OR physicians use music to help soothe the savages of surgery
By Gary Pettus
On a recent morning at Batson Children’s Hospital, the sounds of surgery filled Operating Room 6: monitors beeped, a ventilator hissed, suction tubes squished, Tom Petty’s heart broke.“Last dance with Mary Jane, one more time to kill the pain.”
Hour after hour, rock, pop and more dripped softly from speakers into the antiseptic air as Dr. Lawrence Haber and his surgical team labored to straighten a young patient’s spine.
Metal rods? Check. Screws? Check. Barenaked Ladies? Check.
“Barenaked Ladies,” Haber said to his team, “is always good.”
In the world of modern medicine, where surgical skill is often accompanied by output from iPods, iPads and Pandora, Haber’s melodious milieu is fairly typical.
A survey cited in the medical publication “Injury” in 2008 found that 63 percent of the participating nurses and doctors listened to music in the OR, while nearly 80 percent said that music in that severe environment stimulated serenity, even efficiency.
Haber, 47, chief of pediatric orthopedic surgery and a scoliosis treatment specialist partial to Nickelback, estimated that at least 50 percent of UMMC surgeons believe the likes of CCR, REM and O.A.R. are OK in the OR.
Wayne Gale, a surgical tech who works with Haber and a half-dozen other surgeons at Batson Children’s Hospital, said all but one will inject music into their work.
“They have pretty good selections in there,” said Gale, 47. “The music doesn’t disturb me at all. But I don’t miss it if it’s not there.”
The practice has its critics, and some medical experts lump it with other purported OR disruptions, including cell phones and pagers. But Haber has been sold on it at least since he was a second-year resident.
“I did a knee scope once with a sports surgery guy who was playing Pink Floyd,” Haber said. “’Dark Side of the Moon,’ I believe. I thought, ‘This is the coolest.’
“In school, I always studied to music, wearing headphones with Guns N’ Roses playing, or AC/DC.”
Also a classical music fan who owns two violins he played until he “got too busy,” Haber laid out his case in the August issue of the American Academy of Orthopaedic Surgeons’ publication.
“There has always been a connection between music and surgeons,” he wrote in an AAOS Now point/counterpoint editorial. “Both disciplines require active thought, manual dexterity and practice to create perfection. One observer in my OR insisted that surgery is like a choreographed dance, so it’s only natural that music would be playing in the background.”
He added this caution, however: “Choose music that makes you happy and relaxed, but also is compatible with deep thought. Avoid depressing music or lyrics like ‘When I die young.’”
Haber wrote the piece at the request of Dr. John Purvis, 64, associate professor of orthopedic surgery and member of the AAOS Now editorial board who, by contrast, has excised music from his OR — with one exception.
“If patients enter the OR still alert, before the anesthesia makes them too groggy, they might be more comfortable if it’s their music they hear playing,” Purvis said. “It can help them relax.
“But during surgery, I see music as a distraction.”
His dissent echoes that of Dr. Stuart J. Fischer, a New Jersey surgeon who tried to puncture Haber’s argument with his dueling essay in AAOS Now.
“Loud music . . . might obscure critical auditory feedback that could be helpful to a surgeon during a procedure,” Fischer wrote.
For his part, Haber quashes the music at key points. Whenever he has to communicate with someone across the room or do a back-and-forth with the anesthesiologist, the music goes off, he said in an interview.
“But the music is never at a level where people can’t be heard. And the type of surgery I do, you feel it more than you hear it,” he said. “It can be done in a way that’s not distracting, and it shouldn’t be, because it’s a serious place where we work.
“But it’s not as if we’re singing in the OR, right?”
Throughout operations that may last seven or eight hours, Haber has the music changed to fit the varying “moods” of surgery. Often, during the first stage, it’s relaxing pop or jazz, perhaps David Grusin.
“In the middle, it’s usually rock,” he said. “You get a little tired; I use it as a pick-me-up.
“At the end, it may be something more fun, like Barenaked Ladies or Maroon 5. Country is also nice.”
Like workplace banter about football or your kid’s soccer game, Haber said, music introduces a reassuring element of normalcy in the “unnatural setting” of the OR, an alien world inhabited by forests of snaking tubes and hoses; alarming organisms that constantly beep, blip or sizzle; and a swarm of needle-nosed surgery lamps gazing down at the patient like giant, thirsty mosquitoes.
Amid these surroundings, Tom Petty and the Heartbreakers, et al., crooned at a low, elevator-ride volume in Haber’s OR – background noise, like the sound of the surf as you devour a best-seller on the beach.
But Purvis said he once encountered the opposite extreme at another hospital – an obnoxious “boom-boom-boom” in an adjoining OR as the attending surgeon performed a noisy joint replacement.
Surveys and studies of medical professionals both bolster and undermine the practice. An analysis published in the British journal Anaesthesia in 1997 found that 51 percent of those surveyed believed music was distracting when a problem arose during the anesthetic.
Conversely, a study published in the Journal of the American Medical Association in 1994 said this: “Based on results of tests measuring surgeons’ cardiac responses and other reactions in a nonsurgical setting, researchers concluded that surgeon-selected music improved the physicians’ performance.”
In 2011, an article in the British newspaper The Guardian cited two somewhat conflicting probes: one claiming that most United Kingdom surgeons said music in the OR helped create a “harmonious and calm atmosphere,” another showing that during tricky operations music was clearly a distraction to novice surgeons.
But for seasoned UMMC surgeon Dr. J. Mark Reed, professor of otolaryngology and communicative sciences and a pediatric ENT, music is all but essential.
“It sure is important to everyone in the room I work with,” said Reed, 49, whose OR selections range from Christian music and ’70s easy-listening to blues and soul. “The OR can be a pretty boring place, especially for the people who aren’t operating. Music helps take their minds to a calm place.
“I do think that heavy-metal music is probably too distracting. We try to stick with uplifting music. But in each OR, you’ll find a different genre.”
Standards from Motown, ’80s hair bands, country, adult contemporary and more are on Batson Children’s Hospital’s OR Hit Parade, said Kathy Lea, 60, an R.N. who works with Haber and other surgeons.
At a different Jackson hospital, where she was employed years ago, one physician turned to Kenny Rogers for comfort and solace, she said.
“One night we were working late and this doctor said to me, ‘Call the radio station and tell them we’re at the hospital fixing a fracture and I need to hear “You Picked a Fine Time to Leave Me, Lucille.”
“They played it, too.”