What’s playing in your operating room?

TORONTO – These days, most surgeons bring their iPhones into the operating room. More than just background noise, music sets the mood and focuses their concentration, becoming a crucial part of a surgeon’s surgical routine.

Dr. Ike Ahmed (pictured), head of ophthalmology at Trillium Health Partners in Mississauga, loves his custom-built operating room with its subwoofer speaker system, the Toronto Star reported.

For Ahmed, music helps pass the time during back-to-back procedures and unifies his team of nurses, surgeons and anesthesiologists who, no matter their age or background, can usually hum along to Pink Floyd. At their request, he won’t play Justin Bieber.

An expert in surgically treating cataracts and glaucoma, Ahmed also uses classic rock as an adrenalin boost before making incisions, some just fractions of a millimetre deep, into a patient’s eye.

On his drive into work, he’ll often sing “Where the Streets Have No Name,” matching Bono’s passionate crescendos.

“It’s like an athlete listening to music in the locker room before heading out onto the field; it gets me psyched up. I can’t tell you how important that is, to get me in the right frame of mind.”

A 2014 editorial in the BMJ estimated music is played in the operating room about two-thirds of the time. Earlier this year, Spotify and the medical app Figure 1 surveyed 700 surgeons about their music habits and found 90 per cent have surgical playlists, many dominated by pop and classic rock.

Most of the time, the head surgeon chooses the music. In Toronto, that usually means no country music, no opera, not too much heavy metal and no songs that hint at death.

Often, anesthesiologists get a say during the critical minutes when a patient is put to sleep. Always, music is turned down or switched off if something goes wrong.

Jessica Grahn, a neuroscientist at Western University, studies the relationship between music and the brain and says people in good moods perform better on all sorts of cognitive tests. And like sex, drugs and food, music is known to boost mood.

“Silence can be better for certain tasks, like those that involve language and complex logical thinking. But for surgeons, who are executing this well-practised manoeuvre over and over, staying vigilant is crucial and music would absolutely help. Especially music that they like.”

Some studies show the benefits of music in the operating room, including one that found plastic surgeon residents stitched more efficiently while listening to their favourite music. Others suggest it’s a distraction.

For Dr. Sunit Das, a neurosurgeon, music is his constant during the controlled chaos of brain surgery. The melodies simultaneously quell his nerves and keep him on the alert.

But whether Beck or Brazilian jazz, Das will not operate to unfamiliar songs. It’s his one musical rule.

Not long ago, one of his patients, a young mother of three, asked to listen to the Tragically Hip during the awake portion of her craniotomy. She believed Gord Downie singing about Bobcaygeon could help ease her terror.

An American, Das hadn’t grown up with the Hip on repeat. So he spent hours learning their signature rhythms and lyrics before adding the band to his surgical playlist.

On the day of the surgery, at one of the most critical moments, Das recalls the Hip’s familiar songs – “Ahead By A Century,” “Courage,” “Fiddlers Green” – streaming into the operating room.

His patient, now awake from her artificial sleep and aware that Das was cutting into her brain, could hear the music that made her think of family and friends and good times, those in the past and those to come.

The Hip will remain on Das’ surgical playlist. “There’s a history now to these songs, an emotional resonance.”