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Smooth Operator
From Beethoven to Barenaked Ladies and from Vivaldi to Violent Femmes, a survey of the musical preferences of alumni in the O.R.

I’m a resident. I listen to whatever the attendings damn well want. Actually, that’s not quite true. It’s whatever the attendings want but the nurses don’t veto. One time I got to pick, though. I brought in Violent Femmes. Bad move. It lasted about three minutes before someone switched it. No one has let me pick since.
—Atul Gawande ’94, Surgical Resident, Brigham and Women’s Hospital, Boston, Massachusetts

I enjoy classical pieces, such as Orff’s Carmina Burana, Vivaldi’s Four Seasons, J. S. Bach’s Fantasy in Fugue and Toccata in Fugue, Fauré’s Requiem, Mozart’s Symphonies Nos. 39 and 41, and Beethoven’s Symphonies Nos. 3, 5, 6, 7, and 9. I’ve noticed that when surgeons get tired as they’re finishing up an operation, the ending of the William Tell Overture can keep them galloping along.
— Elliott V. Miller ’58, Anaesthetist, Massachusetts General Hospital, Boston, Massachusetts

At my hospital, classical music tends to predominate, although the gynecologists seem to like soft rock. One surgeon likes to play the Grateful Dead during operations in the middle of the night; the best I can say about that music is that it helps keep me awake. I think music in the O.R. should be soothing. My taste runs to classical pieces by Mozart and Haydn, as well as operas by Verdi, Bizet, Mozart, and Rossini. My favorite operas range from Mozart’s Don Giovanni, to Dvorák’s Rusalka, to many of Verdi’s operas; Aïda, La Traviata, and Rigoletto are all solid beauty throughout.”
—Carolyn Aldredge ’64, Staff Anesthesiologist, Mount Auburn Hospital, Cambridge, Massachusetts

I play relaxing music for patients undergoing local anesthesia, and I allow them to choose the music, hoping they won’t pick country. When patients are anesthetized in the main O.R., we tend to have no background music for the tense parts of the case, classical music for periods of concentration, and rock-and-roll for opening and closing. Since I am occasionally sleep-deprived as a trauma surgeon, I will sometimes use the music to quiz medical students and residents about rock-and-roll trivia. I once had to reassure a student that this wouldn’t affect her grade.
—Christopher C. Baker ’74, Head of the Trauma Section, Department of Surgery, University of North Carolina at Chapel Hill

I was trained in classical violin and percussion, spent many seasons with the Harvard–Radcliffe Orchestra and the Boston Philharmonic, and have played in music festivals in Austria and Italy for the past nine summers. Despite my love of music, I find it distracting in the operating room. Anesthesiologists are trained to filter out conversation and alarms and focus on the patient. I have often compared anesthesiologists with percussionists. Casual observers may think both seem idle and clueless, but actually they’re aware of what everyone else is doing. Moreover, when things go well, no one pays attention, but when a mistake occurs, everyone notices.

I took an informal survey among the cardiac surgeons with whom I work. Gus Vlahakes ’75 listens to Barry White and old jazz and blues. Cary Akins ’70 listens to light rock, but prefers silence during the onset and termination of cardiopulmonary bypass. Ralph de la Torre ’92, anesthesiologist Greg Koski ’75, and David Torchiana ’81 (who usually likes 1970s rock music) all give a thumbs up for Fatboy Slim, a techno-rock group. Other surgeons claim that Fatboy Slim helps them operate faster. In this day of cost-cutting and operational efficiency, every bit helps.
—Edward Chen ’89, Assistant in Anesthesia, Massachusetts General Hospital, Boston, Massachusetts

I’m not particularly fond of music in the O.R., but if there is music, I prefer it to be classical—especially the symphonies of Beethoven and Brahms—and reasonably sedate. There’s a rhythm to operating, and it shouldn’t be broken by anything that has a different rhythm.
—John M. Head ’50, Professor of Surgery Emeritus, Dartmouth Medical School, Hanover, New Hampshire

I like to listen to everything from Vivaldi to the Rolling Stones. I enjoy the Beatles, Dire Straits, old country tunes—anything with a good tempo. (If you play the slower Baroque music, you can get bogged down.) I also enjoy Mozart and, depending on how bold I’m feeling, Beethoven. During induction of the patient, we surgeons defer to the anesthesiologists, and when things get exciting or require concentration, we turn the music down. When residents are too slow, we may play “Dueling Banjoes” to speed them up.
—Cedric Kavena ’84, Staff General Surgeon, Phoenix Indian Medical Center, Phoenix, Arizona

Music and medicine absolutely go together—just not in the operating room. When music was played, I preferred it to be classical.
—Susanne Learmonth ’52, Retired Anesthesiologist, Veterans Administration Medical Center, White River Junction, Vermont

Music can lighten the mood in the O.R., but it should not be so loud as to be distracting. If music is played, I prefer that it wait until after the patient is asleep and is turned off before the patient wakes up.
—Maxine Lee ’88, Anesthesiologist, University of Arkansas Medical Sciences, Little Rock, Arkansas

Music during surgery is not only enjoyable, but also keeps the tension level down. I enjoy Beethoven, Bach, and Brahms for pleasure. The soothing sounds of the Moody Blues, the Mamas and the Papas, Chris Isaak, and Stevie Nicks reduce tension. And when the situation gets tight, my team knows to immediately put on a disc by Yanni or Enya!
—S. Bertrand Litwin ’59, Chief of Thoracic and Cardiovascular Surgery, Children’s Hospital of Wisconsin, Milwaukee, Wisconsin

As attending physician to the Boston Ballet, I like to listen to classical music, especially ballet scores. I also enjoy country music.
—Lyle J. Micheli ’66, Director, Division of Sports Medicine, Children’s Hospital, Boston, Massachusetts

My first impulse is to answer “absolute quiet.” The operating room should be a silent place of concentration on the welfare of others, preferably with good air conditioning. I would not object to a few kind words, if not sweet words, from the members of my team, especially my scrub nurse. But I would not like to hear any distractions such as grunts or shifting of the feet by medical students who object to hanging on to a retractor.

As for music, I do answer “absolutely none.” If the music is that of Haydn, Mozart, Bach, or Beethoven—or even if it’s good modern jazz—it’s worth listening to. But I can’t do that and operate at the same time. A little Gershwin or Cole Porter might be a bit more acceptable. But why should I listen to some beginner hack his way through Rhapsody in Blue when he doesn’t even know the proper tempo for the E major slow movement? And as for Cole Porter, few modern musicians understand how to maintain the basic dance rhythm in his wonderful slower pieces.

Music has been too much a part of my life to try to listen to it with one ear while digging out a liver tumor with both eyes and the other ear. I am reminded of the time Brahms’ Variations on a Theme by Haydn was being played while David Hume—at that time, a resident at Brigham Hospital—was operating. Hume muttered, “I wish they’d take that third variation a little slower.”
—Francis D. Moore, Sr. ’39, Moseley Professor of Surgery Emeritus, Harvard Medical School, Boston, Massachusetts

This is my eighth year of residency, so I’m subjected to whatever music other people want to hear. If I had a choice, I’d listen to mostly classical pieces by Mozart, Beethoven, and Vivaldi, because I think most other works are too distracting. Jazz saxophonist Joshua Redman also is wonderful in the O.R. But even then, in stressful moments, I’ll ask that the music be turned off. During closing, when our work becomes more automatic, popular music is fine. We’ll listen to anything from Pearl Jam to Natalie Merchant to Barenaked Ladies.
—Theresa Quinn ’92, Surgical Resident, University of California, San Francisco

I like to play the mainstays in orchestral and chamber works—you know, the usual guys—Mozart, Mendelssohn, and the Three B’s—Bach, Beethoven, and Brahms. I avoid opera, because although I like it, the staff doesn’t. Absolutely no rap; oldies but goodies are permitted. Rossini and Sousa are great for closing.
—Vincent Reale ’68, Chief of Plastic Surgery, Genesee Hospital, Rochester, New York

At our hospital, we once had a surgeon who liked full-blown opera; I tend to avoid operating rooms in which Wagner’s The Ride of the Valkyries is being played at full volume, because I’m not an opera fan. Some of my fellow surgeons also play rock, ranging from Jimi Hendrix to Smashing Pumpkins, depending on the age of the surgeons. There’s not much hip-hop, but this is Madison.

As a cellist, I find classical music distracting if it’s something I’ve played, although occasionally I’ll listen to Yo-Yo Ma. I prefer soft music that doesn’t distract, such as 1950s jazz, especially that of John Coltrane and the Modern Jazz Quartet.
—Peter Thurlow ’77, General and Vascular Surgeon, Associated Physicians, Madison, Wisconsin

This article appeared in the Summer 1999 issue of the Harvard Medical Alumni Bulletin.