AMA Journal of Ethics®

Illuminating the art of medicine

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AMA Journal of Ethics®

Illuminating the art of medicine

Virtual Mentor. January 2001, Volume 3, Number 1.

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Classical? Celtic Harp? Big Band? Show Tunes? What Turns You on in the OR?

Many surgeons listen to music while performing surgery, a practice that should be implemented with respect to all who will be present in the operating room.

Faith Lagay, PhD, and Sara Taub, MA

Classical? Celtic harp? big band? show tunes? What turns you on in the O.R.? Or are you one of those who thinks that, aside from the "sponge" and "hemostat" orders and a bit of running narrative explanation, silence is golden during surgery?

Musical preferences differ greatly among surgeons who like to work with background tunes, but they agree on the benefits. Music, they say, improves both their ability to cope with stress and fatigue and the speed and accuracy of their performance. As Eric L. Lazar, a surgery resident puts it simply: "I seem to think better with it on."

At present, there are no data to support these claims, but one study looked at the effect of music during experiments that mimic the stress of surgery. In this study, surgeons performed the same tasks with musical selections of their own, experimenter-selected control music, and no music. When working with their own selections as background, participants were less influenced by external distractions and thus better able to concentrate on the task and perform it correctly. Moreover, their cardiovascular responses remained significantly lower and they exhibited only small changes in blood pressure over baseline, even when under stress.

Surgeons who prefer to work in a silent environment offer various reasons for their choice. Since musical preference is so highly individual, some consider it just too complicated and bothersome to find selections that would appeal to the entire team. Other surgeons rank it as an interference, and some strongly denounce music's effect on their team's and their own concentration and mood. Furthermore, they think it detracts from the professional image of the team and the gravity of their task; this is of special concern when the patient remains awake during surgery.

It's worth noting as part of this discussion that some researchers believe that music has a therapeutic impact on patients. Pieces that are selected by patients, according to these researchers, can help anaesthetize them before surgery, calm their heart rate and respiration during, awaken them after, and reduce their experience of pain.

Should music be played in the operating room during surgery? There's no intrinsically "right" answer. It seems, though, that since the surgeon is not alone in the room or in the work being done there, the decision about whether and what to play should be a collective one.

To read the views of several surgeons around the country on listening to music in the OR, as well as the musical preferences of those who engage in the practice, please refer to Kristen Watson's piece, 'A new spin on medical "records": Music in the OR,' in the Journal of the College of Physicians and Surgeons at Columbia University.

The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.