Billy Joel is telling fans directly: he is not going anywhere. The 77-year-old musician says he is doing better after receiving a brain shunt to treat normal pressure hydrocephalus, a diagnosis that forced him off the road last year, and he is now following doctors' recommendations as he works through physical therapy.
Joel said his balance, memory, and overall ability to function have all improved since the procedure, according to the Chicago Tribune. He initially found the idea of having a tube implanted in his brain unappealing, he said in a SiriusXM interview, but he is now assuring supporters that he is alive and well. Hydrocephalus is an abnormal buildup of fluid in the brain, and doctors treat it by surgically implanting a shunt — a flexible tube that diverts excess cerebrospinal fluid from the brain's ventricles to the abdominal cavity, according to the Mayo Clinic. Shunts require long-term monitoring because of the risk of blockage or mechanical failure, the same source notes.
A Diagnosis That Followed a Grueling Schedule
Joel, a New Yorker who built one of music's most demanding late-career touring schedules, closed out his record-breaking 11-year monthly residency at Madison Square Garden on July 25, 2024, completing his 150th lifetime performance there after grossing more than $260 million, according to Best Classic Bands. He also performed at Allegiant Stadium in Las Vegas that November. Less than a year later, in May 2025, he canceled a string of shows — including a Madison Square Garden gig — and announced he was canceling all concert appearances to focus on treatment.
Doctors had told him that playing rock music very loudly gave him something like a concussion every time he performed, Joel said, per the Tribune's report. That warning, tied to his 2025 hydrocephalus diagnosis, is part of why his long-term touring future remains uncertain even as his recovery progresses. Any return to the stage during his recovery remains uncertain.
An Underdiagnosed Condition Gets a High-Profile Face
Normal pressure hydrocephalus is clinically marked by a classic triad often summarized in medical training as “wet, wobbly, and weird” — gait instability, cognitive impairment, and urinary incontinence — per the National Institute of Neurological Disorders and Stroke. It is also discussed in relation to dementia. The condition affects older Americans and can be misattributed to conditions like Alzheimer's or Parkinson's disease, according to the Hydrocephalus Association.
Mourning a Collaborator Who Shaped His Early Career
Joel's health update arrived just days after he posted a message mourning the death of Jon Small, his longtime friend and collaborator, whose family identified cancer as the cause of death, though no official cause had been disclosed in wider coverage. Small died September 4 at age 79 at his home in West Palm Beach, Florida. A funeral was held September 9 in Great Neck, New York, and Joel confirmed the death publicly on social media September 8, according to AXS TV.
Small, a former drummer, played alongside Joel in the 1960s Long Island band The Hassles and later in the hard-rock duo Attila before he became a music video director and producer. That band dissolved in 1971 after Joel had an affair with Small's then-wife, Elizabeth Weber — who married Joel in 1973 before their 1982 divorce — though Small later drove Joel to the hospital after a suicide attempt, and the two eventually reconciled and resumed working together professionally. The Hassles were inducted into the Long Island Music and Entertainment Hall of Fame in June 2025.
Small went on to direct Aerosmith and Run-D.M.C.'s landmark 1986 “Walk This Way” music video and earned a Grammy nomination for Joel's “Live at Yankee Stadium” concert film, per AXS TV's report. He also worked on Joel's videos for “Baby Grand” and “Tell Her About It.”
Joel's turbulent path with his oldest musical partner and his own uncertain path back to the stage make for parallel stories converging in the same week: one closing a chapter, the other still being written. For now, he says he is following his doctors' recommendations, continuing physical therapy, and simply reminding fans, as he put it, that he's still here.
