I walk into my patient’s room as he is receiving a blood transfusion with a guitar strapped across my back and sheet music in hand. He is used to seeing me in the early mornings when the surgical team rounds. He has been in the hospital for a week now, recovering from a liver cancer resection. He had joked with me in the operating room before he went under anesthesia, and I had looked forward to checking in on him the subsequent days. Yet each morning afterward, I watched him retreat. He ate less. He spoke less. Though he met his postoperative milestones, it was clear to me that he was losing heart each day he continued to be hospitalized, and was perhaps in need of something that we had not provided him yet.
As part of my school’s “Music in Medicine” service organization, I ask whether he would like me to sing and play guitar for him. I confess that I only know Christian worship songs. I am unsure of his own beliefs, but I know he is close with his son, a pastor, and I hope the music might offer him some small semblance of home.
He looks uncomfortable, his heart rate hovering in the 120s as he receives a blood transfusion. After a moment, he gives a slight nod. I take it as permission.
I begin to play “What a Friend We Have in Jesus.” A few verses in, his breathing deepens. He falls asleep with a faint snore, and I notice on the monitor that his heart rate has drifted down to the 80s. The nurse rushes in, concerned about a possible transfusion reaction. When he stirs and appears stable, we watch as his heart rate climbs back into the 120s. Puzzled, she decides the drop was likely an unusual blip and steps out.
I start my second song, “It is Well.” Once again, he falls asleep, and once again, his heart rate settles into the 80s. When I pause between songs, it rises abruptly to the 120s – even though he remains asleep. As I finish a final hymn, I see the now-familiar pattern: his heart rate easing downward as the music continues. I leave quietly, careful not to disturb his rest.
For many days afterward, I wonder what truly underlay those fluctuations. Was it increased parasympathetic tone as the music lulled him to sleep? A physiologic response to improving volume status from the transfusion? Or was it something less easily measured – the comfort of melody, the familiarity of hymns, the subtle easing of a homesick spirit?
My team ultimately attributes the fluctuations to his restoring volume status. And perhaps they are right. The blood replenished what his body lacked. But I cannot shake the sense that the music replenished something else – something the transfusion could not supply.
The day before his discharge, I walk into my patient’s room to find him sitting up in bed, digging into a large bowl of yogurt. I pull out an incentive spirometer, and he chuckles – the first laugh I have heard from him since his operation. He tells me he prefers the Acapella device because he likes the sound it makes; he pretends it is a saxophone. When I am urgently called away from the room, he calls after me in a steady voice: “I’ll remember you when I play”.
I do not get to see him again. But I no longer worry about his spirit. I had watched it return.
Whatever the true explanation for his heart rate fluctuations, I know this: long after he forgets the units of blood transfused or the numbers on the monitor, he will remember the music – the music that met him in a way medicine alone could not. And in that memory, perhaps, is a different kind of healing.
Contributing Writer
Cooper Medical School of Rowan University
Sarah Kim is a medical student at Cooper Medical School of Rowan University in Camden, New Jersey. In 2022, she graduated from New York University with a Bachelor of Arts in Biology, and a minor in Child and Adolescent Mental Health Studies. She enjoys cross-stitching, reading, playing piano or guitar, and running in her free time.