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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Stephanie ChenWhen Chen was four, she climbed onto the piano bench at her home in Austin, Texas, and picked out a tune. At six she began taking lessons. At nine she made her orchestral debut with the Austin Civic Orchestra, playing Mozart’s Concerto no. 23.

By high school, medicine began to interest her. But music was her love. She auditioned for Juilliard and got in.

Musically, she was touching the upper ether. But something was missing. In her first year she began performing in hospitals and found that the spiritual healing of music fed a desire to have an even more direct and tangible effect on people. She took science classes at Columbia through the Columbia-Juilliard Exchange, a program that allows selected students from each school to take classes at the other. By her senior year she decided to go into medicine.

In 2013 she entered P&S and became president of the Musicians’ Guild, the group that oversees musical events. The guild, like all student activities, falls under the canopy of the P&S Club, which calls itself “the most comprehensive student activities organization in American medical education.” She also started Artreach, a concert series for hospital patients at CUMC.

During her first year, Chen practiced a few days a week. Second year is different. At P&S, students start their clinical rotations in the second half of their second year, requiring a musician to do something entirely new: drastically limit her musical pursuits.

To mark the transition, Chen put on a concert in January in “celebration of the end of classroom lectures and the beginning of hospital rotations.” A bravura sendoff, borne through the bones of the gaping Rachmaninoff grand. Chen played a Chopin polonaise, the Ravel piano trio (with Jeremy Ying on violin and Chris Hoeger on cello), and Beethoven’s Piano Sonata no. 23 in F Minor (Appassionata), an immense and turbulent edifice of precipitous difficulty.

Chen scaled it, pinned aloft in clouds of beauty, struggle, and conflict. Then she came down in a furious, flurrying march, ended on three hammer blows, and took a final bow.

“My musical involvement on campus is a little pathological,” says violinist Jeremy Ying, who came to P&S straight from Harvard. “I never have enough.” Ying is a caprice, a human pizzicato, all vivacity and pluck. He signs up for everything, and has opinions on nearly that much.

The string quartet is the kingpin of chamber music. Thus began Ying’s essay for his med­-school application. “That contentious statement got me in trouble with a few interviewers,” Ying says, referring to some woodwind players. “My entire essay was based on my experience in a string quartet. Being on a medical team is like being on a musical team.” The string quartet is a conversation between instruments, Ying wrote, and for an elegant conversation to take place, one must have a full understanding of the language. In this case we had to control our instruments as if they were bodily extensions and play together in a concert . . . This teambuilding exercise prepares me well for physician consultations and the intricate dance in the surgery room.

Jeremy YingYing loves to communicate, sometimes provocatively — he does salty standup comedy, too — and ties his sociability to his instrument. “Not to harp on pianists,” he says, “but they’re more lone wolves. They can be very introverted and standoffish. Violinists are usually social chameleons, because they almost always play with others.”

Ying grew up in Plano, Texas, near Dallas, and displays a Texas-­sized capacity for spreading himself out. There he is, dressed in black, leading the five-member beatboxing vocal group the Pentamedix; and there, directing CUMC’s a cappella group, the Ultrasounds; and there, in a tux and orange bow tie, conducting the pit orchestra for the Bard Hall Players’ production of The Music Man. He says music makes him “more in touch with the human condition,” and now that he isn’t trying to go pro (“If you don’t break at sixteen, there’s very little chance that you’ll make it”), his relationship with music is “much more fun.”

“Music brings people together,” he says. “Last night, we had a Pentamedix rehearsal in my apartment. We chatted, we had snacks, we sang, and it sounded great. I just love music — for my own pleasure, for school functions, for my friends.”

Ying has to go. Another packed day: lunch, study, and his Internet book club (he’s reading The Brothers Karamazov). He knows now, in the fall, that his activities will be curtailed in the spring, when he starts his rotations. Perhaps, like a bear before hibernation, Ying is fattening up.

Jessica Means likes to cut through a good barrier. At Harvard, she was the first female conductor of the Hasty Pudding Theatricals, a student group that has been putting on burlesque shows since 1844. She also has a gift for sight-­reading. When she moved to New York in 2009, she went around to the Broadway theaters, handing out her résumé, saying, “I sight-­read. I’ll play for you.”

One night, Alice Ripley, the Tony Award–winning star of the musical Next to Normal (written by Tom Kitt ’96CC and Brian Yorkey ’93CC), was standing outside the Booth Theatre on West 45th Street signing autographs, when Means broke through the force field of fame and said to Ripley, “I’m your new accompanist.”

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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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