Having not written his First Symphony until age 51, in 1942, Martinu then proceeded to write one every year until 1946. He composed the Symphony No. 5, which was originally inspired by the Red Cross but in the end dedicated to the Czech Philharmonic, between January and May of 1946. Rafael Kubelik led the Czech Philharmonic in the work's premiere at the First Prague Spring Festival, on May 28, 1947. After No. 5, Martinu didn't return to the symphony form until 1953 and the Fantaisies symphoniques (also known as his Sixth Symphony).

The multifaceted and mercurial nature of the Symphony No. 5 to some extent mirrors Martinu's own state of mind at the time. Filled with great hope for the future at the end of World War II, in September 1945 Martinu was offered something of a dream teaching post—a professorship in the Master Class of Composition at the Prague Conservatory. He immediately accepted the position, but ended up having to wait until November 1946 for a reply from the Conservatory. In the meantime, he was given the chance to lecture at the Berkshire Summer Music School at Tanglewood, Massachusetts; it was in the months before he began teaching there that he wrote the Symphony No. 5.

Like the Symphony No. 3 that preceded it and the Fantaisies symphoniques that came later, the Fifth Symphony is in three movements. A three-note motif heard at the beginning of the work becomes the basis of the first movement, which is in five sections, alternating fast and slow tempos. There is a haunting quality in the movement's slower sections that is, however, dispelled by the lively, bucolic music of the faster ones. After the sparkling opening of the second movement Larghetto, a flute takes an extended solo over pulsating strings. The movement as a whole is rather playful, and more of a scherzo than a slow movement (it is meant to fulfil both functions). The finale begins with a poignant Lento. The body of the movement, largely Allegro, borrows both thematic material from the first movement as well as its strategy of alternating fast and slow sections. The movement turns aggressive at times, but is for the most part a lively and optimistic conclusion.

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