Grand Rounds Vol. 5, No. 43 is Up

This week's edition of Grand Rounds is hosted by Joe Kim at the Medicine and Technology blog.

This week's episode includes my latest post on finding the optimal background music for dictating ICU chest films.

What is the Best Background Music for Dictating ICU Chest Films?

I was on call this weekend, where I dictated reports on about two hundred ICU chest films. This turned out to be a fine time to test an iPhone app called White Noise, which was a software pick of the week on last week's MacBreak Weekly podcast by Scott Bourne and Alex Lindsay.

White Noise generates random background sounds to replace the background sounds you already have, but don't want. Besides playing actual white noise, this app also plays brown, pink, blue and violet noise as well as other sounds, including 6 different intensities of rainstorm.

Even in my relatively quiet reading room, there was a surprising variety of annoying background noises this weekend, and White Noise did a fine job of covering them all. This got me to thinking about another topic from the same podcast, where Scott and Alex debated whether there were optimal background sounds for different activities. What would be the best background for dictating ICU chest films?

I listen to a lot of audiobooks and podcasts when performing mindless tasks like laundry, dishwashing or commuting. However, I find these way too distracting for cognitive work like film interpretation. So, I designed a quick and dirty controlled study on myself (n = 1), pitting White Noise against three different styles of music: Cajun/swing (Red Stick Ramblers), heavy metal (Metallica), and baroque (Glenn Gould playing Bach's Goldberg Variations).


My results are summarized in the bar chart above, where the vertical axis shows the number of minutes it took me to read 10 ICU chest cases while listening to a particular background. Despite my dubious experimental design, the results are intriguing: I seem to be about twice as efficient while listening to Bach as I am while listening to Cajun/swing. Just in case the first run of Bach was a fluke, I did an additional run of 10 films on a few more of the Goldberg variations. This second run was pretty similar to the first Bach run. However, before I could replicate runs on other styles of music, I ran out of films to interpret.

Taking this at face value, maybe these results are not so surprising. Maybe Lewis Thomas was right when he said:

Music is the effort we make to explain to ourselves how our brains work. We listen to Bach transfixed because this is listening to a human mind.

A quick googling of this topic shows that I am not the first to tread this ground. I quickly found a paper by Cassidy and MacDonald, titled "The effect of background music and background noise on the task performance", published in 2007 in the journal Psychology of Music (vol. 35; pp 517-537). One of their conclusions:

In conclusion, the current study has highlighted the detrimental effect of sound (noise and music) on task performance, in comparison to silence...

(Oops -- forgot to collect data for silence alone...)

They also found that introverts (e.g. radiology nerds) find music and noise more distracting than extroverts (e.g. orthopedic surgeons). Hmmm...

I also ran across a recent article on the work of Warren Brodsky of Ben-Gurion University, who has studied the effects of music on high-risk driving behavior. In a nutshell: fast music makes you drive faster -- and less safely.

For example, while listening to a piece of music, drivers are immersed in much cognitive work including aural analysis and processing of the music components at various levels related to understanding, operations of short- and long-term memory, emotions, and of course extra-musical associations which continually surface from music stimuli.

In other words, music may not relax your brain -- it may make it work even harder.

Nevertheless, I'm not quite ready to give up on music just yet. So, to add some rationality to my rationale, I'll collect some more data the next time I'm on call. Just in case silence is actually golden, I will add an arm to the study in which I dictate to silence alone. However, despite the growing evidence that background music is distracting, I secretly hope that Bach wins again.

The Future of Folk Music is in Great Hands

My day job is teaching radiology to residents and fellows. This educational model of young whippersnappers learning from the geezers is also pretty common in the world of fiddle music.

It's a huge pleasure to see young radiologists and young musicians coming into their powers, especially when one sees them making diagnoses or playing tunes that even the geezers find challenging.

This was definitely true last week at the Festival of American Fiddle Tunes. It was hard to hear some of the young musicians play without feeling like a giant truck was coming up fast in my rearview mirror. Here are two examples of the many talented teens at Fiddle Tunes:

First, listen to Emma Beaton (cello) and Tatiana Hargreaves (fiddle) play the living heck out of this old fiddle tune...



Finally, watch the 204 Trio, with Lea Kirstein (cello), Scott Leach (fiddle), and Ethan Jodziewicz (bass) play their arrangement of Liz Carroll's tune: "Lost in the Loop".



I'd say that the future of folk music is in great hands...

Capo -- Cool Tool for Musicians or Radiology Residents

If you are a musician, the word "capo" brings to mind the device that we guitar and banjo players clamp on the necks of our instruments to change key.

However, Capo also refers to a new and rather swell Mac program for learning tunes from recordings. Capo does this by playing a torrent of music at a speed slow enough for one to comprehend. Here's the really cool thing: it does this without changing the pitch of the music!

The following screenshot shows Capo playing "Heather Bonne", a swell tune I snagged last week at a jam session at the Festival of American Fiddle Tunes.


As a fiddle player, I learn a lot of tunes from field recordings made at festivals, jam sessions and concerts. Although I'm a quick study, some intricate or especially twisty tunes are a lot easier to learn when slowed down in this way. Then, once I've worked out the notes, I can play along with the original at a slower speed until I've learned it well enough to play it at full speed.

Capo is not the first Mac program to do this job. I've used The Amazing Slow Downer and Transcribe for years. These fine programs work quite well, but their interface clearly shows their original Windows roots. Capo, on the other hand, was born on the Mac, and is simply gorgeous. It also ably meets the classic Mac software test: "Can I use this without reading the instructions?"

How is this relevant to radiology? The fiddler in me would answer, "Bite me -- who cares!" However, the radiology geek in me would point out that music isn't the only thing you can slow down with this application. If I were the sort of person who transcribed lecture notes or speeches, Capo would be a huge help.

I could also imagine using this app for learning other languages. I suspect that Capo would work pretty well in slowing down foreign language broadcasts to a more understandable pace. It may also be useful among native English speakers separated by their common language. As a long-displaced Southerner, I have gotten pretty good at decoding the Uzi-paced speech patterns of Yankees. However, newly displaced immigrants from below the Muffin-Biscuit Line may find Capo handy for this now and then.

But wait, there's more: Capo is currently on sale at half-price. I paid full price when I bought it a while back, but am now considering grabbing a few extra licenses as gifts for deserving pals.

The only thing that would make Capo even better would be to release an iPhone version. I've suggested this to Capo's developer, so don't touch that dial...

Radiology Blog Compendium

The folks over at e-Health News Blog have compiled a list of Top 50 Blogs to Help You Further Your Healthcare Career.

My blog is listed there under Medgeek Toys. I would add only that if something I mention on my blog helps you further your career, I'd consider it a tool rather than a toy. Besides, "tools" are tax-deductible, and "toys" are not. :)

Why is Six Afraid of Seven?

The title of this post is in honor of today's date, which is the answer to the question posed in the title:

Because 7 8 9!

My son liked this joke when he was four. I still like it.

So there.

Back in the Saddle Again...

I spent much of April through June preparing for many talks at many meetings, which involved 3 trips to the East Coast in one month. Great fun, but a bit draining.

To recharge, I just spent all of last week with my son at the wonderful Festival of American Fiddle Tunes in Port Townsend, WA.

I first went to Fiddle Tunes back in 1985, and have been back many times since. This year I spent my mornings in a truly excellent swing fiddle workshop by Kevin Wimmer, afternoons in an exhilirating bandlab led by the Red Stick Ramblers, and evenings until real-late-thirty jamming with pals. After a week of this much fun, going back to work was actually kind of restful.

Besides spending many hours pushing an analog stick back and forth over an analog sound box, I spent a few hours recording some highlights with my new iPhone 3GS and my Flip Mino HD recorder. In past years, I've taken several bags of technology along with me to this festival. This year, it was mostly a bag of chargers for the items above, and a laptop to dump files to every night.

The 3GS came pretty darned close to being the One True Device last week. Besides tuning my fiddle, its built-in video recorder grabbed a lot of fine musical homework for me for the rest of the year. In previous festivals, I've recorded tons of audio. However, video is light-years better -- the 3GS let me record not only the music, but also the bow strokes, fiddle finger positions, guitar and banjo chords, body language, and smiles of the musicians. It would be pretty hard to go back to mere audio files alone after this.

It's also very nice to have the time and energy to blog again.

Ahhhhh........