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

Lessons From Duke Ellington


Listening to The Duke, I realized that I care for patients best when my clinical encounters are like jazz duets—lots of listening and imbued with improvised spontaneous interplay.

Driving home from work one recent Friday, I tuned in to the local jazz radio station and a Duke Ellington piece came on—”Things Ain’t What They Used to Be.” While I enjoyed the Duke’s piano intro, horns playing the familiar riff and the band’s swinging beat, it occurred to me how fitting the title is to our current times. There’s something about jazz song titles, especially The Duke’s, which capture a mood in a few honest and simple words. The music itself is like life— pulsatile, spontaneous, unpredictable, and emotive.


While stopped at a traffic light, “Things” finished, and I put on my “Duke Ellington Essentials” album. The pieces gave me an eerie sense of confluent epochs, like the Duke had just composed these tunes for a new release called, “Pandemically Speaking,” or “Ellington in Quarantine.” Titles like “Don’t Get Around Much Anymore,” “Go Away Blues,” “In My Solitude,” “If You Were in My Place,” “What Would You Do?” and “I Got It Bad and That Ain’t Good,” call out contemporary sentiments  just as well as anything else I’ve read in the last year, despite the very different time period and events for which they were originally inspired.


Jazz is rooted in spontaneity and connection which is difficult to achieve with social distance. Musicians rely on close listening, facial expressions, physical movement, and feed off the audience’s energy. Interplay brings the music to life. The unexpected is expected. In this sense, jazz is a metaphor for much of what has been stolen from us under the pandemic’s reign. We’ve had to read from the score—solo improvisation can be life threatening. Socializing had to be more carefully planned and curated. Expressions are often obscured by masked faces, and we can’t get close enough to hear whispers or see subtle gestures. Life with COVID in our midst can feel like a blues scale played in straight eighth notes, and we know, again in the incomparable poetry of Ellington, that “It Don’t mean a Thing if it Ain’t Got That Swing.”


Duke’s tunes are jazz standards, but no two versions sound the same, and no two listeners hear them the same. This is also true of patients and their concerns. There are infinite variations. I’m at my best when my clinical encounters are like jazz duets, mostly listening, imbued with spontaneous interplay and improvisation.


When I pulled into my driveway, I sat in the car for a few extra minutes and listened to the rest of “Mood Indigo,a slow, contemplative blues with a clarinet infused horn arrangement that makes some of the melodic lines sound almost like human moans. Indigo is a deep blue, dark and mysterious, like the canvas color on which I imagine COVID would choose to paint its landscape. But unlike this current viral backdrop to our lives, the song is a serene and beautiful escape.





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