A 53-year-old male is emergently brought to the operating room for repair of a bleeding gastric ulcer. The patient is sedated from a previous upper endoscopy performed to diagnose the bleeding. The patient weighs 133 kg, has a bull neck, and has a known difficult airway. The patient’s heart rate is 140 and his blood pressure is 90/60 mm Hg. He is breathing spontaneously and has an oxygen saturation of 94% on room air. The surgeon is waiting. What is your plan?

A 48-year-old, 223 kg female is scheduled for a gastric bypass surgery. Her medical history is significant for osteoarthritis, hypertension, type II diabetes mellitus, and gastroesophageal reflux disease. She uses a continuous positive airway pressure (CPAP) machine at home. What are your concerns? How would you approach this patient? Are there any tests you would like to have before surgery? How would you induce anesthesia in this patient? What would you use for maintenance of anesthesia?

As Grisey's new girlfriend, Mireille Deguy became an essential part of his family life. When Raphaël was going through a tough phase as a teenager, he came to stay with them. Deguy fell into the role of disciplinarian by default. “Gérard wasn't able to be firm with his son because he felt guilty for leaving him when he was small,” she said. Raphaël recalled that he and his father had their “first real conversations” at this time. But Grisey didn't pass his love of classical music on to his son.

Like France Detry, Deguy also went to visit Lucie Monna, Grisey's mother, with him. She remembers the house as having a small interior but a large garden. They only went into the town of Belfort once; Grisey preferred to walk around the small hills, forests, and ponds by the village of Chèvremont. They enjoyed the view of what Alsatians call la ligne bleue des Vosges, the silhouette of the mountain range that separates the region from its neighbors. Deguy recalls that in this time, Grisey was thinking of leaving Paris for a place in the country, a desire strengthened by the time spent in the natural environment of his childhood home.

Like Detry before her, Deguy picked up on Monna's strictness. She realized Grisey and his mother couldn't interact on an intellectual or musical level. In photographs from these visits, Monna is as well put together as always, her clothes and her hair orderly, but her gaze is a little slack. In about 1995, Monna began to suffer from dementia. One day, she had a stroke and fell. Grisey felt he had no choice but to bring her to a nursing home, though he did so unwillingly. Claudia Doderer remembers Grisey calling her after a visit to the home in Belfort, shocked and sad, and saying, “Claudia, now I understand how the world works.”

According to Deguy, life in the nursing home was too difficult for Monna and she died after only six months. “In spite of everything, he was close with his mother,” Deguy said. To process his loss, Grisey began reading texts by the ancient Tibetans, Greeks, and Romans on death, and planning for the composition of Quatre chants pour franchir le seuil. In 1962, at the age of sixteen, Grisey had composed his first piece for his mother, the Petite Caprice en La.

Grisey's death followed the composition of his masterpiece on death. Originally a requiem for his mother, it became an autorequiem. It's an unsettling circumstance, made more so by the frequent references to death in his writings. In June 1998, he had said of the Quatre chants, “Why are the final decisions the most painful ones? Saying goodbye? Attachment? To what, from what?” Friends had memories of things that seemed prophetic in hindsight. “He was fascinated by death, as a symbol and as a fact,” Zinsstag said. Claudia Doderer remembered his flushed face after a particularly intense lesson, Wintle a surprisingly full medicine cabinet for what seemed to be such a healthy man. Jocelyne thought there might have been a connection between his mental anguish at the end of their relationship and the brain aneurism that ended his life.

But there is also evidence that Quatre chants was the beginning of a new stylistic era in Grisey's life, and that he never thought of the piece in connection with his own death. One example is the unfinished work based on the mirlitonnades. Many of Grisey's friends recalled that after completing the Quatre chants, he was exhilarated about the possibilities he had discovered. “He was going on and on about that piece, really the only time I’d ever heard him go on about his music,” Joshua Fineberg said. “He’d figured out what he needed to do.” A letter to the artistic director of the Donaueschinger Musiktage, Armin Köhler, shows that Grisey was already planning commissions past the year 2000. After the completion of Quatre chants, Grisey told George Benjamin how excited he was about this new-found stylistic independence; he called his friend Jean-Pierre Luminet and said he had found “a new language that begins with this composition.” He also spoke with Jean-Luc Hervé, who remembered something Grisey told him. “We are like onions,” Grisey said. “We shed our skin.” At the time of his death, the composer was the closest he’d ever been to his true self. He was fifty-two years old. “He died just as he was coming into focus,” Christopher Wintle said.

The French musical scene was stricken, having lost one of its leading artistic personalities. For the critic Cestin Cazaban, Grisey's death “opened a breach in a generation.” In Le Monde, Gérard Condé wrote, “Sudden, unexpected, the announcement of his death leaves us distraught.

In January 1991, Mireille Deguy, a dark-haired, fine-featured mezzo-soprano of Moroccan-Jewish heritage, went to the Maison de Radio France to listen to a concert at the Présence Festival of contemporary music. Deguy, an elegant woman with a certain warm formality, had studied voice in Aix-en- Provence in the south of France and in Lausanne, Switzerland. She worked with singers like the eminent German mezzo-soprano Christa Ludwig and studied at the Academy of the Opéra national de Paris, developing an interest in contemporary music.

Grisey was also at the Maison de Radio France that day, his head in the clouds. He had been overseeing the mix of a recording of Talea. But his mind was on something more ambitious: his massive new orchestral work, later to receive the title L’Icône paradoxale, for the Los Angeles Philharmonic.

When a mutual friend introduced Deguy to Grisey, she noticed his distraction, but also found him kind, and keenly interested in the singing voice. They discovered that they had a lot to talk about and began spending hours on the phone. “It was very simple, because I had the impression that he was someone I had already known for a long time,” Deguy said.

Within two months, Deguy and Grisey were together. “It happened very quickly,” Deguy said. “It was fate.”

But Grisey was still in a relationship with France Detry. Like Jocelyne, Detry was aware—and to a large extent reconciled—to the fact that Grisey was not the monogamous type. For Detry, it was important to grant Grisey the freedom to be with other women, first when he lived in Berkeley, then as he commuted between Brussels and Paris:

Like Jocelyne before, Detry remained a port in the storm of Grisey's erotic life.

In November 1965, Grisey moved to Paris. His new living quarters were at 20 rue de Monceau, in the eighth arrondissement. This address housed a Catholic lycée for children ages eleven to nineteen called Sainte-Marie de Monceau, now Lycée Fénelon Sainte-Marie. Grisey was almost certainly connected to the institution through his Marianist schooling in Belfort and was granted a tiny room of about sixty-five square feet and regular meals in exchange for doing small chores like sweeping classrooms, erasing blackboards, and washing dishes on the weekends for the nuns who lived on the premises (the lay teachers and the students lived elsewhere). On the outside, the building was a drab and dirty white, but at least it had a large communal balcony, and there was a piano in the dining room that he could practice on. A photograph from this period shows the slender, fine-featured young composer sitting at a desk, his chair rubbing up against the bed, with pictures of Greek antique art on the walls, a record player, and at least one LP with music by a Boulanger sister. The school was centrally located, and, for a boy from a working-class family, free room and board in Paris were not to be taken for granted.

On February 13, 1966, after a year and a half of silence, Grisey returned to writing in his “old journal.” At the Conservatoire National Supérieur de Musique he primarily attended courses in écriture. Though taught in many conservatories, Paris has undoubtedly one of the most difficult écriture programs in the world. Grisey would focus on this musical scaffolding for the next three years. His routine was rigorous, his focus almost single-minded: “I get up early and I go to Mass when I’m able. Then from 8:30 to 11:30, I compose. In the afternoon: accordion, piano, reading, studying scores, counterpoint, etc. In the evening: letters and listening to records.” On March 9, 1966, he admonished himself to “Work. Work, yes, work like the bees, with application, without looking to the right nor to the left, without comparing myself with others, without waiting to see the result nor what is left to do.” Evidently, Grisey found the difficulty of his studies at the Conservatoire less intimidating than invigorating.

As a young teenager, Grisey was preoccupied by his nascent sexuality, but also by religious ideals of purity.

As an adult, Grisey made frequent notes describing his dreams and state of mind. These jottings are often impossible to read. When they are legible, they offer valuable insights into his psychology. One such document, undated though likely from the mid-1990s, contains what seems to be a list of the desires and fears that motivated his id, in his own perception (or that of a psychoanalyst):

• • Rivalry with and imitation of my father

• • Fear of solitude (death of my grandmother), fear of death

• • A taste for pleasure, discovery, beauty

• • Substitution of one woman for another (if not pornography, fantasies, images)

• • A taste for risk, challenges, exceeding one's limits (going all the way)

• • A taste for play and the good things in life

• • Fear of homosexuality (= violence)

The first item on the list is classically Freudian. The fourth item, Grisey's awareness of his own need to be surrounded by women, will become relevant, both biographically and musically, in his adult life. To the contempo-rary reader, it is Grisey's “fear of homosexuality,” and the “equals violence,” that raises questions about his childhood.

But none of Grisey's many friends, lovers, and confidants could recall the composer mentioning that violence had been done to him. His written archives make no further mention of any such traumatic event. Guy Lelong, a writer and openly gay friend of Grisey's later in the composer's life, said that Grisey was not at all homophobic.

The abstract idea of rape makes the occasional appearance in Grisey's journals and in his writings on music. In one diary entry from the early 1980s, he wrote in a mysterious poem, “The Unknown rapes me.” In his 1982 article “Le devenir des sons” (“The Becoming of Sound”), he said that “musical form has something terrifying about it: it contains voyeurism and rape … .” He was pointing out that if we don't want to see an image, we can close our eyes; if we don't want to hear a sound, we can't close our ears, because they don't have lids. Sound penetrates us whether we consent to it or not. Like sex, sound is a pleasurable experience that must be entered into willingly. Otherwise, this experience is distorted into violence. Throughout his life, Grisey was extremely sensitive to unwanted noise.

On October 10, 1978, the Ministère de la Culture announced to Grisey that its Commission de Commandes Pédagogiques had awarded him a commission for a youth or amateur orchestra, for a fee of 5,000 francs. The piece that resulted from the commission was titled Manifestations.

Grisey's original concept was for a twelve-minute piece in four movements. He only completed the first movement, a study on the harmonic spectrum called Manifestations: … pour trouver le silence (Manifestations: … to find the silence), and the fourth, a musical joke named Manifestations: pour échapper à la television (Manifestations: to escape the television). He never finished the inner movements, though he did give them names and make notes on potential forms. The second, on the theme of acoustic beatings, was to be titled … pour avoir un air de joie ( … to have a sense of joy); the third, on white noise, was tentatively named pour que les arbres… . ( … in order for the trees). Several detailed sketches for … pour avoir un air de joie exist but were never composed through. They suggest that the finished piece would have included a significant spatialization component.

The two completed movements of Manifestations (initially called Incantations) add up to a minor work, meant to be easy to perform. But they still show the extent to which Grisey's spectral ideas of structure had become anchored in his thinking. This was not a hasty commission that he could just toss off; he made detailed and intricate sketches for the piece. The improvisatory compositions of his youth and the aleatoric or installation-like pieces of his student days were now permanently banished from his compositional method, even when the stakes were low.

In the first movement of Manifestations, the two flutes, each assigned to an orchestral group, have the most difficult parts. Grisey noted this in his sketches, suggesting that the piece was composed for a particular youth orchestra. Grisey assigns each flute pitches from a harmonic spectrum on C. Flute one gets the odd partials, flute two the evens. Each flute performs a series of durations which are varied but tend to decrease in length toward the middle of the piece before tending to increase again; the number of available pitches grows at the same time, meaning that each flute has a rigorously structured and clearly audible “intensity crescendo” toward the center of the movement.

From January 3 to March 31, 1980, Grisey participated in a course for composers at IRCAM, the musical research institute founded by Pierre Boulez at the Centre Pompidou in Paris. In these early days of the institute, the tech-nology was clunky, with even simple acoustic procedures requiring hours of labor. But the participants’ enthusiasm was palpable; the atmosphere was one of chaos, excitement, and fruitful exchange between science and art.

Grisey's teacher during the course was the eminent American psychoacoustician David Wessel, whom Boulez had brought to Paris in 1976. In the summer of 1980, Wessel was joined on the IRCAM faculty by Stephen McAdams, a Canadian researcher who specializes in music cognition and perception, topics of acute interest to Grisey. Wessel introduced Grisey to McAdams.

Grisey's interest was moving from the abstract concepts of traditional acoustics, explored in pieces such as Périodes and Partiels, to the messier realities of the human processing of sound. Grisey had wide-ranging conversations with McAdams throughout the early 1980s. They organized some “mini informal experiments” on the composer's idea of instrumental synthesis, where a spectral harmony strikes the ear as somewhere between a chord with distinct pitches and a single sound. This state of fragile fusion was of profound interest to Grisey at this point in his aesthetic development. “I remember hearing a rehearsal. Boulez was conducting a piece of Grisey’s,” McAdams recalled. “Boulez had a very analytical ear and he could hear anything out of anything, regardless of how complex it was. He was trying to make it so that he could hear everything. Grisey was like, ‘No, no, no, no. It's supposed to all melt together.’”

Grisey and McAdams tried to find the point where this state of fusion would disintegrate: when did certain pitches or overtones emerge to the extent that our brains would process them separately? How could the Western tuning of equal temperament be tweaked to achieve this spectral fusion without recourse to complex microtonal notation? The ultimate judge for the integration of these scientific experiments on instrumental synthesis in Grisey's music was a non-scientific one, namely Grisey and McAdams's “collective ears.”

McAdams was struck by the lack of boundaries in Grisey's thinking.

In April 1970, Grisey read Gravity and Grace (1947), by the legendary theologian and philosopher Simone Weil. It was auspicious reading for the young composer: Weil, a devout Catholic from a Jewish background, was a profound religious thinker who also “had a deep veneration for the great Hindu and Taoist writings,” as her editor Gustav Thibon writes. In additional to her ecumenicalism, Weil held a near-religious veneration for art. For her, as for Grisey, faith and musical listening were close to the same thing. Weil writes:

In other ways too, Weil's work dovetailed neatly with Grisey's instinct toward a less dogmatic, more mystical and sensual version of his Catholic faith. Gravity and Grace, written in aphoristic style, contains many ideas that Grisey integrated into his aesthetic, especially the equivalence between “extreme attention” and prayer and the insight that “Time does us violence; it is the only violence.” (The second idea resurfaces much later, in Grisey's Quatre chants pour franchir le seuil.) Weil had a carnal understanding of Christianity that aligned with Grisey's own: in Waiting for God, she writes, “God has provided that when his grace penetrates to the very center of a man and from there illuminates all his being, he is able to walk on the water without violating any of the laws of nature.”

Grisey wrote far fewer diary entries in the 1970s, making it impossible to trace his month-by-month development as in the previous decade. But the ones that do exist contain important aesthetic reflections. Reading Weil, Grisey emphasized the humanist distinction that Christ had not suffered for God but suffered for mankind on behalf of God. Returning to a theme of his youth, he also noted Weil's injunction to “be only an intermediary between the uncultivated ground and the ploughed field, between the data of a problem and the solution, between the blank page and the poem, between the starving beggar and the beggar who has been fed.”

Grisey's écriture classes at the Conservatoire National Supérieur were a constant in his student years. Several exercise books from that time remain: Grisey practiced figured bass accompaniment, counterpoint, harmony, and orchestration in notebooks that ran into the hundreds of pages. In a later interview, Grisey complained of this education, at once boring and difficult and destined to produce a generation of traditionalist-copycat composers:

Still, Grisey was a proficient and motivated student, and successfully mastered the requirements of the Conservatoire. He received first prizes in history of music (1966), harmony (1967), fugue and counterpoint (1968), and second prize in piano accompaniment (1970). The latter was especially impressive considering the piano wasn't his first instrument.

The only letters Grisey wrote between 1968 and 1970 were again during his breaks in Belfort. These letters were typical of the composer's youth: he avoided the prosaic in favor of the abstractly spiritual. On February 17, 1968, Grisey meditated on death in a letter to Jocelyne Simon, returning to a theme of his teenage years. “Death, too, so close and so far …” he wrote:

On April 10, from Belfort again, Grisey told Simon that he was reading Blaise Pascal's Pensées. The book contains much that appears relevant to Grisey's aesthetic. For Pascal, human nature was at its core a process of constant change, an idea that fits neatly into Grisey's later goal to write music of a “pure sonic becoming, mutating ceaselessly.” A famous passage in Pascal also parallels Grisey's later idea of the different planes on which his music operated, from the microscopic to the cosmic. “What is a man in the infinite?” Pascal wrote.