It has been two years since the publication of the seminal article, “Surgeon Preference and Music in the Operating Room: A Randomized, Controlled Trial” by Crandall et al.1 A highly regarded2 and frequently cited3 study, it highlighted the importance of musical choice in the operating room. Key findings included unanimous agreement that when a patient is critically injured or ill, music is a distraction and should be off or very low; however, nearly all surgeons were comfortable with music during less urgent procedures.
As noted in the Crandall study, nearly all work examining music in the OR has been patient-focused in terms of intraoperative and postoperative comfort, analgesic needs, and anesthetic requirements. Subsequent to this, a systematic review and meta-analysis was published in The Lancet, which concluded that music in nearly every form, irrespective of timing, duration, or musical choice, helped reduce postoperative pain and narcotic needs.4 As the 2015 Grammy Award Winner for Music in the Operating Room, I need to declare this conclusion both deeply disturbing and potentially dangerous. The idea that the choice of music is irrelevant to patient outcomes has clearly never been studied in an operating room with a surgeon playing only show tunes for 12 hours. The same 12 songs OVER and OVER and OVER. It’s even worse if it’s from a children’s movie. How can that not make your eyes water and hands shake? All of the authors (MC), and I imagine many readers, would agree that these musical choices could not help but contribute to postoperative wound infections and hemorrhoids.
Happily, I have been an attending for over a decade, so I am no longer subject to the kind of suffering I once endured. But I do vividly remember the days of endless re-do liver transplants and Whipples with portal venous reconstructions and the assaults on my sensibilities from endless operettas and Modest Mouse marathons. Please, as a courtesy to your trainees, treat intraoperative musical choice with the same kind of measured respect and attention to the literature that you would, say, preoperative cardiac evaluations. We surgeons are frequently, some would say inherently, narcissistic, so we do not consider the effect of our music on our trainees, the OR staff, and anesthesiologists. That is simply villainous. Think what would happen if we had no control at all and the music were piped in overhead after being carefully selected by The Joint Commission. If we continue to be serial offenders, afflicting our colleagues with Justin Bieber or Celine Dion, we will see a revolt and it will soon be out of our hands.