A post-election letter

Dear songwriters and aspiring songwriters,
If you are interested in connecting with a Trump or Hillary supporter, email me at hih.connect16@gmail.com. No musical experience necessary, just a willingness to listen and connect with an open mind and heart with someone we hope we can understand better. Details below:

Last night and today have been full of confusion and alienation for many of us. Into the early hours of the morning, we watched as it seemed we no longer knew the people of America. Paul Krugman shares the sentiment in his article "Our Unknown Country."

I think many of us are in despair over our country we love so dearly. I see from the flushed faces of friends, the posts of outrage on facebook, support groups at the medical center, and my sleepless tearful night, too. While we grieve and mourn, many of us feel an intense desire to do whatever we can to help.

The night before the election, I had an unexpected call conversation with Alan, a 68-year-old devoted Trump supporter in Alaska. Hillary's get-out-the-vote script told me to politely end the call with this Trump supporter, but I listened because he wanted to speak. I disagreed with him on most every issue, but after 30 min, I also heard about how he liked to go fishing, and how he wanted a better life.

I didn't change his mind about who to vote for in the slightest, but I developed fellow-feeling and connection with a man I would have previously thought unrelatable, and I think he felt at least somewhat similarly about me, too.

The fight towards understanding is not always palatable or easy. As I write and convince myself, it might not make sense. But sometimes the most important thing we can do is connect and heal on personal levels. For me, I know of no better medium to do so than through music.

Friends, if you are willing to try this, I ask you to email me at hih.connect16@gmail.com. You will collaboratively write a song with a Trump or Hillary supporter, and I or other musicians will guide you through the process of doing so. You do not need prior musical experience, only an open mind and heart to connect.

Our country is resilient and we will go forward. It starts with working together. We can connect with other stories and share our own—it's one small step towards healing our nation.

Email me at hih.connect16@gmail.com if you are interested in participating.

Andrew Bird and Atul Gawande on Music and Medicine

Dr. Gawande, my sister, and me at Dunkin' Donuts--jk, The New Yorker Festival!

My sister Lucy and I half-run half-skip to Gramercy Theatre in East-side downtown NYC. I check my watch as we exit the 23rd St 6 train subway—"Lucy, we're making good time: 6:55 pm!" Just 5 min before the show...

As we enter the there's this suspiciously festive red glow which reminds me of a BBC Proms moment in London's Royal Albert Hall, except it's The New Yorker Festival and I'm equally nerding out to see Dr. Atul Gawande and musician Andrew Bird in conversation. "Whoa, Lucy...I was kind of expecting a lecture hall or something..." Are you serious

Are you serious—no question mark—is the new album of Andrew Bird's. Andrew's music makes me think of the intimacy of Zoe Keating's one-woman looping cello orchestra with the energy of Joy Kills Sorrow's folksie-stringy-plucky drive. A classically-trained "true goth," as Dr. Gawande describes, Andrew casually remarks, "well, there's a reason why conservatories are called conservatories." A rebel, he wields his violin like a ukulele-turned-fiddle-turned-harmonica as he whips out what The New York Times describes his "inner operatic folkie." Lucy turns to me and whispers, "he makes me want to play the violin."

We listen as "Puma" fills the theater:

'Cause it gives rise to the rumor she's a girl and not a puma
And that light that shines is not a pearl, it's just a tumor
...
But the doctors, they told me to stay away
Due to flying neutrinos and the gamma rays, oh

"What is cancer?" Andrew ponders aloud, first as an aside; then, his eyes light up as it hits him—he's talking to a surgeon..."What IS cancer???" And in childlike curiosity, "I mean, does cancer have a reason for being there?" It was one of my favorite moments of the evening, as Dr. Gawande explains in true physician-educator style the mutations that give rise to cancer, and that the cells are trying to survive...

"Ah! So they have a will..." Andrew replies, somewhat-satisfied.

"I write about things I don't understand," says Andrew. Cancer. Fake palindromes. He also writes about "a lot of things we're not talking about as people," and sometimes his approach is from a "scientific angle that shows us what we're made of."

An audience member asks Andrew about the social responsibility of the artist. He says, "when it speaks from the heart, do it." But when the responsibility comes from external pressures, from "duty to speak out," it "usually doesn't go well."

I think music is one of the best mediums in which external motivations can start to dissolve, because art allows us to so naturally connect and start the feel that intrinsic understanding rather than the prescribed duty; the sense of what I get when I read a piece of fiction, like George Eliot's Middlemarch rather than one of those "develop kindness" books like David Brooks' The Road to Character (Rebecca Mead further makes the point).

After the talk, Lucy and I discuss over pizza and chocolate mousse cake (a delicious combination, by the way): how does the social responsibility of the artist compare to that of the physician? It's a question for us all as we ponder the boundaries of our professions, but in medicine in particular, there is the toxic notion that as long as we treat the biological disease, we're doing our job. But Dr. Gawande and many know otherwise. Gawande writes in Being Mortal,

We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival. But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive...

The chance to shape one’s story is essential to sustaining meaning in life; that we have the opportunity to refashion our institutions, our culture, and our conversations in ways that transform the possibilities for the last chapters of everyone’s lives.

I think tonight's conversation is about a sense of will. Why are we alive? It's about creating our own meaning, of crafting our own song, of breaking from classical traditions to create something richer—looping and whistling along. And the will of connecting with another, of seeing how our experiences are inherent in another's—whether between physician and musician, or any number of communities and identities. It's a testament to the power of listening and relating through music.

Our power to choose

Premiere of David Lang's "the public domain" for 1000 voices at the Lincoln Center. Lyrics: "Our power to choose"

"Where have you been? I wondered about you..." says the patient lying on the bed in front of me. Light streams in from the Hudson River, and I think how peaceful a time this is, how unchanged and natural it feels, to be seeing the searching calmness on this man's face. He has a gentle smile on.

Except that everything is not the same. It had been a week since I had seen my patient. On my last day on the wards, I told him I needed to help this world make music. And he said, "go do it."

I came back for a practical purpose--to pick up my tablet. I had stalled long enough. Part of this seemed symbolic. I'd given him my tablet so he could talk to his family; I'd entrusted a part of me to him. So maybe I stalled because telling him felt like a statement bigger than any meeting with a dean or signing of a contract.

Donned in my white coat, he asks me the usual questions--

"What do records say?" "What's happening to me?" Eyes alight.

The tablet is on the table. His phone, now fixed, is in his hand. I sit down on a chair beside him. And I have to I tell him I didn't know what was happening--I hadn't been a part of the team for the past week. I see the dejection in his face; I feel my own disappointment. And then he says,

"go do it."

I will go forward caring for others in a different way: it's uncertain, but I believe in it for us all--and if I don't, I will forever ask, what if? I have to give it a shot or live with regret. I have a deep sense of what I'm fighting for and why, and no matter what path or profession I end up in, I'll never lose that: music at the core--about connecting with humanity.

Before going, something compels me to ask him, "what makes a good doctor?" His answer:

1. Be loyal
2. Be prepared
3. Be charismatic
4. Believe in god

A doctor comes into the room. I'm about to say--"I'm just a medical student," but I catch myself.

As I look back, I smile, we smile, I'm going.

Hope and aspiration

Evening ensemble, from metmuseum.org

From Jeff Nunokawa's note today:
"One thing essays have always been about (not all of them of course, but enough of them to notice and call part of the tradition) is everyday life: things that come with everyday life (the death of a moth; the rise of the sun). Well, there’s something about everyday writing, especially the kind that aims to help keep you company while you start everyday that reminds me of the morning as it’s been handed down to me. It’s a little repetitive (to say the least, as my mother would say), but also a little hopeful. It’s some weird combination of routine and experiment: writing everyday, starting everyday. I guess what I’m trying to say is this: the faith of our mothers and our fathers you can also find in the everyday writing I’m trying to do here. That faith inheres in a hopeful feeling that goes along with and a little beyond the less than hopeful feeling that you have when you first wake up and realize you have to to get up and do the same damn thing you did yesterday and the day before. It’s the faith that believes that there’s something on the other side of our everyday trying and it’s not all dark."

And a poem my classmates and I discussed today in our Narrative Medicine session:

Aspiration
Henrietta Cordelia Ray, 1848 - 1916

We climb the slopes of life with throbbing heart,
And eager pulse, like children toward a star.
Sweet siren music cometh from afar,
To lure us on meanwhile. Responsive start
The nightingales to richer song than Art
Can ever teach. No passing shadows mar
Awhile the dewy skies; no inner jar
Of conflict bids us with our quest to part.
We see adown the distance, rainbow-arched,
What melting aisles of liquid light and bloom!
We hasten, tremulous, with lips all parched,
And eyes wide-stretched, nor dream of coming gloom.
Enough that something held almost divine
Within us ever stirs. Can we repine?

Tomorrow, I'll have my evaluation on history-taking and the physical exam ('H&P' History & Physical, in med-speak). I'll share songs written for patients and evaluate the impact of those songs. I'll write a final patient case write-up on chest pain. Next week, I'll take the Shelf Exam in Ambulatory Medicine and give a presentation on the songwriting project. Lots to study, learn, write, present! But in the spirit of Jeff's note and Henrietta Ray's poem, I shall climb the slopes of life with throbbing heart / and eager pulse, like children toward a star.

It’s the faith that believes that there’s something on the other side of our everyday trying and it’s not all dark.