Twelve years ago James Gilchrist MRCP found himself at a career crossroads: he was on a prestigious medical rotation and he had a diary full of semi-professional singing engagements. He told me how he had gone to discuss his future with his consultant. “To my surprise, this eminent physician told me he himself had always regretted not having followed his own non-medical dream. He put it to me that I might come to the end of a medical career still wondering ‘What if?’ ” James left the rotation early to try his luck, intending to look for a new medical job if it didn’t work out.

He has never returned. Well, apart from a brief test hospital locum job which demonstrated to him that while consulting, like riding a bicycle, is a skill you never lose, you need to do enough of it not to be racked with anxiety about making a mistake. He considered general practice. Sessional GPs often have several strings to their bows. “ But I found I couldn’t do both medicine and music properly” says James. He chose singing.

His career as a lyric tenor is assured. After a concert at the Aldeburgh Festival, a member of the audience accosted him. “I used to tell you off for humming in my operating theatre. Now I have to fork out a fortune to listen to you.” But he is kept in touch with the world of medicine: his wife is a sessional GP.

Unsocial hours is less of a problem for GPs than for musicians. “Naturally, concerts tend to be held during most people’s leisure time, so I am working when my sons come home from school and when they have football matches. You have to be very disciplined to book family holidays and not let an engagement, however prestigious, creep in.” Continuing professional development, however, is common to both. A singer continues to take lessons, to learn both music and words, to understand exactly what those words in an unfamiliar language mean, and to work out how to perform  new and strange works which make unfamiliar demands on the voice. And all self-employed people have to attend to their diary and their accounts.

Consulting is a performance art, and when you are running late with a surgery of anxious patients, it is attractive to imagine standing before an applauding audience rather than the crowd in the waiting room, and to reflect on the different penalties contingent on missing a high C and missing a diagnosis. James’s music isn’t the sort that attracts the corporate hospitality crowd, more interested in schmooze than Schubert. As he looks his audience in the eyes they are wide-awake and appreciate what they hear. But however immediate and spontaneous that reaction may be, he says it isn’t the same as a personal letter of thanks. “Musicians, like doctors, tend to hear from people when things go wrong, and it is wonderful when someone does write to tell me how much a concert meant to them.”

James Gilchrist is one of a handful of doctors who have become full-time musicians. Alexander Borodin trained as a doctor, although he was studying the chemistry of aldehydes when he started writing music which invokes emotional reactions: listen to ‘In the Steppes of Central Asia’. Spending time in hospital as a child probably influenced Jeffrey Tate, born with spina bifida, to study medicine; the surgery he underwent in those years may have made possible his subsequent career as a conductor. Another conductor, Venetian-born Dr Giuseppi Sinopoli, wrote a dissertation on the connection between acoustics and the mind before turning his analytical skills to the study of musical scores. There may be other doctors hidden in orchestras, though it seems unlikely that many would give up a medical career to play second fiddle.

Music may be less obviously useful than medicine, but it is has an important place in most people’s lives. Desert Island Discs hasn’t been going for 67 years for nothing. And the effects of music  can be profound: I was in a sultry Royal Albert Hall the day the Soviet tanks crushed the Prague Spring. The USSR State Orchestra was about to play the cello concerto by Antonín Dvořák. A Czech. The atmosphere in the hall, like the weather outside, was electric. There were taunts from the audience. Then someone shouted “Let them play”. And they did. With what passion. The soloist, Mtsislav Rostropovich,  seemed to be in tears as he played, uniting the audience and the orchestra in an emotional experience of shared humanity. Later, Rostropovich defected to the west.

Music can reach us when we are beyond the comfort of words. Music therapy has proved a valuable help to people suffering from almost any health problem; most obviously psychiatric disorders, neurological disease, development disability, and of course stress, but also medical problems. James Gilchrist calls music the medicine of the soul.

First published in NASGP Newsletter 'The Sessional GP' April/May 2009

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