Maestro John Mauceri with three members of his virtuoso medical team: Dr. Eugene A. Grossi, Dr. Adam H. Skolnick, and Dr. Jonathan Samuels.
Credit: Haley Ricciardi
As an acclaimed orchestra conductor, John Mauceri, now 80, relishes tough challenges, from interpreting complex symphonic scores to melding the talents of more than 100 musicians into perfect harmony and synchronicity. Long past what’s usually considered retirement age, he has continued doing the work he loves.
Even chronic illnesses couldn’t keep him from the podium. In 2017, when stiffness and swelling in his hands made it difficult to grip his baton, Mauceri’s primary care physician at NYU Langone Health, internist David Kudlowitz, MD, suggested he see rheumatologist Jonathan Samuels, MD, co-director of the Joint Preservation and Arthritis Center. Dr. Samuels diagnosed him with psoriatic arthritis, an autoimmune disease that attacks joints and tendons, and prescribed immunosuppressive drugs that brought the symptoms under control. Two years later, Mauceri was diagnosed with chronic lymphocytic leukemia, a form of blood cancer that causes abnormal white blood cells to proliferate, leading to fatigue and other symptoms. When Dr. Samuels found that the leukemia had painfully infiltrated a bone in Mauceri’s ankle, requiring surgical intervention, Michael L. Grossbard, MD, chief of hematology at NYU Langone’s Perlmutter Cancer Center, treated him with a targeted therapy that put the malignancy into remission and enabled Mauceri to keep conducting.
But starting in January 2024, a cascade of medical crises pushed the maestro’s formidable coping skills to their limits—and threatened to end his life. First, a bout of COVID-19, followed by viral pneumonia, left Mauceri with a persistent, agonizing cough. “The wheezing was so violent, it actually threw me out of bed one night,” he recalls. Unable to climb a flight of stairs without gasping, he visited the Ronald O. Perelman Center for Emergency Services, where a liter of fluid was drained from his left lung. He was hospitalized for a week, until the symptoms eased.
Back home, new miseries emerged. Mauceri’s left ankle puffed up, and the swelling spread to both legs and his abdomen. He gained 30 pounds in two months due to fluid retention and struggled to fit into his clothes and tie his shoes. Meanwhile, his shortness of breath returned with a vengeance. “I could no longer function as myself,” he says. “I felt like I was trapped in someone else’s body.”
Mauceri’s plight concerned his physicians, too. “I’d never seen him so sick,” says Dr. Samuels.
Although standard cardiac ultrasounds did not demonstrate a definitive cause, Dr. Samuels suspected a heart problem might be the culprit. He sent Mauceri to cardiologist Adam H. Skolnick, MD, the Charles Aden Poindexter Associate Professor of Medicine. Dr. Skolnick is a member of NYU Langone Heart, a constellation of clinical services across the institution’s 7 inpatient locations and more than 70 physician practices. Cardiology and cardiothoracic surgery are key components of the center, and its experts work closely with those in other specialties to ensure that patients with complex conditions receive optimal care.
“When a patient presents with this type of swelling, we start by considering the most common causes and then work our way to the less likely possibilities,” Dr. Skolnick explains. “Could it be heart failure? Liver or kidney dysfunction? Blood clots? A cancer recurrence? As the saying goes, ‘When you hear hoofbeats, think horses, not zebras.’”
One thing was certain: Mauceri’s doctors had to move quickly, before the fluid buildup sent him into multiple organ failure. After draining another two liters from his lungs, the care team—now including Dr. Skolnick, Dr. Samuels, and Dr. Grossbard—ordered test after test, working to uncover the cause of his condition.
By early May, evidence swayed Dr. Skolnick to consider a zebra: constrictive pericarditis. In this rare condition, the protective sac around the heart—the pericardium—becomes thickened and rigid, impairing the organ’s ability to pump blood. The disorder can result from an infection, an autoimmune disorder, or an adverse reaction to certain medications, but its origin often remains unclear. While other types of pericarditis cause sharp chest pain, the constrictive variety is typically painless and can’t be detected via an electrocardiogram or echocardiogram.
To confirm his hunch, Dr. Skolnick ordered a cardiac catheterization, a procedure in which a thin, flexible tube is threaded through blood vessels to the heart. The test showed abnormal intracardiac pressure readings, which strengthened the case for diagnosing constrictive pericarditis. A follow-up MRI scan revealed thickening and inflammation in the pericardium, adding further validation.
The only way to definitively diagnose the disorder, however, is through open surgery. For that, Dr. Skolnick referred Mauceri to Eugene A. Grossi, MD, the Stephen B. Colvin, MD, Professor of Cardiothoracic Surgery.
On June 5, 2024, Dr. Grossi embarked on the three-hour procedure. Sure enough, the normally flexible, stretchy protective sac had been transformed into a stiff, leathery pouch. Fortunately, the pericardium is not essential for normal heart function, and removing it is the gold-standard treatment for constrictive pericarditis. “It’s like the heart is a hard-boiled egg, and we’re peeling off the shell,” Dr. Grossi explains. “When the entrapment is released, most patients experience complete relief from their symptoms.”
Mauceri was discharged a week after the surgery. He quickly lost his fluid weight and regained his customary energy. By September 2024, he was able to attend the bar mitzvah of Dr. Samuels’s sons. Soon afterward, he conducted concerts in London, Paris, and Japan. “I feel like I did back in college,” he marvels.
Although music and medicine are very different fields, Mauceri sees his NYU Langone doctors as kindred spirits: world-class professionals who are passionate about their work and who tackle extraordinary challenges with both skill and orchestral precision. “We are all healers, though I do it with music,” he says. “The rapid response and creativity of my care team is a truly uplifting example of humanity. They’ve given me the gift of extra time, and I plan to use every minute of it.”
