The painful life of Cole Porter.

After listening to Cole Porter's delightful songs, easily some of the most sophisticated, witty, and melodious ever written for the American theater, many assume that his life was a Champagne-drenched romp through high society. This was, essentially, the view captured in Night and Day, the 1946 Hollywood bio-epic starring Cary Grant as Porter. However, a soon-to-be released film, De-Lovely, featuring Kevin Kline as the composer-lyricist, proposes to explore well beyond such hazy or sanitized versions of the Cole Porter story. Indeed, many aspects of Porter's life simply could not be discussed in great detail during the 1940s and 1950s, such as his 35-year marriage to socialite Linda Lee Thomas. Although the Porters shared deep emotional ties and loyal friendship, throughout their marriage Cole Porter preferred both long-term intimate relationships and brief physical encounters with men. More striking, however, was Porter's medical history, which is scrupulously documented in a biography by William McBrien. After years of equestrian sportsmanship, in October of 1937, the composer's legs were crushed when his horse shied and rolled directly over them. The half-ton horse's fall delivered compound fractures to both of Porter's thighbones and provided the entryway for osteomyelitis, perhaps 1 of the most serious and difficult to treat infections known. Even today, as every doctor knows all too well, infections of the bones, which are slow to absorb even the most powerful of antibiotics, present a daunting challenge to treatment. Always an optimist with his chin pointing decidedly northward, Porter told friends that in the hours immediately after his fateful accident, as he waited for emergency medical help, he took out his notebook and composed the lyrics for what became the hit song, “At Long Last Love”. Over the next 2 decades, Porter underwent a series of excruciating operations on the bones and nerves of his legs. Determined not to let these injuries diminish his busy creative or social life, Porter continued full throttle as evidenced by the scores of photographs during this era depicting the formally attired composer being literally carried by his valet to social events and Broadway openings, not to mention producing a torrent of songs and musicals that remain standards of 20th century American theater, jazz, film, and popular music. At the same time he wrote many of his best-known, confectionary musical masterpieces, Porter was undergoing a brutal medical regime that would stop most in their tracks. For example, writing in 1945 to the choreographer Nelson Barclift, Porter explained the details of his latest operation in which the surgeon had to rebreak the bones of his legs, remove the jagged ends, splice the Achilles' tendons, and remove 8 inches of his tibia bones to perform a bone graft over the fractured areas. Most vexing, however, was continued evidence of staphylococcal infection in the poorly healing bones and severe pain from scar tissue pressing on the nerves that made tortuous even something as light as the touch of a sheet. Coincident to the opening of such Broadway hits as Kiss Me Kate (1948), Can-Can (1953), Silk Stockings (1955), and the remake of the 1939 motion picture, The Philadelphia Story, appropriately retitled High Society and starring Frank Sinatra, Grace Kelly, and Bing Crosby in 1956, Porter's physical condition plummeted. In 1958, after a valiant battle, the germs inhabiting his bone marrow won and Porter's right leg was amputated at midthigh. Although he was fitted for a prosthetic leg and underwent rigorous physical therapy, the man whose witty lyrics and melodies epitomized hope and joy had little to be hopeful about. Porter told many friends, after the amputation, “I am only half a man now.” In his last years, Porter confined his once glamorous nights and days to his apartment in the Waldorf Towers. The horrible pain he experienced in both of his severely damaged limbs led to an ever-increasing reliance on alcohol and narcotic painkillers. Sadly, these problems, combined with the surgical removal of part of his stomach for gastric ulcers, bouts of pneumonia, bladder infections, kidney stones, and loneliness (his beloved Linda died in 1954), all led to overwhelming depression and debilitation. When Porter died at the age of 73 in 1964, few people, save his closest friends and associates, had any idea of the painful and tragic life he led for more than 25 years. Miraculously, through physical anguish, drastic surgical procedures, and the grip of addiction, he could still trip the light fantastic in his mind and reliably inspire the rest of us to do so as well. Such stories remind patients and doctors alike that regardless of the outcome, the human spirit remains the most formidable foe of illness.