The Hippocratic Overture

Students at Columbia’s College of Physicians and Surgeons are getting ready to practice. Will it make them better doctors?

by Paul Hond Published Spring 2015
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The CUMC Symphony Orchestra, with Hanjay Wang Conducting / Photographs by Jörg Meyer

Two grand pianos face each other, fitted along their broad curves but not touching, like two continents early in their separation. At one piano, Aidin Ashoori, who weeks earlier had played Chopin at Carnegie Hall, adjusts his bench. At the other, Stephanie Chen, a Juilliard graduate, lifts her arms. Chen and Ashoori are set to attack Gershwin’s Concerto in F, the grand finale of an evening that included violinist Jeremy Ying sawing a Bach partita and pianist Devon Joiner sculpting a Chopin ballade.

Several factors make this recital curious. First, there’s the venue: Bard Hall Lounge, which by day is a study area in the Bard Hall dormitory on Haven Avenue and West 169th Street, on Columbia’s medical campus. Second, the performers — there are a dozen on the night’s program — are all medical students. Third, the audience of more than sixty is made up of medical students and faculty, and most of them are musicians. Fourth, this evening in the fall of 2014 is a “Musical Monday,” one concert in a long-­running bimonthly series that is among many student­-run musical events presented throughout the academic year, covering classical, pop, and musical theater.

Fifth, there’s the Steinway that Ashoori is playing. Legend has it that it once belonged to the composer and pianist Sergei Rachmaninoff. We’ll get to that.

Ashoori and Chen go to work, rattling the room’s windows with a burst of trembling octaves. The harmonic vibrations in Bard Hall Lounge clash loudly with popular notions of medical­-school life — the stress, burnout, and anger that the New York Times once described as “the misery of the med student.” To be fair, most of the performers this Musical Monday have yet to enter Major Clinical Year, or MCY, a period of clinical rotations that at any school is extremely taxing — a 2013 Slate article called it “The Darkest Year of Medical School” (subhead: “Students come in altruistic and empathetic. They leave jaded and bitter”). And while the Slate piece didn’t mention Columbia’s College of Physicians and Surgeons (P&S), it’s still odd to hear, inside Bard Hall Lounge, not weeping and gnashing of teeth, but Vivaldi.

So how did all these concert-­level musicians end up at P&S? Last year, of some 7,800 applicants, the school enrolled 160 future doctors, more than a third of whom were as comfortable with operettas as operations. While skilled musicians aren’t a rarity in the medical profession — both occupations require, after all, high doses of discipline and ambition — the rate in the student body at P&S is striking. Is there some other influence at play?

“I was a loud baby. Difficult. I threw tantrums. The only way my parents could shut me up was to play music.”

Thus Aidin Ashoori’s fixation with music and the mind took root at an early age.

Still, it’s hard to imagine this gentle, formidable pianist as a screaming infant — his outbursts come so dressed in rippling triplets and sforzando bolts.

“When they told me they had the Rachmaninoff piano, I knew I wanted to come here.”

Ashoori was born in Japan, where his parents worked as biomedical researchers. His mother was from China, and would take her son on her bicycle through the streets of Kyoto to his piano lesson. His father was of Persian descent and moved to Japan in 1979.

Aidin AshooriWhen Ashoori was seven, the family relocated to Houston. Ashoori’s parents saw his skill at the piano and pushed him. “My frontal lobes hadn’t really developed, so I didn’t have conscious awareness of what was going on,” says Ashoori, a neuroscience buff. “I could be stubborn, but I felt that I should do what was expected of me.”

It wasn’t until he was twelve and encountered Arthur Rubinstein’s recordings of Chopin that all the hard work he’d put into piano began to make sense. Now he had a model to emulate. He won awards, and was recommended to a famous teacher. “He was very strict, very harsh. He’d call you names, slap your wrist. I practiced out of fear. I dreaded every lesson.”

When Ashoori was fifteen, his parents split up. Ashoori sank into a depression. “I felt hopeless about everything, and I worked those feelings out through music.” Music, skateboarding, chess — those things saved him from falling under some bad influences, he says.

Around that time, he was invited to perform at a hospice. As he played, he watched in amazement as the glum, apathetic audience came to life. “It was the most appreciative crowd I’ve ever played for. Some people even cried. I thought, ‘This is interesting.’ I realized there’s a huge connection between music and the mind.”

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I am a P&S alumnus, class of ’81. While at MIT, prior to coming to Columbia P&S, I was privileged to play the trumpet in our Concert Jazz Band and also in the Festival Jazz Band. Once I embarked on my medical education, I was unable to maintain my “chops” on the trumpet.

After completion of my residency, I picked up the saxophone, in that the chops required of the woodwind player was far less than that of a brass horn player. I was fortunate to have been able play as the lead alto in our local community big band, the Swing Shift Orchestra, for about 10 years up until a couple of years ago. I was also fortunate to play a number of gigs in small combo bands over the years in various local venues.

As I read this very well written article exploring the connection between music and medicine, I was very moved by some of the insights that were shared.

Musicians, by nature and by training, are better listeners. Musicians also tend to be more passionate and compassionate, striving for perfection while attempting to connect with all of humanity through a universal language. This is by no means to say that non-musicians are less proficient, passionate or compassionate, in defense of many colleagues that are not musicians, yet practice surgery with virtuosity and technical excellence or practice medicine with similar clinical excellence.

I remember when I was an attending at Cedars Sinai Medical Center, I would try to encourage the surgical residents to strive for technical excellence using the analogy of musicians striving to be able to perform at Carnegie Hall. Virtuosity in the operating room should be no different that virtuosity in Carnegie Hall.

There is no doubt that my love of music and my pursuit of virtuosity with my instruments has greatly helped me in becoming a better doctor overall, in becoming a better general and laparoscopic surgeon with the manual and physical dexterity skills required of any horn, string, or keyboard player, and also in becoming a “conductor” in the operating room with many key players all working harmoniously to achieve the best outcome for our patients.

I would like to add an additional insight that was not brought up in the article.
Jazz, which can justifiably claim its rightful birth and maturation in America, has contributed significantly to my development as a surgeon. In Jazz, there is much emphasis on improvisation, which requires not only listening to what is going on, but requires one to then create extemporaneously music that works both in rhythm and in harmony. In surgery, while most straight-forward cases proceed in the classical mode, there are situations that require a quick shift into the jazz mode, requiring the surgeon to improvise and go quickly with different keys, tempos, meters, and unconventional chord changes.

This cross training, without a doubt, has helped me to quickly and effectively navigate difficult situations in the operating room which I believe has resulted in better patient outcomes.

I applaud Stephen Nicholas, the Dean of Admissions, for his insightful recognition of attributes other than test scores and grades, in his mission of selecting new future doctors that will excel and contribute greatly to society as physicians and surgeons of great ability both in regards to technical skills and intellectual skills, but also in regards to passion, and compassion.

Thank you so much for your thoughtful and interesting comment and for your additional insights. With your permission we would love to publish a portion of this comment in the next issue of our magazine.

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