AANS Neurosurgeon | Volume 29, Number 1, 2020

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Improvisation

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Many physicians and neurosurgeons enjoy or play music at a high level. My main interest was music before entering neurosurgery. This interest took a major backseat through medical school, training and early practice. Eventually, as I became more comfortable with my surgical practice, I found time to begin studying music again and playing keyboards with several jazz groups. After more than 20 years of jazz and neurosurgery, I have found that there are interesting, and perhaps obvious, similarities between the two professions.

Jazz Mimics Neurosurgery

While study and practice are critical in both professions, improvisation, which is so critical to higher level jazz, may be less obviously related to neurosurgical practice. As surgeons, we all should know the specific steps in the operation. At a more advanced level, we often must leave the plan and be open to new or different directions that are dictated by the specific circumstances of each operation and not generally knowable prior to making an incision. This process is almost identical in jazz improvisation. Adherence to general principles forms the foundation. However, too rigid adherence has the potential to diminish the quality of the interaction between members of the group, thereby rendering the sounds less interesting, original and free; key features of jazz improvisation.

Humility’s Benefits

Humility is another shared element. This essential quality allows a player to carefully and thoughtfully listen to others while playing and, thereby, follow and supporting the ensemble. While humility in surgery may be less apparent, the experienced and open-minded surgeon recognizes that it plays a vital role in improving surgical outcomes. Listening to your assistants and even one’s own intuition, as opposed to rigidly moving in lockstep with the fundamentals, frequently leads the surgeon to consider other possibilities or, at least, carefully consider and adapt more effectively to the patient and pathology at hand. High quality surgery and high-level jazz improvisation absolutely benefit from an openness that is born, in part, of humility. This trait can also be hugely beneficial when innovation and research are part of the neurosurgeon’s mindset.

Jazz, Art and Neurosurgery

Art is another shared element and for a neurosurgeon the “art” of the practice is born of a combination of:

  • Careful patient and imaging assessment;
  • Literature appreciation;
  • Technical surgical skill; and
  • Intraoperative treatment decision-making.

The art in playing jazz is born of similar core elements, combining:

  • Basic study;
  • Broad music appreciation; and
  • Listening and playing skills.

In both professions, these fundamental elements can be easily and consistently scripted. Yet, it is how the practitioner integrates these elements to engender either the surgical procedure or the improvisational music passage that constitutes the art and is dramatically different across practitioners.

These ideals may be comfortably applied to any activity or profession, but to effectively function above the fundamentals requires study and practice, time, dedication, courage and a sincere willingness to learn from one’s mistakes; characteristics shared by those who truly love their craft as I do both jazz performance and neurosurgery.

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Deborah Benzil | December 16, 2019 at 10:58 am

fabulous!!
db

AANS Neurosurgeon Spotlight: Winter 2020 – The Mind of a Neurosurgeon - Neurosurgery Blog | December 30, 2019 at 12:43 pm

[…] Improvisation, Jack P. Rock, MD, FAANS […]