Many surgeons are as captivated by the chord progression and harmonic balance of a symphony orchestra as they are by the challenges in the operating room (OR). The surgeons featured in this article demonstrate their surgical acumen in the OR, and away from the OR they reveal their unique talents as classical musicians. These classical musicians and surgeons recognize the value of both passions.
Blending two passions
Peter F. Crookes, MD, FACS, proudly notes that he can hold his own as a classical violinist in a string quartet—and in an OR. Originally from Belfast, Ireland, Dr. Crookes has continued to improve his violin playing as he has pursued a practice in upper gastrointestinal and bariatric surgery. He is a professor and director of the medical student surgical clerkship at the University of Southern California (USC) department of surgery, Keck School of Medicine, Los Angeles.
“I grew up in an impoverished working class family in Belfast, in Northern Ireland, and my parents had no money for formal education. Still, my four siblings and I all learned to play the violin,” he said.
Dr. Crookes started playing at age 11, and music was the love of his early life. “As a kid, that’s what I did—I listened to classical music endlessly on our record player. I was totally immersed in music. Now, if I’d had more money, if I had come from a middle-class professional family, I would have wanted to go to a conservatory. That’s probably what I would have done with my life, but my parents could not afford to finance that kind of education.”
In the 1970s, as Dr. Crookes yearned for a musical career, the British government was funding free medical education to qualified students. On a full scholarship, Dr. Crookes was able to attend the Queen’s University Belfast School of Medicine, Dentistry and Biomedical Sciences and completed his surgical residency there. He came to the U.S. in 1990 for a one-year fellowship at USC and has been here ever since.
Dr. Crookes’ life has been a blending of his two passions: surgery and music. “I think what my music playing has given me is a more human face as a surgeon,” he said. “Music teaches you to listen, and listening to classical music is rather like reading a long novel. You have to understand the narrative. It’s not like listening to a three-and-a-half minute song on the radio. Classical music focuses your attention, and you have to listen to find out why things are developed. So being a musician has greatly enhanced my ability to listen as a surgeon.”
His musical background also gives him a strong sense of history. “To appreciate the compositions of Bach, Brahms, Beethoven, and Mozart, you need an understanding of what was happening in Europe in the 1700s and 1800s and then what was happening in medicine,” Dr. Crookes explained. “Life in 19th century Europe was terrible for people in many ways. This was before anesthesia. Diseases that are curable today killed the great composers. Mozart died at age 35 of strep throat. Mendelssohn died from a series of strokes at age 38. Music and surgery are two important strands of society, and to understand history is to understand where surgery was then and where we are today.”
Wunderkind turned accomplished surgeon
Dr. Crookes treasures his associations with surgeons and musicians alike. He goes back a few years with a younger colleague, pianist Hiroko Kunitake, MD, MPH. “Dr. Kunitake was a kind of a wunderkind as a kid in San Diego,” he said. Dr. Crookes happily recalls that when Dr. Kunitake was a student at the University of California, Los Angeles (UCLA) the two of them gave a combined academic lecture and recital as part of a surgical biology club meeting associated with the American College of Surgeons (ACS) 2007 Clinical Congress in New Orleans, LA, a performance he hopes that someday they can repeat in front of another audience.
Dr. Kunitake, who is today an assistant professor of surgery at the Boston University School of Medicine and an Associate Fellow of the ACS, began pounding the keys of a piano at four-and-a-half years old. “My parents lived in a small town in Texas, and I took lessons from the local teacher,” she said. “My dad was in the Navy, and we eventually moved to San Diego,” where she met piano teacher Jane Bastien, who guided Dr. Kunitake’s musical talents though high school.
Classical music was serious business in the Kunitake household. “My two brothers and I all played the piano, and we spent a lot of time practicing. In high school, I probably spent four to six hours a day at the piano.” Practice proved challenging but deeply rewarding for Dr. Kunitake, and playing the piano became an essential part of her life. As she learned the important role of discipline in any undertaking, she mastered the piano and seriously considered dedicating her life to performing classical music.
“After high school, I applied to both music conservatories and colleges. My parents really wanted me to have a liberal arts education.” In 1992, Dr. Kunitake became a freshman at Harvard University, Boston, MA, where she majored in biochemical science but continued to take piano lessons at the New England Conservatory of Music. After graduating from Harvard, Dr. Kunitake received a three-year fellowship from the American Pianists Association, which supported her study and performances around the country.
Dr. Kunitake then completed a doctorate in piano performance at the USC Thornton School of Music in Los Angeles. Soon after, an international piano contest would change the direction of her life: She and three other young U.S. pianists were selected to compete in the 2000 Chopin International Piano Competition in Warsaw, Poland.
The event reaffirmed her love and appreciation for classical music. “This was a fantastic, eye-opening experience for me,” Dr. Kunitake said. “It was just awesome to meet and listen to these outstanding musicians from around the world.” After the competition, she turned her attention to medicine, because science and medicine had always fascinated her.
“I had wanted to be a surgeon for a long time,” she said. “I attended medical school at UCLA, and completed my general surgical residency at Massachusetts General Hospital in Boston.” This was followed by a fellowship in colorectal surgery at the University of Minnesota, Minneapolis.
Being a surgeon and a world-class musician are not mutually exclusive. In Dr. Kunitake’s view, the two skill sets complement one another, a point supported by hematologist, oncologist, and Pulitzer Prize-winning author Siddhartha Mukherjee, MD, who noted the similarities of the two professions. Observing the contributions of Prussian-born Austrian surgeon and musician Theodore Billroth, born in 1829, who pursued the two disciplines with “almost equal verve,” Dr. Mukherjee wrote, “The professions still often go hand in hand. Both push manual skill to its limit; both mature with practice and age; both depend on immediacy, precision, and opposable thumbs.”*
“Creating something with your hands is very gratifying,” Dr. Kunitake said, noting that both disciplines require dexterity, and, at their most basic levels, are challenges of the hands as well as the mind. “I absolutely enjoyed pursuing both interests, and it has turned out to be a wonderful, interesting road for me.”
Currently, playing the piano relieves many of the stresses of Dr. Kunitake’s surgical life. “Today, I play the piano for myself. I find it very soothing and very satisfying,” she said. She also enjoys listening to other accomplished musicians play. As a Boston resident, Dr. Kunitake holds a subscription to the Boston Symphony Orchestra, where she can absorb classical music as an avid listener.
Becoming a surgeon requires overcoming any number of barriers. Alvin H. Crawford, MD, FACS, a pediatric spine surgeon in Cincinnati, OH, knows firsthand about overcoming social obstacles. His musical interests began at age 11 as an African-American youngster in Memphis, TN. He originally played the trumpet but switched to the clarinet, which he said was better suited to his embouchure, referring to how a player applies the lips to the mouthpiece of a brass or wind instrument. By the time he was in high school, he was spending many evenings backing up professional musicians when they came through town. He could read music and would rehearse with band members in the afternoon and perform with them in the evening. Music was his life, and he fully expected to make it his career. After high school, he received a full musical scholarship to Tennessee A & I University (now Tennessee State), a historically black institution in Nashville. There he did what he loved: He studied classical music during the day and played with local bands at night.
Then one fateful day, his brother, thinking that he was reassuring him, told him that he would have no problem finding work as a high school band director after graduation. “I immediately thought, ‘But I don’t want to be a public school band director.’ I loved my high school band director but could not see that as my future. I loved challenges, and that idea just didn’t challenge me. Wasn’t there something else I could do?”
The conversation led to an epiphany for the young man. He decided to find a new life course and set his eyes on medicine. He began taking prerequisite courses for medical school and eventually graduated in 1960 with a double major in music and chemistry. He turned the practice and discipline that he had applied to his clarinet playing to his undergraduate premedical courses.
At that time in the segregated South, African-American people were generally barred from attending state-supported medical schools. Dr. Crawford refused to concede to discrimination. Touting his high scores on the Medical College Admission Test, he protested the University of Tennessee Medical School’s refusal to admit him.
Dr. Crawford rarely loses an argument, and he won this one. He was granted admission, and in 1964, he became the first African American to graduate from the school. Dr. Crawford admits that he wasn’t the most popular student on campus, but he never allowed himself to become a victim of discrimination. Despite the obstacles, he studied and worked hard and, all the while, he continued to play the clarinet. He began his residency at Chelsea Naval Hospital, MA, and completed it at the combined Harvard University Orthopaedic Program. In 1977, Dr. Crawford began his career in Ohio as director of orthopaedic surgery at Cincinnati Children’s Hospital Medical Center, OH, and remained chief there for 29 years.
Today Dr. Crawford is a widely respected academic orthopaedist who has given as much to the world as he has received. He has offered his orthopaedic teaching skills in such varied places as Germany, Sweden, Brazil, Colombia, Saudi Arabia, and West Africa. Specializing in treating scoliosis, Dr. Crawford is one of the nation’s foremost authorities on video-assisted thoracoscopic surgery, which allows surgeons to insert rods through small incisions to straighten the spine. He is also an authority on neurofibromatosis in children.
He has achieved many firsts in his distinguished career. He was the first African-American president of the Scoliosis Research Society, an international society that studies spinal deformities, and is a past-president of the John Robert Gladden Orthopaedic Society. He is the founding director of the Crawford Spine Center at Cincinnati Children’s, and in 2004 he was honored with the dedication of the Crawford Chair in Pediatric Orthopaedics and a subsequent chair in spine surgery.
Dr. Crawford’s clarinet playing took on a secondary role as he pursued a medical career, but now that he is a professor emeritus at the University of Cincinnati College of Medicine, he has the time to take clarinet lessons at the College-Conservatory of Music and play with a number of ensembles. He is a lead clarinetist in Cincinnati’s Queen City Concert Band, and he also plays with the University of Cincinnati Summer Community Band. In addition, he plays the saxophone in the Undercover Big Band of Cincinnati. He was a guest student in jazz improvisation at the University College Conservatory of Music this year and was recently appointed to the Dean’s Advisory Council of the University of Cincinnati College Conservatory of Music.
Playing with a band is a team sport, Dr. Crawford said. “In surgery and as a member of an ensemble, you go through a lot of the same things. You work as a member of a team in the operating room, and you play as a group. You maintain a key with other members of the band, and in surgery you need the rhythm and cooperation of the team, including the patient.”
He doesn’t consider his successful pursuit of two disciplines all that unusual. “A lot of physicians are serious musicians,” he said. “In many ways, the required skills are similar.”
Rediscovery and rejuvenation
John E. Rosenman, MD, FACS, a vascular surgeon in Burlingame, CA, who attended the University of California, San Francisco, School of Medicine, grew up in a family of musicians and a home filled with classical music. “Playing music was a tradition in my family,” he said. “My mother was a musician. My father was a surgeon and also a musician, and my siblings were all musicians. We had an ensemble in our house. We all grew up constantly playing and listening to music.” In that respect, nothing has changed for Dr. Rosenman. His wife plays the flute and cello, and their children are all musically inclined, although only his son is a professional musician.
When Dr. Rosenman took up the cello at age eight, he quickly discovered his own connection to music. Playing the cello became a challenge and a passion, and he pursued it enthusiastically. “I didn’t play with an orchestra in high school,” he said. “Primarily, I played chamber music with family and friends.” Private lessons helped him develop his craft, and he considered becoming a professional musician for a time. He began undergraduate school at Oberlin College, OH, which offers both a music conservatory curriculum and a liberal arts program. “Halfway through my first semester there, I realized that I wouldn’t be in the top tier of musicians,” he said. “I was more interested in academic topics, and I decided that music would be a better avocation.” Academics soon consumed his life. “I misconstrued how little time I would have to devote to my cello,” he said.
Then came medical school and surgical training, marriage, and three children. “I was so overwhelmed with the process of becoming a surgeon and having three little children at home that I didn’t touch the cello for a very long time.” About 25 years ago, after a 10-year hiatus, as he settled more comfortably into his professional and personal life, Dr. Rosenman returned to the cello, seeking to enhance his playing technique. For the first time since high school, he took private lessons.
“It was surprisingly easy for me to get back into it,” he said. “Actually, when I started playing again, I was better at it than I had been.” He now participates in two quartets and earnestly fits three days of practice a week into his schedule.
“When I practice the cello, I’m completely outside my work life,” he said. “It’s a place where I am completely engaged outside all of my responsibilities.” Now that he is in his mid-60s, and his surgical practice has slowed a bit, he finds time each summer to spend a week at a musical workshop for amateur musicians. In the summer of 2014, he lived in a dorm and attended a workshop at Scripps College in Claremont, CA.
“For me, it’s like Christmas in summer,” Dr. Rosenman said. “You are absorbed in music for one week. It takes you completely away from your professional life.”
Amateur musicians get to know each other through the workshops, which are offered in many major U.S. cities and internationally. “You see a lot of physicians there, but not as many surgeons. Surgery is generally so time-consuming, and it’s hard to commit to any kind of regular schedule.”
Most of Dr. Rosenman’s patients are aware of his musical skills. “In vascular surgery, many patients are long-term, and you take care of them year after year. I’ve known many of my patients for years, and they are really interested in my cello playing,” he said.
Performing classical music is ultimately about creating something of beauty, which surgeons do in their own time and in their individual style. Surgeons employ the kind of discipline that has propelled their careers and turn that concentration into their music. The task requires focus, practice, and passion. Their passions, both surgical and musical, make the world a better place.
*Mukherjee S. The Emperor of All Maladies: A Biography of Cancer. New York, NY: Scribner; 2010.