Dr. John Leonetti, a skull-base surgeon at Loyola University Medical Center, has his operations down to a routine, even when it comes to the background music.
“The vast majority of what I do is tumor surgery, (removing) big tumors of the skull that sometimes take 6 and 12 hours,” Leonetti says. “At the beginning of the case when everyone is full of energy and enthusiasm to get things going we usually play fast, upbeat music.
“My preference is for John Mellencamp and Phil Collins type of music, but I have a theme song, George Thorogood’s `Bad to the Bone.’ Our goal is to get down to the skull in a hurry, and so the nurses put on that song on the CD player I bought for the operating room. It’s my opening song for just about every case.
“Once we’re into most tumor cases, there’s a point where we need dead silence because what we do requires monitoring of certain nerves and the monitoring system has an audio feedback to us, meaning if we touch a nerve we hear a response.”
Once the tumor is removed and the monitoring systems are shut down, Leonetti says he switches to “what I guess we would call closing music. Usually at the end of the day it tends to be mellow. We have a lot of ’60s Motown discs, especially the Temptations, my favorite. I also like Frank Sinatra and Harry Connick Jr. at the end of the day, too.”
Some surgeons swear by background music; others detest it. But it’s a way of life in most operating rooms.
“Music helps break the tension,” Leonetti says. “I’m sure that in every situation, there comes a point where you can block out not only the music but any talking or noise, so you can concentrate on what you’re doing. But music is definitely soothing.”
Dr. Andrew Brill, a gynecologic surgeon at the University of Illinois Medical Center, noted that the use of music in operating rooms “goes very far back. In my experience being in a number of surgeons’ environments, I think that classical music tends to be the predominant theme.
“I don’t know if that reflects the grandiosity of the personality-classical music tends to be much more grandiose than anything else-but surely it would fit the nature of the beast in the operating room. Especially if you walk in and hear Beethoven’s Ninth Symphony, you know there’s quite a personality in the room.”
Brill prefers the contemporary instrumental/light jazz pastiche usually called new-age music, particularly Andreas Vollenweider, Ray Lynch, Kitaro and Shadowfax. “I’ve always listened to this,” he says. “I’m a product of the ’60s, and these kinds of things live forever in your soul.”
Music in the operating room, Brill added, “perpetuates two changes: It congeals individuals into better teamwork and it diminishes the tension around difficult operative tasks. I’m very conscious of hearing it (while working).”
Tuning in
Dr. James Piper, a liver transplant surgeon at the University of Chicago Medical Center, says that “where I trained and did my residency, they didn’t allow music in the operating rooms. The head nurse didn’t think it was appropriate, and although she was in the minority she made the rules. It’s so much nicer with music.
“We have overhead music in all the operating rooms, but the radio stations are picked for you. I’m just not a big fan of those real 1993 stations, like ‘XRT. I bring in my own CDs. I’m into oldies. I listen to what I grew up with, high school and college type stuff. I like Billy Joel, even his new stuff. I really like Phil Collins, got a lot of the old Genesis stuff. Pretty much every Beatles CD they have. I like some musicals too. I’ve got `Phantom of the Opera.’ I like Eric Clapton `Unplugged.’ Three or four Eric Clapton solo albums-`Slowhand,’ `August.’ I never was a heavy-metal type of person.”
For Dr. Aaron Rosenberg, an orthopedic surgeon at Rush-Presbyterian-St. Luke’s Medical Center, the operating-room soundtrack depends on “what we’re doing and what kind of mood we’re in. We often listen to radio stations. We listen to WCKG (classic rock), WJMK (oldies), WXRT (progressive rock) and WNUA (smooth jazz). If we’re operating at night, we’ll listen to Dick Buckley (jazz) on WBEZ.
“We also listen to CDs. But we don’t listen to much classical music, because it tends to be more soothing and we like something more upbeat, like almost anything else you use music to accompany. In orthopedics we do a lot of pounding and hammering and use power tools like saws. So we like music with a fast, rhythmic pace. With delicate work, dissecting, we want something a little more soothing.
“As I get older, I am more and more influenced by the music the residents listen to. I let them bring in their CDs and I get exposed to a lot of contemporary stuff that way. They play World Party, 10,000 Maniacs, Los Lobos. I’ve been listening myself lately to a lot of Gypsy Kings, Go West.”
A generation gap
Dr. Jose Velasco, a laparoscopic surgeon at Rush-Presbyterian and also chairman of surgery at Rush North Shore Medical Center, says he is “all for” operating-room music. After all, he says, he ordered built-in CD players for each operating room at Rush North Shore.
“I used to enjoy having music in the operating room-smooth, classical, relaxing type of music,” Velasco says. “What has happened quite honestly is that the new generation has come around, residents and students. Their choice is rap music, rock ‘n’ roll, hard rock. I don’t think that is relaxing. I think that is disruptive.”
Dr. Douglas Chyatte, a neurosurgeon at Northwestern University Medical Center, says he prefers classical music. “My residents prefer more modern music. They don’t like to listen to composers that are dead. Composerwise, I tend to play a lot of Mozart because I think it’s very relaxing for most people in the operating room. The chief resident I have now likes 103.5, whatever that is.” (It’s WWBZ, a rock station.)
At Columbus Hospital, neurosurgeon Leonard Cerullo, director of the Chicago Institute of Neurosurgery and Neuroresearch, says he prefers “either classical or new age. I just choose a channel on the radio. I like WFMT and I like WNUA. Whatever they’re playing is what I listen to.
“But what happens is that at a certain part of the case when I’m really concentrating, I don’t hear it anymore. Then later when we’re closing, it’s kind of the denouement of the operation and I hear the music again. So it really doesn’t matter.”
Dr. John Sanders, a heart surgeon at Northwestern University Medical Center, says his idea of music is “very soft type classical music. Not opera, non-vocal. Either tape or CD because I don’t want vocal or news or anything that would be distracting, something that you would listen to and say, `Oh, I didn’t know the Bulls lost,’ something like that.
“There’s an enormous capacity in a complex operating room, like a heart room or neurosurgical room, for there to be sidebar conversations that arise naturally but can be distracting to the surgeon who’s trying to do the work. Sure, you can silence that, if you want, but a very soft background of classical music tends to keep it down.
“Specifically, I like what I would call fairly baroque pieces. I like Bach, Mozart, some of the more peaceful things. You don’t want a lot of Wagner in there or rock music either, but I know people that do. It drives me crazy.”
Sanders noted that with current anesthesia techniques patients cannot hear, but he says that “some people feel that there are even unconscious abilities to hear in which case some peaceful music would be fine, I suppose. As long as it’s not organ music.”
Not too much Wagner
At Rush-Presbyterian, neurosurgeon Kelvin Von Roenn prefers classical music and opera he has on tape and CD. “I prefer (the operas of) Verdi, Rossini and Wagner, in that order. From Verdi I’m partial to `La Traviata,’ also `La Forza del Destino’; with Puccini, probably `Tosca’; and with Wagner it depends on whether I can get the others in the room to listen to it for a very long time. A lot of times everybody says, `Please turn it off.’ I tend to play it louder than most people. It doesn’t seem to bother me.”
Dr. Gregory Matz, chairman of otolaryngology/head-neck surgery at Loyola University, says: “I do a lot of long cases, a lot of cancer surgery. I like to listen to opera in the OR; my four favorite operas are `La Boheme’-which was the music in the movie `Moonstruck,’ remember?-`Madame Butterfly,’ `Rigoletto’ and `Don Giovanni.’ But I will listen to any opera. It relaxes me.
“Then when we’re finished and we’re sewing up the skin, I will allow three minutes of Pink Floyd’s `Dark Side of the Moon’ or some Grateful Dead, but I can’t stand any more than that.”
Obviously, musical preferences are as different as each surgeon, but you just can’t stop rock ‘n’ roll.
Heart surgeons Bradley Allen and Renee Hartz, who are partners at the University of Illinois Medical Center, where Hartz is chief of cardiovascular surgery, play different music for each stage of the case.
“Early on we may play some Grateful Dead, maybe some Jimmy Buffett,” Allen says. When a heart-lung machine takes over for the patient, he says, “we play much more soothing and calm music. We play more new age, Enya, Earl Klugh, David Lanz; or some jazz, Everett Harp, David Benoit.
“When we’ve finished the operation and we’re closing the patient, we play more jazzy and rock music. Beatles, Gypsy Kings, Wailing Souls-those are popular for closing. We also play harder rock-Eric Clapton, Rolling Stones.”
Dr. Ricardo Izquierdo, a plastic surgeon at Loyola Medical Center, says his soundtrack depends on whether his patient is under full anesthesia or awake and mildly sedated. “If the patient is awake I try to find something that’s a common denominator, Beethoven or Segovia, who is a Spanish classical guitarist, or maybe John Coltrane or some soft jazz,” Izquierdo says.
“When the patient is asleep, I will listen to R.E.M., Suzanne Vega and Bonnie Raitt, and even such eclectic stuff as Talking Heads and old stuff like acoustic Hot Tuna and early Eric Clapton-Yardbirds/Cream. Every once in a while I will listen to Motley Crue.
“I’ve surprised a few people in the OR, because sometimes I will play a lot of rock ‘n’ roll, for example a lot of Grateful Dead and the offshoots like the Jerry Garcia Band. People have no idea who they are and then when they find out, they’re surprised. But in the operating room, the tension is multiplied several fold and something that is calming to me is important.”
TOPPING THE CHARTS IN THE OPERATING ROOM
Our random sampling of the musical preferences of Chicago surgeons while they work was hardly scientific, and the music varies greatly depending on the surgeon and the case.
Baby Boomer doctors tend to prefer rock, though usually not the cutting-edge stuff. And those who prefer classical music often favored light, soothing sounds, such as Mozart.
Here are the five artists or groups whose names came up more than once, a sort of Surgeons’ Top 5:
– Eric Clapton
– Phil Collins
– Beatles
– The Grateful Dead
– Gypsy Kings
