C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Meaningful Chords

Takeaway

When my patient’s wife brought his guitar to the hospital, I realized it’s impossible to overestimate the impact of reuniting patients with what matters most to them. Do what you can to make this happen. 

Everything is music. No really, I mean it. A note is a frequency; harmony, frequencies; rhythm, wildly slow frequencies. Rain, the windshield wiper, your heartbeat, sodium ions, depolarization – frequencies.    

 

Music is everything. In the early weeks of my nursing career, I cared for a young man with liver cancer metastasized to multiple bones. When we met, he was just beginning to find his rhythm again after days of excruciating bony pain. Steroids and opioids helped him feel humanoid.  

 

But he was cachectic, his mood was low, and his bones still ached. His wife was profoundly worried. Not perseverating, not obsessing, far from catastrophizing. Her worry wasn’t located in her mind, but in her person. She’d found herself suddenly dogpaddling in a thick tepid soup upon diving into what she thought was a green-blue glacial pool. 

  

I asked the young man how he was feeling. His wife’s eyes welled.  

 

“You know, I don’t feel terrible.” This is often the best we can hope for in our profession. 

 

“Tell him about your guitar,” his wife said urgently.  

 

It turned out this young man was an avid musician. He inherited his late grandfather’s acoustic guitar when he was a child, which led to a wholehearted passion by the time he was 14. Now in his late thirties, he played in various restaurants and clubs, solo and in groups. He played when he was alone, and he played when they had guests over.  

 

“Not having my guitar is the most painful thing right now,” he said. 

  

“Would it be possible for you to bring his guitar in?” I asked his wife. 

 

“I told you!” she squealed gleefully. 

 

I came in the next morning for my shift, and he was lounging in his bed, seducing the entire staff with his grandfather’s Martin “Dreadnaught” and an understated, cooing voice. He looked like a different person – eyes bright, posture proud, skin blushed. Wife beaming, swimming in a glacial pool.   

 

It’s impossible to overestimate the impact of our patients reuniting with the things that matter most to them. For this young man, music was everything. But it could just as easily be a family member, a living room, or a semblance of engaging in their lifelong work. Everyone will sing a unique song, but it’s all music.   

 

 

 

 

 

 

 

 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.