Table Of ContentPhys.Perspect.17(2016)354–360
(cid:2)2015SpringerBasel
1422-6944/16/040354-7
DOI10.1007/s00016-015-0171-y Physics in Perspective
Einstein Up in Smoke
John Lisle*
Albert Einstein’s biographers have not explained why he developed the abdominal aortic
aneurysm that led tohis death. Early conjectures proposedthat it was caused by syphilis,
without accurate evidence. The present article gives evidence to the contrary, and argues
thattheprincipalcauseofEinstein’sdeathwassmoking.
Key words: Albert Einstein; smoking; pipe; abdominal aortic aneurism.
Many writers associate Einstein’s genius with his pipe. One night in May 1905,
Einstein made a breakthrough toward the special theory of relativity. Describing
thatevening,onebiographerasked,‘‘Howdidhespendit?Hesurelyindulgedin
his old habit of smoking pipes and cigars while scribbling on countless scraps of
paper.’’1SurelyEinsteinwassmokingwhenhehadhisbreakthrough.In1930,the
New York Times ran the front-page story ‘‘Einstein Evolving Yet Another The-
ory,’’ describing the man as ‘‘calculating, jotting down figures and symbols,
checking equations, smoking his pipe when he has not forgotten to light it.’’2 A
similar article described him pondering the nature of the universe: ‘‘Out of this
thought experiment and pipe smoking new basic laws of behavior are expected,
laws such as those of Euclid and Newton that lead to new systems of mathemat-
ics.’’3 After Einstein’s death, his friend and doctor Ja´nos Plesch wrote some
reminiscences of the man, noting, ‘‘The greatest help in his work was his pipe.’’4
Such anecdotes are exaggerations, yet the alleged link between Einstein’s genius
and his pipe smoking persists, as it does with the fictional Sherlock Holmes.
But strangely, nobody links Einstein’s smoking habit with his death. Not one
account of Einstein’s death in thebiographiesby Jeremy Bernstein, Denis Brian,
RonaldClark,AlbrechtFo¨lsing,WalterIsaacson,Ju¨rgenNeffe,orAbrahamPais
mentionssmoking.5Atmost,somebiographersmentionhisdoctor’sorderstostop
smoking after surgery. Even medical articles discussing Einstein’s death have
neglected to connect his smoking with his chronic ailment.6
ForEinstein,smokingpipetobaccowasadailyritual.Hewrote:‘‘Diet:smoke
like a chimney.’’7 His favorite brand was ‘‘Revelation’’ by House of Windsor.
Whenill,Einsteinsometimesstoppedsmokingfollowinghisdoctor’sorders.After
an ailment in 1915, he wrote to friends, ‘‘I am feeling quite fine … I recuperated
*JohnLisleisagraduatestudentinthehistorydepartmentoftheUniversity ofTexasat
Austin.
354
Vol. 17(2016) Einstein Upin Smoke 355
well,particularlyaftermakingthetoughdecisiontogiveupsmokingentirely.’’8In
1920,Einsteinhadto‘‘abstainfromsmokingduringhisseveregastricillness.’’He
resumedthehabitsoonafterwards.9RelentingtohiswifeElsa’sdemands,Einstein
agreedtoabstainfromsmokingonThanksgiving,1934,untiltheNewYear.‘‘You
see,’’hesaid,‘‘Iamnolongeraslavetomypipe.Iamaslavetothatwoman.’’10
Right after New Year’s, he lit up again.
By1947,hehadstoppedagain.Whenavisitorthenofferedhimsometobacco,
Einstein passively remarked, ‘‘No, thank you. My doctor has forbidden me to
smoke. Personally, I don’t think it would affect me. But my doctor is a sensitive
man—and I don’t want to hurt him.’’11 Ja´nos Plesch summed up Einstein’s ‘‘de-
votion to tobacco,’’ writing: ‘‘He is hardly ever to be seen without a pipe in his
mouth, except when it is a cigar instead. A good cigar is a real pleasure for him,
anditslightingupaceremony.Officiallyhiswifeallowedhimonecigaraday,and
outwardlyhesubmittedtothisdiscipline,butinhisroomtherewasalwaysaboxof
cigars kept replenished by good friends in the innocent conspiracy to throw dust
into Frau Elsa’s anxious eyes.’’12
Tocircumventhisdoctors’orders,hisgrandsonBernhardrecalledthattheold,
frumpy Einstein picked up cigarette butts off the street in Princeton.13 Plesch
corroboratedthisstory,rememberingEinsteinas‘‘ashamedofhisownweakness’’:
Heusedtogoeverydaytohisinstitutetakingthepathacrossthemeadow.But
going that way, he never had the chance to find cigars and cigarette ends, and
therefore since the ban on smoking had been imposed on him he preferred to
goalongthestreet,wherehecouldfindenoughcigarandcigarettebuttstofill
his pipe, so that he could smoke without being noticed. He did not want to
offend his doctor by not following the prescription, but he had made up his
mind that he would very soon ignore the ban quite openly.14
Pleschfeltsorryforhisoldfriendand‘‘resolvedthatthiskindofsubterfugeshould
neverbenecessaryagain.FromthenonIsuppliedhimwithtobaccoandcigars.’’15
Presumably, Plesch saw himself as a good friend in the ‘‘innocent conspiracy.’’
Plesch’s son Peter recalled that his father ‘‘never realized the relation between
smokingandlungdiseases,especiallylungcancer.Hehimselfwasanenthusiastic
smokerandprescribedsmokingasarelaxantandsedativetonervouspatients.’’16
Einstein endured many health problems throughout his life, including a liver
ailment, gastric ulcers, jaundice, congestive failure, hemolytic anemia, and a
dangerous abdominal aortic aneurysm (AAA). In December, 1948, surgeon
Rudolph Nissen performed life-extending surgery on Einstein by wrapping cel-
lophane around the aortic aneurysm. A photograph shows Einstein leaving the
hospital soon after surgery, sitting in a car—and holding his pipe (Fig. 1). Once
againhetriedtoquitsmokingaftertheoperationandwastemporarily‘‘reducedto
suckingonacoldpipe.’’Whenhereceivedtobaccoasagifthegaveittoafriend
after first sniffing it.17
356 J.Lisle Phys.Perspect.
Fig.1. EinsteinleavingtheBrooklynJewishHospitalaftersurgeryforhisaorticaneurysm,pipe
inhand.Credit:JournalofSurgery,GynecologyandObstetrics(ref.6).
In 1950, more than half the adult men in the US were smokers.18 That same
year, when he was seventy, Einstein accepted a lifetime membership in the
Montreal Pipe Smokers Club. It had been fifteen months since his surgery. He
wrotetotheclub’spresident,‘‘Pipesmokingcontributestoasomewhatcalmand
objective judgment in our human affairs.’’19 In April, 1955, his ‘‘grapefruit-sized’’
aneurysm finally ruptured, causing severe pain. Einstein experienced internal
bleedinganddiedthenextmorning.Indeed,ofthosewhosufferarupturedAAA,
‘‘mortalityis85to90%.Ofthosepersonswhoreachthehospital,only50to70%
survive.’’20 Einstein refused further medical assistance after he predicted his
imminent end, saying, ‘‘I want to go when I want. It is tasteless to prolong life
artificially; I have done my share, it is time to go. I will do it elegantly.’’21
Dr. Plesch tried to determine the origin of Einstein’s AAA. He conjectured
thatsyphiliswastheculprit,sayingthatEinsteinwas‘‘astronglysexualperson.’’22
Knowing of the physicist’s escapades with various women, Plesch asked: ‘‘Why
such a healthy and good-looking man should not have been unlucky and acquire
syphilisinoneofhisadventures.InmylongmedicalpracticeIhavefoundalmost
without exception that abdominal aneurysms are of syphilitic origin.’’23 He bol-
stered this conjecture with the argument that Einstein suffered from ‘‘extensive
secondary anaemia attacks,’’ which Plesch thought indicated an earlier syphilitic
infection. But then, Plesch remarked, ‘‘It might, of course, be that Einstein was
exceptionalinthatrespecttooandthathisaneurysmwasnon-specific.’’24Einstein
biographerJeremyBernsteindismissedthisdiagnosis,‘‘IamnotaphysicianbutI
would put this in the same category as the advice—provided in an appendix to
[Plesch’s]autobiography—toexposeyoungchildrentotanningmachinesinorder
to prepare them for exposure to the sun.’’25
ContrarytoPlesch’simpression,syphilisandAAAinthedescendingaortaare
seldom linked. ‘‘In the prepenicillin era (1936) … only 136 [aortic aneurysms
collected from the literature] were below the diaphragm, of which 1 of 10 were
causedbysyphilis,demonstratingtherarity.’’26Anotherpaperfurtheranalyzesthe
connection between syphilis and AAA; when late vascular manifestations of
syphilis go untreated, ‘‘syphilitic aortitis is reported in 70–80%,’’ of which 10%
Vol. 17(2016) Einstein Upin Smoke 357
experience ‘‘significant cardiovascular complications’’ like AAA. Out of that
already narrowed field, the descending aorta is the least likely (15%) affected
segment.27Summingup, justover1%(15%of10%of70–80%)ofuntreatedlate
vascular manifestations of syphilis result in an AAA in the descending aorta,
which is a low incidence rate.
EvenfifteenyearsbeforeEinstein’sdeath,peoplewerearguingagainstastrong
connection between syphilis and AAA. In 1941, the medical journal The Lancet
published a note by M. H. Pappworth on ‘‘Abdominal Aneurysm and Syphilis’’
aboutamisleadingreportthatclaimedthatsyphiliscausedAAA.Thereportonly
quoted one modern author, who ‘‘deduced that 39 of his 73 cases were due to
syphilis.Butof38ofhiscasesinwhichpost-mortemrecordsaredescribedonly5
hadmicroscopicevidenceofaorticsyphilis.’’28Thesenumbersarenotinsignificant,
but they certainly do not support the conjecture in Einstein’s case, especially
becausenosignsormanifestationsofsyphilisinanypartofhisbody,includinghis
dissected brain, were found.29
There is, however, an undeniably close connection between abdominal aortic
aneurysmsandsmoking.Ina2014informationsheetforpatientswiththedisorder,
‘‘Albert Einstein and Aortic Aneurysm,’’ Dr. Fe´lix Ramı´rez states, ‘‘90% of the
Fig.2. Einstein with his pipe—the tobacco can in front was his favorite brand, ‘‘Revela-
tion.’’Credit:PermissionbyProfessionalSportsAuthenticator(PSA).
358 J.Lisle Phys.Perspect.
peoplewithAAAhaveahistoryofsmoking.’’Still,Ramı´rezdoesnotmentionthat
Einstein smoked.30 In an ‘‘Analysis of Risk Factors for Abdominal Aortic
Aneurysm in a Cohort of more than 3 Million Individuals,’’ 80.22% of people
developingAAAsmoked.31Onestudyfoundthatcurrentsmokerswere7.6times
more likely to have AAA than nonsmokers.32
AnotherarticleintheNewEnglandJournalofMedicinestatesthat‘‘Smokingis
thestrongestmodifiableriskfactor’’forthosewithAAA.‘‘Theprevalenceandsize
of aneurysms are strongly associated with both the amount and duration of
smoking; cessation of smoking can reverse this risk and is associated with a
reduced rate of aneurysmal growth.’’33 In the book Aortic Aneurysms: Pathogen-
esis and Treatment, Dr. B. Timothy Baxter writes that, ‘‘AAA is more closely
associated with cigarette smoking than any other tobacco-related disease except
lung cancer.’’34
Although several studies focused mainly on cigarette smoke, another study
found no association between AAA and the type of tobacco used, whether pipe,
cigar, or cigarette.35 Though non-modifiable risk factors for AAA include older
age, male sex, and a family history, the US Preventive Services Task Force now
‘‘recommends one-time screening for abdominal aortic aneurysm (AAA) with
ultrasonography in men ages 65 to 75 years who have ever smoked.’’36
Einsteindiedattheageof76.Oneofhispipeshasbecome‘‘themostpopular
object in the Modern Physics collection’’ at the National Museum of American
History.37 Einstein compulsively gnawed a hole through its bit. With high prob-
ability,wecannowsaythatthesamepipethatgaveEinsteinaniconicimageand
brought him comfort also ensured his demise. Regardless, Einstein lived as he
wished—irreverently. He once wrote: ‘‘You may believe that smoking is bad for
your health and nevertheless be a smoker. And this holds true for all the evil
impulses that poison life’’38 (Fig. 2).
Acknowledgments
IthankProf.AlbertoA.Martı´nezandProf.AbenaDoveOsseo-Asareforhelpful
suggestions and encouragement in writing this article.
References
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2ClarenceStreit,‘‘EinsteinEvolvingYetAnotherTheory,’’TheNewYorkTimes,July27,1930.
3‘‘Dr.EinsteinConsultsCaliforniaPhysicists,’’TheNewYorkTimes,January4,1931.
4PeterPleschandJa´nosPlesch,‘‘SomeReminiscencesofAlbertEinstein,’’NotesandRecordsof
theRoyalSocietyofLondon49(1995),320.
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11Quoted in Leonard Lyons, ‘‘Einstein Has Pipes, but Won’t Smoke,’’The Austin Statesman,
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1947),213.
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Einstein-eccentric-genius-smoked-butts-picked-up-off-street.html.
14PleschandPlesch,‘‘ReminiscencesofAlbertEinstein’’(ref.4),320.
15Ibid.
16Ibid.,328n15.
17JamieSayen,EinsteininAmerica(NewYork:Crown,1985),222.
18‘‘AchievementsinPublicHealth,1900-1999:TobaccoUse—UnitedStates,1900–1999,’’Centers
for Disease Control Morbidity and Mortality Weekly Report, accessed October 4, 2015, http://
www.cdc.gov/mmwr/preview/mmwrhtml/mm4843a2.htm.
19‘‘EinsteinJoinsPipeClub,’’TheNewYorkTimes,March12,1950.
20K. Craig Kent, ‘‘Abdominal Aortic Aneurysms,’’The New England Journal of Medicine371
(2014),2101–8.
21QuotedinPais,SubtleistheLord(ref.5),477.
22PleschandPlesch,‘‘ReminiscencesofAlbertEinstein’’(ref.4)309.
23Ibid.,310.
24Ibid.
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26Jeyakumar Williams, Gopi Krishnan, and Hema Devarajan, ‘‘Syphilitic Abdominal Aortic
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Aorta,’’InteractiveCardiovascularandThoracicJournal14(2012),4450–71.
28M.H.Pappworth,‘‘AbdominalAneurysmandSyphilis,’’TheLancet237(1941),804.
360 J.Lisle Phys.Perspect.
29DianaKormosBuchwald,directoroftheEinsteinPapersProject,informsmethat,asfarasshe
isaware,theprojectdoesnotcontainEinstein’smedicalrecordsorautopsyreport.
30Fe´lix Ram´ırez, ‘‘Albert Einstein and Aortic Aneurysm,’’ Argentine Journal of Cardiology 83
(2014):250,http://doi.org/10.7775/rac.v82.i3.4089.
31K.CraigKentetal.,‘‘AnalysisofRiskFactorsforAbdominalAorticAneurysminaCohortof
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32TeunWilmink,CliveQuick,andNicholasDay,‘‘TheAssociationbetweenCigaretteSmoking
andAbdominalAorticAneurysms,’’JournalofVascularSurgery30(1999),1099–105.
33Kent,‘‘AbdominalAorticAneurysms’’(ref.20).
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inAortic Aneurysms: Pathogenesis and Treatment, ed. Gilbert R. Upchurch, Jr., and Enrique
Criado(NewYork:HumanaPress,2009),62.
35J.T.Powell,P.Worrell,S.T.MacSweeney,P.J.Franks,andR.M.Greenhaigh,‘‘Smokingasa
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36‘‘FinalRecommendationStatementAbdominalAorticAneurysm:Screening,’’U.S.Preventa-
tiveServicesTaskForce,accessedOctober4,2015,http://www.uspreventiveservicestaskforce.org/
Page/Document/RecommendationStatementFinal/abdominal-aortic-aneurysm-screening. It is
unclearwhetheranyapparentdelayinthewidespreadpublicgraspofthelinkbetweenAAAand
smoking was influenced by the tobacco industry’s strategy to obfuscate recognition of tobacco
healthhazards.ThisstrategyiswellchronicledinRobertN.Proctor,GoldenHolocaust:Originsof
the Cigarette Catastrophe and the Case for Abolition (Berkeley: University of California Press,
2011).
37‘‘Einstein’sBrierPipe,’’TheNationalMuseumofAmericanHistory,accessedOctober4,2015,
http://americanhistory.si.edu/collections/search/object/nmah_334905.
38AlbertEinstein,lettertoJohnCranston,May16,1951,reprintedinAlbertEinstein,Einsteinon
Peace,ed.OttoNathanandHeinzNorden(NewYork:SimonandSchuster,1960),556.
DepartmentofHistory,UniversityofTexasatAustin
128InnerCampusDr.,B7000
Austin,TX78712,USA
e-mail:[email protected]
