The Art of Medicine

An excerpt from "The Art of Medicine: Thoughts on a G String" from The Lancet (2009):

There have been writings about the relation between
medicine and the listening aspects of music, but nothing
on the playing of music. Why do so many doctors pursue
music? Why does the orchestra of doctors in Boston (the
Longwood Symphony) receive audition inquiries on a
daily basis?

Mark Jude Tramo, a neurologist, songwriter/musician,
and director of The Institute for Music and Brain Science
at Harvard and Massachusetts General Hospital, feels that
“there is overlap between the emotional and social aspects
of relating to sick patients and communicating emotion to
others through music…Some would speculate that there is
[also] an overlap between aptitude for science, which most
premeds major in, and for music.”

Lisa Wong—violinist, paediatrician, and president of
the Longwood Symphony Orchestra—speaks for the
many who came to medicine after years dedicated to
serious musicanship. “The music we create builds in us
an emotional strength, sense of identity, and sense of
order. Then it is given away—we play for others, we play in
ensembles. We come to medicine and it is the same thing.
The giving, the service—in music and medicine—is a natural
connection.”

I was surprised to find my eyes watering after reading the article. Surprised to find myself laughing sighs. It struck me as a deeply personal grasp of my own motive for becoming a doctor, and I suppose an afirmation of it in some way other than my own head was more than just reassuring.

The musician touches others through music--a statement banal enough. What gets less noticed are transformations music brings upon the musician. Music is a beautiful gift, and all the more beautiful because it has helped me realize that medicine works the same way, and beyond. Music and medicine are about sharing something beautiful, about creating something extraordinary together—musician and listener, physician and patient. Musicians may craft an experience to bring their listeners adventure, escape, relief; Doctors may craft an experience to bring their patients life. Sometimes life seems so ordinary that we forget that it is extraordinary. Yet, life—is something more beautiful, far richer than any song could express. Medicine, music, and most things I suppose, are about touching others.

Happiness Through Health and Music

“Music has Charms to soothe a savage Breast / To soften Rocks, or bend a knotted Oak.”

-William Congreve

I came across Regimens: Soothing Melodies for Cancer Patients from the New York Times this morning, stating that new research suggests that listening to music may reduce pain and anxiety in cancer patients. This research isn't new per say, the original paper is actually a systematic review paper that put together data from 30 trials.

Here is the plain language summary:

Having cancer may result in intense emotional, physical and social suffering. Music therapy and music medicine interventions have been used to alleviate symptoms and treatment side effects in cancer patients. In music medicine interventions, the patient simply listens to pre-recorded music that is offered by a medical professional. Music therapy requires the implementation of a music intervention by a trained music therapist, the presence of a therapeutic process, and the use of personally tailored music experiences.

This review included 30 trials with a total of 1891 participants. The findings suggest that music therapy and music medicine interventions may have a beneficial effect on anxiety, pain, mood, quality of life, heart rate, respiratory rate, and blood pressure in cancer patients. Most trials were at high risk of bias and, therefore, these results need to be interpreted with caution.

Although music has been used for pain relief since the ancient times, only recently has music come under empirical scrutiny for pain management in clinical settings, with a focus on postoperative, labor, and chronic pain, three common types of clinical pain. 

Looking at various papers on music interventions, the mechanism underlying music’s pain reducing abilities have been largely attributed to the psychological factors of distraction and relaxation. Other physiological explanations seem to relatively neglected. However, in the end, the psychological mechanisms are inherently physiological themselves, perhaps mediated by a spinal mechanism. So in the end, the gate control theory of pain may serve as an uniting mechanism to explain the beneficial impact of music intervention on pain management.

Though it may not be clear how music heals, one thing is clear: it doesn't hurt to have music. Research isn't necessary for us to know that. As a doctor, I'll take advantages of music to connect with patients. Doctors spread happiness through health, and musicians do so with music. So, why not do both?

Music in Medicine at MA General Hospital: Dr. Conrad

Chronicles of Boston Breakout: Day 3
After the music therapy session, we went to the Massachusetts General Hospital to visit Dr. Conrad, a surgeon and the Director of the Music in Medicine Research group . Here is a bit of background information about Dr. Conrad:

Claudius Conrad, Director of Music in Medicine of the Department of Surgery and the Benson Henry Institute for Mind Body Medicine, is well-known for his work understanding the role of music in modern medicine. He holds an MD, a doctoral degree in stem cell biology, and a doctoral degree in music philosophy from the University of Munich. He has been awarded several honors for his work, including the Excellence in Research Award, the Leadership Award of the American College of Surgeons, Steinway Artist, and many others. As a trained concert pianist and lecturer, he promotes the scientific use of music in medicine at prominent institutions around the globe.

Dr. Conrad gave us an informative lecture on his research on how listening to music (Mozart) helps performance (performing surgical procedures and motor control tasks). The results of his studies show that listening to Mozart decreases stress (by measuring stress indicators in the blood), and improves motor performance. In one study, subjects were asked to perform motor tasks, similar to surgical procedure tasks, in either a silent, dichotic music, mental loading, or Mozart condition. The results showed that subject's speed and accuracy in the tasks increased in the Mozart condition. Also, the blood samples taken from the participants showed that those in the Mozart condition had lower indicators of stress and that nurses (blind to the study) rated those subjects as more relaxed. See the paper, "The effect of defined auditory conditions versus mental loading on the laparoscopic motor skill performance of experts" published in Surgical Endoscopy, 2010.

What really astounds me is how Dr. Conrad is able to do such research, be a surgeon, and a touring concert pianist at the same time. He told us he attended medical school and a music conservatory at the same time!

For more on the music in medicine research Dr. Conrad does, check out this video: "Music in Medicine--Dr. Conrad"

Dr. Seibel and Healthrock. The new Schoolhouse Rock...for medicine?

Chronicles of Boston Breakout: Day 3
This afternoon, we visited Dr. Seibel for a fun informal discussion at the Boston Medical Center. What a treat! He played us songs on his guitar from Healthrock, a creative music business he created similar to Schoolhouse Rock, except related to medicine and health education. Now here's a doctor who brings creativity and music to his motto of "It's better to stay well than to get well." Here's more about Dr. Seibel and Healthrock:

Dr. Seibel founded HealthRock® (www.healthrock.com) to make health education fun and easy to remember. His songs go in one ear...and Rock the other! As DocRock™ he leaves audiences smiling and singing his songs long after his presentations are over. He has written 12 musical CDs, the songs and lyrics to three musical comedies and has spoken at the US DHHS, the CDC and at professional meetings, schools and companies across the country. His motto is: “It’s better to stay well than to get well.” You can learn more about Dr. Seibel at www.MSeibelMD.com.

During our discussion, Dr. Seibel treated us to his very own performance of his own songs on the guitar, singing the lyrics with great energy along the way, ranging from Gospel to rap, on topics from colonoscopy and mammograms to healthy eating habits. It was such a delight seeing his enthusiasm and enjoyment as he performed. It certainly was contagious, and we enjoyed it very much! It was especially fun hearing his little improvised song to welcome us, along the lines of "greetings to students of Princeton University, thank you!" Well thank you, Dr. Seibel, for showing us the widespread powers of music to not just entertain, but to educate and heal. Well, Dr. Seibel asked for a testimonial so here's mine:

He left us college students with some parting words of wisdom:
"Try to think where you're going. It's important to know how you think in the long run. Explore, and then stick with your goal."

I'm inspired by Dr. Seibel's ability to bring his passion and creativity into his medical practice. In his words, I'm "sticking with my goal" to do so as well.