To many boomers coming of age in the 1960s, British pop singer Petula Clark’s Downtown was just one of the many idyllic tunes of the time. For me, as a frightened teenager in 1966 being wheeled into the operating room for an appendix ready to burst, the song had a special meaning. It was playing on a radio in the OR when I was being moved from the gurney to the operating table.
As Petula sang, “When you are alone…” everything went blank.
I had two other encounters with music in similar medical settings later in life.
The first was when I was asked what music I wanted played in the operating room when I was having a tumor biopsied and removed. The second was when I woke up in the middle of a rotator tear operation and heard classical music I did not like. In the recovery room when the doctor came by, I asked him about his choice of music. He just scratched his head. “You heard and remembered that?” he asked.
Yes, I did.
Ancient Healing Practice, Modern Touch
Listening to music during surgery or before and after is not new, but medical researchers are learning more about its value for fearful and very ill patients undergoing rigorous procedures and the professionals who perform these procedures.
More studies are showing that music is good for the psyche as well as the body when there is stress and anxiety around surgery.
I believe we are just at the beginning of understanding the tremendous potential of music for patients.
— Ronit Fallek, Montefiore Medical Center
As early as 1914, however, the Journal of the American Medical Association published a letter about the use of music played on a phonograph in the operating room. The following year, another physician provided a detailed account of the benefits of moving a phonograph from the recovery wards into the operating room itself. He found that patients almost universally tolerated anesthetic induction better and also benefited from reduced anxiety before undergoing the “horrors of surgery.”
Fast forward to the present. Today, music is often in the air in the hospital setting.
Dr. Claudius Conrad, a surgeon with the MD Anderson Cancer Center in Houston, says in modern medicine, “We have lost some of the art of using music to battle the ‘horrors of surgery.’” But Conrad (who treats patients with liver, biliary and pancreatic cancer) and a team of surgeons at Anderson hope the scientific investigations of music in the operating room will increase the use of what is considered a surprisingly effective way of helping patients and possibly staff.
I Can Bring my Headphones to Surgery?
Conrad recommends that his patients bring their headphones with them into surgery so their preferred music “can be played before, during and after their often very extensive operations. My patients really enjoy bringing a personal, familiar and enjoyable element to the sometimes cold and sterile environment of the operating room.”
He believes many operating room teams realize that “even under adequate anesthesia, auditory information is being processed. So, one should not assume that the patients’ musical preference is not important when under adequate anesthesia.”
“As doctors,” Conrad, says, “we should aim to see how we could honor the wishes of our patients. We are there to help patients. Our studies have shown that the objective magnitude of the surgery is not correlated with the patient’s stress level about it. For patients with a high anxiety level, music can be beneficial.”
Music as a Pain Reliever
Ronit Fallek, director of the Healing Arts Program at Montefiore Health System in New York City, works collaboratively with departments across the medical center to help surgery patients. ”Without question, before and after surgery, music has been shown to enhance recovery, reduces pain medication requirements, and promotes early mobilization,” she says.
Fallek describes a study conducted by Linda Chlan Ph.D., R.N., in which severely ill intensive care patients following extensive surgery were played Mozart or other music of their choice while they received support from a ventilator: “I believe we are just at the beginning of understanding the tremendous potential of music for patients. Research on the beginnings of music in a healing context showed that our ancestors knew about it all along,” says Fallek.
There is little debate, she adds.
“Music therapy reduces anxiety and pulse rate during medical procedures in adults, and anxiety and pain in children undergoing medical and dental procedures. One systematic review of 42 randomized controlled trials in the peri-operative setting showed that music interventions reduced patients’ anxiety and pain in 50 percent of the studies reviewed. Another systematic review of 15 studies indicated a significant positive effect of music on post-operative pain,” notes Fallek.
Often, soothing music is offered to patients before surgery as a way to help them relax and ease anxiety, she says. Gentle music also can be played to help patients transition from an anesthetized state to an alert state.
In the Post-Anesthesia Care Unit at Montefiore, for example, music therapist Kristen Corey plays gentle harp music to help create a peaceful environment for patients emerging from surgery, as well as for family visitors and staff.
Physicians Benefit, Too
Recently, Conrad and his MD Anderson colleagues also conducted a research project to determine if listening to music in the operating room contributed to physicians’ performances. He found that more than 70 percent of all physicians “listen to music in the operating room, using an MP3 player or Internet streaming. Of those physicians, many stated that the music helps them focus and perform better.”
Gratefully, I am not scheduled for surgery any time soon. But I know one thing: When I do go in, my family will have a copy of my playlist. And I am thinking, should I include Petula Clark’s Downtown on it?
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