Let your doc be your DJ
General anesthesia or local? Hip-hop or Sinatra? These are among the decisions facing Dr Frank Gentile in his double-duty job as anesthesiologist and self-styled DJ of the OR. He doesn't use a microphone or speak in a fake baritone. But the eclectic range of CDs he loads onto the anesthesia cart headed for the operating room would impress any bona fide disc jockey. Gentile's collection is between 50 and 100 CDs, and his iPod holds about 5,000 songs. "I choose my music strategically. I know my surgeons' tastes," says Gentile, the anesthesiology chairman at Edward Hospital in Naperville, Illinois.
There's Eminem and 50 Cent for one surgeon who likes rap, the songs are "cleaned-up" to avoid offending anyone. For another doctor it's Metallica. Others prefer oldies or opera. Gentile picks different types of music for different stages of surgery. Many surgeons prefer up-tempo beats for the final stage and one doctor Gentile works with "always closes to J-Lo."
Many US operating rooms have sound systems, so playing music during surgery has become commonplace. Some doctors say it relieves the tension; studies have shown it can also benefit patients, even reducing the need for anesthesia somewhat during surgery. In many hospitals, the task of selecting OR music often falls to the anesthesiologist _ and it's one many take seriously. Some say amassing impressive music collections is even an effective marketing tool _ a way an anesthesiologist can ensure being picked when a surgical team is being chosen.
"Sometimes surgeons will say, 'I won't work with that anesthesiologist because he's a fuddy-duddy and I don't like the kind of music he plays,"' said Dr. Doug Reinhart, an anesthesiologist in Ogden, Utah.
Reinhart surveyed 301 American Society of Anesthesiology members and found that providing operating music was among non-medical tasks many performed. Anesthesiologists in private practice and those under 50 were most likely to serve as the operating-room DJs. Gentile says the DJ task falls sort of naturally to anesthesiologists, given their role. While their medical duties continue after a patient is asleep, including monitoring vital signs and administering intravenous fluids _ anesthesiologists are less tethered to the operating table than surgeons and other OR staff. They're often more free to walk around during surgery, or to change a CD.
Gentile thinks music makes surgeons work more efficiently. "If they're working faster and they're happy, the flow of the operating room is happier."
If things aren't going well during an operation, or if the music starts becoming a distraction, Gentile says he turns it off. Reinhart, 51, said nurses and surgeons provide the music in the surgery center where he works, but he was the OR DJ at his former job at a private Dallas hospital.
"I had a little boom box on top of my anesthesia cart and I had a selection of CDs, a lot of country and classical and kind of quieter soft rock," Reinhart said.
Patients' tastes must be considered when surgery involves only a local anesthetic, he said. "We're not going to play rap when there's a 90-year-old lady in there, it would scare them to death."
Dr. Greg Irvine, an orthopedic surgeon in Portland, Oregon, says he's worked with anesthesiologists who load their iPods and laptops with special music mixes catering to specific surgeons' tastes, then plug them into the operating-room sound system.
Irvine says he's usually so focused on operating that he barely hears the music and generally lets others decide what to play _ unless "they put on something I really can't stand," like when an anesthesiologist started playing military music from Eastern Europe. "It was a little intense," Irvine said.
On the flip side, Irvine said several years ago an anesthesiologist turned him on to bluegrass singer Alison Krauss _ he'd never heard her "phenomenal" voice until it filled the operating room one day.
"I went out and bought one of her early CDs," Irvine recalls. Gentile's own taste in music leans more toward heavy metal, though he chose something much more mellow when he had sinus surgery a couple of years ago.
"I went to sleep listening to Coldplay," he said. Gentile dreamily says that now, whenever he hears that same CD, "I get taken to a pretty cool place."