The operating room is not a quiet place. There’s the sound of surgeons talking, the beep of the heart rate monitor, and then there might be the vocal stylings of a pop artist.
Globally, anywhere between 53% and 72% of operating rooms play music, usually unbeknownst to the patient under the knife. And it’s not a new phenomenon; it was first introduced in 1914 to help ease patients into going under local anesthesia. In 2006, an Australian surgeon advocated that iPods should be common features in ORs.
“For the awake patients, I think the evidence is relatively clear. It’s fantastically beneficial,” David Bosanquet, a surgeon-in-training at the University Hospital of Wales told the British Medical Journal (paywall) in 2014. Bosanquet said that for patients who are about to go into surgery, having music to listen to can be something that calms them down, without any of the side effects of medication.
A small 2014 study published Nature Scientific Reports found that when people listen to music they enjoy—regardless of the genre—they’re able to focus. Though this study was done on a college and graduate students, it could apply to annyone
Usually, Bosanquet explained, they play something that everyone would be familiar with, like top-40 or older rock. It can’t be too complicated or unfamiliar, because that would detract from the atmosphere. Podcasts or other kinds of spoken-word, he said, wouldn’t suit because they’d take too much attention away from the task at hand. Most often in the OR, surgeons listen to the kind of music that can easily be tuned out while they work.
Bosanquet told Quartz that the most senior surgeon in the room usually chooses the track. “Predominately it’s the consulting surgeon’s preference, although sometimes it’s the anesthesiologists preference or the scrub team,” he said.
Alan Youn, a plastic surgeon in Detroit, told CNN he listens to Lady Gaga in most operations except for facelifts. STAT News wrote that during a 16-hour surgery for a patient with metastasized appendix cancer, the playlist swung from the Black-Eyed Peas to the Beatles to Adele. And David Levine, an orthopedic surgeon at the Hospital for Special Surgery in New York, told Vice that classic rock and roll—or anything with an upbeat tempo—is good for “closing music” as surgeons suture up the patient at the end of an operation.
There are some times, though, that music isn’t appropriate. Bosanquet said that when operations that are considered routine go awry due to unexpected complications, the OR typically goes silent. Not only is music turned off, but any casual chit-chat also ceases.
“Noise consumes your cognitive bandwidth, and it’s incredibly frustrating if you’re…trying to focus and concentrate and you hear someone chattering around about the TV they watched last night or there’s music on in the background that’s overly loud and blaring,” he said.
A 2015 study in the Journal of Advanced Nursing found that music in the OR can interrupt communication. But, of over 5,000 interactions between different surgeons and nurses, there were only 69 times when someone didn’t hear a request properly; 63 of those were in cases where music was playing.
Music in the OR is just a harmless way to help people get in the zone. Bosanquet says that sometimes, he doesn’t even notice it’s playing. One time, he says, “Whilst I noticed the music before and after the operation, during the operation I didn’t register it,” he said. “It wasn’t actually taking up cognitive bandwidth at that point because I was concentrating on what I was doing.”