Friday, June 11, 2010


People often seem to think that members of the medical world are excessively preoccupied with, defined according to, and ruled by a status-oriented system. That may have been an accurate perception a generation ago, but I've seen enough surgeons sweeping O.R. floors, attending physicians socializing with interns, and doctors having deep conversations with custodians to believe that "medical people" have matured a little past the old caste systems that governed the hallowed halls of medicine. Not a lot, perhaps - but a little.

I've been busy over the last couple of weeks - overwhelmingly busy, in fact - immersing myself in another world which is full of joy and fulfillment for me but which also surprised me by what it had in common with medicine.
  • People highly trained and skilled in a discipline that demands total commitment, superb knowledge, hard work, talent, and long hours.
  • Shop talk, engaged-in with relish and even pride, that can often leave outsiders feeling out-of-the-loop or even condescended-to.
  • Excessive preoccupation with who's "important" - the seasoned, perhaps famous professional, the experienced teacher, the uber-talented whiz kid - and where everyone fits into a silently understood hierarchy.
You'd think I was talking about doctors, but I'm actually referring to musicians.

I'm producing a concert that means more to me than pretty much any other creative project I've undertaken, and I've just held some auditions for both the principal and ensemble roles. In the process I've been gently chided for being over-friendly with "V.I.P.'s" (for example, faculty members at music colleges) and surprised by things like a singer's discomfort over the possibility of running into one of his students at our audition. I guess I just don't understand why there's so much lack of humility in these circumstances. So what if your student goes to the same audition you go to? How wonderful that you prepared him well enough to be ready for that!

As for the "V.I.P." thing, well - I have a number of reasons for disliking the whole notion. The first is my background: a grew up in a society in which the line between haves and have-nots was and is as stark as can be. I was born into the side that held the power, material comfort, educational advantages, and prestige, and I saw people lord it over those who didn't, and I hated that and hate it still.

Another reason is my profession: I don't believe in V.I.P.'s on my operating table because I'm going to take care of the disheveled, impoverished vagabond with the same standard and attention as I would take care of the queen of England, the president of the United States, or any Hollywood celebrity. Illness and death remind us all that no one human being is, in the end, intrinsically more powerful than any other; we just allow or prevent the exertion of power by various means. I also use trousers as a reminder: we all put them on one leg at a time; no one's that special.

A third reason is my faith, meaning my view of the world and the human person. The teacher I've chosen to learn my life lessons from taught that I should love each person. Period. That even the so-called least in society are worth the world. End of story. And because that picture of human worth includes me, then I need not look askance at others - either for their faults or disadvantages or for their talents and successes. It just so happens that the concert I'm producing is concerned, at its core, with this very idea, so I was doubly surprised that people would show interest in it but still feel preoccupied with who should be in a place of honor and who lower or higher.

I don't pretend to be immune to insecurities about being good enough, fitting in, or doing well. On the contrary, I've often struggled with such insecurities both in medicine and in my other endeavors. Learning humility has been a journey not about acquiring some kind of false modesty, the kind that leads people to deny their gifts or abilities, but rather about learning to see and affirm intrinsic goodness and good work in others and myself.

Several evenings ago my daughter and I attended a master class given by two amazingly talented, intelligent, artistically generous New York songwriters. We learned so much, not only because the feedback they gave singers and composers was so insightful, incisive, and well-articulated, but also because they offered their wisdom with such genuine humility - with kindness, humor, respect, a clear intention to affirm others' good work and effort, and self-effacing wonder in the achievements of others. I am convinced now that the most effective teachers are those who have the inner security in themselves that comes from genuine humility: the openness to recognizing the goodness of others, and to letting their light shine while sharing one's own light generously with them.


Elaine Fine said...

The social hierarchies in the world of medicine are as foreign to me as the social hierarchies in the world of music are to you. The world of music is much smaller than the world of medicine, though. There are exponentially more qualified people to do the work that is to be had (and that includes projects like the one you are engaged in producing) than there are medical professionals to do the work that is to be had in medicine. Because of the interdependently web-like structure of the medical profession, beginning with medical school, people enter into it with the knowledge that their hard work, talent, and good attitudes will allow them to remain (well) employed in their profession. This is not the case with professional music.

As a person on the "consumer" end of the world of medicine, I have rarely been privy to observe the mystique of the medical world. When I do interact with doctors wearing my street clothes, they all want to talk about music with me. Before reading your blog (and this post, in particular) I didn't think about the hierarchies that operate in the medical world, hierarchies that I imagine also have a great deal to do with the varying amounts of money medical professionals make for the work they do.

True artistry in the classical music world may be acknowledged from time to time, but only a small fraction is rewarded. Most classical musicians today, aside from those that marry well, make a comparatively small amount of money, so the hierarchies you see may come from the illusion that the VIPs are rewarded for what they do.

Those musicians who project an aura of being something special are people who are talented at projecting such an aura. Sure, most of them can play, or sing, or write well enough to do any job, but their success, their rise to the top, comes from how they structure their social-professional lives. "Shop talk," you may notice, has a large self-promotional component. It is necessary for mere survival in a world that gets most of its musical entertainment from recordings.

I have always lived by holding "play it, don't say it" as my personal motto, but it is the people that "say it" that get noticed. I have found that it's the people that "say it" over and over that get more chances to "play it," and so the cycle continues.

Best of luck with your project!

Anonymous said...

thank you, elaine fine, for the insightful comment. my sister is a struggling professional cellist. probably doesn't help that she's very shy. --physician and sometime violinist

Lisa Johnson said...

I'm glad that your project is progressing. So exciting! ; )

hesam said...

good luck. Im glad that your project running.