At the time of writing, covid lockdowns are tightening, and deaths are climbing. It is serious stuff as I know from working in ICU. We’re ten months in, and have who-knows-how-many months still to go. As such, I think we need to look for relief wherever we can find it. For this reason, I’ve been channelling the BBC radio show, Desert Island Discs. Broadcast since 1942, there are over 3,000 episodes, and it has been voted “the greatest radio programme of all time.” Guests, aka “castaways,” choose eight recordings (plus a book and luxury). These are intended to sustain them, and define them during hypothetical isolation. Hyperbole aside, because of coronavirus, we have all experienced real time as “covid castaways”: marooned on six-foot islands. I suggest we don’t wait for the BBC to call; let’s share our eight “Covid Isolation Discs.” I’ll share mine (see below) if you share yours.
Music provides a universal language, and playlists show who we are, what we love, and how we endure. This matters more than ever, because, alongside a viral pandemic, we have a parallel mental health pandemic. Things are bad, and we haven’t hit the worst of the Northern Hemisphere’s winter blues. Mathematically, the third Monday January (aka “Blue Monday”) is usually the nadir, but who knows with covid-19 dominating the equation. A shocking number of people have already reported despair, and almost everyone can sheepishly admit to uncharacteristic outbursts or nihilism. Like literal castaways, we need flotsam to grab onto, and I’m prescribing music over Netflix and booze. If we really are “in this together” then let’s share what’s on our (musical) minds. It truly doesn’t matter if it’s Mozart or Metal, as long as it keeps us close while we have to stay apart.
Even as blessed vaccines come to the rescue, music might still help during covid-19 as much as pills and potions. This is not just because so many other pharma trials have flopped, but because the evidence around music therapy is robust and growing. Who knew? Well, not this traditionally-trained ICU doc. At least, not until I felt the need to study up. I did so because, after coming home from covid-chaos, I was increasingly retreating beneath my headphones. I wanted to understand why music helps when words fall short. Music may be what emotions sound like.
One of my sons shares my love of music, and bought me the book “This is your brain on music.” It now makes sense why each time we’ve had musicians play in the ICU it has stopped me in my tracks. It is part of why I often ask families if there is a special piece a dying-patient would like to hear, and why I find it sad if this was not shared. Similarly, when patients and families come back to visit I am curious if there was music that comforted them in the hospital, and energized them in rehab. In the outpatient setting, music is being used to penetrate the fog of dementia, thaw those frozen with Parkinson’s, and reconnect those isolated in autism. In short, in medicine, I think it is time to break the silence.
The Functional Magnetic Resonance Imaging (fMRI) literature suggests that brains light-up when exposed to meaningful music. Those pieces are as individual as you and me. Your playlist is not my playlist, and nobody should judge. The right pieces simultaneously engage memories, emotions, and motor cortices. Music offers a whole brain workout, and mainlines oxytocin (the cuddle chemical) and dopamine (the movement messenger).
I have long been fascinated by communication. While language communicates information, music likely communicates emotion. Together they offer complementary “life support.” Music appears to be both a major catalyst and glue. If this seems hyperbolic then remember that few drugs are powerful enough to simultaneously makes us remember, feel, imagine and move. Music is powerful stuff, as illustrated by the fact it’s easier to recite song lyrics than text or poetry. Music is also one of the most efficient ways to affect mood: just think of the scary music from Jaws or Hitchcock, versus that soundtrack that always makes you smile. Music unlocks emotions that we didn’t even know were there, and playlists become the literal soundtracks to our lives. What a shame to keep them to ourselves.
Literature is increasingly showing that music can reduce blood pressure, pain, and anxiety. It can improve sleep, mood, alertness, and memory. Regardless, while listening is therapeutic, making your own music is even more so. Therefore, don’t outsource all your happiness to big-music: instead, sing, perform, improvise. Playing in a band, or singing in a choir can dramatically boost oxytocin and synchronize EEG waves. Don’t be held back just because, like me, you can’t play or hold a tune. You’re not looking for a recording contract, just a few minutes of release.
Each of us has experienced magical musical moments: such as when the symphony rises, the beat drops, or the guitar solo kicks in. Musicologists call this “frisson” or “aesthetic chill”. For the physiologists, it comes with piloerection (hairs standing on end), mydriasis (wide attentive pupils), and the need to shake your booty. Beloved music also liberates the prefrontal cortex, thereby making us more cooperative and less fearful. During covid-19, we need all the cognitive (and literal) bandwidth on offer. I will never be a good meditator, but I welcome a prescription for more time with my stereo and under my headphones. I suspect in the months ahead I will rely on AC/DC as much as Amadeus; but I’m eager for you to show me otherwise.
My covid isolation discs
- ELO- Mr. Blue Sky
- The Cult- She Sells Sanctuary
- Hayley Westenra- O Mio Bambino Caro
- Sarah Mclachlan- River
- Trooper- We’re Here for a Good Time.
- David Gray- Say Hello Wave Goodbye
- Nicola Benedetti- Bonnie Banks of Loch Lomond
- Edith Piaf- Non, Je Ne Regrette Rien
Peter Brindley, Department of Critical Care Medicine, Department of Anesthesiology and Pain Medicine, and the Dosseter Ethics Centre, University of Alberta, Edmonton, Canada. Scholar, Peter Wall Institute for Advanced Studies. Twitter @docpgb