Article In Brief
Phillip L. Pearl, MD, FAAN, once pursued a career as a professional jazz musician. Here, he talks about why he chose neurology instead and how he integrates his passion for performing jazz in on- and off-hours.
Phillip L. Pearl, MD, FAAN, first developed an interest in neurology during a medical ethics course he took as an undergraduate student at Johns Hopkins University in Baltimore. Assigned to work with the head of pediatric neurology, the late John M. Freeman, MD, Dr. Pearl said he was “inspired by the intellectual challenge coupled with the emotional valence of the work.” The experience led to his first published paper on quality of life for patients growing up with spina bifida, and a lasting interest in developmental neurobiology and pediatric neurology.
As a resident at Baylor College of Medicine in Houston and then a fellow at Boston Children's Hospital and Harvard Medical School, Dr. Pearl developed a subspecialty interest in metabolic epilepsy. Today, he is director of epilepsy and clinical neurophysiology and the William G. Lennox Chair and Professor of Neurology at Harvard Medical School.
Throughout his education and medical career, however, he has nurtured a complementary avocation as a professional jazz musician. He spoke to Neurology Today about the early influences that shaped that interest and how he integrates music into his work as a neurologist.
How did your passion for music begin?
I grew up in Baltimore, where my father was a professional jazz musician, a trumpet player, and my older brother was an accomplished trumpet player as well. I started playing the drums, which in my family was somewhat rebellious, when I was 6 years old. That led to the xylophone, marimba, and vibraphone in the percussion family. When I was about 10 years old my parents bought a piano for my younger sister. She hated it, but I loved it and sat there night after night for hours and figured it out. Even now when I walk into someone's house, the first thing I always ask, to my wife's chagrin, is whether they have a piano.
By the time I was 11 years old, the neighborhood music teachers told my parents they couldn't teach me much more and recommended that I go downtown to the Peabody Conservatory of Music, where they had a preparatory department. So I began studying at Peabody, and when I was accepted to college at Johns Hopkins, I also auditioned and was admitted to Peabody as a music student. I was playing in bands professionally by then—by my senior year of high school I was in a wedding band, playing four or five weddings every weekend. I played in bands all through high school and college on multiple instruments, mainly piano, drums, and vibes.
How did you sustain your musical career during your medical training?
Once I got to medical school, I found that I had to stop the regular professional playing, but I picked it up again later. I did run the class band that played the annual medical school follies, which remains a favorite reminiscence at class reunions.
How does music integrate with your career today?
While in DC, I was a professor of neurology, pediatrics and music at George Washington University. I had a band that included some great jazz musicians, and we played frequently at the famous Blues Alley club in Georgetown as well as other venues. In 2004, we even released a CD called “Live at Jazzmatazz.” Jazzmatazz was a gala fundraising event that ran for about eight years at Children's National Medical Center to support the medical needs of indigent children in the nation's capital. Our “Dr. Phil Pearl Children's Hospital Band” played alongside greats like B.B. King and Shirley Horn. The proceeds of our CD, which was released at a Blues Alley gig, went to the Kids' Care Fund.
About six years ago, I was recruited to lead the epilepsy program at Boston Children's Hospital, where I completed my own training in 1990. Since then, I have become a member of the Longwood Symphony Orchestra and am on the faculty of the Music and Health Institute at the Berklee College of Music. We are planning the next meeting of the International Association for Music and Medicine for May-June 2020 in Boston.
Tell us more about your educational lectures on music and the brain.
One series of lectures is “Medical Problems of Musical Masters,” where I talk about the medical problems of great musicians, such as Beethoven's deafness, Schumann's madness, Ravel's dementia, and Shostakovich's neuropathy. I explain the medical histories and play the music of each composer. These presentations cover various genres of music. I have a Cole Porter set, after reviewing his history of his severe leg injuries and associated neuropathy and ultimately phantom limb pain. I show pictures of Gershwin's brain tumor.
I first began giving that lecture at the AAN Meeting years ago during a course with colleagues Bob Pascuzzi at the University of Indiana and Jonathan Newmark, a Juilliard-trained pianist and Columbia-trained neurologist who has served as a military physician. By now I have given these lectures all over the US and throughout the world, including Japan, Israel, Italy, Japan, Portugal, Sao Paolo, Taiwan, and Turkey. This summer I'll be speaking at an international conference on music and medicine in Vilnius, Lithuania, and next year I am scheduled to give musical talks in Paris and Melbourne.
Another talk I started giving at the AAN is a “Head Talk” on the neurology of creativity: how the brain processes music, what happens with neural plasticity and music, and what happens in the brains of people who play and study music. It is also of interest to talk about maladaptive plasticity, from musician's dystonia, which plagued Robert Schumann, to musical hallucinations and musicogenic seizures—seizures triggered by music.
And you're also involved with two bands made up of neurologists?
Yes, I play regularly at the AAN meetings with Neuro Jazz, a group of neurologists including Brian Litt from the University of Pennsylvania on bass; Marc Schlosberg from the Washington Hospital Center on saxophone; Steve Glusman, who practices in El Paso, TX, and was a New York jazz drummer before medical school; and Jorge Rodriguez, a clinical neuropsychologist from Virginia who is our vocalist. We also have a new trombonist, Andy Woo, from UCLA, and he's exceptional. We don't really get the opportunity to rehearse between meetings, but it always comes together.
I'm also in the Dysrhythmics, made up entirely of epileptologists. In addition to myself on vibes and Brian Litt on bass, that group is led by Bob Fisher from Stanford, and includes Steve Schachter from Harvard on piano, and Chris Anderson from the Medical College of Wisconsin on drums. We play at the annual meeting of the American Epilepsy Society, always a fun December event.
How else do you use music on the job?
I have a new job that makes my parents laugh—I'm the volunteer piano player in the lobby at the Brigham and Women's Hospital on Thursday afternoons. I get there at 2 pm after the epilepsy conference. I'm supposed to play for an hour, but if I fit in 15 minutes, it's a good day. The patients and visitors gravitate to it. Live lobby music can be so important to the atmosphere of a hospital lobby; it can really make a difference.
Have you ever composed your own music?
I have! I was asked to play a requiem at a special conference in Tokyo in memory of Professor Yukio Fukuyama, known as the founder of child neurology in Japan. He passed away in July 2014. When I was asked to play at a memorial conference the following year, I started looking at requiems by Schumann, Brahms, and Chopin. I thought I'd have to take off two years of my life to play one of them, and even then wasn't sure I could have done it!
I was talking about this with my colleague Harvey Sarnat, well known throughout the world in neurology and neuropathology, while viewing posters together at an AES meeting, and he suggested that I write something myself for the event. I laughed—but then thought more about it. I had done some composing before, with some pieces that are copyrighted in the Library of Congress. So I wrote a piece called “Ode to Fukuyama,” using elements of both Western and Eastern music. It went over so well at the memorial that I was invited back to Tokyo a year later for another meeting, where they held a special ceremony and played a recording of my composition that they had commissioned from a professional pianist. It was quite an experience to hear my own music played with someone else's interpretation at a very special event. The feeling was ineffable, to be honest.
Did you ever consider going into music full time?
I did think seriously about that, but frankly the valence, the significance of medicine drew me to it as my priority. Also, my father had too many musical colleagues struggling to survive, despite huge talent—more than I ever had—and used to tell me I was too good at school to go into music. Again, he was a professional jazz musician and had seen the whole picture. I grew up in it and am used to it being an integral part of my life.
What do your patients think about your musical pursuits?
Patients and their families are very, very interested in this. They go to the internet and listen to me playing recordings and listen to my lectures that people have posted on the internet. I have patients and families who specifically come to me because their child who has epilepsy or a neurological problem is studying music.
So many doctors also play music, as your bands demonstrate. Why is that?
People who go into medicine are bright and creative and passionate about what they do, and that applies to their humanistic pursuits, not just scientific pursuits. The NIH just sent out a request for grant proposals to do research in music and health, and there's so much more research going into the effects of music on health, and early musical training and development of the brain. Besides, they're both art.
Music also has a real logic to it; I think that does attract people in medicine, especially neurology, because neurologists are very drawn to the process of reasoning, localization, and differential diagnosis.
Music has a system of logic as well. Even improvisation is not a free for all—it has certain rules. I've gone to gigs and played with people I'd never played with before, performing pieces I'd never played or heard. You have to be able to get in there at a high level. But there are ways of doing it, as long as you follow the rules, rhythmically and harmonically. It all follows a logic—you can break the rules, but you need to know what you're doing first. I think the logic of music is part of its appeal to people who are in medicine, and to neurologists in particular.