Anaesthesia in popular music: a qualitative review of records
2018; Elsevier BV; Volume: 121; Issue: 2 Linguagem: Inglês
10.1016/j.bja.2018.05.050
ISSN1471-6771
Autores Tópico(s)Musicians’ Health and Performance
ResumoEditor—I recently discovered the record Anna Stesia on Prince's 1988 album Lovesexy, prompting enquiry into the representation of anaesthesia in music. Music has long been incorporated into our everyday lives, and ‘There is probably no other human cultural activity which is so all-pervasive and which reaches into, shapes and often controls so much of human behaviour’.1Meriam A.P. The anthropology of music. Northwestern University Press, Chicago, Illinois1964Google Scholar The advent of popular music and mass media has enabled the phenomenon of ‘mass entertainment’. Mass media has many purposes, from reinforcement of conventional morality to social protest,2Hirsch P.M. Sociological approaches to the pop music phenomenon.Am Behav Sci. 1971; 14: 371Crossref Scopus (57) Google Scholar and can also influence our patients' perceptions of medicine. Patients' preconceived ideas are important in anaesthesia. They affect experiences and satisfaction, arguably amongst our most important outcomes. By creating anxiety, they may precipitate modifications in technique, such as drug choice, dosing, or mode of induction. Popular music's portrayal of anaesthesia may be relevant to practice and general interest. In this letter, I explore themes represented in popular music to understand better our patients' perceptions. A qualitative review of music records was performed using a keyword search of an online database.3The STANDS4 network. Lyrics.com. Available from: http://www.lyrics.com (Accessed 22 March 2018)Google Scholar Records were included if released for general sale before the end of November 2017, with lyrics containing one or more of the following keywords: anaesthesia, anaesthetic, anaesthetise, anaesthetist, anesthesiology, and anesthesiologist. British and American English spellings and grammatical variations were included. Records were excluded if lyrics were not in the English language or unidentifiable, or if re-recordings or ‘cover’ versions. Demographic details were collected from an online database.4Discogs. Discogs.com. Available from: https://www.discogs.com (Accessed 22 March 2018)Google Scholar Outstanding details were retrieved from the highest hit on the search engine Google.5Google. Google.com. Available from: http://www.google.com (Accessed 22 March 2018)Google Scholar Thematic analysis was performed using a framework approach. Familiarisation with lyrics took place whilst listening to the records, in ascending order by artist. The presence of nominated expectant themes was documented: altered consciousness, analgesia, paralysis, and altered sensation. Emergent themes were identified and all records were re-examined for their presence. Descriptive statistics were calculated and chronology recorded. Data were stored in Ninox Database (Ninox Database, Ninox Software GmbH, Berlin, Germany) and analysed in Apple Numbers (Apple Numbers, version 4.3.1, Cupertino, United States of America). Two hundred and seventeen records were identified (Supplementary Table S1) that were released over 61 yr (1956–2017), of which 23 (11%) were singles. Song titles contained keywords in 14 (6.5%) cases. The predominant genre was ‘rock’ (146; 67%), followed by ‘hip-hop’ (36; 17%), ‘electronic’ (26; 12%), ‘pop’ (4; 1.8%), ‘jazz’ (3; 1.4%), ‘comedy’ (1; 0.5%), and ‘funk/soul’ (1; 0.5%). Ella Fitzgerald's Ev'rything I've Got was the earliest release. Releases increased over time, peaking in the 2000s. Fourteen charted in the ‘Top 20’. The highest were Bad Medicine by Bon Jovi in 1988 and Bad Day by R.E.M. in 2003, reaching number 1 in the USA. Themes identified were altered consciousness (145; 67%), literal administration of anaesthesia (32; 15%), recreational drug use (including alcohol) (32; 15%), analgesia (30; 14%), death (30; 14%), altered sensation (27; 12%), procedures without anaesthesia (24; 11%), induction (21; 9.7%), maintenance (16; 7.4%), emergence (16; 7.4%), inhalational anaesthesia (15; 6.9%), merciful use (14; 6.5%), intravenous anaesthesia (7; 3.2%), local anaesthesia (7; 3.2%), paralysis (4; 1.8%), euthanasia (4; 1.8%), and regional anaesthesia (1; 0.5%). Most of them appeared from the 1970s. Volatile anaesthetics appeared from 1974 and intravenous agents from 1985. Paralysis and euthanasia featured later, from 1992 and 1995, respectively. Analgesia was mentioned from 1996. Altered consciousness appeared in various contexts. Metaphors included sleep, dreaming, darkness, loss of control, emptiness, purgatory, and suspended animation. Analgesia frequently related to heartache. Altered sensation appeared commonly regarding numbing emotions. References that are more literal were found in records, such as Here Comes The Supernatural Anaesthetist by Genesis and The Hospital Song by 10cc. The Associates describe how ‘anaesthetists don't dance, they have balls with masks in France’ in Message Oblique Speech. The parody, Anaesthetist's Hymn, by Amateur Transplants is notable. Enter Shikari released Anaesthetist during turbulence in the National Health Service resulting in junior doctors' strikes (Fig. 1).6National Health Executive. Health service focus: junior doctor contracts dispute timeline: key events. Available from: http://www.nationalhealthexecutive.com/Health-Service-Focus/junior-doctor-contracts-dispute-timeline-key-events (Accessed 22 March 2018)Google Scholar ‘Yellow jelly shot hard in vein’ may refer to thiopentone in Jawbreaker's Outpatient. Halothane, ether, and chloroform were also mentioned. Metaphorical agents included people (always female), voices, censorship and propaganda, and music itself. Euthanasia was associated with anaesthesia in several records, most explicitly concerning Dr Jack Kevorkian (1928–2011) in Anvil's Doctor Kevorkian.7Biography.com. Editors. Jack Kevorkian. Available from: http://www.biography.com/people/jack-kevorkian-9364141 (Accessed 22 March 2018)Google Scholar Records also referenced suicide, murder, and war. Complications were identified in accounts of death, delayed emergence, allergy, and accidental awareness. The results suggest that anaesthesia is a prevalent subject in music records. Themes were projected in metaphorical and literal contexts, some with a negative light. The increase in the number of references towards the 2000s may reflect changes in the music industry, with an expansion in the diversity of music records. High chart positions are significant when considering influence. The numerous references to altered consciousness are in keeping with the expected understanding of general anaesthesia in the public. The use of some themes was less typical of ‘real’ practice. The motives of artists should be considered when reflecting on thematic representation of anaesthesia. Although patients may be able to differentiate between the illustrative purpose and reality, it is possible that the overall picture painted in music may skew our specialty's depiction in society. This study was limited by its subjectivity and use of unverified databases. Release years may not have represented peak popularity. The analysis was lyrical, with scope to explore musical form and interactions, such as those between melody, lyrics, and rhythm. The search was restricted by keywords, but these provided a starting point and further work is welcomed. Noteworthy exclusions should be mentioned: Prince's Anna Stesia, P!nk's Just Like a Pill, Metallica's (Anesthesia) Pulling Teeth, and The Ramones's I Wanna Be Sedated. Some patients' understanding of anaesthesia may have been influenced by descriptions in music to the point of holding false beliefs. This is worth considering in our interactions with patients. This study provides an interesting insight into the specialty's integration within popular culture. Study design, data collection, data analysis, manuscript preparation: E.A.D. Figure 1 was reproduced with the permission of 30 Century Management on behalf of Enter Shikari. The author declares that they have no conflict of interest. No funding declared.
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