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Medical Humanities

The Songs We Share: On Music and Medicine

Henry Blair

March 15, 2019

Music has always been an integral part of my life, threading itself into the very way I perceive and interpret the world. There was even a time long ago, back in high school, when I once seriously entertained the idea of pursuing a career in music. As a cellist, I’ve enjoyed my share of thrilling moments on stage at various international competitions and concert halls over the years.

And so when I began medical school a year ago, I feared that I’d have to give up music for good. Fortunately, that was not the case. Now that medicine, too, is my life, I find a compelling parallel emerging, a duality: my medicine and my music. Both are science and art. Both deal in the business of life. When I care for patients, just as when I play or listen to music, I am given incredible access to the mind of another person, and challenged to grapple with a vast host of human experiences and emotions, familiar and foreign.

In my medical vocation, I have had the opportunity to volunteer at a hospice, where I once blundered into a curmudgeon of a man—let’s call him Alfred—with my well-intentioned cheer and good wishes. Alfred’s cheer, however, had left him after his kidneys had failed, and good wishes are hard to negotiate for a man who is dying of end-stage renal disease. His expression of indifference, even disgust, for me was no different than his regard for anyone else who attempted engagement. I had been silently dismissed, good cheer and wishes notwithstanding.

He had backed me into a corner, an excuse by which we in medicine are often seduced: “Oh well…I did my best.” The entire proceeding took only a moment and had silently sealed a lose-lose deal.

Music, as a rule, strives toward a goal, a resolution—the tonic, or home note, which begins any opus in a particular key. Along the way, it allows for tangential asides, forays into experimentation, dissonances, and surprises. Its trajectory appropriately mirrors segments of our lives, with its ups, downs, and bouts of tension that eventually coalesce with the beauty of a denouement that ties together all that came before it. In health, we play our own songs—we are our own songs—heard by physicians with a discerning ear. Disease is a tension, and we await our safe delivery to our home notes.

Alfred already knew how his song would end; his life and emotions had disintegrated into a tangled mess of discordancy. There was no home note waiting.

I noticed his attention toward another part of the room, from which a mellifluous jingle drifted like a fresh breeze. Courtesy of an FM radio and the local symphony orchestra, the cacophony of Alfred’s kidney disease had been temporarily buffered by his focus on the music.

“Debussy?” I asked.

“Indeed,” he agreed, after a brief pause.

I watched his face as the music unfolded. Discordances and surprises lurked. Tension mounted. I imagined the music perching him on a sonic precipice, the verge of chaos, before a resolution turned the corner, scooped him up, then placed him ever so gently back on level ground: the home note. His austere expression relaxed into one of contentment.

“Lovely,” I murmured. He half-smiled. I wondered whether music was my way in.

“Yes,” he replied, tenuously. Debussy soon transitioned into a Geico commercial. Seizing the moment, I took out my phone and reflexively selected a song on my music playlist: “June” from Tchaikovsky’s piano suite The Seasons. Wistfulness appeared on his face. “…Tchaikovsky is perfect,” he mused, as if to no one. “Oh, and Mendelssohn, too. I like Mendelssohn very much,” he quickly added, as if for me.

A long-lost spark in him struggled to rekindle.

We sat there in silence, soaking in the music. The five-minute “June” ended and “July” began. Then came “August.” We managed to make it through the rest of the months, except for December, which inexplicably was missing from my phone. After the suite was over, we spent a few more minutes in silence.

“Where’s December?” he finally asked.

“Coming soon,” I answered.

“Thank you,” he whispered, and he closed his eyes. After a moment, he opened them again. “So you’ll be coming back?”

“Count on it,” I said. “I know where you live.”

One of the most mysterious aspects of music lies in its apparent meaninglessness—in the sense that it occupies a realm apart from our conventional abstractions of truth and facts; it doesn’t tell us what to think or what to feel. Rather, it teaches us how to feel. Music, in all its richness and complexity, reflects back to us the facets of life that are joyful, melancholic, savage, valiant, shocking, noble, and infinitely beguiling. Music can trigger our most cherished memories, and in a way, helps us make sense of our emotions.

The connection between health thus clearly extends beyond mere metaphor. Doctors heal, but so does music. Music is uniquely human—certainly the way we use and enjoy it. Few drugs impact our cerebral hemispheres, limbic system, and cerebellum as benevolently, intricately. Music produces no adverse events; it neither provokes allergies nor triggers undesirable side effects. Is being moved to tears an adverse event?

Over the next few weeks I visited Alfred five more times, each time bringing several pieces of music—arias from Dvorak’s Rusalka, Bach’s cello suites, Rachmaninov’s second piano concerto, Schumann’s Waldszenen, Mendelssohn’s Songs without Words, and Brahms’ clarinet sonatas. Even though we spoke only sparingly, the music transported us to a secluded and sublime plane, immersing us in a beautiful and subtle awareness of the intricate cocktail of memories, emotions, and sensations welling up in each of us. We were embarking on a journey, trekking along the same path but responding to what we were hearing through the idiosyncratic lenses our separate lives had created.

After each piece ended, we would trade a few words about our thoughts and feelings while hearing the music. This process was restoring him in a way that medications hadn’t, and as a medical student this was not lost on me.

Alfred passed away a little over a month after our first shared encounter with Tchaikovsky’s Seasons. On the surface, it might seem his end wouldn’t be greeted with appropriate closure, for he wouldn’t have a proper funeral or the currently trendy “celebration of life.” I envision, however, that the month I spent with him had brought his song closer to his home note. The hospice disclosed where the limited arrangements were going to be, and I was there ahead of the few who accompanied his casket to the site.

There is still very little we know about how music affects us, and how I chose to interact with Alfred certainly isn’t something that is taught in any conventional medical curriculum. It worked, however, for him; and it worked for me, too, when I hummed to myself the strains of “December” for him.

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