What is music medicine?

You don’t have to be a music lover to benefit from music’s healing impact. Studies have found that just 30 minutes of listening to relaxing classical music can decrease levels of stress hormones in the blood. 

Science demonstrates the power of music’s healing properties. The field is called music medicine. Music medicine researchers study how certain music-based interventions impact stress, pain, sleep and mood in patients. They also assess how different musical stimuli affect surgeon performance and provider wellness.   

We spoke with Mei Rui, DMA, assistant professor of Neurosurgery and director of Music-in-Medicine at MD Anderson, to learn more about the emerging field of music medicine and Concerts in The Park, a new concert series at MD Anderson featuring world-class musicians and ensembles. An award-winning concert pianist, Rui spearheads clinical trials using live music intervention to enhance patient outcomes, wellness and surgeon performance in the operating room.

What is music medicine? 

Music is a powerful modulator of the human stress response. Music is safe, cost-effective and non-narcotic. Research suggests classical music reduces stress, pain and anxiety in clinical settings with no known side effects.  

Our multidisciplinary study team includes neurosurgeons, oncologists, acute-care providers, ICU nurses, neuropsychologists, anesthesiologists, neuroimaging specialists, data scientists, award-winning composers and world-class musicians. Using state-of-the-art technologies including fMRI, EEG, and proteomic analyses, we analyze cells, blood, brainwaves, vitals and more to measure the impact of music on health outcomes.  

Different types of music target different pathways in the brain. Listening to a mix of both familiar and unfamiliar music can help the brain recover from a stroke or surgery by stimulating oxygen and blood flow to critical brain regions. 

These benefits extend to health care providers, too. We have found that listening to prescribed music enhances blood flow to brain regions associated with emotional regulation and empathy. Surgeons perform certain tasks even more accurately and efficiently when exposed to classical music. 

What types of patients benefit from music medicine? 

Music can help everyone! Studies have shown that intubated and even fully sedated patients under general anesthesia respond positively to prescribed music. The patient does not need to be conscious or aware. Simply being in the same room while the music plays lowers levels of stress biomarkers and improves hemodynamic stabilities. 

Music can also help healthcare providers who work long shifts and have irregular sleep schedules. Listening to relaxing music can promote sleep mindfulness and potentially reduce risks for burnout. 

During the height of the COVID-19 pandemic, I founded an initiative at the hospital where I was working to comfort isolated patients and burnt-out providers. I reached out to musical collaborators including cellist Yo-Yo Ma, pianist Emanuel Ax, and musicians from the Houston Symphony and the Juilliard String Quartet. Over 400 live bedside concerts were performed for isolated patients and burnt-out providers. 

What is prescribed music? 

“Prescribed music” refers to musical compositions that target a patient’s neurophysiological mechanisms and mood states.  We define prescribed music based on certain compositional elements of relaxation. Instead of focusing on genre (pop, jazz, rock and roll), prescription music should be selected based on compositional elements like timbre, tempo, instrumentation, dynamic range, accentuation and articulation.  

Prescribed music is emotionally nonintrusive. Music that contains the compositional elements of relaxation yields more consistent and effective results regardless of a person’s age, gender, profession, preference, or prior musical training. 

Most people prefer certain genres of music, artists or songs. But if patients or providers choose music simply based on what they like, the results can be undesirable. Like any other kind of medicine, music can have side effects. For example, some music can be emotionally triggering, especially vocal music or pieces with overly activating rhythms. Such pieces can be too stimulating for unstable ICU or intraoperative patients, and they can compromise surgeons’ abilities to perform fine motor tasks. 

How do you decide what music to prescribe? 

It depends on the desired outcome. For example, we might want to promote sleep and stress reduction in ICU or postoperative patients. In that case, we would choose soothing pieces such as a Chopin Nocturne or Schumann’s Traumerei played at a low volume. 

We have had success with music that contains a perfect balance of novelty and familiarity. Examples include Bach Goldberg Variations and slow movements of Mozart's piano sonatas. Delicate and beautiful themes reemerge multiple times throughout such pieces, invoking a sense of familiarity. However, these composers weave in subtle variations each time the theme returns, which helps your brain stay entrained and in a meditative state. 

Prescription music is not the typical “elevator” music that numbs, bores and makes us tune out. Hearing the same melody on repeat can quickly turn from a pleasant experience to an excruciating one. Instead, prescription music simultaneously enlightens and calms the mind.   

How is music medicine being used at MD Anderson? 

My goal is to use evidence-based music programming to optimize the acoustic environment of care at MD Anderson. Having performed over 600 concerts for audiences around the world, I am passionate about using music as a universal language to connect with patients, caregivers and providers. We’re holding our inaugural Concert in The Park on Thursday, Nov. 2 at 5 p.m. I will perform George Gershwin’s iconic “Rhapsody in Blue” on the piano with the TMC Orchestra. 

During the performance, attendees will witness a live experiment with real-time EEG data collection and projection by my collaborator from the University of Houston, Dr. Jose Conteras-Vidal. Neurosurgery chair Frederick Lang, M.D., and I will both wear 32-channel EEG caps. Attendees will be able to visualize how a soloist’s and a non-musician audience member’s brains respond to performing and listening to the dynamic sections in the concerto on large screens.  

I am immensely grateful for the donation of a Steinway Spirio D concert grand piano, which has been supporting Concerts in The Park. It also plays pre-recorded, simulated live music from 11 a.m. to 1 p.m. every day in The Park. We have already held pop-up concerts in The Park, on the Skybridge, and in other high-flow public and waiting areas at MD Anderson. It has been deeply rewarding and meaningful for me to play for patients and staff. 

Several free concerts have been scheduled for the fall season and beyond. We are also scheduling more pop-up concerts, so check for updates. I also look forward to bringing live bedside concerts directly into the patient rooms.  

See a schedule of upcoming concerts at MD Anderson.