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Why medicine is like a jazz solo

Arthur Lazarus, MD, MBA
Physician
September 6, 2025
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An excerpt from Born to Heal: Medical Narratives Set to the Soundtrack of Classic Rock.

Dr. Evelyn Moore had always believed medicine was more than a profession; it was a calling. Not in the dramatic, messianic sense that some doctors held onto (where they saw themselves as saviors) but in the quiet, steady way a lighthouse stands guard over stormy waters. She was not there to rescue ships but to guide them safely home.

For nearly forty years, Evelyn had practiced cardiology in a mid-sized city where heart disease was prevalent, but specialists were scarce. A group practice had recruited her fresh out of fellowship, and she had stayed, despite more lucrative offers elsewhere. Commitment, she often told her students, was not about chasing prestige but about being present. And she was present: through long nights, difficult diagnoses, and moments when she had nothing to offer but a hand on a patient’s shoulder.

Her reputation extended beyond medical expertise. Evelyn was known for the way she spoke to her patients: no jargon, no condescension, just clear, compassionate truth. She believed communication was as much a part of healing as medication or surgery. When Mr. Alvarez, a retired mechanic, was diagnosed with congestive heart failure, she sat with him and his family for almost one hour, drawing pictures of the heart on a notepad. She outlined his options, not just what was possible, but what was best for him as a person, not just a case.

Her colleagues admired her, but some found her pace exasperating. “Evelyn, you cannot spend that much time with every patient,” Dr. Kim had once said, shaking his head. “You will burn out.”

She smiled. “I would rather burn out than rust out,” she said, in agreement with Neil Young’s legendary line: “It is better to burn out than to fade away.” Music had always been her second language, a soundtrack to both her life and her practice. Her love for rock and jazz was no secret; her office had a turntable with Harvest stacked next to Blue Train, and she often used music as a metaphor for medicine.

The way she saw it, patient care was like jazz, structured but improvisational, deeply technical yet reliant on feel. “Medicine is like a Coltrane solo,” she once told a group of residents. “You learn the foundation, but every patient forces you to improvise.” She saw her role not as a virtuoso but as a member of a band, listening and responding, letting the patient set the tempo.

One of her longtime patients, Mrs. Holloway, shared her love of music. At 83, she had outlived a heart attack and two valve replacements. At every appointment, they talked about jazz. “Doc,” she once said, “you ever notice how a good jazz tune finds its way home, no matter how far it strays?” Evelyn nodded. “Just like the heart,” she said. “It skips a beat, gets lost in the noise, but it always finds its rhythm again.” The same is true of the doctor-patient relationship, Dr. Moore thought to herself. She always reeled in the melody of the conversation at the end.

Her ability to connect through music extended deep into clinical conversations. Once, after diagnosing a young musician with an arrhythmia, she could see the fear in his eyes. “Your heart is just playing a little offbeat,” she told him. “Nothing we cannot smooth out.” She handed him a printout of his EKG. “See this? It is syncopation. You are a jazz drummer; think of it as polyrhythm. We will bring you back to four-four time.” The young man smiled. He was relieved and laughing. “That actually makes sense.”

It was moments like this that defined her. She understood that following medical oaths was the foundation of good practice, but it was not the ceiling. From Hippocrates on down, she was required to do no harm and act in the best interest of her patients, maintaining high ethical standards. But it did not require her to listen to Mr. Alvarez’s grandson talk about his soccer game or to personally follow up with a worried patient after a procedure. Those things were beyond duty. That was where medicine became a commitment: a commitment to presence, to understanding, to the moments that statistics and guidelines could never capture. A commitment to seeing patients not as cases, but as people, with fears that needed soothing and victories that deserved celebrating. A commitment to making medicine more than a science, but a human art form, one that, like jazz, thrived on rhythm, improvisation, and the patience to listen.

One day, a young medical student shadowed her on hospital rounds, watching as she examined a patient recovering from a bypass surgery. The student was eager, eyes full of ambition. “Dr. Moore, what is the most important skill for a cardiologist?”

She smiled as she adjusted the blanket over her sleeping patient’s feet. “You would think it is knowledge, but knowledge is everywhere. The real skill is earning trust. When patients trust you, they listen, they follow through, they heal.”

And that was why her patients loved her. It was not just the cutting-edge care, the evidence-based decisions, or the collaboration with her colleagues. That was done behind the scenes, out of view from patients. No, it was the way she treated them, not as cases, but as people with stories, with fears, with aspirations.

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She never saw herself as a hero. She was simply a physician who honored her commitments. And in a world where medicine often felt rushed and impersonal, that was more than enough.

Because medicine, like music, was not just about playing the right notes; it was about listening. About knowing when to lead, when to follow, and when to pause for quiet passages. And as long as she could keep the rhythm, as long as her patients still trusted her to hear their stories, she would keep playing, playing in the band.

Arthur Lazarus is a former Doximity Fellow, a member of the editorial board of the American Association for Physician Leadership, and an adjunct professor of psychiatry at the Lewis Katz School of Medicine at Temple University in Philadelphia, PA. He is the author of several books on narrative medicine, including Narrative Medicine: New and Selected Essays, and Narrative Rx: A Quick Guide to Narrative Medicine for Students, Residents, and Attendings, available as a free download.

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