NEW YORK – The pianist Alice Sara Ott, barefoot and wearing a silver bracelet, was smiling and singing to herself the other day as she practised a jazzy passage of Ravel at Steinway Hall in Midtown Manhattan. A Nintendo Switch, which she uses to warm up her hands, was by her side. A shot of espresso sat untouched on the floor.

“I feel I have finally found my voice,” Ott said during a break. “I can finally be myself.”

Ott, 35, who made her New York Philharmonic debut on April 4, has built a global career, recording more than a dozen albums and appearing with top ensembles. She has become a force for change in classical music, embracing new approaches (playing Chopin on beat-up pianos in Iceland) and railing against stuffy concert culture (she performs without shoes, as she finds it more comfortable).

And Ott, who lives in Munich and has roots in Germany and Japan, has done so while grappling with illness.

In 2019, when she was 30, she was diagnosed with multiple sclerosis. She said she has not shown any symptoms since starting treatment, but the disorder has made her reflect on the music industry’s gruelling work culture.

“I learnt to accept that there is a limit and to not go beyond that,” she added. “Everybody knows how to ignore their body and just go on. But there’s always a payback.”

Ott has used her platform to help dispel myths about multiple sclerosis – a disorder of the central nervous system that can cause a wide range of symptoms, such as muscle spasms, numbness and vision problems.

She has taken to social media to detail her struggles and to challenge those who have suggested that the illness has affected her playing. She said she felt she had no choice but to be transparent, adding it was important to show that people with multiple sclerosis could lead full lives.

“I don’t consider it as a weakness,” she said. “It’s a fact. I live with it. And I don’t want to make a big drama out of it.”

Conductor Elim Chan, who performed with Ott a few months after she began treatment, said that from the start, Ott had a “don’t baby me” attitude about her illness.

“She is able to go to a very beautiful and fragile place, but it’s also very honest and has integrity within it,” Chan added. “Then she flies from there. And that is something I find very beautiful.”

Ott was born in Munich to a Japanese mother, a piano teacher, and a German father, an electrical engineer. She began piano lessons at age four, drawn to the expressive power of music. When she was 12, she started commuting to Salzburg, Austria, to study with renowned teacher Karl-Heinz Kammerling.

After winning a series of prizes, her career took off, and at 19, she signed with prestigious music label Deutsche Grammophon. Still, she began to feel uneasy about classical music’s emphasis on tradition in programming, concert formats and dress.

She sometimes faced sexism. A colleague once told her to play a passage of Beethoven like a “cute little Japanese woman”, she said. And her packed touring schedule was taking a toll on her as a musician, she added.

She began to forge her own path, working with artists such as experimental composer Olafur Arnalds to record reimagined versions of Chopin. Eager for a more rugged sound, they went searching for out-of-tune pianos in bars in Reykjavik, Iceland.

In 2018, while on tour in Japan, Ott began to experience health problems, feeling some numbness in her lips and later having difficulty walking.

Doctors said her symptoms were probably caused by stress. But when she returned to Munich after another tour a few months later, half of her body went numb. After undergoing tests, she received her diagnosis – relapsing-remitting multiple sclerosis, the most common form, in which symptoms can flare up and dissipate.

At first, Ott said, she was scared and panicked. But she also worried about upsetting her family. “There were lots of times when I just locked myself somewhere and cried.”

Her only knowledge of the illness came from the story of Jacqueline du Pre, the British cellist who died of complications from multiple sclerosis at age 42 in 1987.

On the day Ott received her diagnosis, she lost control of her left hand while playing a Chopin nocturne at a recital in Munich. She ran offstage, sat on the floor and cried, and cancelled the rest of the concert.

But as Ott read about modern treatments, she grew more optimistic, especially since her illness was in the early stages. In February 2019, about a month after her diagnosis, she posted about it on Instagram.

She wrote: “An acknowledgement is not a weakness, but a way to protect and gain strength, both for oneself and for those around us.”

Ott was praised for her courage. When she toured, musicians approached her to share their experiences with multiple sclerosis. But her health challenges also drew scrutiny.

When a critic reviewing one of Ott’s albums last autumn suggested that its inclusion of some easier pieces was related to her multiple sclerosis, she shot back. On Instagram, she noted that she had explained her choice of repertoire and that she had plans for more albums. She said that such reductive labelling was “the exact reason why it’s still so hard for many to come out and talk about their own conditions”. NYTIMES