The summer of 2008, when electives for the medical students were announced, several students found it surprising that a medical college elective would be titled ‘Rhythms in Evolution’. A primary intent of the said elective was to allow the interested students an exploration of their musical talent and the possibility of its application in medicine. In retrospect, going through that elective turned out an enjoyable, enriching, and melodious experience.
The elective involved two music classes per week, each lasting for about three hours. Three skeptic medical students, namely, Farwa, Abaseen, and Adil, each with only a limited prior exposure to music composition, enrolled for the class. A pre-course questionnaire was administered to assess the musical aptitude and interest of the three participants. The music room where the classes took place was a small room lined with computer stations and a view of the bright and sunny hills situated around the outskirts of Karachi. Except for a keyboard, perched on its stand at the far end, nothing about that room resonated a musical note. Dr. Jamsheer Talati, a general surgeon by profession and a trained classical pianist by passion, was the instructor. The computers were to be used for downloading and listening to audio files, to train the ear and wet sensibility for the main course, and to employ software to work with musical notations.
The first week of the course was devoted merely to studying the history and evolution of various genres of music over the ages, spanning music from the ancient ages, classics, rock, jazz, and techno. The activities comprised of extensive music listening and group presentations of the findings and experience. The presentations and discussions featured selected composers from different eras. By the end of the first week participants had heard and discussed a rich concoction of music from all ages and many regions of the world.
In the second week, participants took a closer look at the various elements and intricacies of music that bestow it the richness and variety that so often goes unappreciated: Rhythm, timing, frequency, timbre, organum, counterpoint and elaboration were therefore discussed. During the same week, participants listened to the works of eminent composers, including Tchaikovsky, Prokofiev, Bach, and Messian. The participants were encouraged to pick the emotion that the composer tried to communicate through music, and to understand how various tones and melodies were being exploited to create a scene in the mind of the listener. In medical language, this is known as the external locus, which is an emotion perceived to be expressed in a musical piece. The external locus is stronger than the internal locus; emotions felt in response to music [1]. Music, like speech, thus forms a mode of communication. Pleasant emotional responses to music have been localized to certain areas of the brain; ventral striatum, orbito-frontal cortex, amygdale and ventral-medial pre-frontal cortex [2]. Interestingly these regions of the brain are also relevant to motivation and reward, and judgment [2].
During the same week, participants were introduced to musical notation. Music Publisher 6; a computer software that allows the writing and playback of sheet music, was mastered and effectively used to develop musical notation. Over the course of the week that followed, these compositions were embellished upon using the concepts of counterpoint, organum, and variations of timing. Music notation is like a language; pitch, harmony and melody structure the communicating sound, whereas rhythm and meter give it temporality. It comes as no surprise that music training is considered to have potential for enhancing verbal skills [3-4].
The forth and final week of the elective, each participant was asked to choose a story or a piece of poetry and express it, or the emotion it evoked, in the form of sheet music. The written music was tried out on various instruments, with the help of Music Publisher 6, in order to experiment with the melody. Farwa, Adil, and Abaseen took, respectively, poems by the great Persian poet, Rumi and a character from the film Elephant Man, as inspiration for their compositions. The end of the fourth week marked the end of the elective. The participants had gained significant prowess in musical notation and composition, modifying and refining their original compositions and sharing them with each other. A post-elective assessment revealed they had developed an initial interest as well as a greater appreciation for music.
Farwa’s composition (Rumi)
Adil’s composition (Frere Jaques (Are you sleeping?))
Abaseen’s composition (The Elephant Man)
Music, like language, communicates shapes, patterns, textures, and scenarios. Neuroimaging studies have ascribed musical experience to the fronto-parietal mirror neuron system [5]. These neurons are responsible for how we detect the feelings conveyed by speech or music, ‘mirror’ them in our perception and generate a personalized response. Language, music, and motor activity converge at this very neural system. Musical appreciation can therefore intensify our emotional experience and enable us to empathize [6]. Skills acquired through training in fine-arts, such as music, help to cultivate empathy, emotional sensibility and consideration of humane aspects not taught by medical textbooks.
Adil Shah and Farwa Ali are second year medical students, Abaseen Afghan is a third year medical student at the Aga Khan University, Karachi , Pakistan
adil.shah.m07@aku.edu
The authors would like to acknowledge the assistance of Jamsheer Talati, a Professor in the Department of Surgery, and Syed Ali, an Associate Professor in the Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
References:
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2. Blood, AJ; Zatorre, RJ. Intensely pleasurable responses to music correlate with activity in brain regions implicated with reward and emotion. Proc Natl Acad Sci. 2001;98:11818–11823. doi: 10.1073/pnas.191355898. [PubMed]
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doi: 10.1093/scan/nsl029.
6. Marie Forgeard, Ellen Winner, Andrea Norton, and Gottfried Schlaug, Practicing a Musical Instrument in Childhood is Associated with Enhanced Verbal Ability and Nonverbal Reasoning. 2008 October 29. doi: 10.1371/journal.pone.0003566.