A Baton for Karaoke Intertwined with The Blade of The Surgeon

Joon Pio Hong, MD, PhD, MMM (Editor Emeritus of APS)

Marco Innocenti, MD

Geoffrey G. Hallock, MD

History we are. Indeed, we know Greek πλαστική ( plastikē ) refers to the art of modelling or sculpting, especially in clay. 1 Understandably then, “plastic surgery” as conceived by Zeis (1938), 2 is an art where inert materials have been replaced by more malleable flesh. 1 Can it be a mere coincidence that the etymological tree leading to “karaoke” (some say ker-ē-ˈō-kē, others kə-ˈrō-kē or kä-rä-ˈō-(ˌ)kā), 3 also has roots in ancient Greek ὀρχήστρα ( orkhḗstra ), this leading to the now universal English (orchestra). 3 4

Yet the transition to the word “karaoke” itself must be credited to the Japanese just a half-century or so ago as a blend of their words kara (“empty”) and オケ ( oke ), a clipping of オーケストラ ( ōkesutora ) as derived from the English “orchestra.” 4 So-called “empty” because no musical instruments typically are present and those involved sing-along to a prerecorded accompaniment that projects their voice and comments. 3 5 “Empty” may also be interpreted as a void that must be filled by some amateur and often vulnerable performer(s) (as per Fig. 1 ).

Fig. 1.

Les Trois Mousquetaires6— The Three Musketeers leading the “karaoke”—Innocenti, Hallock, Hong—in turn heroic , chivalrous , and always swashbucklers .

Not to forget Daisuke Inoue, some say the inventor of karaoke, the winner of the 2004 Ig (sic Ignoble) Nobel Peace Prize, who in satirical fashion retorted that the essence of his invention was “providing an entirely new way for people to learn to tolerate each other.” 7 A less contemptuous tone might say that karaoke is just another form of music, and for some physicians, another medicine. Do not forget that even the ancient Egyptians and Greeks used music to control the mood and physiological responses of their patients. 8 The efficacy of music both preoperatively and postoperatively in patient management has a long and documented history. 9 10

On the other side of the coin, music in the operating theatre itself can enhance the efficiency of the performance of microsurgical skills, 11 12 13 by reducing stress, providing relaxation, and promoting concentration. 14 15 Even behold, already there is found music, 8 where in the future we all will use while performing robotic surgery. 16 This intimate connection to surgeons should not be so surprising since a host of cognitive skills are common to both music and surgery—intensity of concentration, advance anticipation of all steps to follow, strictness in adhering to the proper order, improvisation or flexibility to overcome the unexpected event, virtuosity of a master who can spontaneously and effortlessly adapt as need, an ability to listen to the other members of the team and understand their concerns, while creating harmony so all together achieve the desirable outcome. 14 Music better teaches how to listen, a step essential in learning empathy and compassion, 14 17 virtues rarely intertwined in surgeons but deserve to be. 18

Yet some say karaoke is more than just the music itself. Metaphorically speaking, karaoke is a form of schooling and education, and not just entertainment. 19 Whereas traditional schooling has norms of behavior that must be abided by, karaoke is basically free of constraints so that the learning is never premediated but more improvisational, perhaps even innovational. 19 Innovation, not dogma, has always been on the tip of the tongues of these three musketeers. 20

Where does this all lead us? The emphasis today is to seek “happiness” and avoid burnout by achieving the now cliché of “work–life balance.” 21 22 23 24 25 Some might camouflage this as “work–home” 23 or even “work–leisure” balance, 25 but no matter not always so simple a dichotomy. Should not our professional duties be better if integrated to encompass our lives outside the workplace? 24 Opportunities exist in both venues to build rewarding relationships and accomplishments that create an even greater impact concurrently for the lives of our patients, our teammates, and ultimately ourselves. A simple means to calmly achieve this goal, these same three musketeers have found with just “karaoke”—simultaneously allowing us to grasp networking and leisure with our peers, for always an improvement.

So remember when Rohrich questioned—“What do you do when the music stops? … You keep dancing.” 26 Life always has surprises—be they unexpected detriments, obstructions, mere roadblocks, the daily new rules and instructions, and sometimes even administrators that will need to be overcome. As surgeons, we must rely on our past and present preparation and skills to conquer whatever may be the confrontation in all aspects of life. So, “What do you do when the karaoke stops? …You keep operating!”

Funding Statement

Funding None.