Pitt med students Sae Jang (Class of ’17) and Pouya Joolharzadeh (Class of ’19) carefully put on tissue paper– thin yellow hospital gowns and bright blue gloves. They are outside the room of palliative care patient James Dorsey (not his real name). Dorsey has been at UPMC Presbyterian for almost a month.
But the med students aren’t here for rounds. Jang picks up her cello, and Joolharzadeh gets his violin. They walk into the room, and Jang asks Dorsey if he’d like to hear some music. “Something from the ’50s or ’60s,” he replies.
Jang sits in the corner of the room and starts playing “Yesterday” by the Beatles. Joolharzadeh follows with Bach while Jang stands close to Dorsey. Nurses gather outside the door. An infusion pump beeps nearby.
About three years ago, Jang started MusiCare, a program that gives medical students opportunities to perform for patients. Michael Chiang (Medical Scientist Training Program, Class of ’21) and Shawn Tahata (Class of ’18) helped formalize MusiCare in the Clinical Experiences curriculum and expand the program, which now brings students to play at UPMC Presbyterian and Children’s Hospital of Pittsburgh of UPMC.
“I think that feeling of doing something positive for patients is really empowering as a medical student, especially in the first two years, when you are [mostly] studying from books and memorizing. It reminds us why we came to medical school,” Jang says.
Across the hospital, Audrey Kindsfather (Class of ’20) is playing harp in the dialysis unit. Behind her, patients take videos of the performance on their phones. A man getting dialysis tears up. “I think it’s beautiful,” he says. “I just wish I was in a different situation.”
Kindsfather, who joined MusiCare last year, co-coordinates the program with Joolharzadeh and Elena Nikonova (Class of ’19). Kindsfather’s harp wouldn’t fit in the palliative care rooms, so she and Jang expanded the program to the dialysis unit and to Children’s with help from Jane Schell, an assistant professor of medicine at Pitt. Kindsfather, who started playing piano at age 6 and took up harp at 12, sees the time she spends organizing the group and performing as self-care.
“It takes care of our mental health,” she says.
Schell, who is the faculty advisor for MusiCare and hosts informal musical get-togethers at her home, says this group of students is ahead of the curve.
“When we go into medical school, it’s so easy to get focused on the physiology. It’s very easy to become dehumanized in the medical setting. Our patients have a lot of suffering. . . . Music helps our patients and our staff feel like humans. That, in and of itself, is therapeutic.”
"That is the impressive thing, to see medical students really pick up on that piece,” Schell says.
Now in her fourth year of medical school, Jang engages with patients directly as part of the curriculum. While she was doing her rotation in thoracic surgery, a patient caught her eye. She had seen the patient daily for weeks during rounds and decided she could deepen the connection by playing music for her.
But when Jang brought her cello into the room, she realized the patient didn’t recognize her. Because Jang had been focused on getting through the medical checklist when she saw her, they hadn’t established a relationship.
“I remember this incredible feeling of guilt. Since then I’ve really changed the way I talk to my patients. In my initial interviews, I’ve started to ask them, ‘What’s one thing that’s really important to you as a person?’” Jang says.
Joolharzadeh has found that performing music in the hospital has not just changed how he sees patients, but also how he sees music itself. While getting a bachelor’s degree in music, he struggled with performance anxiety—his hands would shake to the point that he couldn’t play.
“So far, playing for these patients has made that anxiety diminish, because it’s not about me anymore,” he says.
MusiCare is now among the variety of clinical settings where med students can volunteer for course credit. Nikonova, a pianist, would like MusiCare to grow to include residents and other physicians.
“Music itself bypasses everything and goes for the straight emotional appeal. For medical students it’s cool because we can speak with residents and doctors and patients of all ages. Everyone will gather around a source of music when it’s performed,” Nikonova says. “There’s nothing [else] that gives you that kind of room to breathe in the hospital.”