Epidemiology is a hot topic in the COVID-19 era. Institutions like the World Health Organization, the U.S. Center for Disease Control, and the European Centre for Disease Prevention and Control, the loci of epidemiological studies, were founded to trace the origins and control the spread of diseases and their causes. These institutions have always been important components of our quest for survival, but the critical nature of their work has risen in the public awareness during this COVID-19 era. With news of successfully completed vaccine studies from major pharmaceutical companies and global universities and the approval for their distribution and administration, there has been an ever-so-slight emotional shift toward the positive. Negative emotions toward and fears about the vaccine news present themselves too, as anti-vaccine voices and false information regarding vaccines also make their voices heard. Within our post-truth era, it seems that, for every well-formed, testable fact, there is an impassioned and heated rebuttal based largely in emotions and feelings. While often destructive, such emotions are to be expected, I suppose. We are, of course, human beings, and emotions are certainly part of that equation. And emotions aren’t all bad. Some of our best moments are filled with emotions. So how might we go about negotiating these impasses?
In March 2015, Dr. Danielle Ofri wrote an op-ed in The New York Times entitled “My Patient Doesn’t Do Vaccines.” Ofri recounted an act of emotional epidemiology, the scientific idea that there is a patient zero, an original source, from which our emotional reactions to various stimuli emanate just as there is with viral outbreaks. Near the end of a particular appointment, Ofri recommended a flu shot to a patient, who responded amicably, “I don’t do vaccines.” Knowing the minute likelihood of changing the patient’s mind, Ofri initiated a respectful exchange with the patient through the “genuinely curious” query, “Tell me why you won’t take vaccines?” The exchange progressed with the patient offering various reasons common in the anti-vaccine literature, such as chemical preservatives, links to autism, side effects, compromising immune systems, and a general state of fearing the unknown. Ofri responded with scientific data to counter each offered reason. Ofri noted that “he seemed open to hearing what I had to say, and I genuinely wanted to understand the root of his concerns. But we kept going in circles.” In my reading of Ofri’s op-ed, the task of understanding the root of his concerns emerges from this conversation as the most important action. In conversations and social media, we’ve all encountered these seemingly unproductive circularities on topics from global pandemics and virology to politics and religion. Ofri expressed a concern that I share during the COVID-19 era. “The scientist side of me remains dumbfounded when clear and present facts do not convince people. But the other side of me recognizes that it’s not all about facts and that I won’t get anywhere just citing them.” Their exchange of facts and emotive rebuttals concluded with the patient’s statement, “I’ll think about it,” a statement that Dr. Ofri concluded “was about as much as [she] could possibly ask for.” (Ofri 2015)
Danielle Ofri isn’t the only doctor considering this idea of an emotional epidemiology, a search for the source of our emotional reactions. Lee Daniel Kravetz explores this in Strange Contagion: Inside the Surprising Science of Infectious Behaviors and Viral Emotions and What They Tell Us About Ourselves (HarperCollins 2017). Elaine Hatfield, John T. Cacioppo, and Richard L. Rapson promote the virus-like transmission of emotions in their thorough study, Emotional Contagion (Cambridge, 1994). While more cultural than emotive, Richard Dawkins’ idea of memetics from his seminal work, The Selfish Gene (Oxford 1976) also seems relevant to such discussions. These studies are important in understanding how we relate to one another, how our feelings and emotional responses affect others, and perhaps most significantly in the self-exploration of where our own emotional responses originate and how they alter our own perceptions of the world around us. Despite the frustration in such encounters, I don’t find the circularity of such discussions to be completely fruitless, although they certainly seem so in real time. As with Ofri’s encounter, the response, “I’ll think about it,” might not only be “about as much as” could be expected, but it might indeed be progress. In our post-truth era of data denial, thinking about it seems to be half the battle.
My own academic discipline, music theory and analysis, might seem somewhat outside the box of application for Ofri’s task of instigating discussion across the wide chasm of disparate ideologies and approaches to scientific data. The idea of emotional epidemiology—the idea that there is a locus of origin to our emotional reactions to the world around us—is, however, somewhat related to the study of music and likely to the entirety of our interactions and daily tasks, no matter your field of study or line of work. Replace the word “vaccines” with any frequently divisive topic, such as politics or religion, and Ofri’s story is widely applicable. Although benign at first glance, music and its analysis sometimes also incapsulate such emotive responses. Music’s power to influence and trigger a wide spectrum of emotions has been well documented, at least as far back as Plato and Aristotle. Likewise, music inspires powerful opinions about its interpretation, as evidenced by the plethora of recordings of many well-known works such as Beethoven Symphonies or Bach Cello Suites or covers of great songwriters such as Joni Mitchell or Bill Withers. Well-made art leads to an endless multiplicity of interpretations, but that doesn’t make it completely subjective. Facts are still present in a musical score. One can’t call a pitch, C-natural, when the score clearly shows that it is C-sharp. And the skill of listening to the difference between a C-natural and a C-sharp or between the way different artists interpret a musical phrase takes quite a bit of development.
But Ofri’s task goes far beyond just facts as rebuttals for emotional reactions. It’s more about process, the how and the why of getting to knowledge over the knowledge itself. And that’s why her exchange was successful. She got her patient to think about it. She got her patient to engage in the process. In music analytic circles, arguments over the proper interpretation of specific chords are a great example, and they sometimes get heated on a level that often seems somewhat unwarranted. As with Ofri’s discussion, the how and why are much more important here than the analytic label. What the notes are doing is more important than what we label them. And that sometimes is lost not only in student’s understanding of what the notes are doing and how they are functioning, but also in the exchange of ideas between professional music theorists and analysts. The process of listening to the music and to each other is lost in the emotional rebuttals of our already formed analyses.
For Ofri, it’s about that process of listening. She herself connects the process of listening to music to the interpersonal listening process between doctor and patient. Ofri is a cellist and openly connects her musical experiences to the listening skills required in the doctor/patient exchange. In What Patients Say, What Doctors Hear (Beacon Press, 2017), Ofri notes the never-ending process of learning how to listen to music and relates that to the same process of learning how to listen to her patients. We often think of listening as an innate activity, but it’s not. It’s something that has to be developed, sometimes with painstaking effort. It’s something that sometimes has to be pointed out to us. “But you’re not hearing exactly what I’m saying” is a phrase one often encounters in a person-to-person exchange. Likewise, with music, the level of nuance in our hearing of a song or piece of music might also not quite be what the music is fully saying. There might be elements of the score that are slipping by unnoticed that significantly alter the way a passage is heard or performed, that alter the communicative meaning of that musical work. There might be facts that we are missing, important facts that significantly alter the meaning of a passage. In the act of music analysis and even further in the act of communicating a musical analysis or interpretation to another human being, there is an exchange of information that requires the same kind of open discussion as described by Ofri. Music theory and analytic discussions sometimes involve views that sit across a chasm seemingly as wide as that of Dr. Ofri and her patient who didn’t “do vaccines.” Debates arise in music analytic circles as to what analytic approach is best with perspectives coming from big data (corpus studies), linguistics, brain and cognitive sciences, narrative analysis, historical approaches, performance studies, and many, many more. And many times, two different perspectives reveal contradicting analytic and interpretive results. With so much time put into any analytic endeavor, emotions often rise as a prominent component of the presentation of disparate analytic results. Subjective though artistic interpretation can sometimes be, these disparate perspectives on music analysis don’t necessarily mean that one perspective isn’t more accurate than the other, more based on factual musical, historical, or scientific data or that another perspective isn’t inherently wrong and outside the bounds of that same data. The content of these debates is beyond the scope of this article, but the debate itself, the exchange of information, is the focus here. Ofri’s discussion points and responsibilities as a doctor clearly set her on one side of the debate, but that’s beyond her point. Her op-ed is about the methodological exchange of data and not necessarily the data itself. There are scientifically tested facts certainly at play that can be used to sate emotional responses and the prevalence of fear in these trying times. But we also have to find lines of communication to get people to hear those facts, to get them, as with Dr. Ofri’s patient, to think about it. Indeed, in medicine and music analysis alike, the process might end up being as important as the data itself.
–Nathan Fleshner, Assistant Professor of Music Theory, University of Tennessee, USA