Wednesday, May 21, 2008

WHY MOZART RELIEVES THE PAIN OF INTENSIVE CARE PATIENTS

NY TIMES For Claudius Conrad, a 30-year-old surgeon who has played the piano seriously since he was 5, music and medicine are entwined - from the academic realm down to the level of the fine-fingered dexterity required at the piano bench and the operating table. "If I don't play for a couple of days," said Dr. Conrad, a third-year surgical resident at Harvard Medical School who also holds doctorates in stem cell biology and music philosophy, "I cannot feel things as well in surgery. My hands are not as tender with the tissue. They are not as sensitive to the feedback that the tissue gives you." Like many surgeons, Dr. Conrad says he works better when he listens to music. And he cites studies, including some of his own, showing that music is helpful to patients as well - bringing relaxation and reducing blood pressure, heart rate, stress hormones, pain and the need for pain medication.

But to the extent that music heals, how does it heal? The physiological pathways responsible have remained obscure, and the search for an underlying mechanism has moved slowly.

Now Dr. Conrad is trying to change that. He recently published a provocative paper suggesting that music may exert healing and sedative effects partly through a paradoxical stimulation of a growth hormone generally associated with stress rather than healing. . .

Dr. Conrad's music dissertation examined why and how Mozart's music seemed to ease the pain of intensive-care patients. He concentrated not on physiological mechanisms but on mechanisms within Mozart's music. . .

Dr. Conrad noted that Mozart used distinctive phrases that are fairly short, often only four or even two measures long, and then repeated these phrases to build larger sections. Yet he changed these figures often in ways the listener may not notice - a change in left-hand arpeggios or chord structures, for instance, that slips by unremarked while the ear attends the right hand's melody, which itself may be slightly embellished.

These intricate variations are absorbed as part of a melodic accessibility so well organized that even a sonata for two pianos never feels crowded in the ear, even when it grows dense on the page. The melody lulls and delights while the underlying complexity stimulates.

But even if this explains the music's power to stimulate and relax, "an obvious question that comes up," Dr. Conrad said, "is why Mozart would write music that is so soothing."

Mozart's letters and biographies, Dr. Conrad said, portray a man almost constantly sick, constantly fending off one infection or ailment after another.

"Whether he did it intentionally or not," Dr. Conrad said, "I think he composed music the way he did partly because it made him feel better."

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