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Upstate's music man: His 'prescriptions' target stress

Mitchell Karmel, MD, in an operating room in the radiology suite with a sampling of the thousands of albums he owns. (PHOTO BY ROBERT MESCAVAGE)

Mitchell Karmel, MD, in an operating room in the radiology suite with a sampling of the thousands of albums he owns. (PHOTO BY ROBERT MESCAVAGE)


Patients answer many questions on the paperwork they complete prior to an interventional radiology appointment at Upstate.

But when they arrive for a biopsy, catheter installation or other procedure, if their doctor is Mitchell Karmel, MD, patients face one additional question: To what music would you like to listen?

Classic rock is a popular answer. Many patients prefer something mellow, like Van Morrison‘s "Astral Weeks" album.

Once, a woman with breast cancer requested AC/DC. “That‘s not the most relaxing music,” Karmel pointed out.

“It‘s relaxing to me,” the woman said. And Karmel played "Hell's Bells."

In his decades of experience, Karmel said only one patient has requested silence instead of music. Most patients defer to his preference, which changes from day to day. Some try to stump him.

“What I‘d really love to hear is ‘Boris the Spider,‘ ” one patient said. Karmel thumbed to the song released by The Who in 1966.

Another said, “I‘m sure you don‘t have ‘Several Species of Small Furry Animals...‘ ” and didn‘t finish the song title before Karmel was pulling up "Ummagumma," Pink Floyd‘s double album from 1969 that featured “Several Species of Small Furry Animals Gathered Together in a Cave and Grooving With a Pict."

When a patient requested Iron Butterfly‘s “In-a-Gadda-Da-Vida,” Karmel needed clarification of the heavy-metal classic. “The five-minute version or the 17-minute version?”

Karmel‘s iPod contains more than 9,400 songs. His iMac holds 24,500 more. He prides himself on full libraries of all genres, saying he needs to have all of his music at his fingertips “because you never know what you will want to listen to.”

Young technologists and nurses are impressed that his music collection contains modern rap and R&B music.

Karmel advocates music during radiologic procedures, not just because it creates a pleasing work environment. “Music has healing qualities, there‘s no doubt about it,” he said. He points to studies showing music can reduce postoperative pain and anxiety, reduce the amount of pain medicine and increase patient satisfaction.

At Upstate, Karmel is director of interventional radiology. His medical degree is from the University of Buffalo School of Medicine. He completed an internship at Memorial Sloan-Kettering Cancer Center in New York, a residency through Cornell University and then a fellowship at Harvard Medical School in Boston.

Carmel has always liked music. It was in first or second grade that he and his classmates were assessed and funneled, if they made the cut, into"' band class. He remembers the first day of band, when the teacher looked him over. " 'You have long fingers. You‘re playing clarinet.' ”

He played clarinet, even though he thought the drums would have been more fun.

His real love of music blossomed during summer camp at the age of 14, when he was among the big kids who got to attend a concert at Tanglewood. Performing were B.B. King, Jefferson Airplane and The Who. Karmel was hooked.

Today he appreciates and listens to all sorts of music, from philharmonic orchestras to rap. His favorite remains “the inspirational and melodious” Pink Floyd.

More than once, Karmel has had patients ask for the name of the album that played during their procedure. He pulls out a sheet of paper. He writes a mock prescription, for stress, to be taken as needed: Pink Floyd‘s "The Division Bell."

Research 'notes'

Using music during patient care has been the subject of many a medical study by researchers around the world. Here‘s a look at five studies:

Music during mammography?

Music therapy has the potential to decrease the amount of anxiety. However, it did not decrease the amount of pain participants experienced during mammograms that screen for breast cancer.

Researchers from: Robert Wood Johnson University Hospital in New Brunswick, NJ, and the University of Virginia Medical Center in Charlottesville.

Published in: Clinical Journal of Oncology Nursing, June 2014.

Music during prostate biopsy?

Listening to music during a transurethral ultrasound-guided prostate biopsy significantly reduced patients‘ feelings of pain, discomfort and dissatisfaction. Men who listened to music during the procedure had lower heart rates and blood pressures afterward than men who did not.

Researchers from: Chungbuk National University in Korea.

Published in: Urologia Internationalis, December 2014.

Music for children during MRI?

Listening to music, watching a clown show or interacting with a dog all demonstrated a beneficial effect in reducing negative emotions in children facing magnetic resonance imaging. Also, the number of children requiring sedation during their scans dropped significantly.

Researchers from: Meyer Children‘s Hospital and the University of Florence, Italy.

Published in: Pediatric Reports, March 2015.

Music during colonography?

Patients who listened to music and/or inhaled the scent of essential oils while they underwent a computerized tomographic colonography reported little improvement in pain or discomfort. However, they requested music and/or oils for subsequent imaging scans.

Researchers from: Kameda Medical Center in Japan.

Published in: European Journal of Radiology, December 2014.

Music after surgery?

An analysis of 4,261 studies shows that music after surgical procedures reduces postoperative pain, anxiety and the use of pain medicine and increases patient satisfaction. While the patients‘ length of stay is not affected, the authors wrote, “music is a noninvasive, safe and inexpensive intervention that can be delivered easily and successfully in a hospital setting.”

Researchers from: Queen Mary University in London.

Published in: The Lancet, August 2015.

fall2015coverThis article appears in the fall 2015 issue of Upstate Health magazine.