jan Teller, chief scientific officer at the Dystonia Medical Research Foundation in Chicago. Klein estimates that he was practicing and performing as much as 50 hours a week. Paradoxically, though, professionals in certain other fields that require repetitive movement—such as barbers or tennis players—rarely develop dystonia. Which is what makes the condition so perplexing.

Unlike Parkinson’s and Huntington’s diseases and other movement disorders, dystonia is not degenerative, so early intervention can allow patients to fully recover their mobility. “It’s more like a radio receiver out of tune,” explains Teller. “You just have to readjust, and sometimes you don’t know what button to press. Maybe you move a little to the left and walk by the window and extend the antenna.” The problem for musicians is, they often don’t recognize dystonia when it first hits. Looking back, Klein recalls a moment in 1998 when he felt a searing pain in his sternum, a sensation he now believes was the result of his muscles beginning to tighten. But that possible warning sign, more than two years before his diagnosis, went unrecognized.

When Klein talks about the past, he doesn’t shy away from darkness, but he is not morose. He swings wildly from quiet, somber reflections to stories told with such great urgency and excitement that every sentence seems to end with an exclamation point.

As he talks, his arms are in perpetual motion. It’s only when he takes a breath and lets them drop to his sides that his physical deformity becomes clear. With his hands relaxed, his right fingers hang normally, like branches of a willow tree. His left hand, though, curves into the shape you might use for a bull in a shadow play—his ring and middle fingers curl inward, nearly touching his palm. These are their new resting positions. The difference is maybe an inch, but enough to reverberate across Klein’s life. 

The changes in his playing started out small. He’d hold a note just a fraction too long or muddy a technical passage a bit. But the small changes grew more noticeable, becoming a full-blown crisis. Every time he played, he would have to force his fingers into place. As a result, the left side of his body would tense up. Eventually, the tendons in his left wrist and arm got so swollen that Klein developed tendinitis, which caused him agonizing pain and quickly eroded his playing.

He began taking regular breaks from the orchestra to ease the strain on his body. “I would come back for a week or two at a time and then disappear for a few months,” he recalls. Even when he was scheduled for a concert, Klein would wind up canceling more than half the time because he didn’t feel he could perform.

The dystonia didn’t hinder his mobility in any other part of his life. He had no trouble tying his shoes, typing an email, or even playing the English horn. It only affected his ability with the oboe. “I just felt incapable,” he says. “It was like I didn’t understand who I was anymore.” 

Consumed with finding a cure, Klein visited more than 30 doctors, trying different therapies. He went to a chiropractor. Then an acupuncturist. He took lessons in the Alexander technique—a method meant to alleviate pain and discomfort by realigning posture—and tried a few rounds of hand massage. “The masseuse would dig into every finger, every little muscle and knuckle, and then I’d play oboe in his office while they dug into different parts,” recalls Klein. Nothing seemed to help.

This went on for more than six months, and Klein’s search became increasingly manic. “Every two to three weeks, I would see a doctor with all my best hopes,” he says. “When nothing changed, the doctor would either refer me to someone else or tell me that the condition was incurable. I would go home depressed for a few days, feeling sorry for myself until a new idea came out and I would start searching again. I was willing to try anything.”

Klein had a new oboe made, one built from violetwood, much lighter than the traditional ebony, thinking the change would make playing less strenuous. It didn’t. He tried Botox injections in his fingers. Novocain too. He took a few doses of levodopa, a drug prescribed to Parkinson’s patients. He tried finger weights. One doctor said his condition might be the result of mercury in Klein’s fillings. (A dentist quickly dispelled that notion.) A nutritionist suggested he change his diet, so Klein cut carbs. He tried walking with better posture and not carrying his wallet in his back pocket anymore.He even underwent energy healing. “I would sit in a room and the doctor would be 10 feet away from me, moving his hand around and asking me if I could feel a blockage,” says Klein. “I think he was just trying to convince me that I felt something.”  

His bouts with tendinitis got worse, and by November 2001, Klein couldn’t play a note. He decided to take a three-month medical leave from the CSO to recuperate. By then, his personal life was also in turmoil. Three days after his leave began, his wife filed for divorce. Klein subsequently lost custody of his two young children and began sliding into an even deeper depression. 

In the morning of July 3, 2003, Klein sat down at his computer to write a suicide note. Killing himself, he felt, was the only way out of his despair. “I was having trouble understanding what I was here to do. Where would I go? I was dangling in a very unstable circumstance.”

Just as he was finishing the note, Klein got a phone call from a friend in the orchestra. She had noticed that he seemed out of sorts in rehearsal the day before, and when she asked Klein about it, he began screaming and crying. His colleague knew someone who had worked in a crisis center and had that person call Klein immediately. They spent the next two hours together on the phone until Klein finally backed off from his suicide plan. “I felt astounded for about a week,” he says. “It was as if a part of me died.”

He continued to try to perform with the CSO for another year. But ultimately, it proved too difficult. In the summer of 2004, almost three years after he was diagnosed with dystonia, Klein resigned.

Without an income—the CSO’s insurance company had denied his claim for disability benefits because he could still play to a degree—Klein felt he had nowhere to go but back to Brazil. He moved in with his parents in Curitiba, marking the beginning of what Klein calls his “exile years.” 

It wasn’t an easy adjustment. The first few months in Brazil, Klein would often jolt awake at 4 or 5 in the morning and jump out of bed to look for his oboe, thinking he was late for rehearsal. In reality, he had all but given up the instrument. “Every now and then, I would practice a little, and it felt good. Then I’d do a bit more. By the weekend I had tendinitis, and I’d close the case again.” No longer performing, he toured the country judging music competitions and even tried conducting.

He also spent a lot of time reading, particularly about Beethoven. “It was curious to me how he could have been depressed, disabled, rejected, and still maintained a sense of humor,” says Klein. “Even at the end of his life, Beethoven comes up with something like the Ninth Symphony, which talks about love in the world. So I asked myself, What do I have that’s still good? What are other dreams I’ve had that do not depend on these two fingers?” That’s when Klein decided to create music festivals.

In 2004, he formed a double reed festival to be held annually in Panama City. At the inaugural event, Klein met Catalina Guevara, a bassoonist from Costa Rica. “I remember when I first heard him play, it was like magic,” says Guevara. “You cannot imagine that this person is sick.” They were married two years later and eventually had two children. 

In 2006, Klein started the annual Festival de Música de Santa Catarina, or FEMUSC, a free two-week gathering of South American music students. The students perform together and are coached by talent from around the globe, including several of Klein’s former colleagues from the CSO. The undertaking helped him start to heal emotionally: “I felt I was doing something worthwhile.”  

Over the next few years, Klein continued to expand FEMUSC. (Last year, some 800 musicians performed, and roughly 60,000 people attended.) He also landed a job with the Brazilian government helping to form youth orchestras in some of the most troubled areas in the state of Paraíba. 

But even with such high points, Klein pined for a bigger stage. “I saw him once crying in the night,” says Guevara. “He woke up another time and said, ‘I used to tune the orchestra. I was the leader of that orchestra.’ ” Though he had moved on with his life, he clung to the hope that he might one day return to the CSO. “I taught myself to accept that the page was turned, but I did always wonder.”

Klein’s limited playing had a silver lining: The longer he went without picking up the oboe, the more his body relaxed. And the less tension in his muscles, the longer he could play. But whenever he felt a tinge in his left arm—a sign of tendinitis—he had to stop.

Over the next few years, he gradually increased his playing, performing at a few festivals, and each time he’d take on a more ambitious solo repertoire. Last February, Klein played with Mexico’s National Symphony Orchestra, and at a March recital in Colorado, he performed some of the most technically challenging music he’d tackled in years. “I’ve always tested where my limits are,” he says. “And I try to stay as close as possible to them.”

That same month, Klein got an unexpected call from the CSO’s director of orchestral personnel, John Deverman, inviting him to play with the orchestra for two weeks in April. Klein immediately accepted.

When he arrived in Chicago, Klein got more news: His successor, Eugene Izotov, had left for San Francisco, and the principal oboe chair was vacant. Klein debated whether to audition. “I wasn’t sure I wanted to jump back in, only to be stuck with issues of dystonia one or two years in.”

Then, on the second day of rehearsals, Riccardo Muti himself, the CSO’s famed music director, pulled Klein aside and encouraged him to try out. “It was like he could read into my heart and see how oppressed I was,” says Klein.  

So, for the first time in more than two decades, Alex Klein started preparing for an audition.

In June, two days before he was due onstage for one of the hardest job interviews on the planet—auditioning for Muti—Klein couldn’t muster a note. “I would begin to play something and immediately feel fatigued.” Standing in the guest room of a friend’s Oak Park home, Klein stared at his sheet music, bewildered. “I knew it was psychological. The internal pressure was so big. I thought, Maybe I just shouldn’t do this—not expose myself to ridicule. Maybe I had my chance. What if my symptoms come back? What if I’m not able to play with the same sound, same interpretation, same technique and control?”

But Klein knew this might be his only shot, so he pressed on. Every time he froze, he’d take a break and surf the internet or call his wife or take a walk to calm his thoughts. And when he returned to the music stand, he would start off slowly. “I would practice something not too difficult so that I could ground myself. I knew I could play the repertoire, but I needed to play the easier things as reassurance of the beauty.”

The day of the audition, Klein showed up at Symphony Center promptly at 9 a.m., the first of the candidates to arrive. “I felt a little bit like a zombie,” he recalls. “I knew what I had to do, and I needed to quiet down all of the self-doubt.”

He played twice, the first time for about 10 minutes and the second for 20. He thought he had performed well, but he wasn’t sure. He retreated to the basement lounge to wait for word. Nearly two hours went by as the other candidates auditioned. Then, around noon, Deverman descended the stairs to announce the decision. He offered Klein the spot. “I didn’t jump up and down,” recalls Klein, but he was plenty excited. “It was hard to believe. My life had been interrupted and now I got to do it again.” 

Klein may have gotten the second chance he yearned for, but endings don’t always come perfectly wrapped up. He is still plagued by self-doubt and suicidal thoughts, and he is now having to deal daily with intense pain and to adjust to a grueling schedule. 

But Klein has come up with a few tricks to help him cope. Back when he was first dealing with the dystonia, he discovered that if he glued a small Brazilian coin on top of the G key, he could play his oboe slightly to the left. That small adjustment, Klein believes, is enough to trick his brain into thinking he plays the saxophone rather than the oboe, and that offers some relief. 

He’s also changed his technique. While most oboists tend to play an equal number of notes with each hand, Klein now relies on his right as much as possible. When he does use his left, instead of extending his fingers fully to reach the keys, he rotates his entire arm. That difference “actually gives a little slide between the notes, like a string player changing position,” says Klein. “It’s almost a signature of mine now.”

It’s 10 o’clock on a Friday morning in November, and Klein is still working through the pain in his fingers from the previous night’s CSO performance of Ein Deutsches Requiem by Brahms. He has to play it again in just a few hours. It’s a particularly long piece, one that is both physically and emotionally demanding, but it’s a favorite of his. Klein performed the requiem with the CSO in 1999, and a recording of another CSO performance of it was one of the few he would listen to after returning to Brazil. “All requiems tend to be somber and macabre, because it is a mass for the dead,” says Klein, resting his hands on his kitchen table. “But Brahms, he had the idea that dying should not be something bad, it should be a hope for the eternal life. And he did it in such a way that glorifies life instead of just disappearing from the face of the earth. It’s so beautiful and poetic—it’s a search for truth and answers.”

We arrive at Symphony Center an hour before the concert, but the lobby is already crowded. Klein heads to the musicians’ lounge, and I take my seat in the balcony. As Klein settles into his chair onstage, I recall a question I posed to him earlier: What will happen if he can’t make it to the end of the season? “That’s frightening,” he had said. “It’s so frightening that I would rather not go there. I just have to make it to June. If I can make it to June, I’ll know I can do this job.”

When the requiem begins, Klein straightens his back and dips his shoulders as he sways back and forth. His melodic lines are rich and heavy, both blending with the orchestra’s massive somber sound and shimmering above it. I watch, barely shifting my gaze for the full hour. Just a few minutes before the end of the piece, as the chorus and orchestra quiet to a peaceful resolution, Klein takes a deep breath. He relaxes his torso and leans back in his chair, as though to firmly root himself in the mass for the living.