My patient is intubated and under general anesthesia. It is 7:15 a.m. “Should we do the time-out?” I ask my OR team, which includes the anesthesiologist, the circulating nurse, my fellow and the scrub tech.
We huddle around the patient and discuss her case. She has a 15 cm pelvic mass (roughly the size of a cantaloupe), I explain, that appears to be coming off the right ovary. We finish the timeout once we have confirmed the patient’s identification, procedure, blood products, antibiotics that were administered and other relevant checklist items. My fellow heads to the scrub sink so she can wash up. I’ll soon join her, but I take a detour first.
I walk over to my iPhone and Bluetooth speaker on the stainless steel cart in the corner of the room. I open the Apple Music app and select my “OR” playlist. I leave to scrub in the sink, slip into blue surgical gloves and place each hand into my Biogel latex gloves. When I come back, the app is playing “Can I Kick It?” by A Tribe Called Quest.
Now, I am ready to operate.
You could say I have an eclectic mix of music on my OR playlist. My rule is “keep it upbeat and keep it good.” While I operate, songs from Phoenix to Daft Punk to the Rolling Stones will be heard. From the first incision to the moment I break scrub after placing the last closing suture, music is playing.
Listening to music while operating not only makes the day more enjoyable and invigorating but also can be incredibly calming. Most people would agree that when you are lying unconscious on a table, putting your life in a surgeon’s hands, you hope not only that she is great at what she does but that she is going to remain calm under pressure.
Many physicians have long recognized the calming effects of music. In fact, medicine and music have a long symbiotic relationship throughout history. Galen, the most accomplished physician and surgeon of the Roman empire, felt so strongly about music that he recommended it as part of the educational curriculum. The French physician Rene Laennec took consolation from his childhood illnesses by playing music. As a doctor, he invented the first stethoscope which resembled a long woodwind-shaped hollow cylinder. Some believe this design was influenced by his playing of the flute. Albert Schweitzer, the surgeon who won the Nobel Peace Prize in 1952 for his humanitarian work in Africa, was just as famous for his superior performances of Johann Sebastian Bach. Music was integral to Schweitzer’s work; the vast amount of money he raised for his hospital in Africa came from playing concerts around Europe.
It goes without saying that surgeons face many extraordinary pressures and stresses. Music can reduce that and help surgeons be in a more optimal state. A study in JAMA showed that surgeons who play music in the OR, when exposed to a stressful nonsurgical task, were calmer and performed better while they played their preferred music. Another study of surgeons performing robotic surgery revealed that music helped to improve surgical efficiency and decreased muscle fatigue.
Neuroscientist and musician Jamshed Bharucha believes that music connects us through shared experience and results in greater cooperation and synchronization. An evolutionary theory of music is that it is a tool that brings on social bonding and group cohesion. Take, for example, a study on 4-year-old preschoolers in Germany. The children who sang together showed more pro-social behaviors, such as being more cooperative and helpful, than the children who did not sing together.
These effects also seem evident in the OR while listening to music. In a survey study of OR teams from three separate hospitals, 79 percent of OR nursing staff members and physicians said that music makes them calmer and more efficient while working.
In essence, listening to music helps the team function better and brings a more harmonious group dynamic.
Patients also benefit from listening to music. One significant impact of music is that it decreases patient anxiety before and after surgery. For example, in a randomized trial of 207 women who were to undergo breast surgery, women who listened to music beforehand had significantly lower anxiety scores while waiting than women who did not listen to music. In an analysis of 73 clinical trials that assessed the effect of listening to music after operations, researchers found that music helped reduce patient pain and analgesia use and improved patient satisfaction.
The next time you feel anxious on your way to your doctor’s office or to the hospital for surgery put on some of your favorite tunes. Athletes do this to get in the “zone.” Watch any NBA game, and you will see many of the world’s greatest basketball players walking into the arena with headphones on.
Music has always been mysteriously powerful. The Greeks ascribed the powers of the god Apollo to both music and healing. Now, more than 2000 years later, the benefits of music for the patient and the physician continue in modern medicine.
I published this story previously in the Houston Chronicle.