Thoughts on a G String - by Danielle Ofri, The Lancet
The moment has ļ¬nally arrived. After 3 years of sweating through etudes, scales, and Suzuki practice books, my teacher utters the words that every cello student yearns to hear: āItās time to start the ļ¬rst Bach suite.ā
It started on a lark, really, when I asked my daughterās ļ¬rst violin teacher how to coax a child to practice. She casually commented that the best thing is to see a parent practice. I hailed the nearest taxi and promptly purchased a cello. I started lessons, applying the same brute-force approach Iād acquired in medical schoolāplaying the assigned notes over and over again until they were seared in my memory like the Krebsā cycle and the 12 cranial nerves.
I added cello to the chores of my lifeācaring for patients, teaching, writing, and editing. But over the 3 years, an unexpected transformation occurred. Far from being a chore or a parental device to inļ¬uence my daughterās propensity to practice, cello turned out to be something that I genuinely wanted to do each night, almost to the exclusion of all else. Newspaper reading shrunk to cursory glances. Phone calls were avoided. Medical journals slipped to the subterranean level of the reading pile. Journal subscriptions lapsed.
I still love my āday jobā, taking pleasure in teaching students and connecting with patients, but I have to be honest that, at this point in my career, the sense of growth has remained at a relatively steady state. With music, however, the intellectual challenges develop in ways that are new and surprising to me. The trajectory of learning, of frustration, and of accomplishment for the beginning musician has more in common with the intellectual vibrancy of life as a beginning medical student. I ļ¬nd that I am more driven to enhance my musical skills than I am my medical skills, although I certainly donāt wish the latter to falter.
As I continued to pursue the cello in the evenings, hospital-corridor conversations during the day revealed musicians hidden in all sorts of unlikely clinical corners: the pathologist who played violin, the ER doctor who was an accomplished cellist, the clinic director who played saxophone, the student whoād ļ¬ipped a coin between Julliard and medical school, the anesthesiologist who studied ļ¬ute at Eastman School of Music before āretiringā to a more practical career, the pulmonary fellow whose legendary beer-chugging habits masked a prodigious violin repertoire. Was this just a matter of uncovering a common hobby by making the eļ¬ort to look, or might there be some intrinsic connection between?
I knew there was a doctorsā orchestra here in New York City, and as I started poking around I learned that there were others in Boston, Houston, Los Angeles, and Philadelphia. There was also one in Europe, one in Jerusalem, one in Australia; even a World Doctorsā Orchestra.
Was this merely because most doctors grew up in middle-class homes conducive to music lessons? I searched other professions, and uncovered one lawyersā orchestra in Atlanta. But I couldnāt ļ¬nd a single accountantsā orchestra, or architectsā orchestra, or engineersā orchestra. There wasnāt any orchestra made up of Wall Street executives, computer programmers, government oļ¬cials, or direct marketers.
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 aĀ 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 āthere 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.ā
Lisa Wongāviolinist, pediatrician, and president of the Longwood Symphony Orchestraāspeaks for the many who came to medicine after years dedicated to serious musicanship. āThe music we create builds in us an emotional strength, sense of identity, and sense of order. Then it is given awayāwe play for others, we play in ensembles. We come to medicine and it is the same thing.Ā The giving, the serviceāin music and medicineāis a natural connection.ā
Michael Lasserson, a British double-bass player, retired family physician, and founder of the European Doctorsā Orchestra, speaks from the perspective of the dedicated amateur. Although he was raised in a family of professional musicians, it was clear rather early on that he was headedĀ for medicine rather than the stage. But, āmusic never lets you go,ā he says. And it is more than just a hobby to make one a happier doctor. āIt is a means whereby one is lifted away from the essential loneliness of clinical decision-making and action, into a world of a common enthusiasmĀ and endeavor as the group searches for the beauty of sound [and] the composerās intent, and those few hours have what can only be described as a healing function.ā
There is also the risk-taking that oļ¬ers parallels between medicine and music. It takes a certain amount of fortitude to slice open a patientās abdomen with a scalpel. No less is required to take on Mahlerās seventh or the late Beethoven string quartets. āWe hurl ourselves with suicidal courage against the commanding heights of the repertoire,ā Lasserson says, hoping just to ātouch the hem of that greatnessā, though he acknowledges that sometimes, for the amateur, āmiming skills will come to the fore.ā
I debate this every night as I approach that single precious hour of energy after all the childcare has been completed and before exhaustion forces me to bed. Do I read that groundbreaking clinical trial that will surely impact my practice? Do I work on that unļ¬nished book chapter? DoĀ I read the newspaper and catch up on world events? Do I organize the entropy of my desk? Do I exercise for 30 minutes as I routinely exhort my patients to do?
Unfailingly, the answer is ānone of aboveā. No matter how tired I am, no matter how much neuronal lint has accumulated throughout the day, I tighten the hairs on my bow and dig the end-pin of the cello into my rutted carpet. As I start to work on my assigned music for the week, I ļ¬nd myself focusing ever more narrowly on a single page, a single line, a single measureāeven a single note.
Temperamentally, this is the exact opposite of life in the hospital, in which I feel pelted by ringing phones, needy patients, impossible schedules, irritating bureaucracies, and a cacophony of meaningless minutiae. It is a glorious relief, instead, to struggle forāand occasionally achieveāprecisely the right note. But then, there is a step even beyond that. The note doesnāt have to merely be rightāit also has to be beautiful.
Prelude of Bach Suite #1, from Anna Magdalena notebook
Beauty is not something that gets much shrift in medicine. Other than the experimental design of a classic study that might be referred to as āelegantā, there isnātĀ much in medicine that falls into the category of beauty. Beauty is inherently unpragmaticāit doesnāt enhance eļ¬ciency, increase productivity, earn a grant, or cure a patient. Maybe it is this lack of beauty that drives doctorāmusicians to struggle to draw some into their lives via music.
But perhaps there is indeed something in medicine that is related to beauty. After all, medicine is about lifeāthe wriggling, sensual, bodily aspects of being alive. This is not something that can be said about engineering, law, or accounting. Although being aliveāand being sickācanĀ frequently be unpleasant, it never ceases to be miraculous. That miraculousnessāand the privilege of doctors to be part of itāis a beauty in itself.
Willa Cather once said, āNovelists, opera singers, even doctors, have in common the unique and marvelous experience of entering into the very skin of another human being.ā The beauty of entering the very skin of another human being is how many musicians describe the emotional experience of playing music. And for many, it is the striving to achieve thatāalmost more than theĀ attainmentāthat oļ¬ers the most pleasure. As we physicians strive to achieve the best for our patients in the messy, corporeal world of clinical medicine, we work to enter that very skin of another human being, and perhapsāwith luckāwe can touch the hem of that greatness.
Ā©www.johnabbottphoto.com
Touching the hem is about all I can aspire to, but thatās enough. Iām willing to grovel for that. The sheet music of the ļ¬rst Bach suite appears straightforwardātwo pages of evenly spaced notes in the key of G. No intricate timing, no double-sharps, no key shifts, no clef shifts, no fancy ornamentation. But as anyone who as ever tussled with Bach knows, that simplicity is ruthlessly deceptive. āOne measure at a time,ā my teacher has instructed me. āIt needs to be completely memorized. Expect to put in about a year on this.ā This is said without irony.
Week after week, month after month, I tiptoe gingerly through the music. The melodic phrases are simultaneously simple and horriļ¬cally complex. But when Iāve survived a measure and can play several notes in sequence, the beauty is astoundingāthe type of beauty that really does take theĀ breath away. I havenāt made it to the hem yet, and may never. But thatās okay. Itās all in the reaching.
(fromĀ The Lancet, 2009;373:116-117)
Hope you all enjoy this wonderful piece by Dr. Ofri that is so reflective of my feelings on music and medicine. Bolded is my emphasis.
- The Musical Brain: a 4th year medical student and a musician
snowghoul
yousharknotpass
dailybridgerton
tangentwithtanner
kaledo-art
turnnoffyourmind
origamiaround
annaxmalina
stormborns
izzy806
