In 1876 Nietzsche broke with Wagner, and in the same year his increasingly bad health (the early effects of a brain tumor) compelled him to request a leave of absence from his academic duties at the University of Basel. In the autumn of 1876 he joined his friend Paul Rée in Sorrento, at the home of a wealthy patron of the arts, Malwida von Meysenbug, and began work on Human, All Too Human.