Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Have Guitar – Will Travel


Consider how you might use your creative gifts—and your imagination—to connect more deeply with your patients and bring them joy.

When I was a hospice doc, I made a lot of home visits, and I loved doing them. I found it inspiring and humbling to enter physically into patients’ lives and stories on their terms. And I loved feeling connected to the long tradition of house calls in medicine, actually carrying in one hand a black bag with traditional implements of the trade (stethoscope, BP cuff, first aid kit). But in the other hand, I would often carry a far less conventional tool: a Cordoba mini guitar. With this instrument at hand, I would often fold music into the blend of stories, exam, and medical decisions that would make up the visit. The effects could be astonishing.


Take Mrs. H, an elderly woman with end stage cardiomyopathy. Despite continuous four liters oxygen at home, she was dyspneic at rest. “Hello, Doctor.” Pause for deep respirations. “How are you?” More breaths.


She sat on a stately sofa wearing a simple dress and makeup, and offered me a seat to her left with a kind gesture of her hand. Her husband arrived from the kitchen, wearing a t-shirt and khaki shorts, carrying a glass of water for me. He looked frazzled, but friendly. He commented on my instrument and invited me to play.


“I take requests,” I said, turning to Mrs. H. “What kind of music do you like?”

“Oh, I don’t know,” she said with an embarrassed shrug.

“She likes hymns,” offered Mr. H, now seated in a comfy armchair across from me.

“Okay, do you know this one?” I started playing “Just a Closer Walk with Thee.” When I reached the first chorus, I looked over at Mrs. H and noticed her lips were moving. She was mouthing the words—no, as I leaned in, I could hear it—she was singing. This gracious woman, who couldn’t speak four words without air hunger, sang with me word-for-word to the close of the hymn. At the end, she beamed with joy and asked for another song. With a grin on his face, her husband seconded the motion.


Music can be powerful medicine, indeed, and a growing body of literature attests to this fact. But I’m not advocating for doctors to start carrying harmonicas in their white coats (though that’d be pretty cool). The point I hope to raise here is broader, that we as clinicians should be open to—and curious about—artful ways to connect more deeply with our patients and families and communities. Even better, just as research scientists and tech innovators constantly strive to push the envelope, we clinicians should pursue creative innovation, harnessing the power of imagination to drive toward fuller, deeper, and better care. That movement might take place in the realms of research and education, but it doesn’t have to. It could unfold in the mind of an individual, you or me, sitting in front of a patient like Mrs. H. And it could start, as many important things do, with a few simple questions:


1.) What brings your patient joy?

2.) Do you have any knowledge or skill in that area?

3.) What hidden talents do you have?


Consider how you might use your creative gifts—and your imagination—to connect more deeply with your patients and bring them joy. You might feel some gladness, too. After all, speaking from personal experience, joy is contagious.