It was, says Charlie, a friend, “one of the stranger moments in my life.” The middle of the night, an operating theater in a hospital in east London, toward the end of a difficult and stressful delivery. This was Charlie and his partner’s first baby, a boy, his umbilical cord was wrapped around him, and it was a tense moment for everyone.
“So there we were,” says Charlie, “wheeled in for a caesarian. I was next to my partner, who was well dosed with anesthetic, doing my best to comfort her. And someone says, ‘What shall we have tonight, then?’ and puts on some thumping house music. It was 3am and to be honest I didn’t have the energy to object. And everyone did their jobs extremely well; I’ve no complaints. But our eldest son was born to the sound of some hardcore Ibiza club hit. Very surreal.”
Most of us probably picture operating theaters as temples to surgery, their tense, nervy silence broken only by the rhythmic beeping of a monitor, the background hum of a ventilating machine, the occasional bark of the surgeon asking a nurse for an instrument. In fact, they’re more likely to be filled with the strains of Bach, the Black Eyed Peas, even Black Sabbath. Most surgeons, it seems, listen to music while they work — and research suggests it’s good for their work.
Photo: Reuters
A survey published last weekend showed 90 percent of surgeons in the UK put music on the theater’s sound system during operations, with half of respondents favoring up-tempo rock, 17 percent pop music and 11 percent classical. Plastic surgeons play the most music, it appears; ear, nose and throat specialists the least. Most said music contributed to creating a “harmonious and calm atmosphere”; a third, slightly alarmingly, added that it helped stop them getting bored.
Can music really have this effect? As Rahul Parikh, a San Francisco doctor, points out in a recent column on the subject for Salon.com, the links between music and medicine are many and ancient. The Greek god of healing, Apollo, was often portrayed with a lyre. Many distinguished doctors have also been accomplished musicians. In The Emperor of All Maladies, his book on cancer, Siddhartha Mukherjee explains that music and medicine often “go hand in hand. Both push manual skill to the limit; both mature with practice; both depend on immediacy, precision and opposable thumbs.”
But even non-music-making surgeons seem to benefit from listening to music in theater. There’s been a good deal of academic research on the topic, most suggesting music helps medics (the big exception being novice surgeons; a 2008 study in Surgical Endoscopy showed that junior surgeons performing a tricky virtual operation for the first time performed less well when listening to music. For such people at such times, it’s plainly a distraction).
For experienced practitioners, however, music really seems to work. A 1994 study from the Journal of the American Medical Association took 50 male surgeons aged 31 to 61 who habitually listened to music while they worked, and measured their heart rate, blood pressure, response times and task accuracy during a complex and stressful subtraction task. The volunteers had to complete the problem listening first to music they had chosen themselves, and then to Pachelbel’s Canon in D, the famously soothing chamber piece familiar from a thousand weddings and the Pure New Wool commercial.
The researchers, from the psychology department at the State University of New York at Buffalo, found that when listening to self-selected music, the surgeons displayed rock-steady vital signs and did the math faster and more accurately than when they were listening to Pachelbel. They also found listening to Pachelbel was better than not listening to any music at all. They surmised that listening to music, especially music of a surgeon’s own choosing, led to decreased stress and increased performance.
So what do surgeons like? Ben Challacombe, 38, a consultant urologist at Guy’s and St Thomas’ UK health service Foundation Trust in London, says that for background music during a case, he favors a mix of “old favorites and more contemporary stuff.” During the operation itself, he wants “familiar, reassuring tunes — interesting, not elevator music, but not distracting either. The closest in terms of a radio station would be Magic FM. So — this is going to sound horribly cheesy — it might be a Dire Straits album, or Elton John.” Then in the final phase, “we like something more contemporary and more upbeat: Killers, Kings of Leon, Coldplay maybe.”
Music can also serve a practical purpose, Challacombe says: He uses six five-minute tracks to give him vital audio cues during delicate robotic kidney surgery, when “you basically have a maximum 30-minute window to remove a cancerous tumor from a kidney. The traditional way is for someone to call out the time, but that’s distracting and quite stressful. With the music, I know where I am without that.” Music in theater tends to be “a generational thing,” Challacombe says, with few surgeons over 60 liking it. “Although there’s one older consultant here, he really likes his opera. And occasionally an anesthetist will just say, ‘No music,’ which you obviously respect.”
It’s well known that listening to music can help patients. Several studies suggest patients who listen to soothing music through headphones while being put to sleep and during surgery require less anesthetic — up to 50 percent less in some instances — and recover more quickly afterwards. One groundbreaking 2008 study found that melodic music actually decreased the activity of individual neurons in the brain. “There’s no question, music reduces anxiety before surgery,” says Zeev Kain, an anesthesiologist at Yale University, who has done research on the subject. “It will decrease the amount of pain or anxiety medication a patient needs.”
Anesthesiologists and the rest of the operating team also tend to like music to work to — but not always. If the surgeon, who almost invariably gets to choose the soundtrack, happens to be addicted to Metallica or Meat Loaf and they’re not, tensions can arise. A study by the department of anesthesia at Glasgow’s Western Infirmary surveyed 200 anesthesiologists; it found 72 percent worked in theaters where music was played regularly, and around 63 percent generally enjoyed it. Some 26 percent, though, said they thought music, especially music they didn’t know and like, could at times “reduce vigilance and impair communication.”
For that reason, Gabriel Weston, an ENT surgeon at Frimley Park hospital near London, says she prefers to ask her scrub nurse what music she would like to listen to — “But that’s probably a female thing. I try very hard not to be someone who insists on anything, and asking her to choose is giving a choice to someone who’s really important.” In operations using local anesthetic, she says, she often asks her patients if they have a preference.
There’s even been research, albeit not very conclusive, into the best kind of music for surgeons to listen to. A study from 1976 found that rock was pretty good. But a Surgical Endoscopy paper last year suggested that all things being equal, calming classical music was probably better than hard rock or heavy metal. According to Surgical Innovation, hip-hop, reggae and other more energizing genres can have a beneficial impact too.
Ultimately, the results probably have more to do with personal preferences. Most surgeons reportedly accept, though, that they have to be sensible about volume: At the first sign of discord in the team, or a potential problem with the surgery, the music gets turned off. And there’s a short list of songs that no one would ever dream of playing during an operation: Queen’s Another One Bites the Dust; The Stones’ Let It Bleed; Don’t Fear the Reaper by the Blue Oyster Cult; Take My Breath Away from Top Gun. No point tempting fate, is there?
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