#1: A DJ Saved My Life
All Ears producer Annaliese Redlich ready to head into the operating room at St Vincents Hospital
Episode Description
In ‘A DJ Saved My Life’, we join a surgeon and anaesthetist in the operating theatre for a look at the role music plays in a life and death situation. How can music help communication, creativity and stress management? Is there a link between pub-rock and microsurgery?
In this episode
Guests: Dr Ramin Shayan, Dr Anthony Singh, Dr Tara Karnezis
Intro Theme: First Kiss Goodnight - “Story One”
Music Credits: Davey Lane - “(Sittin On) the Dock Of The Bay” cover, Davey Lane - “Back In Black” cover, Podington Bear - “Caterpillar Bridge”, Podington Bear - “Pives & Flarinet”
All Ears is produced and presented by Annaliese Redlich, with mentorship and editorial support from Beth Atkinson-Quinton and the Broadwave team.
Get in touch
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Annaliese Redlich [00:00:07] We all know the effect music has on our mood. You know, getting motivated for a workout or the overwhelming heart tug of a sad song. But what if I would tell you that it plays a starring role in supporting those working in life and death situations? Hey Annaliese here with All Ears on this episode, we find ourselves witnessing firsthand the important role music plays in the day to day of an intense workplace - an operating theatre. So get on your scrubs as we head into surgery and get ready for this episode of All Ears: 'A DJ Saved My Life'.
[00:00:58] And how did we end up here? Well, a while back, I was riding my bike and I was hit by a car. I was actually really lucky and wasn't hurt too badly, but, I had to get an MRI scan that stands for Magnetic Resonance Imaging, by the way. It's a huge machine that uses magnetic fields and radio waves to take pictures of your insides. In my case, they were looking inside my arm and shoulder to see how much damage had been caused. So I show up to my appointment not thinking at all about what's involved in this MRI. And it turns out that you've got to lie incredibly still in a very small, tunnel shaped space for what can be quite a long period of time while a really loud machine scans your body.
[00:01:50] [SFX: MRI noises]
[00:01:50] For obvious reasons, this commonly causes high levels of anxiety in patients. That and the tiny space that you stuck in, and to help you relax they give you headphones and let you select your favourite music. Put on the spot, one name popped into my head: Otis Redding.
[00:02:15] [Cover of Otis Redding - (Sittin' On) The Dock Of The Bay starts to play underneath]
[00:02:15] And I have to say, a very soothing choice in the circumstances. While I was in that claustrophobic situation, each time I began to panic, I put my mind back to Otis - his voice, the lyrics, the music, and I was fine.
[00:02:48] Now, humans are innately attuned to the beat in music. After all, a steady beat is with us from the beginning of life in the womb. The heartbeat. Studies have shown that our anxiety levels are tremendously reduced when listening to music that mimics the resting heart rate for healthy adults by the way, that's 60 to 100 bpm.
[00:03:13] After my Otis experience, I started thinking about all the places that music is used to make us comfortable or relaxed us in the medical world. I've had many friends who have selected music while having an operation where they need to remain conscious. And giving birth is another time where music can be vital for mothers in labour. But, I was curious about the lesser known scenarios.
[00:03:33] Six months later, I'm at this Christmas party and I meet a surgeon and I ask him about this. But to my surprise, he was way more excited to tell me about the role it plays in theatre in his own practice, to support his mood and concentration.
Dr Ramin Shayan [00:03:48] When there's been some sort of difficult element to say, a microsurgical part of the operation, for example, the blood vessel that we're trying to connect, the flap of tissue, the air of tissue that we've moved with its blood supply in its entirety, might be in the tissue that's had previous radiotherapy. So, it's very sticky or friable, or fragile. It might be that there's been a leak from the saliva through a tumour onto those vessels so that the tissues are difficult to deal with or it's down a deep whole or the patient has some clotting prob lems and you can see that there's some microsurgical element of adversity.
Annaliese Redlich [00:04:23] That's the surgeon, Ramin Shayan. He's a specialist reconstructive plastic surgeon in Melbourne, Australia.
Dr Ramin Shayan [00:04:29] When we release the clamps, my anaesthetist will put the opening part of 'Back in Black' on. So that you know that, do you remember that, that opening from 'Back in Black'?
Annaliese Redlich [00:04:42] Sing it for me.
Dr Ramin Shayan [00:04:44] It goes (sings) de-neh tsk de de-neh tsk, de de-denon tsk, de de de de de doo. (finishes singing). And, that that to me is like, right, we're done, we're on. And, you see the blood flow, and for me that goes with it. It just goes as part of that. The clamps are released, the blood flows across from the patient's body into this bit of tissue, it moves, it starts to bleed and pink up, and it's alive. And, you're back from that difficult point and there's nothing that that that has become, for me, such anthemic and symbolic part of a song that when I hear it walking past the pub or on the radio, it will for me, where it takes me is releasing the clamps on a free flap. So, that's, that's basically one of the big examples I could think of.
[00:05:39] [Cover of AC/DC - Back In Black starts to play underneath].
Annaliese Redlich [00:05:39] Now, I live in Melbourne, a city which has been the incubator for some of the most important bands and artists to come out of Australia. AC/DC moved here from Sydney around 1974 before they went on to conquer the rock n roll world, of course. But, this city is also famous for many other innovations. In fact, only one year before AC/DC called Melbourne home in 1973, some game changing advancements in microsurgery happened here that radically transformed the way operations were done overnight, making Melbourne and those surgeons international rock stars to this day in this field of medicine. Depending on your music taste, I guess you could liken in this operation to The Beatles releasing Sgt. Pepper, things were never the same again. And Ramin, our surgeon, was the private assistant surgeon to one of those game changes, Ian Taylor. So when he invites us in to witness an operation and the role music plays, we are most definitely in the right place with the right surgeon.
[00:06:43] [SFX: operating room noises].
[00:06:43] Here we are at St Vincent's Private Hospital. The operation has just gotten underway. It's bright and early on a Friday morning and the team are working hard. Around me I see about eight people in scrubs. I've been told that Dr Anthony Singh, the anaesthetist, is today's DJ, as ever in this partnership between a Ramin Shayan, the surgeon, and the anaesthetist. Tell us about what we're listening to now, Dr Anthony Singh.
Dr Anthony Singh [00:07:22] Well, this is one of Ramin's selections today. We're playing that Fat Freddy's Drop and this song is called 'Roady'. We're just setting the time and setting the mood for the, for the theatre.
Annaliese Redlich [00:07:34] That's anaesthetist Dr. Anthony Singh. He's on duty today, of course, to administer the anaesthetic and keep our patient comfortable, but also to program the music for this operation. He's been a friend and colleague of Ramin, the surgeon, for over 10 years. So, what made does Fat Freddy's Drop bring to surgery?
Dr Ramin Shayan [00:07:53] Yeah well, Fat Freddy's Drop is a, it's a rhythmic thing. It's it's about keeping rhythm, keeping moving. No sudden, no sudden changes. You know what you're getting. But it's building and it's it's soulful and it's rich.
Dr Anthony Singh [00:08:10] As you know, music is a very personal choice and it's very hard to choose for a group of diverse staff members. There's at least a dozen people that come and go over the course of the morning during an operation. This is their workplace as well. So, you've got to make sure that we're not playing anything too offensive or too, too loud. But then again, we don't want people to sleep either. So, it's just finding that, finding that middle ground that keeps the surgical team ah, motivated, and gets rid of that dead space that's ah, that can fill the air sometimes in a long operation such as this.
Annaliese Redlich [00:08:43] ...And this operation has just begun on a young woman who is involved in a car accident several years back. She's lying on the table in front of me, mostly covered in sheets and all I can see is her abdominal area and left leg. But I can tell just from this that she's petite and probably in her 20s or so. And as you can hear, an operating theatre is a very noisy place. There are all sorts of machines and computers to monitor the patient that bleep and beep. There are at least six very focussed people all playing a role in the operation. There are doors and trolleys and instruments clanging and keep your ear out for a buzzing sound. That's the sort of burning tool that the surgeons are using to precisely cut the patient's skin.
Dr Ramin Shayan [00:09:27] So most of you will know a bit about this patient, so, she's a young lady who was driving along in, ah, New South Wales coast, and came over the crest of a road. Um, it was a driver, an overseas driver who was in a hire car and he obviously subconsciously veered onto the wrong side of the road and as he came over the crest their cars met head on and she's had what's called an avulsion injury, or pulling the ah muscle insertion of all the abdominal oblique muscles out um from the pelvic bone.
Annaliese Redlich [00:10:07] Again, a reminder that I really am a wuss with blood and as we speak, I'm watching pretty much clear, perfect skin begin to be opened up by the scalpels of the surgeon, all to the soundtrack of Fat Freddy's Drop. This music conjures up visions of a summer holiday, swimming, palm trees, something that could not be further from what I'm actually watching. Honestly, I'm trying not to faint. There is blood and flesh, not skin, but deep red flesh and fat and muscle. I don't know about you, but I have never seen this before. Not in real life anyway. And as they work, another layer of the human body is revealed. I feel like I'm going to pass out. Luckily, no one else in he does. And those people. Well, there's Ramin, plus another surgeon. Each surgeon has a nurse. There's the anaesthetist, Anthony. And he has a nurse. Plus, there's a medical student observing and us, of course. We're all in scrubs and you might hear that our voices are a little muffled. That's cause we're all wearing masks. Now, back to message and Ramin.
Dr Ramin Shayan [00:11:14] Today, we're using a spare part from her our own body, which is from the leg. To reinforce that missing or injured layer of abdominal muscles. This operation is called a 'free-flap'.
Annaliese Redlich [00:11:30] Wow, so just a normal Friday morning at work or?
Dr Ramin Shayan [00:11:32] It is. It is. Well, not this particular case, but...
Annaliese Redlich [00:11:42] Now, aside from my sweaty palms, an urge to faint, I am beginning to feel an overwhelming sense of awe at what I'm witnessing. Think about it. The only time you are ever likely to be in this situation is when it's you on the table, unwell, unconscious, probably very anxious about the operation and hopefully not remembering a thing or, if you're one of the medical staff in which case you're used to blood and bodies and life and death. But me? I am not. I'm an observer and I am front row and centre to this extraordinary display of the vulnerability of our bodies and how exceptionally skilled and caring these doctors and nurses are. It's overwhelming. And I'm now even more fascinated than ever about how people support themselves in the intense day to day reality of this job. Luckily, I've got someone who can give us some thoughts on this.
Dr Tara Karnezis [00:12:35] Well, I don't think many people have that insight of what goes on in an operating theatre. It's like people... I know I was one that was like serious? You don't ever think that they're playing music and they're having that whole discussion about oh what playlists do you want? I wouldn't have thought until I realised it myself. My name is Tara Karnezis. I am a medical researcher at St Vincent's Institute and I worked closely with Ramin Shayan who is also my husband.
Annaliese Redlich [00:13:02] Tara Karnezis is an incredibly accomplished medical researcher. In a nutshell, her work looks at how we can design better therapies to support cancer patients through their treatment. She's gonna be PhD from Stanford. She heads up her own research group. She's pretty much a genius. And yes, she tells me that music is also helpful in her work practise. And, she's got some great insights into why it plays such an important role for women.
Dr Tara Karnezis [00:13:25] He's a very creative person. Ramin is an amazing artist. He needs to have a creative outlet so he likes to write and he likes to draw. So in the absence of time that he gets to do these things, music is the only creative outlet he has that doesn't require time. It's just something that you choose and you listen to. But, it does give you that sort of, I don't know, kind of, it's an intersting thing, I don't think, I mean, I don't think he would would function without it. Like if you you to cut that out of his life as well, he would, there would be, there would be some sort of consequence I would imagine. He'd be much more stressful than what he is now.
Dr Ramin Shayan [00:14:02] I think of myself, interestingly, as probably more creative ah, than, a didactic learner. So the plastic surgery and the research, the thing I love about the research is that essentially you're limited by your own creative imagination. And you have the same problem in front of 10 different people. And every time you front up, every time you get in the saddle, every time you turn up for work, it's an opportunity to create a new solution. And so I feel that that's probably the biggest thing I love about my job, is that, the creative outlet. And it does allow you, within the bounds of common sense and logic and patient welfare and everything, but to be creative about how you go about it. It's the very essence of how we try to approach our work.
Annaliese Redlich [00:14:51] Okay, so as someone who knows absolutely nothing about the mindset of surgeons, I have to say, this does come as a surprise. So remember, in school, I don't know if you ever did this, but we had to sit through countless personality tests and vocational tests and Myers Briggs indicators, and definitely I was told that I was a right brainer, meaning that I was creative and feeling and artistic. The opposite to left brainers who are linear, mathematical, fact and logic driven. You know, lawyers, doctors, surgeons.
Dr Tara Karnezis [00:15:21] There is that artistry even in surgery. There's a certain, plastic surgeons. There's this kind of artist, creative connection because you have to kind of create, you have to have the basic skill set to do your operation but some people are better at it than others. So I think that sort of, um, music that he has in the background provides him with that creative energy that he uses to sort of, have, or operate on people in a successful way. So then the outcome is a good operation and the people, the patients are happy with the end result. So if you took that away from Ramin, (big breath in) I think that would be a consequence of how, um, he operates and how stressed he's feeling. So you need, I think he needs to have in his life, for sure. Couldn't take it away from him. Yeah.
Annaliese Redlich [00:16:06] It turns out that there is an ancient connection between music and medicine, with the ancient Greeks believing that Apollo was both the god of healing and of music. And, music aside for just a moment, the link between creativity and surgery really does make sense, particularly when you look at the history of plastic surgery, which, by the way, is fascinating and really needs its own show. But a quick overview.
[00:16:32] [SFX: Music fade underneath].
[00:16:33] Plastic surgery was essentially born in India in and around the sixth century B.C. to remedy the brutal practise of removing the noses of adulterers. Fast way forward to World War One and the advancement of military technology, which far outpaced the medical advancements of the time, resulting in a devastating loss of life and for many who survived permanent and horrific disfigurement. World War One saw the great efforts of mask makers employed to fit disfigured soldiers to help them assimilate back into society.
[00:17:04] [SFX: archival tape of The Guinea Pig Club from World War Two]
[00:17:07] And by World War Two, The Guinea Pig Club was founded in Queen Victoria Hospital in East Grinstead, Sussex, in England by Archibald McIndoe, who was a plastic surgery pioneer treating British and allied aircrew. The music you can hear right now is a recording of actual members of the club singing together. The Guinea Pig Club was named due to the highly experimental nature of the surgical techniques used, and the name was embraced. It was way more than a slightly insensitive name for a hospital wing. Archibald McIndoe had to come up with very creative solutions to severe injuries. For example, recreating the missing fingers on a hand by making incisions between the knuckles. McIndoe and The Guinea Pig Club set out to make the lives of wounded servicemen as normal as possible, as many were in there for years. This meant permission to wear casual clothes in the hospital, and they even had beer kegs in the wards. The creative ingenuity championed by McIndoe and his team remains as important today in plastic surgery as it was over 70 years ago.
Dr Ramin Shayan [00:18:10] The whole field of plastic surgery is, to an extent, born from a desire to create a solution. And so, what I think we do with cancer and trauma, it's very indiscriminate in how it afflicts the patients. And so the very nature of plastic surgery in itself is seeing a problem turn up and find a creative solution with a certain set of tools. And that, in its essence, is why you do find that I think plastic surgery in particular has a close affinity to the visual arts, drawing, painting, which I personally do, and at one point wanted to be a painter and musical pursuits as well. And a lot of plastic surgeons are fine musicians. It is fairly, fairly standard to have a very individual and recognisable musical taste for each surgeon. And every operating theatre in plastics has its own set of speakers and a musical repertoire and it's an intrinsic part of the fabric of plastic surgery, and in particular microsurgery. I like a certain array of songs playing when I do microsurgery and it balances the mood, it balances the task, it brings together what we're trying to do and what point of the operation it is, you know, it's the the hard yards versus the home stretch. It's the initial phases versus the thinking time. And so, that creativity, I think, is very intrinsic to surgery in general, but in particular plastic surgery and the types of problems that we encounter in reconstructive plastic surgery.
Dr Anthony Singh [00:19:46] Ramin and I have been working together for a number of years now, and we like to celebrate special occasions or commiserate changes of Australian prime minister. We might have a playlist that's basically Australian songs going from the 20s and 30s all the way up till today. So, you know, with the change of prime minister, we got through a session of Australian music from Slim Dusty to Peter Allen, to Tina Arena, Hilltop Hoods, and there are a few Jimmy Barnes anthems in there as well for good measure, but it's more just an acknowledgement of monumental changes.
Annaliese Redlich [00:20:15] As an anaesthetist and a DJ, it must put you in the higher pay bracket for any DJ on the face of the planet I would say. (laughs)
Dr Anthony Singh [00:20:24] Ah some DJs do quite well. (laughs)
Dr Ramin Shayan [00:20:28] But like any good DJs, he's got a good stash of drugs there, that you can see behind me. (all laugh). It's just he has to account for them, is all.
Dr Tara Karnezis [00:20:38] There's a bromance between Anthony and Ramin. They work so closely together that one influences the other. So I'm thinking when they listen, when they choose their music, or when Anthony chooses that music, um, he often says, oh, Anthony choose this music, what do you think? So I listen to it as well and I say that's really good. Um, but, it always is associated with a successful operation. So when he has a good day operating, there's that sort of connection to the music list that they were playing to at the time, and it's usually because of Anthony's selection. (laughs)
Annaliese Redlich [00:21:12] You can well and truly hear how important music is in this friendship between our surgeon Ramin, and anaesthetist, Anthony. And amusingly, this environment is ripe for thematic music programming opportunities as well.
Dr Ramin Shayan [00:21:25] One of the first times we were looking for a little vessel, tiny vessel digging through tissues, that is actually carries some blue dye in it, so it shows up as blue, and you searching for it for about two hours, and um, as soon as we found it for the first time when we'd done this operation, he put on an afternoon of blue theme music. So, you know, there's the Whitlams cover of is it Bob Dylan's song? And there is, you know, 'Electric Blue' and all these sort of things, 'True Blue', the Elton John song, and 'That's Why They Call It the Blues'. So, he managed to put on a whole theme song. It was just special for me because this is the first time I'd done this operation. And, you know, we'd been looking for two hours for this blue vessel and then out came, you know, this whole, I was never aware that there was so many songs about the theme about being blue.
Annaliese Redlich [00:22:11] Do people generally recognise your genius in ah...
Dr Anthony Singh [00:22:13] No. No. (laughs).
Annaliese Redlich [00:22:15] ...in topical programming? (laughs) Do you feel underappreciated in this gig?
Dr Anthony Singh [00:22:18] Well, it's not it's not about the accolades and the recognition but having a few choices in there that that have an underlying message, sometimes it's just for my own amusement sometimes.
Annaliese Redlich [00:22:28] It's generally the case for DJs.
Dr Anthony Singh [00:22:29] Yeah, or it might reflect the type of operation that we're doing.
Annaliese Redlich [00:22:34] A fair bit of 'I've Got You Under My Skin' type?
Dr Anthony Singh [00:22:34] Yeah, that kind of thing. Or, scars, or scar tissue. Or...
Dr Ramin Shayan [00:22:39] 'It's Closing Time...'
Dr Anthony Singh [00:22:40] Yeah, or 'We're Done - The Madden Brothers.
Annaliese Redlich [00:22:44] The Madden Brothers?
Dr Ramin Shayan [00:22:45] Anthony speaks to me through his music. (laughs)
[00:22:51] [SFX: Operating theatre noises fade out].
Dr Ramin Shayan [00:22:51] I'll have my microsurgery music, I'll have my starting music, I'll have my closing music. And um, I think part of the relationship I have with my anesthetist is that they know all this and they intrinsically relate to it and it's just a, it's a beautiful symbiosis. You work with people who know you and are good friends, that's part of the poetry of it all and why it's a beautiful thing to be a part of.
Dr Tara Karnezis [00:23:13] It influences people's relationships and you get a better job done if everyone's happy with the choice of music.
[00:23:18] [SFX: Music fades in underneath].
Annaliese Redlich [00:23:19] If you can bond over something with your workmates...
Dr Tara Karnezis [00:23:24] Mmm well, that's a good thing.
Annaliese Redlich [00:23:25] It's only good.
Dr Tara Karnezis [00:23:25] Yeah. Yeah. So, music may facilitate that.
Annaliese Redlich [00:23:30] To be honest, I really thought that this is what this story would be all about, friendship, and the role that music plays in enriching that connection in a life and death environment. Of course, we generally spend more time with the people we work with than our partners, family or friends, and it's long established that having quality relationships at work create better work related outcomes. But more than that, this really is a living example of what music does to open up and reframe our thinking patterns and processes and connect us to the creative parts of ourselves.
[00:24:03] [SFX: Music fade out underneath].
Dr Ramin Shayan [00:24:03] I noticed when I had come through my basic surgical training after having done med school for six or seven years, you do internship and then resident training and unaccredited work as a junior surgical trainee and you really get flogged. I mean, you work between 70 to 110 hours a week for years on end. It became a survival thing and it became the antithesis of creativity. And when I started my PhD research, I realised, retrospectively, that it took me three months to undo that and to to put my brain in a place where I could actually have original thoughts and have creative concepts and to read the literature and place into context what I was doing and to have these connections happen. Really, when you're in survival mode, you can't have that. And so I think, what music does in the operating theatre is it places your mind contextually into the place that it needs to be, sufficiently observational, or sufficiently creative, or sufficiently focussed.
Annaliese Redlich [00:25:14] Who would have thought a bike accident and Otis Redding would lead us here? But here we are! Witness to not only music's key role in soundtracking Ramin and Anthony's bromance, but as we've seen in the operating theatre, just how essential it is to their day to day work. And remember, back at the beginning of this episode when I mentioned two significant events in Melbourne's history, AC/DC's move here in 1973 and the complete evolution overnight of microsurgery the following year. Well, Ramin has a final thought on that, too.
Dr Ramin Shayan [00:25:46] There's two great contrasts, there's Fat Freddy's Drop and AC/DC and I do like my Australian rock music for that. You know, Cold Chisel, Midnight Oil, AC/DC. It links back to the fact that microsurgery is a very Melbourne story. Um, the story of microsurgery is about how a little town in the southern hemisphere actually changed the way that medicine is able to be practised globally, overnight. And and, you know, it was done on a shoestring and the research budget was small and it was done in the era when Midnight Oil, Cold Chisel, AC/DC were coming up from their grassroots in pubs and you were getting, you know, these guys who barely could put food on the table and were generating the foundations of dynasties of music. And in a way, microsurgery to me is paralleled in that story. And, and Melbourne and Australia and, you know, St Vincents and Royal Melbourne or, you know, the, the, the local pubs be it the Espy or the Rob Royal or wherever these these bands were playing. Um, they go hand-in-hand. It's like that that classic video clip of 'Long Way to the Top' where AC/DC is sitting in the back of a truck going down Swanston Street. There is nothing more Melbourne than that. And so for me, there is that element of historically linking back to where the roots of this discipline have come from as well.
Annaliese Redlich [00:27:13] So, it turns out there's a link between microsurgery in pub rock.
Dr Ramin Shayan [00:27:17] There is a very strong link between microsurgery and pub rock. Microsurgery is a pub rock of medicine.
[00:27:29] [Cover of AC/DC 'Back In Black’ plays].
Annaliese Redlich [00:27:29] A huge thank you to Ramin Shayan, Tara Karnezis, Dr Anthony Singh and all the nurses and staff St Vincent's Private Hospital and the O'Brien Institute, I have to say that working on this story has forever changed the way I look at the human body and hear Fat Freddy's Drop and AC/DC. Thanks also to Davey Lane, who helped out with music for this episode. And Beth Atkinson-Quinton for editorial support. We'll see you next time. For most stories about and for All Ears.
Dr Ramin Shayan [00:27:59] It goes (sings) de-neh tsk de de-neh tsk, de de-denon tsk, de de de de de doo. (finishes singing). And, that that to me is like, right, we're done, we're on.Annaliese Redlich I just wanted to jump in and say thank-you for joining me for the first episode of this series. I feel really thrilled to have your ears on this show and I hope that you’ll stay with us because we have so many more stories to share with you. Remember to subscribe to All Ears on your preferred platform so you don’t miss any episodes and if you can rate the show and leave a review it seriously takes about 30 seconds to do this, I would be so grateful as it helps little shows like this reach way more people. Also, connect with me online via Facebook, Instagram and Twitter @hearallears, that’s h-e-a-r All Ears and full transcripts of each show are available at the Broadwave website, plus some other great shows they’re working on. There, that’s enough for now.
Multiple voices [SFX: Broadwave, Broadwave, Broadwave, Broadwave, Broadwave.]