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What Are Surgeons Listening to While You're Under the Knife?

From Avicii to Zeppelin to Brand New, what gives surgeons a steady hand during hours and hours of pressure situations.

While you're getting sliced open, disassembled, and put back together again, the music playing during that chaos is probably the least of your concerns. Although years of training goes into being a surgeon, a human life is always on the line and there’s that looming chance for something to go awry, however slight. That’s why most surgeons listen to music in the operating room, to create a comfortable environment. And while there are no true regulations on what a surgeon can or cannot listen to, there are certain things that are simply understood like keeping the volume at a reasonable level, respecting your co-workers’ sex and race when it comes to choosing music, and most importantly, making sure that the music is turned off before the patient regains consciousness.

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So what do surgeons listen to to help ease that tension? We talked to some the East Coast’s top orthopedic surgeons to discuss their listening habits in the Operating Room, how listening to music in the O.R. has evolved, and how music, personally, helps them to get through the many difficult surgery cases they face each day.

Thomas W. Wright, M.D.
Orthopedic Surgery, Hand and Upper Extremity
University of Florida Medical Center

What do Surgeons Listen to in the OR?

NOISEY: So what kind of music are you listening to in the OR?
Dr. Thomas W. Wright: Well, it varies. I kind of run back and forth between a couple of OR’s, so generally the fellows have what they want on and I listen to what they have unless it’s annoying as hell. But they know what I like and my preference is country, second would be classic rock. Those are my favorite two [genres]. My only taboo is if they put rap on I can’t deal with it, so I’ll turn that off.

I don’t change the music a lot while I’m in there, I’m pretty much focused on what I’m doing. If I’m tired and closing, it’s definitely nice to have something upbeat, like to crank up some Boston or something like that.

We usually just put on a panel of music but for country I like a lot of the top country stuff. I actually like the newer stuff more than the older stuff. My son likes the older stuff. For classic rock, you name it, bands from the 60s and 70s, that’s great stuff. I can’t necessarily tell you that there’s a single album I’m passionate about though.

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I never played in a band or anything like that but I’ve certainly always enjoyed music. In fact, I don’t think there’s anybody who doesn’t enjoy music, but I guess there must be somebody out there.

How is music helpful to you in the operating room?
TW: If you play [the music] right it can actually take the tension off of a generally stressful environment, so it can definitely be a calming influence. Let’s say if you’re a little fatigued, which happens towards the end of the day, if you play the right music it can definitely energize you to pick up the pace and move along. So you can definitely change your tempo with the tempo of the music a little bit. Whether we’re actually doing that consciously or not, I doubt it- it’s probably subconsciously. But I think it does happen.

There’s always music on. I don’t feel right if it’s quiet. We’d be feeling pretty uncomfortable, so there’s always something on.

I have major battles sometimes, especially in the outpatient surgery center. There are a couple of my techs who absolutely hate country music, so we have some brawls and they end up putting their music on. If it’s not too annoying, I’ll run with it, but every so often I have to assert my seniority.

David S. Levine, M.D.
Orthopedic Surgery, Foot and Ankle
Hospital For Special Surgery

So what kind of music are you listening to in the OR?
Dr. David Levine: I would say that when we listen to music in the OR there’s a presumption that it adds in some way to the functionality and the experience, it shouldn’t be intrusive. If all of a sudden there’s a challenge in the operating room, I’ve had to say to the anesthesiologist, who is in charge of the music since they’re at the top of the table near patient’s head, to turn the music off or to turn it down. What’s obviously very important is for everyone to have good communication and to have their roles and move forward during the operation. For example, if you have loud music going and you need to tell the nurse or person in scrubs next to you that you need something and they can’t hear you, that’s not a good thing.

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In most circumstances, the anesthesiologist will ask the surgeon what they would like to listen to that day. Sometimes they’ll just put on what they want. I would say that when I grew up as a kid in the 80s, I was listening to Motown and Disco and stuff like that. I was also influenced by a brother of mine who would listen to that lighter, early alternative kind of stuff- things like Culture Club, Alphaville and Yaz. So I have my old youthful affinity for things like that, even some early rap music like the Sugarhill Gang. Once I started to enter my young adult life, I started to gain an appreciation for what I hadn’t been into before, which was classic rock. So I really love classic rock.

My children are now teenagers and as you know, teenagers are totally listening to more music with Spotify and stuff like that. They have way more access to things now. So I’m going to say that I have, only because of access and repetition, started to really get into EDM. So I like listening to Avicii, Tiesto, and David Guetta, stuff of that. I would say that my own preference also limits things that are too noisy. So when it comes to stuff like dubstep and Skrillex, I can’t stand it. It really starts to become nails on a blackboard for me. I would say most of the time in the OR I’m listening to classic rock and even classic R&B, things like that.

There’s a fair amount of music, particularly in the rap genre, that’s not necessarily positive towards women and a little misogynistic. We are very sensitive to the fact that there are many women working in the operating rooms and lyrics that talk about certain things are not necessarily appropriate in the OR. You don’t want people to be offended or complain. It may not be something that you think about but when it comes to stuff like sexual harassment, but there has to be boundaries and limits on what you put on. I happen to like Eminem and 50 Cent. I love the sound and the beat, but some of the lyrics might not be seen by someone else in that same favorable way.

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How is music helpful to you in the operating room?
DL: We actually have a term called "closing music." After the the main part of the surgery is done, let’s say you’ve finished fixing the ankle or whatever it is in my case, you still have fifteen minutes or more to close all of the layers and finish the skin, put on the splint and whatnot. At that point you will want closing music, [which] is upbeat and uptempo for a number of reasons. Number one, it’s fun to listen to, and number two, it actually makes people speed up. Now, you never want to speed up at the expense of quality of course, but putting on some classic rock and roll or something like that is good. It’s certainly not going to be classical music, that’s for sure.

Internet radio stations are often repeating songs throughout the day and sometimes we’re in the operating room for eight hours straight, working on four or more different patients. We often joke about who the last one is to notice that we’ve already heard that same song earlier in the day, so that can be fun.

Music allows us to be comfortable and confident. If we’re used to listening to music in general, it’s nice to listen in the operating room because it doesn’t distract us from focusing- it actually helps feel a familiarity with our surroundings as part of a “zen” nature of being focused and taking care of what we do.

John Haskoor, M.D.
Resident, Orthopedic Surgery
UMASS Memorial Medical Center
What do Surgeons Listen To in the OR?

So what kind of music are you listening to in the OR?
Dr. John Haskoor: I think a lot of times, especially for a resident, it depends on who you’re working with that day. I’m sure you’ll see that a lot of different attending surgeons will have a lot of different music tastes, so you play off of them and try to find a common ground. I’ve noticed that you can’t really go wrong with classic rock- some Led Zeppelin in the background or even some 90s grunge stuff like Pearl Jam and Nirvana. That seems to have mass appeal.

For me, I listen to a wide variety of stuff. I think alternative music is something I listen to a lot now, bands like Alkaline Trio, Brand New, even a little bit of Weezer can be good too. You don’t want something that’s too overpowering or that takes too much of your attention but to have something in the background that you can get a rhythm too.

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Choosing the music in the operating room is pretty much open game. You can always put yourself out there and put something on and see how people react to it. Some attending surgeons will leave it up to you and say if you want music to just put something on. As long as it’s something that’s not horribly offensive to them, they’ll be alright with it.

Music has definitely been a big part of my life, especially since my brother (the author) has been a huge influence on me, always showing me new and different bands that are out there that I keep adding to my playlist. It’s always something I utilize, even when I read and study, so it’s easy for music to carry over into my work life.

How is music helpful to you in the operating room?
JH: I think surgeons are well trained enough to complete an operation under any circumstances, but having music just creates a more comfortable environment. I’m not sure if it has any effect on what actually goes on during the operation but from a comfort standpoint, for a person that likes listening to music and finds a moment of peace and focus with music playing in the background, it can’t hurt.

It also depends on the time of day. I feel like later in the afternoon you may want to play something a little more upbeat or a little more fast-paced just to keep the energy up in the room. In the morning you kind of want to start the day with something a little more mellow to ground yourself and get focused, so it really depends on a lot of factors.

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Joseph Zuckerman, M.D.
Orthopedic Surgery, Hip and Knee Reconstruction
NYU Langone Medical Center, Hospital for Joint Diseases
What do Surgeons listen to in the OR?

What kind of music are you listening to in the OR?
Dr. Joseph Zuckerman: I would say the music that I listen to is mostly popular rock and roll. It’s more the music of my generation, the 60s and 70s, than anything else, which is interesting because I used to bring my own music into the operating room back before all of the stuff online and iPhones and everything else. You’d have to have a boombox that you would put a CD in and stuff like that. It was really kind of a pain in the neck [laughs] because you had to truck the thing around and worry about someone taking it or something. Frankly, it probably wasn’t a good idea to bring these things into the operating room, but we did it and tried to take care of everything.

Since it’s essentially my operating room these days, I don’t even bring any music in, my residents take care of it. They’re kind enough that they’ll hook up Pandora on this small iPod speaker, which is incredible how much sound it provides. Instead of putting on LL Cool J or something like that, they’ll put on something from the 60s or 70s, a song or a group, and I’m listening to music that I like. They would probably call it retro, but it’s music that I enjoy like the Rolling Stones or even some of the earlier stuff in the late 50s and early 60s like the Four Seasons- stuff that I grew up with. I listen to some newer stuff and I’ll know the occasional song, but I definitely don’t listen to classical music. That’s not something I find helpful at all.

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The interesting thing is that one day the anesthesiologist somehow put on show tunes and the music from Frozen came up. They started to apologize and I said “what do you mean? I love Frozen. I saw Frozen and it was a great movie! Keep playing that!”

The whole thing with online music sites, it really changed the operating room. You can listen to whatever you want and be really selective. You don’t have to worry about making your own playlist or burning a CD like the old days.

One of my greatest regrets in life is not being able to play a musical instrument. I love music and even now my wife and I go to concerts to see some of the groups we were listening to growing up. I’m embarrassed to say but we’re going to see Frankie Valli in two weeks [laughs]. But yeah, I’ve always enjoyed music - my wife and I have a record collection and a bunch of CD’s. I took guitar lessons a couple of years ago and didn’t practice and it just frustrated me more, so I like to think that I have a lot of surgical skills in life but not music skills.

How is music helpful to you in the operating room?
JZ: First of all, I think of music in the operating room as the background noise, which is enjoyable to have. It blends itself into creating an environment there that’s more relaxing, because surgery is just inherently stressful. That’s all there is to it. You’re taking care of people, human beings, and as much as everything goes fine ninety-eight percent of the time, there’s always potential for something to happen. So since everyone is usually a bit tense and stressed, I think the music helps with that.

Now, of course you get in a situation where things get tense and I routinely say to turn off the music because I don’t want any distractions with the operation, or occasionally the music is too loud. Nobody is dancing around in the operating room. Again, it just needs to be background and I think it’s very helpful in that way. Plus, a lot of times the anesthesiologist will give the patients headphones to listen to music they have, like they do with MRIs and things like that. A lot of times patients will ask me afterwards if I was playing music in the operating room, since sometimes they only have a spinal anesthesia or general anesthetic, so I think it’s relaxing to patients also.

I think it’s important at the right time, in the right place, under the right circumstances, which for me is ninety-five percent of the time, unless a resident forgets to bring it in or something.

Michael Haskoor took knife to flesh for this interview. Catch him on Twitter.