John Saganty explores the role of music in representing and experiencing the cancer patient perspective.
“Music is a therapy. It is a communication far more powerful than words, far more efficient.” -Yehudi Menuhin
Medical humanities was an unfamiliar concept to myself when I was first introduced to it during my third year of medical school. By undertaking my own medical humanities project, I then understood its vital role in medicine and the university curriculum. In this article, I will discuss how my medical humanities project has changed the way I view patient care and the importance of incorporating medical humanities more broadly in medical education.
Music has a profound ability to communicate and connect individuals without using words. My interest in using music in medicine started when I watched a documentary that portrayed African cultures using singing and chanting to help heal sick individuals. Although I witnessed my father’s experience with bowel cancer, I had little insight into the psychological and holistic effects of the disease. To bridge this gap, I wondered if music could be used to investigate and communicate these complex feelings to others and provide healing in some form. This sparked the creation of my medical humanities project.
The Composition
I wished to compose music that could translate the patient’s journey with cancer and give listeners an insight into their perspective. I collated autoethnographic research that provided detailed first-person accounts with cancer. I realised how diverse their perspectives were and the many factors that had to be considered. Their gender, age, cultural background, spirituality and whether this was their first cancer diagnosis or a recurrence. However, they all had several themes in common: fear, change, isolation, hope, and hopelessness. These themes affected all aspects of their lives.
Building upon these themes, I devised a composition that had seven movements: Self, Physical, Psychological, Emotional, Behavioural, Social, and Spiritual. The order of the movements being based on the order of the patient’s description (see Figure 1). Self deals with the conflict between a ‘healthy-self’ and a ‘cancer-self’, the latter of which the patient is forced into without warning. Physical focusses on attributes, such as hair loss, which define the way a patient perceives themselves. Psychological demonstrates those quiet moments externally but can be internally loud. Emotional illustrates the patient’s desire and need to cope with their own feelings while shouldering the feelings of others. Behavioural revolves around ‘passing’ and the need to hide from the social stigma associated with cancer. Social demonstrates denial or the patient isolating themselves to avoid the negative features of their social circle. The composition ends with Spiritual, which explores the patient’s faith as a final defence against cancer.
For inspiration, I used work from my favourite film scores, including Hans Zimmer and Studio Ghibli. I composed this piece for a string quartet – violin, viola, cello, and double bass – to cover a broad range of feelings and to have individual identities within each movement. I created each movement to play like a story, with a beginning, middle and end. You can find composition recordings on my SoundCloud.
The Performance
I was given the fantastic opportunity to have my piece performed live earlier this year at the Scottish Medical Humanities Conference 2023, which took place at the University of Aberdeen (Figure 2). To have performed this work for students, staff, and healthcare professionals was a lifelong ambition. Between each movement, I introduced the idea behind its creation, but I believe this also left room for the audience’s own interpretation. The goal of the piece was to communicate the patient journey, allowing for healing and to provide affective insight. I specifically remember making eye contact with an individual in the audience, their eyes were filled with emotion and this was when I realised that my piece had done what I had hoped it might. It was an unforgettable experience. You can find a recording of the live performance on YouTube.
The Impact
Through this project, I learned not only about the patient experience and my father. I also learned about myself. The composition process and performance altered my preconceptions of the patient journey. Specifically, I had a more nuanced understanding of the patient journey and no longer understood this journey to have a definite start and end – as most get a delayed diagnosis and the fear of recurrence continues long after being cured.
Medical schools frequently mention using a holistic approach for patient care. However, trainee doctors are rarely given the time to delve into the complex psychological needs associated with being ill. This project allowed me the time and space to explore the psychological and emotional dimensions of life with cancer – and allowed me to put my ideas into practice. It made clear that a holistic approach to patient care is necessary, and I implement this daily with my patients. I hope that one day, this will allow me to become a better oncologist.
Using medical humanities methods was a unique and invaluable part of my university training. I encourage all medical schools to incorporate medical humanities. To have the platform to showcase my work at a national conference to likeminded individuals was a remarkable experience, which many more students and trainee doctors should engage in. Receiving their positive feedback and the opportunities that followed has encouraged me to continue my passion for keeping medicine and music in conversation – and to better understand and improve patient care through interdisciplinary approaches.
About the Author
John Saganty graduated from the University of Aberdeen in 2023. He currently works as a junior doctor in NHS England and plans to become an Oncologist. John has a background in cancer research and completed an M.Phil. in cancer research at the University of Cambridge. His music background is in Tenor Saxophone, Violin, Piano and has been composing from a young age. You can connect with John through LinkedIn.
