Art of Medicine
Jul 2020


Stephanie Cohen, MD
AMA J Ethics. 2020;22(7):E630-631. doi: 10.1001/amajethics.2020.630.


Just as cellular imbalances on a microsopic level can have macroscopic consequences in systemic diseases, so one instrument playing out of tune in an orchestra can compromise the harmony of the entire symphony. In addition, the practice of medicine itself is a balance between science and humanism; after all, physicians are treating multidimensional human beings.


Figure. Equilibrium



Ink on Bristol board, 17" x 11".



This drawing seeks to explore the theme of equilibrium through music, medicine, and art. In music, if a trumpeter decides to improvise and plays his own melody, the French horn player, at first, may follow along. Eventually, however, he can no longer compensate and musical dissonance ensues. Cells and organs can be thought of as the musical instruments in the biological symphony of the human body: in cancer, cells become unresponsive to their environment and also bypass internal checkpoints. As a result, there is an imbalance between cellular proliferation and apoptosis—cells begin to divide uncontrollably. In the gut, an imbalance of flora can lead to Clostridioides difficile pseudomembranous colitis. Neurological and psychiatric diseases can also occur secondary to neurotransmitter imbalances. Clearly, disequilibrium is evident throughout all pathophysiology. In addition, this musical metaphor can be extended to the health care system. Doctors, advanced practitioners, nurses, pharmacists, and social workers are the musicians in a symphony. Each has a particular role, and effective communication is absolutely necessary to deliver the best possible care. What is most important to bear in mind is that the conductor is the patient.


AMA J Ethics. 2020;22(7):E630-631.



Conflict of Interest Disclosure

The author(s) had no conflicts of interest to disclose.

The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.