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Nearly two months ago, I had an epiphany about the similarities between two areas of my life that are important to me. My stepson had alternated between recordings of “Für Elise” and “Moonlight Sonata” on YouTube one night while doing homework, so my husband asked if I wanted to surprise him by taking in Ann Arbor Symphony Orchestra’s performance of Beethoven’s Ninth Symphony. I enthusiastically agreed and the next evening we all got dressed up and without telling him what we were doing, went to the theater and purchased last-minute tickets.

Ann Arbor Symphony Orchestra (April 2019)

Our seats might have been considered nosebleed by some (and surely, each step brought a bit of trepidation as we climbed to a dizzying height), but once we were settled in, we realized it was the perfect vantage point to take in the entire panoramic view. Hill Auditorium is a gorgeous facility where I’ve seen everything from Handel’s Messiah to Snarky Puppy. It’s also the location where I received my White Coat nearly three years ago.

Despite the significant height difference, these are indeed my proud parents; it is a privilege having these folks in my corner. (White Coat Ceremony, July 2016)

All eyes were fixated on the performers up front, scanning the different sections. The most famous movement of the piece, commonly known to many listeners as the “Ode to Joy” theme, is full of moments of crescendo when the instruments and voices swell, concurrent with an emotional response from the audience. The sound reverberated throughout the building and made my heart race, much like on the day I nervously walked across the stage and entered my journey into becoming a physician.

My mind went to the scene of a patient with a racing heart due to unstable atrial fibrillation who required cardioversion earlier that week. You see, the evening of the concert, I was in the midst of a string of overnight shifts as part of my Emergency Medicine rotation. The parallels between the “resus” (resuscitation) bay and the activity on stage in the concert hall were many. Just as each group of instruments has their assigned part to play (literally), members of a health care team have their own roles. While most are adept at carrying out their part with little instruction, it is necessary to continually check in and take cues from the conductor. In the Emergency Department, the maestro may be an attending physician; often though, the faculty member stands back while a resident (physician in training) directs and guides the action, much like the concertmaster is an instrument-playing leader of the orchestra.

As a medical student, I often feel like the tambourine player in these situations: not yet useful enough to be integral in every song, but occasionally given a “solo” and allowed to intervene in an important and noticeable way, like pushing the SYNC and SHOCK buttons of a defibrillator to deliver electrical energy to that patient in the unstable cardiac rhythm. Or, for the patient who dislocated their patella (kneecap), grasping their ankle and gently extending their leg while a resident applied firm pressure on the knee to pop it back into place. These are moments that, much like a moving piece of music, make me hold my breath, filter out the distractions in the periphery, and focus on the art in front of me.

A few hours after the last note had been played, having changed out of my dress and heels and clad in scrubs and white coat, I felt lighter, and ready to work in “concert” with the rest of the group. Walking into the team area, there were numerous exchanges going on, the chatter of various tones and cadences. In between pagers going off, phones ringing and overhead announcements, conversations took place between techs and patients as they were wheeled to their rooms. “Music to my ears,” I thought, as I sipped my coffee and settled in for my Saturday night shift in the Emergency Department.