In local O.R.

's, lead surgeon picks the music Operating in Harmony

September 26, 1994|By Laura Lippman | Laura Lippman,Sun Staff Writer

There were many milestones in Dr. James D. Michelson's medical career: graduation from medical school, residency, that first operation, the day he got to pick the music. . . . The day he got to pick the music? Absolutely. In the hierarchical world of the operating room, the attending surgeon selects the music that his medical team listens to during surgery. This long-held perk has taken on even more significance in the wake of a study published last week that found surgeons work better when they work to music they love. The choices span the radio dial. Area doctors interviewed by The Sun confessed a fondness for everything from salsa to rap, from Bizet's "Carmen" to the Crash Test Dummies' "Mmm Mmm Mmm Mmm" -- one of Dr. Michelson's favorites. He remembers the day he finally got to bring his own tapes with him to the operating room. "Actually, there was a great deal of satisfaction in getting to that point," says the 39-year-old orthopedic surgeon from Johns Hopkins Hospital. "There are certain things like country-western which I abhor. When you're a resident, if the attending surgeon puts on Dolly Parton, you just have to grin and bear it." One doctor, he recalls, picked up on his loathing for a particular song and gleefully played it over and over. "I can't remember the title," he says, "but it's the one with the line 'Drop kick me, Jesus, through the goal posts of life.' " (Actually, that is the title of the song written and performed by Paul Craft.) Music has been a fixture in operating rooms for more than a decade, as any fan of TV medical dramas knows. But in the medical world, something that hasn't been studied doesn't officially exist.

Last week, the Journal of the American Medical Association reported that doctors who control their music are faster, more accurate and more relaxed than those forced to listen to another's musical choices. "In 1889, Nietzsche wrote, 'Without music, life would be a mistake," wrote Karen Allen and Jim Blascovich, after studying 50 male surgeons with self-selected music, someone else's music and no music at all. "Over a century later, our data prompt us to ponder if, without music, surgery would be a mistake." Forty-six of the doctors studied chose classical, but two liked jazz and two picked Irish folk, including a James Galway and the Chieftains tape featuring drums and tin whistles. Given the study's results, why not choose the melodies by popular vote? Reginald J. Davis, a neurosurgeon at Greater Baltimore Medical Center with fairly eclectic musical tastes, says the operating room is not a democracy. He who wields the scalpel picks the tunes. "Basically, the surgeon has the bottom line, the anesthesiologist can overrule -- 'That's too loud, I can't hear my monitor' -- but the nurses and scrub techs are stuck. Surgeons are captain of the ship. "I'm an easy one," he adds, "because I enjoy most things. I don't like opera or country-western, though." For Dr. Davis, a typical day in the operating room can last up to 12 hours. So he brings in a box of compact discs -- the renovated operating rooms at GBMC all have CD players -- and lets the nurses pick from his selection. The day's choices may include Billy Joel, Anita Baker, the Beatles or Sly and the Family Stone. Classical CDs, however, are not part of Dr. Davis' collection. He has less-than-fond memories of surgeons who used to quiz him on composers and symphonies, along with surgical techniques, during his residency. Dr. David J. Schamp, 40, a cardiac electrophysiologist, tunes into WHFS-FM, an alternative rock station, hoping to hear songs by groups such as the Cure, the Pretenders and U2.

But because his patients are awake during the procedures he performs, he sometimes cedes to their wishes. Luckily, he has some younger patients who appreciate his taste in music, as well as his onyx earring. Ultimately, the music becomes background noise for almost everyone. But, as the study attests, the effect on surgeons is autonomic -occurring automatically. So while their blood pressure and pulse might have changed, the 50 surgeons didn't know that. They only sensed they were more focused and relaxed. Was a study even necessary? Isn't it obvious that a surgeon's favorite music would help him or her relax, while music picked by someone else could grate? "Without data, all you have are opinions. Sometimes you think something is common sense, but you need proof," says Dr. Luis A. Queral, co-director of the Maryland Vascular Institute at Union Memorial. An opera buff, he's also been known to listen to the Mambo Kings playing songs of love while he performs carotid endarterectomies. (Translation: he listens to the movie soundtrack of salsa tunes while cleaning out neck arteries.) Dr. Michelson also sees value in the study: "Occasionally you run into the stick-in-the-mud person, who says music detracts from your concentration. If that person happens to be the head of the hospital, you're in trouble." If music helps, do doctors tailor certain music to certain procedures? Dr. Davis says he sometimes asks for silence during tasks that require great concentration. Dr. Queral prefers classical music for such moments. Dr. Michelson varies tempos according to his mood. "When we get to the closing point, someone usually turns to the nurse and says, 'Give us some closing music, please.' That's something that's fast and upbeat." Like the William Tell Overture?

"I don't happen to have a copy of that tape," says Dr. Michelson. "But, yes, that would work."

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