HealingTunes the art and science of a Medical Song

FMF Vancouver Nov 2016

OBJECTIVES - Recognize the science between music, medicine and the art of healing

-Learn a few tricks to mine your creativity, convert daily medical experiences into lyrics and songs

-Learn by example, enjoy a collection of medical songs ranging from hilarious to gut-wrenching

This session is for all who might be intrigued by the concept of

MEDICAL SONGS

learn and be entertained by a couple of old FPs, worlds apart in geography and artistry, but with a communal love of a life enriching song!

Ted “ dr j” Jablonskiis an award-winning multi-instrumentalist singer-songwriter and family physician in Calgary.

He has released nine indie CDs and has numerous television appearances and some radio play on 3 continents. His songwriting is generally inspired by serious themes of illness, death and tragedy, with many cathartic songs about his medical experience.

He is currently working on a full length musical.

William “BILL” EATONis the famous FP palliative care “Humorologist” from Newfoundland with 3 CD releases and a wealth of performances.

He is an articulate and hilarious storyteller and enjoys writing and performing musical comedy – especially with medical twists, themes and content.

He is currently working on a blog for young MDs

None & NONE

DISCLOSURES

Music therapy is increasingly recognized as an adjunctive therapy for palliative care, geriatrics, and childhood illnesses.

The use of music and songwriting as a therapeutic tool for physicians (use with patients or purely for self) is less well established – not established at all.

It is often said that there is an unusually high number of physicians that are musicians (or perhaps, more correctly, musicians who happen to become doctors).

Doctor Musicians

Berlioz

Helmholtz

Billroth

Trandelenberg

Auenbrugger

Sir Francis Bacon

“The genius of music and of medicine are alike. The function of the physician is to tune the lyre of the human body so that it shall give forth sweet and harmonious sounds”

Brain areas activated by listening to music

ATTENTION

MEMORY

EXPECTATIONS / RULES

EMOTION

fMRI

Have subjects in fMRI machine

Listen to music

Listen to rhythm

Imagine playing the music

Musicians vs non musicians

Composite images

Figure 2. Axial slice renderings of mean activations (red/yellow scale bar) and deactivations

(blue/green scale bar) associated with improvisation during Scale and Jazz paradigms.

Limb CJ, Braun AR (2008) Neural Substrates of Spontaneous Musical Performance: An fMRI Study of Jazz Improvisation. PLoS

ONE 3(2): e1679. doi:10.1371/journal.pone.0001679

http://journals.plos.org/plosone/article?id=info:doi/10.1371/journal.pone.0001679

Music and mental tasks

Functional MRI imaging during mental task switching:

Panels A shows brain activation in musically trained children

Panels B in untrained children

Responding to rhythm

Right and Left superior temporal areas

Left inferior parietal lobe

Right operculum

Trained musicians vsuntrained

Increased activation, while listening to music, in:

Pars opercularis

Pars triangularis

Premotor cortex,

Bilateral inferior parietal lobule

Left cerebellum

Neurology of musicIncreased dopamine activity

Professional musicians have largest cortex volumes, followed by amateurs then non musicians

Fine motor skills improved

Greater appreciation of speech syntax

Executive functioning and music involve the same brain structures

Music as Healing AgentStroke patients walk sooner if gait timed to a metronome with music of the same beat

Music reduces pain in burn patients during dressing changes

Age sensitive music grounds people with dementia

Music can calm acutely psychotic patients

Anxiety, insomnia, stress less with music

Listening to music can activate areas of the brain involved in:

ATTENTION

MEMORY

EXPECTATIONS / RULES

EMOTION

The reason for this affinity between medicine and music is hard to explain and will continue to be an interesting topic

1. MUSIC has special properties -neurophysiologic

2. These neurophysiolgic changes may have healing properties

3. this healing effect could be useful for us to heal our patients (traditional musical therapy) OR to heal ourselves! (the wounded healer)

Many physicians believe in the importance of music and its healing powers but are sometimes the first to abandon it due to the demands of clinical practice, personal and family life.

?more than coincidence that so many medical professionals have very significant connections with music (70%)

- formal training (at high level)

- ability to play instrument(s)

-self-report love of music in their lives ( eg. relaxation / stress reliever )

Even with extensive music backgrounds, songwriting may seem like a daunting goal as the process may appear difficult, poorly defined, and shrouded in mystery.

We document information each and every day as a technical part of our jobs.

Can this skill be translated into creative writing and a song ?

We are medical doctors - we live, eat and breathe in the world of medicine (and many of us are well versed in music / formally trained)

so why not combine actual medical themes with music and we may have the ultimate therapeutic weapon?

So what’s a SONG??

So what’s a SONG?? A song, most broadly, is a single (and

often standalone) work of music that is typically intended to be sung by the human voice withdistinct and fixed pitches and patterns using sound and silence and a variety of formsthat often include the repetition of sections. Written words created specifically for music or for which music is specifically created, are called lyrics.

So what’s a SONG??

A magical marriage between

lyrics (some words)

and a melody (some notes)

SONGWRITING for “older” TYPE A Personality Types

Typical SONG STRUCTURE ??

(Title)

Intro thematic / none to extravagant

Verse multiple / rhyming

Chorus one / repetitive

(Instrumental) none to extravagant

((Bridge)) lyrical / instrumental

Extro thematic / mimics intro

EXERCISES

IT’S ALL ABOUT EFFECTIVE AND

CONCISE COMMUNICATION

TOP 5 Simple Exercise

1. NEWSPAPER / TITLE (one phrase)

2. Word in central circle

3. HAIKU (5 / 7 / 5)

4. Title & Emotion (one word / phrase)

5. Voice / Tempo / Style

Now convert to everyday life in clinic (or at home or wherever you are)

If I am open – I will see and hear a newspaper full of phrases / ideas / concepts

WRITEWrite write write write write write write write write write write write write

Write write write write write write write write write write write write write write

Write write write write write write write write write write write write write write write

Write write write write write write write write write write write write write write write write

Write write write write write write write write write write write write write write write write write

Write write write write write write write write write write write write write write write write write write

Write write write write write write write write write write write write write write write write write write write

HEALING SONGs EXAMPLES

BILL

Euthanasia

Palliative Care Blues

We are the Doctors

TED

Ode to a Malady

NUMB

Fix Me

Euthanasia song

I heard you say you’re tired of life. You’ve suffered enough with pain and strifeThe time has come is how I’ll paraphrase ya’You really want to get out of here. You’ve had enough of medical careIt’s bold and it’s unspoken. Euthanasia

Well it’s really not as simple as that. There’s protocol and formatYou need two willing doctors to appraise yaThey’ll him and haw and cogitate. While your poor body degeneratesYou might die before they decide (on). Euthanasia

The funeral home is never free. And don’t forget the lawyer’s feesInsurance forms and taxes mount to fleece yaThe cost of dying’s getting high. It’s not cheap to say goodbyeNow you might have to pay (for). Euthanasia

What to write in your obit, or on the death certificateDon’t let these pithy details displease yaLived a life of great aplomb. Here today tomorrow goneThe pope says “Nope’ to a funeral with. Euthanasia

ODE TO A MALADYDon’t know how you slipped in When you came to beNever made much fuss Sort of grew on meSomewhere ‘long the line Started banging on the doorYou threw a temper tantrum Started rolling on the floor

They tell me drink this poisonThey tell me eat these pillsThey sit and mix their potionsIt goes against my will They try to build me up While the try to tear you downThey save me every time As I watch you drown

Why can’t you settle down We could learn to live togetherYour constant up and down Is worse than the weatherYou make me scream out loudAlways there, you always hoverYou make me want to live You’re almost like my lover

CHORUSThey’re slowing killing Part of meI’m losing you Why can’t they seeWe’ve been together For so longTearing us apart Feels so wrong

Palliative Care Blues

My name is Dr. Morphine and I do Palliative CareI’ll fill you up with morphine in a manner most sincereI’ll infuse your brain so you won’t feel painI’m only trying to make you feel good, or at least a bit better

In the palliative care we keep your symptoms under controlTo load you up with heavy drugs is our penultimate goalWhile your body takes a beating we’ll be holding a family meeting I’m only trying to make you feel good, or at least a bit better

My name is Dr. Haldol and I do palliative CareI’ll give you so much Haldol you won’t even know you’re hereInstead of scratching and screaming you’ll be drifting and dreamingWe’re only trying to make you feel good, or at least a bit better

In the palliative care we worry ‘bout your hopes and goalsWe look after your body and your spirit and your soulYou may as well have your say we’re going to do what we do anyway We’re only trying to make you feel good, or at least a bit better

NUMB

Tonight – I just gotta feel numbEach day I fight the battle, there’s more to come Tonight - I just want to be numb

Right now – I just gotta get numbStood up and decided, Why am I still dumb ?Right now - I just need to be numb x2

Getting off, I’m checking outGoing down always ends my doubtHad too much, need a break(promise I’ll) Start again when I’m awake

Tonight – I just gotta feel numbmore than tired beating my own drumTonight - I just want to be numb

CHORUS Tonight– I just gotta get numbJust need to rest, sorry Dad and momTonight - I am gonna get numb Right now – I am gonna get numb Right now I’m numb

Another BILL EATON TUNE (placeholder)

We are the Doctors Now you might die fast you might die slowFill out a living will so that we will knowJust what tests to do. Is home care best for you?Or would you like to die in the ICU?ChorusWe are the doctors it’s true We will take care of youWe got needles we got pills That will cure up all your illsWe are the doctors it’s true We’ll see you if your hemorrhoids start to bleedWe’ll ask you personal questions all through emergencyThen to the OR you’ll be wheeled where we’ll cure you with our steelJust don’t expect us to ask you how you feelChorusCome see us if you’ve got a pain in the chestWe’ll put you on a waiting list until you arrestThen we’ll slap you in a bed fill you full of tubes and medsAnd we’ll work on you for two hours after you’re deadChorusDoctors have always been fascinated by technological achievements and as such are quite pleased when they can order a fancy test or connect a sick person to a machine. Unfortunately the poor patient can get lost behind the flashing lights and bleeping monitors. Much of the health care money spent on you during your life gets spent just before you die. Some say half of a person’s life-time allotment of health care funding gets used up in the last six months of life. For what?

FIX ME

There’s a jack hammer pounding In the middle of my skull Why can’t you fix meAnd my guts are always churning around and around Why can’t you fix me

You said you were the expert and you gave me more pillsMy usually empty pockets are stuffed full with billsYou set off major heartburn and I’m still - feeling ill

Why don’t you fix me why can’t you fix meMy back’s on fire It sizzling down my legs Why can’t you fix meMy heart is flipping and flip- lopping away Why can’t you fix me

Don’t tell me that its all in my headDon’t tell me that its somehow my faultIf you only knew what you were doing You might even be worth

your saltwhy don’t you fix me why can’t you fix me

My skin’s so itchy that I’ll tear it to pieces Why can’t you fix me My fingers are tingling So numb can’t stop twitching Why can’t you fix me

CHORUS #2I’m dizzy, sort or spinning And I’m gonna pass out Why can’t you fix meCan’t think, can’t talk And my memory is shot Why can’t you fix me

CHORUS #1

Q+A

HECKLING (too late.......)

COMMENTS

DISCUSSION

THANKS++

FEEDBACK / COMMUNICATION (bring it on!!

Ted “ dr j” Jablonski dr.t.jablonski@telus.net

William “Bill” Eaton eatonb@mun.ca