The extent to which Mahler's condition disabled him is unclear; Alma wrote of it as a virtual death sentence, though Mahler himself, in a letter written to her on 30 August 1907, said that he would be able to live a normal life, apart from avoiding over-fatigue.
Alma kirjutas, et see on praktiliselt sama mis surmanuhtlus, Mahler kirjutas aga 30. augustil 1907, et on võimalik elada normaalset elu, kuid ei tohi end üle koormata.