“Music can heal the wounds which medicine cannot touch.” – Debasish Mridha
Many would agree with the saying that music heals the soul. Surely then, music would be a great partner in the practice of medicine and the art of healing. Here, two authors share their respective journeys of being both a medical doctor and an avid musician, and how one practice complements the other in their lives.
Joshua Hoe
I have loved music for a long time. In my favourite Victorian romantic comedy Pride and Prejudice, Elizabeth says to her beloved Mr Darcy in an impassioned speech at the climax of the novel: "I cannot fix on the hour, or the spot, or the look or the words, which laid the foundation. It is too long ago. I was in the middle before I knew that I had begun."
Imagine me saying the same thing, but about music. Perhaps you'll see what I mean more clearly through a few indirect anecdotes. Some things are clearer by illustration than telling.
A musical epiphany
I recently found out why I love the subtle "break-up" distortion on an electric guitar so much.
When you push the gain and tone knob into the right position and attack the guitar strings just enough at the right moment, that distortion on a big sweeping chord on a chorus can take you places. That same distortion on a phrased melody up the neck of the guitar can tell you exactly how beautiful life can be, or perhaps how tragic love lost really is.
And now, in the words of Monty Python, for something completely different: that familiar "distortion" sound is really a technical accident – its roots are in an undesirable artifact caused by driving a tube amplifier too hard. By applying too much gain the audio signal is clipped, introducing harmonic and inharmonic overtones, sustain and that oh-so-lovely face-melting warmness.
But really all those words don't mean much when I hear that overdriven guitar tone in my favourite song after a bad day at work, and it hits somewhere inside at the crossroads between mind, body and spirit (I think that localises to the thorax region in Netter's Atlas of Human Anatomy). That dangerously gritty, warm and blooming sound makes me think of bittersweet pain, a thunderstorm, frustration and catharsis all at once. It's lovely.
I cannot tell you where that power comes from, but it is there and almost universally loved at that, so I know it's not a peculiar taste of mine (like drinking Milo without sugar).
The nature of music
Let me give another example of a powerful experience I've had with music recently. I was innocently surfing YouTube (as one does), and came across a series of videos that really helped me understand the harmonic series for the first time. I was floored when I realised that the twelve – tone equal temperament system that we use almost universally in music, and the intervals between these notes, are found naturally occurring as a principle of physics in the harmonic series. (The harmonic series describes a series of overtones created after a fundamental is played on a resonating instrument. I'll stop here as I can hear an army of much better trained musicians typing furiously to email the SMA News Editor about equal temperament as they read this.)
The mind-bending upshot to all that music-geekery is that music is fundamental to the reality we live in, and to life really.
I may even go so far as to say that when these mere oscillating waves of sound travel through the air and slap your eardrums unceremoniously, and you can feel your spirit lift and soar during your favourite song – that's a hint of the divine and the mind of God right there. That's life and joy, really. (I hope that was enough payoff for having to read through that.)
The experience of music, I think, sits squarely at a meeting point. The meeting between mind, body and spirit, between the technical and sublime, between listener and musician, between one person and a thousand, between hours of chair-warming practice and ten seconds of spontaneous improvisation that scares your pants off, between science and art.
There's a pathway from motor cortex to spinal cord, alpha motor neuron, muscle fibres and to the movement of the vocal cords and fingers, but really, where does the music come from? Where does it go? What does it do when it leaves the musician and causes an audience full of strangers to feel the same feeling at the exact same moment? Is there a rule for having too many questions in a row in an essay? Who knows?
Music and medicine
When I get asked occasionally about how music relates to medicine, to my career and to caring for patients – I get an odd anxious feeling that I have a lot and yet very little to say at the same time. I really want to say "I love music" and proceed to elaborate on that in a long-winded way that would make Gandalf ask for a toilet break.
But really, I could not hope (or even attempt) to begin to summarise the power and joy of music – but I hope that in those meandering paragraphs above, you begin to understand what I mean when I say: "I really love music".
I would defer to my many far more experienced colleagues on this, but insofar in my personal experience as a hospitalist in an acute medical speciality, I have seen a fair amount of suffering. Death is always a sobering reminder that life is unthinkably fragile and finite. Fatigue and weariness at the seeming randomness of illness and suffering are always ready to set in. I do my best to remind myself that the goal of medicine is really to support life, the experience of life and the joy of living, and music has always unfailingly reminded me of that.
To indulge in some of Dr Hoe's music and recordings, visit https://www.youtube.com/joshhoe or follow him on Instagram @hoestudios.
Stephanie Yeap
What is your favourite post – call activity? For some, it may be going home to take a good nap, meeting friends for a meal, or even catching a movie – things that our long work days would preclude us from enjoying regularly. For me, my best post-call moments would be spent singing at one of my favourite bars, under the starlit sky.
My journey as a singer-songwriter began when I was in junior college, having been part of the school's rock band co-curricular activity. Entering medical school, one of my biggest worries was not being able to play music as a working doctor, and hence with every opportunity to perform, my mantra was "this could be my last chance".
This mantra stayed with me through the years, where I'd eagerly contribute to school events, or take part in the Medical Society's annual Open Mic, which led to me taking big leaps in my music career including joining the National Arts Council's prestigious Noise Singapore mentorship programme and taking part in Sing! China auditions. This idea that I had to seize every gig opportunity, or risk regretting declining gig offers when I began work fuelled me as I juggled both music and medical school.
What initially began as little stints on stage as a Year 1 student grew into an exciting journey – including singing live on radio, playing for the President of Singapore and helming my own show on the grand Esplanade waterfront stage.
Perhaps the greatest joy, however, was marrying my love for music with my work in medicine. This manifested in reaching out to others through music, as well as writing songs about my experiences.
Connections through music
One of my most distinct memories was during my Year 4 psychiatry medicine posting in the Institute of Mental Health. We'd been assigned to the A&E where, as many of us know, patients with suicidal intent are often sent. I was to clerk a young man who'd just come in – with a stoic face he revealed that he'd come from a strict family with high expectations for his career. He eventually caved and broke down, sharing that he'd been contemplating taking his life because his father threatened to disown him if he pursued what he loved: music. As opposed to continuing the "nine-grid" history-taking template we'd been taught to administer, I paused and explained, "Actually, I'm a musician too." We then went on to discuss the struggles of being passionate about music, amid the pressures of more "traditional" priorities like good grades and a professional job. At the end, the patient appeared comforted and was encouraged to talk things out with his father. In that moment, it felt almost serendipitous.
Of course, now as a working doctor and especially with the cessation of live music during COVID-19 times, my nights playing gigs have dwindled. Nonetheless, being a doctor has put me in a privileged position to encourage others through music. One such opportunity was collaborating with Creative Nation Singapore (a collective by the National Youth Council) to curate a Spotify playlist entitled "Stockpile of Love", which features songs to encourage front-line workers and COVID-19-stricken patients recovering in the wards.
Reaching out over distances
Writing original music has also allowed me to document my experiences in lyric and song, and connect with others. One amazing encounter I had was receiving an email from a listener in the US – she shared that her daughter, a competitive dancer, survived a harrowing bout of supraventricular tachycardia earlier that year. Having chanced upon "Emergency Room" on Spotify, an original song I wrote about my grandfather, she was inspired to use it as her contemporary solo piece, relating it to her own experiences in the emergency room. For one, it was incredible to realise that my music had reached somewhere so far away from home, but more importantly, it was heartening to know that my music connected to others' personal experiences and further inspired their expression of art.
What would be my biggest advice to peers or juniors who feel driven to pursue a passion outside of medicine, be it music, photography, crafts, gaming or even cooking? Sometimes the best thing we can do is to just take a deep breath and make the plunge, reminding ourselves that "this could be my last chance". Because if not now, then when?
When the pandemic gets better, and you're heading to your favourite bar for a drink after work, don't be surprised if you see a bleary-eyed but smiley singer providing background music for the evening. Just give a little smile and wave, for that could be me post-call!