1 Gulkis

Essay About Music And Medicine

Karsten Moran for The New York TimesCould a coach bring back the intellectual vibrancy from medical-school days for doctors?

Last week in my cello lesson, I spent an hour and a half on a single line of music. It was a snarly line, and I botched it heroically for 90 solid minutes. My teacher was patient, but uncompromising; I was met with blunt feedback at every step and left feeling wholly dispirited.

At home I plowed through that line for the next week, painstakingly dissecting each infuriating dotted-sixteenth note and every nasty double-sharp. On my teacher’s advice, I recorded each attempt, then listened back to repair my errors. It was excruciating for me (to say nothing of the suffering of innocent household bystanders).

There was no eureka moment, but slowly, grindingly, the dissonant cacophony coalesced into a recognizable melody. It was only one measly line, but I’d successfully navigated it. I was one tiny step better than I’d been before.

It made me think about an unusual essay in The Annals of Internal Medicine called “Music Lessons: What Musicians Can Teach Doctors.” The author, Dr. Frank Davidoff, an internist and former editor of the Annals, makes the interesting point that although medicine is learned over many years, the actual practice of clinical medicine is a performance, “in the best and deepest sense of the word.”

Doctors spend much of their energy keeping up with the vast medical knowledge, but scant attention is paid to how this knowledge is dispensed in actual practice, or what Dr. Davidoff would call the performing of medicine.

Musicians, on the other hand, focus intensely on the performing of music. My experience was but a snippet of what musicians spend a lifetime doing — relentlessly practicing, constantly bathed in critical feedback from teachers, audiences, critics and their own ears.

Dr. Davidoff points out that the greatest music teachers are coaches, not lecturers. In contrast, most of our teachers in medicine are lecturers, and information is simply shoveled at the student.

In a recent piece in The New Yorker called “Personal Best,” Dr. Atul Gawande probed the idea of coaches for physicians who would observe doctors in the process of practicing medicine, then give detailed feedback, much like my cello teacher did with me.

The midcareer plateau Dr. Gawande wrote about resonates with me. At this point, I feel comfortable treating most of what crosses my desk, but I’m not really learning much. This is in contrast to the exponential learning I experience as an amateur musician. The exhilaration — even with its implacable frustrations — pulls me to practice cello with a vigor that can’t quite be mustered when I read my weekly medical journals.

This exhilaration, in fact, recalls what I felt as a beginning medical student. The loss of this excitement may be a large component of burnout and plateaus in midcareer doctors.

In music, plateaus are flatly unaccepted. When complacency creeps into my cello practice, my teacher exhorts me, “If you aren’t improving, you are getting worse!” Could a medical coach bring back the intellectual vibrancy from medical school days, spur that constant growth?

Dr. Gawande decided to try, and invited an esteemed surgeon to observe him and give blunt feedback. There were many uncomfortable moments of feeling awkward under observation, of worrying what his colleague would think of him. These are all familiar emotions to me from my cello lessons, where I present the fruits of each week’s practice to my teacher. There is always that painfully long moment after I put down the bow, the deep breath in which my teacher searches for a charitable way to catalog my blunders. Criticism, no matter how softly couched or solidly constructive, is always hard to take. But without fail, I improve after these critiques, once I’ve scraped my battered ego off the floor.

Would doctors actually want a coach observing their work and offering critiques? It’s not a comfortable experience, for sure, but if done in a spirit of self-improvement, without the threats and penalties of the current quality-measures movement, many might be open to it. I surely would. I’m probably a “good enough” doctor now, but it would be hubris to think that I couldn’t be better.

Picking the right coach is paramount. I initially tried several cello teachers. All were excellent, but when I took a lesson with the last one, I knew immediately that I’d found the right mentor. The combination of exacting standards — whether for Suzuki’s “Twinkle Twinkle” or Bach’s suites — and unflinchingly honest criticism, laced with an unfailing optimism that I would succeed if I kept at it, is perfect for me. We’ve been sweating it out together for six years. It’s the hardest, most sustained, most gratifying work I’ve done in the last decade; nothing I’ve done in medicine in these same years comes close.

The main stumbling block, honestly, is time. As I read through Dr. Gawande’s experience — detailed discussions, reviewing videos, observing other doctors — I kept waiting for him to reveal where that time came from. Was it his own free time? Or did the hospital exempt him from some clinical duties (that is, take a revenue loss)?

If doctors are told that coaching is a fabulous idea — go ahead and squeeze it into your schedule! — there will be very few takers. But if we allot some resources (as we do for continuing medical education) and ensure that this will not be used punitively, many doctors would be eager for an experienced clinician to offer feedback. The next step would be to incorporate suggestions from patients. Then the orchestration might really get interesting.


Danielle Ofri is the author of three books, including “Medicine in Translation: Journeys With My Patients.” She is an associate professor of medicine at New York University School of Medicine and editor in chief of the Bellevue Literary Review.

Music Therapy Essays

Abstract Music is a very astounding aspect of life. There are many engaging studies into how music can help people heal from various physical and emotional pains and how music can be a way of life for people who are either deaf or for people that have Alzheimer’s disease, which is what I will be talking about throughout this essay. Music therapy, which was mentioned throughout a website article from the American Cancer Society, is a big part of this essay because it describes the importance of music.

Alongside with the website, I pulled references from the a journal article on the effects of music therapy for patients with Alzheimer’s disease, from excerpts including Moving to Higher Ground by Wynton Marsalis and When Music Heals Body and Soul by Oliver Sacks, Nick Hornby’s High Fidelity, and lastly from the documentary The Music Instinct. ? The Magic of Music Both humans and some non-humans are moved by the undeniable effects of music and sound.

There are many aspects of music and the power of music which visionary researchers, musicians, and ordinary people are curious about; especially engaging are studies into how music can be a way of life for people who are either deaf or for people that have Alzheimer’s disease and how music can help people heal from various physical and emotional pains. The Way of Life Music can mean different things for different people depending on their aspects on their life. Some people go as far as calling music a way of life.

Multiple arrays of reasoning’s are behind people that call it their way of life. Their reasons can reach from being in a hurtful situation to being deaf from birth. People might think that persons that are deaf from birth can’t hear the music that rewards so many of our ears, but believe it or not, they can. According to Elena Mannes, the director of the documentary, The Music Instinct, a woman by the name of Evelyn Glennie who is deaf, uses the vibrations of sound to create her music because it is how she hears.

“The physical fact of vibration is a very crucial part of her life because it is the essence of her art. ” (2009). Music is some people’s way of life; take Evelyn Glennie as proof of that. Music, a Vessel of Tranquility Furthermore, different aspects of life can mean different things, including the fact that you could be forgetting the very reason why you liked music in the first place. For Alzheimer’s disease patients since they tend to forget things, music can be their way of life.

According to a study, for example, that was produced in 2010 they tested how music could help patients and they got results saying that music therapy has positive effects on reducing agitation, which is one of the most intrusive behaviors in [Alzheimer’s disease patients]… This study suggests that if nursing homes or other caring centers use music therapy as a daily program for people with AD, it may reduce intrusive behaviors in patients and decrease the levels of stress and burnout in caregivers. (Zare, Ebrahimi, & Birashk, para. 7).

Music for Alzheimer’s disease patients seems like a vessel of tranquility. The reason being is because everyone’s brain syncs up with music and if Alzheimer’s patients are listening to a slow paced song they would be more calm and compliant. Most of the time, Alzheimer’s disease patients are taken care of by family and friends and it depends on them which can affect their lives personally. Since an Alzheimer’s patient relies on their caregiver, if the patient gets agitated and lashes out at the caregiver it can end very badly to the point that they lose a caregiver.

So, by using music therapy it could completely diminish that possibility. The Perfect Mindset Additionally, music is very important. According to Dr. Oliver Sacks, a neuroscientist and best-selling author, mentions in his excerpt of When Music Heals Body and Soul that on multiple accounts, including a personal experience, that people tend to react positively when introduced to music. It is a mind setter that works to help become a way of life for people who have ailments that prohibit them from daily functions. (2002).

Music provides people with a way to encounter multiple emotions and in doing so, provides people with different mind sets. Mind sets are probably the biggest part of the healing process for persons with ailments. Being in the right mind set can lead people to heal faster or to just feel like they are on top of the world. In order for people to feel like they are on top of the world, they need to have the perfect mindset and the way to achieve it is by making them believe that they can diminish their pain and regain their strength.

Music makes people happy, so provide them with their own music and let them regain that perfect mindset. The Other Side Coupled with music being a way of life, it’s not only a vessel of tranquility, but it can also be a vessel of relief. Music therapy is when a music therapist uses music to improve their client’s health or relieve their pain in doing so. As a result of music therapy, music becomes a vessel of relief for many patients with different ailments.

An example of relief that music therapy can provide such relief, is mentioned on an informative website titled, Music Therapy, where they say that “Music therapy is often used in cancer treatment to help reduce pain, anxiety, and nausea caused by chemotherapy” (2008, para. 3). Music, in many ways, is truly mysterious in the way it works. Sometimes, it’s just noise or something people listen to for enjoyment, but there is a whole other side to music. The other side being that it can help heal the pain that people endure. It’s Possibly Madness.

Another factor, which tends to be commonsense, that goes along with music therapy is the thought of what kind of music to use to help soothe the patient. Knowing what the patient prefers can be a huge factor in music therapy because then the patient would be more willing to listen to it, remember it, and allow themselves to relax. In the book, High Fidelity, Rob Fleming—the main character—asks the reader “Did I listen to music because I was miserable? Or was I miserable because I listened to music? ” (2005, p. 24-25). People really do not know which one is the cause and which one is the effect.

Not only can music make people have feelings, but also it can be the reverse effect of feelings or pain for that matter. If music can be tied to a person’s emotions, then why can’t it be tied to a person’s pain? A patient that is listening to their favorite songs, in contrast, to a patient that is being forced to listen to music that doesn’t appeal to their taste is more likely to feel better because it enlightens them and puts them in a better position or mood.

Enjoyment of Life Along with music being able to put people in a better mood and it also being able to help heal the pain they endure, it also can make them realize that they can still enjoy their life. Life is very important as so are the people that are in the lives of others. No matter what, people should always enjoy themselves and others around them, which is capable through music. Music is a non-biased subject where people that have many differences can come together and create something magnificently beautiful (Moving, 2009, para. 14). The creation of music is the source of all the enlightenment of moods and reducing pain of patients, which is why music and people who get along are so important.

As Bob Marley used to say, “One good thing about music, when it hits you, you feel no pain. ” Many great musicians and artists live by this quote and it’s so true especially with knowing that it can “. . . reduce high blood pressure, rapid heartbeat, depression, and sleeplessness . . . , but medical experts do believe it can. . . aid healing, improve physical movement, and enrich a patient’s quality of life” (Music, 2008, para. 4). Music therapy is a necessity and people are realizing it now. The Beats of Life Music is life, that’s why our hearts have beats.

That is the direct reason that both humans and some non-humans are moved by undeniable effects of music and sound. The studies into how music can help people heal from various physical and emotional pains and how music can also be a way of life for some people are very engaging by many different people. Visionary researchers, musicians, and ordinary people are now starting to get answers on these engaging studies and can now understand life and music at a greater scale.

References

  • Hornby, N. High Fidelity. (2005). New York: Riverhead Books. Print.
  • Mannes, E. (Director), Mcferrin, B. & Levitin, D. (Producers). (2009). The Music Instinct. [DVD] USA: PBS. Original release date 2009.
  • Marsalis, W. (2009) Moving to higher ground. New York: Random House.
  • Music therapy. (2008, November 01). Retrieved November 19, 2013, from. http://www. cancer. org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/mindbodyandspirit/music-therapy
  • Sacks, O. (2002, March 31). When music heals body and soul. Parade Magazine, p. 221-223.
  • Zare, M. Ebrahimi, A. , & Birashk, B. (2010). The effects of music therapy on reducing.

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