My love for music began when I was a toddler, mesmerized while watching a television program that featured a violinist accompanied by a symphony orchestra. As a result of this inspiration, I began playing the violin at age 5 and, a few years later, took up the piano. Playing music to share emotion, love, happiness, and aid in consolation was a healthy ritual that had been passed on through my family’s generations, most notably by my grandmother, Edith, who also played the violin. However, it wasn’t until I became an adult that I found a clear understanding of how music could console and help bring hope.
Like most, I have faced hardships, loss, and tragedy in my life. My first experience with loss occurred when I was just 8 years old and one of my best friends died from brain cancer. Only a year later, my Aunt was killed by a drunk driver. However, these experiences did not prepare me for one of the most impactful losses of my life.
In 1999, I was confronted with the situation of my wife struggling with clinical depression during her first year in medical school at Oregon Health Sciences University. I ultimately decided to add two years to my four-year medical school curriculum in order to be with her. One of the years included a research year that afforded me time to participate in the Portland Columbia Symphony. Despite the added time together, my wife continued to suffer from her advancing disease and tragically passed away in 2011 during our first years of practice. For a time, I was consumed by grief over the tremendous loss of my loving wife, missing her intense laughter and fierce interest in healing the suffering as a medical student. I was also in grief over the loss of love and the medical expertise that she had to offer to humanity. In her final years, she held the status of a board-certified physician but was still finishing her post-graduate training and certifications in medical acupuncture and palliative care.
The power of music
The healing powers of music provide me with relief and calm any negative feelings, such as disappointment, that develop from dealing with difficult patient outcomes. I rely on musical experiences, either listening to it or creating it, to help me care for myself, my patients, their families, and my community.
But with dreams lost, there is room for new dreams to grow. Just as in music, we can hear the beauty of harmony only yielded by shades of dissonance. Music has allowed me to move beyond grief and create a more symbolic message to my community and colleagues.
Beyond grief and tragedy, music has also helped me deal with and manage the daily stresses of my career, including the potential of physician burnout, a growing problem in healthcare. There have been several reports on physician burnout, which is a rising concern and something that we need to recognize and address as peers. High levels of physician burnout can be considered an early warning sign of dysfunction in our healthcare system.
Research has found that professional satisfaction for physicians is primarily driven by the ability to provide high-quality care to patients in an efficient manner. Dissatisfaction is driven by factors that impede this effort, including administrative and regulatory burdens, limitations of current technology, an inefficient practice environment, excessive clerical work, and conflicting payer requirements.1 Although I feel very well supported by my leadership and medical group, my work as a palliative care physician can sometimes be unavoidably stressful or heavy with emotional grief. A journal review published in The Journal of the American Medical Association (JAMA) in 2010 summarized various approaches identified in research studies and randomized controlled trials including reflective writing, meditation, and vicarious post-traumatic growth.2 I found that many of the proposed strategies involved creative sharing of emotion that could be experienced by others rather than done in a vacuum.
Certain meditative pieces on the violin have a soothing effect for me, and I find that playing the rhythmic ragtime piano after a long day can have an uplifting effect on me. Music provides me with personal satisfaction and has helped me manage stress and potential burnout, especially when I share it with the community in the form of lessons to children or free concerts to the public.
Music helps me as a physician
Interestingly, music also helps bring me more awareness as a physician. Working within palliative care, I come across patients and families making difficult decisions that are sometimes adversely affected by cultural attitudes and poor access to information and planning. We practice medicine in a culture that is heavily reliant on the biomedical model. This model can sometimes fall short of addressing the cultural and spiritual suffering that can occur at the end of life. I find it important to go beyond evidence-based research and understand the historical and cultural basis for the varied beliefs, values, and behaviors that occur when there is a threat of life or functional loss. Music allows me to find humility and honor in being a physician during difficult times. When I share music in an open community environment like a street fair, it allows me to stand in awe of the open sharing of love and respect between diverse members of the community.
Professional societies, such as the American Medical Association (AMA), have developed resources to help physicians. The AMA wellness program was developed to help group practices improve physician job satisfaction and reduce physician burnout, with the goal of benefiting everyone within the organization.
I encourage every physician to take a step back and evaluate whether they, themselves, could be experiencing signs of professional burnout and whether there is a creative outlet for healing. Our ability to express in the form of music, creative writing, or visual art is perhaps our best vehicle for bringing inspiration and purpose to those around us who also suffer in life. Inspired by a passion for music, and possessed of a clear understanding for the reasons to share this passion, I believe that every healthcare worker has the potential for developing a resonance between the suffering we experience and the healing in humanity around us.