The Healer's Note
Music as a Medium for Medical Reflection
Narrative medicine is the practice of utilizing the arts and creative expression to foster skills of interpretation & empathy in healthcare professionals, strengthen the patient-provider relationship, and mitigate clinician burnout. Music and lyrical conception in particular have a powerful role to play in the healing process, both for patients and other actors in the clinical space, including providers and learners.
The Healer’s Note, an album of six original songs, was written and recorded by senior medical student Ruja Parikh. It explores the clinical experiences, grief, moral distress, and professional development she faced as a student in healthcare and attempts to demonstrate the capacity of songwriting and musical composition as a practical mode of narrative medicine. Each track is preceded by an explanation of the clinical encounter or experience that inspired it and followed by the lyrics to be read while listening.
Credits​
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All lyricism, composition, vocalization, and piano instrumentation on the songs below is by Ruja Parikh, with guitar accompaniment by Lucien Nuciola on Things We Give Away, Doctor, & Look Around!
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Track 1
Perspective ('everything matters to someone')
The first song I wrote for this project is about the first time a patient of mine passed away. I struggled with reconciling the weight of this loss and the fleeting nature of the patient-provider relationship, as well as the all-at-once emotional and impersonal experience of learning of his death through a note in the chart. As I made my way through these feelings and creating this song, I was challenged to write from a dual perspective – both his and mine.
Track 2
Things We Give Away
A cento poem is a patchwork, created by pulling lines from other works and stitching them together to create a piece with new meaning. I first learned about this style of writing from one of my mentors in narrative medicine, Cara Coleman, who utilizes cento poems in her workshops with patients, providers, and families. I was inspired to translate this method to my songwriting, also drawing on the tradition of writing from the perspective of fictional characters. Here you’ll get a glimpse into the lives of Jay, Ella, Chris, Syd, Bobby, and Layla – six stories from six starkly different professions, but with more in common than you might think.
Track 3
Doctor
Doctor is a song of two simultaneous stories. One is the story of a patient’s relationship with their doctor in the wake of a new diagnosis. The other is about a young doctor’s developing identity as a provider – the weight of legacy and the drive to honor those that came before her. These stories are distinct but woven, capturing the often-surprising similarities between those receiving care and those giving it.
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For Dada.
Track 4
Level Down
As I wrote my way through this series of songs, I found myself constantly wrapped up in my own thoughts and memories. One aim of this project was certainly to explore my internal reflections, but another was to engage in the aspects of narrative medicine that are geared towards understanding another person’s experiences. Level Down was written with this goal in mind; it is a musical interpretation of a narrative written by another student in healthcare. The story she wrote described the speed and rhythm of the intensive care unit as reminiscent of a video game, a comparison that throws sharp light on the mortality faced in critical care and the ways that providers may cope with it.
Track 5
Traumatic Intubation
This song describes the emotional stages I navigated after making a medical error. It attempts to convey both the immediate visceral moments in the wake of my mistake, as well as the thoughts that followed. I was lucky to be
surrounded by a team that ensured the patient’s safety and supported me in the aftermath, but I was struck by an unexpected dissonance – hearing repeated reassurances that medical errors are common and inevitable yet feeling a growing burden of culpability. Writing this song was an exercise in self-reflection and vulnerability, and in hindsight, is one of the truest examples of the role that creative expression can play in helping to grow from experiences like this as learners in healthcare.
Track 6
Look Around!
Look Around! has taken me a near-decade to complete. I wrote the first verse in 2017 as a high school senior, trying to put the feelings of staring down “the start of the rest our lives" into words. It sat untouched for five years, until the summer before medical school when flickers of those same emotions made their way into another verse. It wasn’t until I started writing this album, as I flipped back through my old notebooks and came across the unfinished lyrics, that I realized what the song was always about and how to finally complete it.
Acknowledgments
Thank you so much to the many people who helped to make this project a reality: Cara Coleman and Dr. Irène Mathieu for their mentorship and guidance throughout the writing process, Lucien Nuciola at Side 3 Studios for his accompaniment on the guitar tracks and production of the entire album, Nura Parikh for her original cover artwork, and all the early listeners of my works-in-progress before they became the songs above. I’m so grateful that I’ve had the opportunity to build this album as a culmination of my experiences in medical school and the lessons I learned along the way.