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A Dose of Music

Operating-roomThe world of music has been embraced by medicine since 4000 BC, when "hallelujah to the healer" was played as a contribution to payment for medical care. The ancient Greeks referred to Apollo as the father of healing and music. 

While music as payment stopped long ago, it continued to be a part of health care. Numerous studies have associated  with listening to music. I’ve also previously covered the role of music therapy in care for hospice patients at home and in the in-patient unit at Penn Medicine at Rittenhouse. 

Music can be beneficial to a patient’s health, but the role it plays in care for those patients in a clinical setting is much less discussed. More than 100 years ago, a Pennsylvanian surgeon named Evan Kane wrote a letter to JAMA calling himself a strong advocate for the “benefic [sic] effects of the phonograph within the operating room.” Kane said it was a way of “calming and distracting the patient from the horror of their situation.” Methods of surgery have improved considerably since then, eliminating such “horror,” but music is still a mainstay in surgeries today. Talking with Penn Medicine surgeons revealed a wide variety of musical tastes: from rock to country.

We live in a world with Pandora, YouTube, Spotify and other online streaming services that use an algorithm to suggest music to listen to, but how do surgeons decide what music to listen to while in the operating room (OR)?

A 2014 British Medical Journal editorial said music is most often selected by the lead surgeon, but all the  surgeons I talked to said their nurses, patients, or others on the care team either decide or at least heavily influence the decision.

For example, Samir Mehta, MD, chief of the division of Orthopaedic Trauma, said he’s willing to listen to just about anything, but usually listens to alternative rock, rap, or “today’s hits.”

“There is usually music on in the OR,” Mehta said. “I generally let my residents or the staff in the room pick the station, or even the patient if they are going to be awake during the surgery – as long as it’s not show tunes or country.”

When allowing the rest of the care teams to pick the music, clinicians show important, reasonable guidelines.

“In my rooms, the residents or nurses select the music,” said M. Sean Grady, MD, chair of the department of Neurosurgery. “In only one instance have I rejected the choice. One of our chief residents years ago was a major Abba and Cher fan. I absolutely forbade playing that music after about two weeks when I was in the OR.”

Some surgeons find that music can be a distraction from complex, sometime high-risk operations.

“I prefer no music,” said Alan J. Wein, MD, chief of Urology. “It's my obligation to keep my mind on the subject at hand and, though I understand that other people are different, music really doesn't help me do that. I know my colleagues’ preferences range anywhere from country to classical.”

The theme of allowing patients to decide – if they are consciously awake for the operation to enjoy it – was echoed by many of those I talked to. 

For Gregory G. Heuer, MD, PhD, an assistant professor of Neurosurgery, jazz is preferable, but the patient’s comfort takes priority. For example, he has had requests from devoutly religious patients to restrict what music is played. In those cases, he has played a Gregorian chant that the families appreciated.

“Music in the OR brings a certain level of calming and familiarity,” Mehta said. “There is always a level of stress and heightened awareness when we are in the OR, which there always should be. But anything we can do to create a positive, comfortable environment -- which music does -- is a good thing.”

Kane said music was calming for patients, but it’s beneficial to make their surgeons comfortable as well.

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