About halfway through the angiogram, Dr. Mark Goodwin sensed that something wasn’t quite right.
The music wasn’t loud enough.
So a nurse went over to the stereo and cranked up the volume on U2’s “Beautiful Day.”
What had been a changing-the-sparkplugs-in-the-garage level became a hey-you-kids-turn-down-that-damn-music level.
Music is as common in operating rooms–or in this case, a catheterization lab at Edward Heart Hospital in Naperville–as surgical masks or scalpels. Studies have shown that it relaxes both doctors and patients, improves a doctor’s performance and lowers the amount of anesthesia a patient needs. If you’re going to have surgery or a medical procedure, chances are there will be a soundtrack.
“It’s sort of like if you’re doing a chore around the house,” explained Goodwin, a cardiologist with Midwest Heart Specialists, based at Edward. “You can have music on and still be very concentrated on what you’re doing. There are different areas of the brain that are able to process and do different things at different times. So when the music is on, although I hear the music, my focus is 100 percent on the patient, what’s going on. It’s just relaxing to me to have the music on. It makes me very comfortable in the room.
“What probably differentiates me is I tend to like it fairly loud.”
Fairly loud?
“Fairly loud. Loud enough so you can clearly hear it outside the room.”
That’s not exactly how OR music is often portrayed. In television’s “Nip/Tuck” (9 p.m. Tuesdays, FX), for example, the show’s plastic surgeons often work with tunes such as “Santa Maria” by Gotan Project or “More Than This” by Roxy Music playing gently in the background.
Not always so, say the guys who would know.
“We don’t want anything particularly slow,” said Dr. Andrew Roth, an attending anesthesiologist at Children’s Memorial Hospital in Chicago. “It’s got to be upbeat enough so you keep working, not feel like you’re dying.”
“There is a beat to it, a rhythm they do follow,” agreed Ben Corpuz, clinic coordinator for interventional radiology at Northwestern Memorial Hospital. “It helps with the progress they’re making.”
Name that tune
How do doctors select their music? Sometimes they don’t.
“I guess most of the time, the first thing I do is ask the patient if there’s something they prefer,” Goodwin said. “Most of the patients don’t, but some will bring in a CD from home and that’s what we play. . . .
“If they like something, even though they’re going to be asleep for a procedure, some people believe their hearing sense may still be preserved and we want them to be relaxed and hear what they like.”
Corpuz says patients at Northwestern also get first crack at the CD player. If they have no preference, the medical staff chooses.
“It’s geared to the generation of the workers,” Corpuz said. “So if you have residents, they’re going to be younger, so they like the indie rock thing. Go older, and you get the alternative thing. It follows the decades of music.
“Technicians are a little older, and they like R&B stuff. There aren’t too many on the classical side. We even had a resident who came in and wanted to hear some bluegrass.”
When Dr. Beatrice Mounts is in the OR, a stereo is tuned to FM stations WLIT (93.9), WTMX (101.9) or WILV (100.3).
“At home I listen to Spanish music,” said Mounts, an obstetrician/gynecologist at MacNeil Hospital in Berwyn and who is Mexican-American. “But in the operating room we listen to pop music, ’70s, ’80s, because everyone in the OR is not bilingual.”
She also says that a lot of her patients are middle-age, and they relate to those stations’ playlists. The staff likes it too.
“It’s something that people are familiar with, that they can sing along [to],” she said. “It creates a unity. People are so familiar with the songs, somebody will have a story. `Oh, I remember when that first came out.’ . . . “
Similarly, Dr. Vincent Bufalino, the president of Midwest Heart Specialists and medical director of Edward Heart Hospital, says that from his perspective “it’s oldies but goodies.”
“I’m still stuck on the old stuff. I enjoy classical. I’m not a country and western guy. No rap. . . . 100.3 is sort of my speed on the FM dial. I’m sort of looking for ’60s and ’70s kind of stuff, that’s still what I enjoy.”
Roth at Children’s Memorial says that just like surgery, the choice of music is a joint effort.
“I tend to like ’60s, ’70s, a little country and western, some modern stuff,” Roth said. “I’m not particularly big on classical, but I enjoy it sometimes, depending on what it is. We have people with completely different tastes, from classical to klezmer to pop to whatever.”
During the one-hour angiogram in the cath lab, Goodwin played songs by John Mayer, Jack Johnson, Five for Fighting, The Format, the Goo Goo Dolls, Everclear, Gnarls Barkley, OAR, Green Day and, of course, U2.
“I have four kids, ages 17 to 22, so I get to hear a wide variety of music,” he said. “A lot of which I like, some I don’t. It’s pretty much, I hear a song on the radio or my sons or my daughters play a CD I like, I’ll bring in the CD or we’ll burn something off iTunes and we’ll listen to it.”
Mindful of the mission
No matter how much everyone enjoys music in the OR, doctors always are careful that it doesn’t get in the way.
Roth says he keeps the music at a level where he can still hear his monitors.
“I have the last say when it comes to safety,” he said. “So if something is becoming distracting or too loud, patient safety has to be first.”
“We use volume control,” Corpuz said of how patients are safeguarded at Northwestern. “It’s almost always playing, even in the hard procedures we do with neurology, brain and spine work that tends to be meticulous. So they control their music more.”
But generally the music plays on. The benefits are too many to ignore.
“I saw a study,” Goodwin said, “that showed that no matter what happens, if you just think of a song or break into just whistling or singing, it immediately releases the tension in your body and makes you relax. And I think that’s sort of true. If you think about times when you’re singing, generally you feel better.
“I do think that music, whether it’s a symphony or whatever, touches our soul in a different way. And I think that anything that does that helps heal us.”
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Cue the CD player and let the healing begin
Toe-tapping surgeons aren’t the only ones who benefit from music in the operating room. It can help patients, too, according to several studies.
One, published in 2005 in the journal Ambulatory Anesthesia, found that patients who listened to their favorite music required less sedation during surgery than did those who listened to white noise or operating room noise.
Senior author Dr. Zeev Kain, a professor in the Yale University department of anesthesiology, said that previous studies had shown that music decreased sedative requirements in patients. This study sought to determine if the decrease resulted from listening to music or eliminating operating room noise. Kain’s research found that blocking the sounds of the operating room with white noise did not decrease the patients’ sedative requirements, while playing music did.
“Doctors and patients should both note that music can be used to supplement sedation in the operating room,” Kain wrote.
The study supports what other researchers have found through the years: Music makes a difference in the OR.
A University of Toronto study, published in 1997 in the Canadian Journal of Anesthesia, concluded that elderly patients having cataract surgery were more satisfied with the experience if they heard relaxing music instead of relaxing suggestions, operating room noise or white noise.
And a University of Buffalo study in 1994, published in the Journal of the American Medical Association, showed that the surgeons were able to concentrate better and subsequently perform better if they listened to their own musical selections rather than control music or when no music was playing.
Dr. Mark Goodwin, a cardiologist with Midwest Heart Specialists at Edward Heart Hospital in Naperville, concurs with the notion of better performance.
“An example they give [in the studies],” he said, “is if you’ve ever walked into a situation that is totally dead silent, there is a certain discomfort. In a procedure, first off you want the patient to be relaxed and staff to be relaxed and confident, and it’s not mutually exclusive to have music and do a good job. And I think that when the patient is relaxed and [feels] confident and the staff feels good, everyone does a better job.”
–William Hageman
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Bad-idea playlist
Q’s list of songs you don’t want to hear while on the operating table:
– “Knockin’ on Heaven’s Door” (Bob Dylan)
– “Fixing a Hole” (Beatles)
– “Bad Liver and a Broken Heart” (Tom Waits)
– “Don’t Let Us Get Sick” (Warren Zevon)
– “What’s the Ugliest Part of Your Body?” (Frank Zappa & the Mothers of Invention)
– “She Blinded Me With Science” (Thomas Dolby)
– “I’ve Got You Under My Skin” (Frank Sinatra)
These tunes make the cut
What tops Dr. Mark Goodwin’s playlist? Here are some of his favorite songs:
– “Beautiful Day” (U2)
– “Sympathy for the Devil” (The Rolling Stones)
– “Paradise by the Dashboard Light” (Meat Loaf)
– “Brown Eyed Girl” (Van Morrison)
– “Good Riddance (Time of Your Life)” (Green Day)
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We vote for `Mack the Knife’
If you’re already contemplating what tunes you’ll request for your next visit to the surgical suite, then you need to check out Q’s Challenge on Page 8.
bhageman@tribune.com
