Thursday, March 10, 2016

Little Giants

The following is my piece published in the Spring 2016 volume of the Creighton University School of Medicine quarterly, the Wellness Chronicle.
Look at this obnoxious prick. Who even does that? Did he really think this photo would be cool, just because it was the world-famous Dvořák Hall of The Rudolfinum in Prague?

Yes, yes I did. I was eighteen and raised by a PlayStation, all right?

The only reason this pretentious, self-absorbed, overweight man-child had the chance to pose in such an absurd manner was because my youth orchestra, the El Camino Youth Symphony, took an international tour every two summers. After my sophomore year, we performed up and down Italy; a month after graduating from high school, we toured through Budapest, Prague, Vienna, and Leipzig. Our concert audiences ranged from curious crowds of two thousand in the heart of Budapest to two dozen monks in an Austrian mountaintop monastery. I ate it all up. We fed off their looks of disbelief when they discovered we weren’t even in college yet. (Hell, a couple really talented ones hadn’t even hit their growth spurts.)

So why am I reminiscing about music in a medical newsletter? Because over the years, I’ve learned that truly great teaching transcends any one field. Learning to follow my section Principal player may not help me intubate patients any better, but it sure taught me the value of paying attention to others. Team communication is key to producing the best possible product, be that a perfectly assembled meal in a busy restaurant, a stellar symphonic performance, or the best possible medical care. Some people aren’t the best at verbalizing their needs, which puts the onus on the rest of the team to react to their body language or anticipate the next move. A great surgical assistant slaps the next tool into the surgeon’s hand with nary a command; a great orchestra can tell from the conductor’s face what direction she wants the next few bars to go. In the end, it’s all about the team working together seamlessly to deliver a coherent product or optimal outcome. Whereas most of you probably learned teamwork through team sports or a strong family dynamic, neither of which I really had as a kid, I learned it best in music ensembles.

Dr. Camilla Kolchinsky, the fearless leader of our little band, was not the first to teach me music. But she was the first to teach me to love what I played. My early years in music were as a soloist, playing violin since age 9 and piano as soon as I came out of the womb. Along the way through middle school, I picked up clarinet because Band was a required class in sixth grade. (Nobody warned me that I was only digging myself a deeper social grave by choosing the geekiest instrument of all.) Discovering the joy of ensemble playing, melding melodies and harmonies with other instruments, was a seminal moment in my development. Who knew that other people actually mattered? After I boosted my teenage sexiness 500% by teaching myself the saxophone and joining jazz band, I auditioned for violin in ECYS, one of the “Big Three” youth orchestras in the San Francisco Bay Area at the time.

My first ECYS rehearsal transformed the way I thought about music. Camilla was a tour de force at the helm. Not only did we hammer down the technical points to damn near perfection, but she taught us the stories and history behind the pieces and their composers. She did her best to make sure we cared about what we were playing beyond black notes on white pages. After every concert, the way she beamed so proudly toward the audience, then back toward us, was reward on its own. She approached every piece with both iron-clad mastery as well as a child-like fervor for discovery, as if there were still new layers to unfurl on her umpteenth time teaching the piece.

A year after stepping down as the director of ECYS, she suffered a massive stroke in December of 2015. Since I happened to be home in California at the time, I was asked by the long-time manager, Cathy, to go see her in the ICU.

It was heartbreaking to see a woman I once knew as a firecracker of energy, smiles, and intensity to be floating in such unfamiliar waters. Fully paralyzed on the right, minimal movement on the left, and her speech gone, she looked at us helplessly. I didn't know if she even recognized me. My friend Kevin and I held her hands and hummed some of our favorite tunes that we had performed under her.

"Hey. Did her fingers just move?"

"Here, let me try. Yeah, I think they did! Keep going!"

Beethoven, Tchaikovsky, Strauss, Stravinsky -- we took the room on a Greatest Hits whirlwind tour we played together over a decade ago. She stared at us, but nothing else. Not a twitch, not a smile. Did she know we were singing to her? Or were we just two strangers making annoying, off-pitch noises? Like a mirage of an oasis in the desert, our desperate cling to hope was mere fantasy.

It crushed me. At lunch, Kevin laid out his plans for how Camilla could recover and lead some semblance of normal life again. I had seen too many major strokes and their sequelae to know otherwise. Even with the best rehabilitation and kisses from Lady Luck, she would never be her old self again.

Dr. Camilla Kolchinsky passed away on the morning of Tuesday, February 17th, 2016. She was so much more than just a conductor. She taught us to tell stories through music, to remember the past but inspire the future, and to play with love -- love for the music, for our friends, and for ourselves. She made sure we traveled to the very countries in which the pieces we performed were written centuries ago so we could better develop an understanding for the cultural and historical significance of the music we played. She especially loved teaching the old warhorses. "You know this music because you grew up hearing it, but do you know the stories behind them?" she'd challenge. We were so fortunate to have such a giant be passionate enough to teach a bunch of amateur how to not only play, but to live, the notes. We are all more well-rounded, cultured individuals for having learned from her. I know that I'm going to be a better doctor by carrying on her lessons of teamwork, empathy, and above all, love.

I'll miss you, Camilla. May your baton stay swift and your Russian mistranslations adorable.