E195 - Dr. Mei Rui: The Science of Sound & Music as Medicine

Dr. Mei Rui is a Yale-trained molecular biophysicist, concert pianist, and clinical researcher at MD Anderson Cancer Center, where she runs trials on the measurable effects of music on the human body. In this conversation, we explore what actually happens in the brain the moment music enters it, why the auditory system is the first sense to develop in the womb and the last to go when we die, and how something as accessible as a curated playlist can outperform FDA-approved pharmaceuticals in reducing cortisol. What We Dive Into: 1. Music is not a supplement to healing. In the right context, it is the intervention. 2. The brain responds differently when you actually show up for the music. 3. A longitudinal study in twins showed that three to four years of musical training reduced the risk of Alzheimer's and cognitive decline by 64%, an effect size found in no other single activity. THANK YOU TO OUR SPONSORS: Oneskin — Code KNOWTHYSELF for 15% off - Limited time only! https://oneskin.co/KNOWTHYSELF BASED Body Works — Code KNOWTHYSELF for 20% and a free toiletry bag! https://www.basedbodyworks.com ___________ 00:00 Introduction: Dr. Mei Rui 01:44 A Life Between Music and Science 05:26 What Happens When Music Enters the Brain 07:26 How the Brain Processes Sound and Music 11:32 Why Minor Keys Feel Sad: The Science of Tonality 14:37 Live Piano Demo: Matching Music to Mood 19:06 Music in the Operating Room 27:41 Music as Medicine: Clinical Applications 29:10 The 32% Cortisol Study 31:19 The 16 Compositional Elements of Healing Music 35:11 Oxytocin, Familiarity, and the Parasympathetic Response 36:18 Timbre and the Cello's Resemblance to a Mother's Voice 42:31 Cymatics: Sound Made Visible 45:16 The Ancient Roots of Music as Healing 47:09 Listening vs. Playing an Instrument 55:33 The Musician's Brain: Structural Differences 57:46 Music Training and Protection Against Alzheimer's 59:44 Music, Empathy, and Neural Synchrony 1:01:36 The EEG Experiment: Reading André's Brain Live 1:18:21 What the EEG Data Revealed 1:22:26 Music, Flow State, and the Disappearance of Self 1:26:55 Music as Spiritual Medicine 1:30:23 How to Listen More Intentionally ___________ MORE FROM MEI ✨Instagram: https://www.instagram.com/@meiruipiano MORE FROM KNOW THYSELF 🎙️Spotify: https://spoti.fi/4bZMq9l 🎧Apple: https://apple.co/4iATICX ✨Instagram: https://www.instagram.com/knowthyself/ 🎬TikTok: https://www.tiktok.com/@andreduqum 👥Facebook: https://www.facebook.com/knowthyselfbyandreduqum/ 🌐https://knowthyselfpodcast.com/ MORE FROM ANDRÉ ✨Instagram: https://www.instagram.com/@andreduqum 💼Linkedin: https://www.linkedin.com/company/know-thyself-podcast 📚Book recs: https://www.knowthyselfpodcast.com/book-list

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00André Duqum?

  We put an EEG helmet on me. And this is just a small window into what you're studying, which is the impact of music on our biology and neurology.

• 0:07Speaker 01

  Music engages every critical area in your brain, more so than any other human endeavor.

• 0:12André Duqum?

  Best job ever.

• 0:14Speaker 01

  Music is a natural narcotic.

• 0:17André Duqum?

  Did you prescribe music?

• 0:18Speaker 01

  Absolutely, yes.

• 0:23André Duqum?

  What about nostalgia?

• 0:28Speaker 01

  Music is a medium of communication. It's just so much more natural. Pharmaceutical interventions will carry side effects.

• 0:35André Duqum?

  Blindness, death.

• 0:37Speaker 01

  Our study showed a 32% reduction in cortisol, more powerful than an FDA-approved pharmaceutical drug. It could protect your brain against your degeneration, Alzheimer's, dementia.

• 0:48André Duqum?

  Like a percentage?

• 0:49Speaker 01

  64%. Even under general anesthesia, they used to think what happens acoustically would have much of an impact. Now we know that is false. This kind of music is way to activating. This may send your body into.

• 1:07André Duqum?

  Dr. May Ray, you have a degree from Yale in molecular biophysics and biochemistry. You're a classical pianist, a very good one at that. You're also a yoga teacher and you're doing incredible research and running clinical trials right now. Most people in life are told to pick a lane. You know, choose one path. I would just love to hear from you through your circuitous journey, kind of getting to this point and choosing not just one path. I would love for you to share a bit of your story of how you decided to combine so many of your passions into one.

• 1:43Speaker 01

  So my journey started very early. My musical journey started very early when I was three years old. And I started performing around the world when I was in elementary school. I played my very first recital in Austria for the president of Austria in Hoffburg, Paris when I was 10 years old. And did a lot of competitions. So that was a very intensive period in my life where the primary focus was deliberate musical training. And then in my early teenage years, I had a few. Quite big setbacks and specifically, you know, in the competitive arena.

• 2:27Speaker 01

  And, you know, at that time, I was also very strong academically, always had a very curious mind and high affinity for science and for mathematics. But then I started to explore partially from just a state of curiosity, but also that was during my immigration to the US as well, to New York and going, attending conservatories here. But I discovered that, that I was passionate about a lot of these other areas and I was discovering overlaps between these two fields. That journey then took me to Yale University.

• 3:09Speaker 01

  But throughout the whole, I would say, my teenage years and twenties and even early thirties, there was a lot of internal conflict and uncertainty and wandering and self doubt, like many of us, that are pulled in different directions. So it was really in the last seven, eight years or so that I became more centered and more comfortable with these quite divergent career trajectories. And I found ways to unify them and pursue, you know, music and research in, both in very meaningful and impactful ways.

• 3:51Speaker 01

  But I feel my early training as a concert pianist helped balance a lot of the struggles that exist in academia as well. So, but now they are all part of my ecosystem. Yeah. And all of these factors, they're all very integral part of my system, just like being a mother and being a yogi, yogi. And it's, they all feed me. And on different days, you know, there's no, if you want to call it balance, right, work-life balance, I don't think they already exist, you know, we try to achieve. We always, as humans, have a way of striving toward, going toward a homeostasis and finding equilibrium.

• 4:35Speaker 01

  So on the different day, on any given day, the proportion or, you know, the distribution of how I spend my time will be completely different.

• 4:45André Duqum?

  Do you feel at this day and age like these aren't different caps you wear, but they're all just different aspects of you?

• 4:51Speaker 01

  Yes, and accepting that took really decades.

• 4:54André Duqum?

  Yeah.

• 4:55Speaker 01

  Because especially being told, in this society, you're told to be very hyper-specialized. And I discovered that a lot through my collaborations with these amazing experts in different fields. So everyone has this hyper dedication to their field. But sometimes we lack the full, the big picture, the integration. So I find the open-mindedness and being willing to explore helps my research as well.

• 5:26André Duqum?

  Undoubtedly, and if everybody who's listening to this right now knows the power of music, right? At some point in their life, more some than others, different types of music have been super impactful for them. I know for me, like, music has been a big love of mine for a long time, both listening and playing. And we all know that music is impactful. You're studying it in a very rigorous way to... And it has really big implications on when we listen to music, why we listen to music, the type of music we listen to, the different effects it has on us. And through this conversation, I'm hoping people can really gain context to what the power of music is, so they can properly commune with it and leverage it in their life to be able to be more effective

• 6:09André Duqum?

  at whatever they're doing and understand actually what's happening. What happens to the brain the moment that music enters it? What's happening?

• 6:19Speaker 01

  So it's a very beautiful process. And when we receive an external acoustic stimulus, so even if we track back to when we were in the womb, so the last three months.

• 6:34André Duqum?

  Third trimester.

• 6:35Speaker 01

  The third trimester, essentially. So your auditory system is almost fully developed in utero. And you've heard of the Mozart effect, mothers, expectant mothers putting headphones on the belly. And there is a scientific basis for that. So the auditory sense is really the first one to fully mature and develop. And it's the last one to perish when we die.

• 7:02André Duqum?

  Interesting.

• 7:02Speaker 01

  Of the five senses. And it's the first one to wake up in the morning and it's the last one to go to sleep. So even if you compare it to smell, which is also, so smell comes next.

• 7:15André Duqum?

  Yeah, I'm just thinking like going to bed, waking up, yeah, taste, sight, smell. Hearing is usually the last thing that you're consciously, I guess, aware of before you enter the void.

• 7:27Speaker 01

  And so in, you know, if you look at research in palliative care or someone that may be in even a fully sedated state or under general anesthesia in the operating room, you know, even the providers used to, used to think the, what happens acoustically inside of an operating room, they wouldn't have much of an impact on the well being of the patient. Now we know that is false. So the side effects of the music that you mentioned, if the surgeon has a strong preference for death metal, for example, or very activating hip hop, right, where you have 160 beats per minute, that's way above the, the rate of the human resting heart rate.

• 8:07Speaker 01

  So in some situations, it's been shown that this type of very activating external stimulus, it can cause arrhythmias and cardiovascular and hemodynamic instabilities in the patients that are under GA, under anesthesia. So that translates to increased need for sedatives. So the anesthesiologists would have to work harder to sedate the patient. They have to put extra propofol. So these, these pharmaceutical interventions will carry side effects. So now going back to your question, when, when we hear not just music, but any sound, right? And so there's usually, it depends on, you know, again, the time of the day.

• 8:51Speaker 01

  So circadian rhythm plays also a critical role in how we receive external stimulus. So a first preference plays, so the brain does decide. In the critical judgment center, right? Do I like this? Do I not like this? And also depends on your mood. If you're in open-minded configuration. And you know, the music, whether it's novel versus familiar. If it has a temper that you may be familiar with versus something that's, you know, a piece by John Cage that has a lot of discord and harmonies.

• 9:31Speaker 01

  So all these different elements in the music itself can play a critical role in where or which of the networks are activated. So you may be familiar with the default, the salience and executive networks, right? Let's say we are, you know, you may be overstimulated at the end of a workday. So in those situations, exposure to nature, nature sound, ocean waves, they have been shown to, to let your body and let your neural systems go into the default network, which is, if you imagine you've had gone long hikes or even, you know, if you're driving and

• 10:13Speaker 01

  you may be in a more open state when there's no traffic. Some of us may have had the best epiphanies when your brain is in that default state. And then your salience network decides, it kind of modulates. It's like a traffic cop. So do I go into this default state and, or do I go into this more vigilant executive state where you have to assign different tasks?

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• 11:40André Duqum?

  I'm really curious, I mean, there's a whole philosophical side of things we can open up, which I'm sure we'll touch on, but when you look at, okay, the auditory system is developed in the third trimester and mothers report back the finding that they play calming music and it's calming for the baby, also dogs, right? Play some classical piano music. I know when I've had dogs in the past freak out, like it really helps calm them down. We're, we're human beings, we're also animals and we have this limbic system and I'm curious, is there a reason specifically, maybe mathematically speaking, physics speaking, why like a minor third interval feels universally more sad to folks?

• 12:23André Duqum?

  Why, why these different, yeah, it seems to be pervasive and just a part of the way the universe structured and vibration works.

• 12:32Speaker 01

  That's a really, really great question. And even as a professional musician, I had to think about it for a second. So I know from the scientific side, then, maybe I'll start from the musical side. So the, the minor third, which is a half, half a step, a semitone lower than a major third, so it mimics almost a human sigh.

• 12:55André Duqum?

  So minor third interval, you're saying it mimics the kind of like sighing, releasing, which feels a bit more sad or releasing versus a major third?

• 13:05Speaker 01

  It's this type of more eyebrow raising relation. It depends, of course, on the articulation, the timbre of the music.

• 13:14André Duqum?

  Yeah, it's, I guess it's still a bit of an unanswerable question, why? Why certain things feel the way they do, right?

• 13:23Speaker 01

  That's, yeah, so we did set out to, at least we tried to capture preference, on the preference side, or on the perceived relaxation side. Do participants feel, whether minor or major, may be more relaxing? Because a decade ago, in the music therapy literature, it was believed that it's better to play music in more positive imagers for people that are in pain, or for a teenager suffering from some mental illness, depression. But now we know that is not true. And so the data from our study actually showed it was almost a 50/50 split between, so in self-reported relaxation,

• 14:05Speaker 01

  whether we played exactly the same piece of music modulated to major or modulated to minor. So it was a very, very even split. So there's no clear distinction between which of the two tonalities may be superior, inducing a positive emotional state. But now we know for a minor-toned music that may feel sadder, they're actually more effective if we're targeting someone that may be severely depressed or in a very traumatized state. Because that's actually closer to their natural state, so to speak. If we have a patient that's already very agitated or already very, very upset, you try to play cheerful music for them. It's a feeling of being completely misunderstood.

• 14:50Speaker 01

  And then they sever that connection. They don't want any of it. But...

• 14:55André Duqum?

  Why don't we just, you want to show it?

• 14:57Speaker 01

  I can show a little bit, yeah, the major/major. It can be more effective than...

• 15:01André Duqum?

  Sure, we just keep talking around it, so let's just do it. Okay, so we were just talking about the difference between a minor third and a major third interval, and why they universally feel the way they do. So you can show us that example, so we can hear it and feel it, rather than...

• 15:14Speaker 01

  Of course, yes. So this was one of the excerpts that was used in the study, where we isolated tonality as a variable to see if there is an innate preference for major versus minor.

• 15:44Speaker 01

  Now?

• 16:00Speaker 01

  So while the minor keys may make you feel a little bit more introspective, perhaps, it's not necessarily a bad thing. Because I mentioned earlier, in patients that may be already prone to rumination, or they may be feeling anxious and depressed. Something that's a little bit on the... Or the more pensive side have been found to feel more closer alignment to their existing emotional state.

• 16:30André Duqum?

  When you're sad, you want to listen to sad music. It feels good.

• 16:33Speaker 01

  And then gradually, so through the progression of our music intervention over 30-minute period, we can gradually take them up through the emotional arc to something a little more uplifting.

• 16:45André Duqum?

  Meet them where they are.

• 16:46Speaker 01

  That's right. But then coax them in a way.

• 16:48André Duqum?

  Yeah.

• 16:49Speaker 01

  And lift them up into... So the progression may look like this, right? So we start with...

• 17:04Speaker 01

  This is actually one of the PISA's use in the clinical trial. And then we may modulate to something with a little bit more movement, but still in minor. So...

• 17:34Speaker 01

  And the piece by itself, already compositionally, it goes into slightly

• 17:42Speaker 01

  sunnier harmony. So it's a very subtle way to coax someone that may be in a

• 17:51Speaker 01

  depressive state. And it's in a very gentle way. We help lift them up. And then gradually, the music will become more positive. So we may modulate to something.

• 18:30Speaker 01

  And then adding a little more movement.

• 18:43Speaker 01

  So we introduce a little bit of, you know, a new variable each time. So not to overwhelm the system. That's still a long way from other type of very activating music that I avoid using completely in these studies. Give you an example. This kind of music is way too activating and it may cause me to lose my job if I play it in the intraoperative setting in the operating room. For example.

• 19:29Speaker 01

  So this may send your body into a fight or flight system. Have you never heard of this?

• 19:34André Duqum?

  It could be great for a workout.

• 19:36Speaker 01

  It could be, yes. And or anything with a strong rhythmic drive. This type of music, whether it's hip hop or whether it's... It can increase your blood oxygen level by up to 7%.

• 20:02Speaker 01

  You feel a little bit of adrenaline rush as well?

• 20:05André Duqum?

  Yeah, this is, yeah.

• 20:07Speaker 01

  And it's different. Your response will be very different if this is your very first time.

• 20:11André Duqum?

  Yeah.

• 20:11Speaker 01

  Getting exposed to this. And then in this case, we found through the EEG study, your occipital region gets very activated. So if you think back to the hunter-gatherer days, right? Your occipital region, your vision is... It needs to be very active if you're hunting the forest, right? If you spot a tiger, you know, if you spot or spot a deer that you can hunt. So we noticed that this type of novel stimulus, especially if it's very activating, it triggers the occipital area and also the frontal, where you're trying to make a critical judgment. Do I like this or do I hate it? The classical music genre is particularly challenging

• 20:54Speaker 01

  if we're trying to harness different pieces for... to be integrated for a clinical study. Then the major reason is the sheer complexity and really the infinite choices that's in this repertoire. Everything from Baroque to to modern, right? So unless if you you really have that knowledge when we are selecting the music, it's very important to know compositionally what happens. Because if you have a very calming, a very calming piece that starts very slow, a minute and a half into the piece, we can have a very explosive climax. So if we were using that in a critical care setting, that will translate to elevated blood pressure and so not what we want to achieve.

• 21:37Speaker 01

  So we have everything from love and rapture and...

• 21:59Speaker 01

  To triumph, feeling very victorious and uplifting.

• 22:20Speaker 01

  Now, the same composer also writes something that could be used as a sedative. And this is one of the pieces that's used in one of the trials.

• 22:56Speaker 01

  So a piece like this would work for pain, work for...

• 23:00André Duqum?

  Lullaby kind of?

• 23:01Speaker 01

  Lullaby, yes, it can work.

• 23:03André Duqum?

  Could I name a couple of emotions and try to play it?

• 23:06Speaker 01

  That's great, yeah, I love that.

• 23:07André Duqum?

  Because I find it so fascinating that, again, various different pieces universally evoke certain feelings states within us human beings. Like, what about frustration?

• 23:20Speaker 01

  Oh, that's a great question. Let me think.

• 23:27Speaker 01

  In a more suppressed way or like stuck?

• 23:32André Duqum?

  Stuck, frustrated.

• 23:33Speaker 01

  Yeah, okay, that's a hard one. That's a really hard one.

• 23:37André Duqum?

  I'm trying to give you a couple harder ones.

• 23:38Speaker 01

  Okay.

• 23:41Speaker 01

  Then there's a little bit of release, okay? So we have a moment of stuck frustration, then there's a release, so...

• 24:08Speaker 01

  So this is like a thirty minute long piece.

• 24:16André Duqum?

  Yeah, I'm pissed off.

• 24:19André Duqum?

  Okay, what about nostalgia?

• 24:21Speaker 01

  Oh, I love this.

• 24:46Speaker 01

  What do you think?

• 24:48André Duqum?

  Yeah, I feel that.

• 24:48Speaker 01

  You feel that?

• 24:50André Duqum?

  What about something pure and honest?

• 24:54Speaker 01

  Yeah, so we go to Mozart a lot and some Chopin.

• 24:58André Duqum?

  Yeah.

• 25:24Speaker 01

  It's very uplifting. It's like a little glass of champagne.

• 25:28André Duqum?

  That's a good note to go back in the podcast.

• 25:31Speaker 01

  As you can tell, I'm so much more natural at the piano than in talking.

• 25:35André Duqum?

  I mean, you're great at both, but I prefer music over English any day.

• 25:42Speaker 01

  Oh, my God.

• 25:44Speaker 01

  Well, you can express yourself that way. You're so thankful to have to. It's not as direct, you know?

• 25:51André Duqum?

  Yeah.

• 25:51Speaker 01

  Especially because of my childhood, I didn't talk about earlier.

• 25:54André Duqum?

  Yeah.

• 25:54Speaker 01

  I know, practice six, seven, eight hours a day. That was my medium of communication, you know? So it's just so much more natural.

• 26:02André Duqum?

  Yeah, I'm just curious your thoughts on that.

• 26:04Speaker 01

  So I think for me, this is because of my personal journey. You know, in my developmental years, I spent a lot longer at the piano during my awake hours than away from it. And now we know music engages every critical area in your brain, more so than any other human endeavor. So they have compared. Elite sportsmanship or playing chess, surgeons operating, but playing music really triggers activation, especially performing live music, triggers activation every part of the brain. So in my, in my childhood, instead of having playdates with my neighbors,

• 26:47Speaker 01

  which my kids get to do every day, I was at the piano practicing five to seven hours every day. And, um, and even now as an adult as well, I find that's the most direct and visceral connection. And whether it's through, you know, when I rehearse with other musicians, I also find it, you know, if we play first,

• 27:12André Duqum?

  Yeah.

• 27:12Speaker 01

  there is a natural connection. And that, when that's built, and it's much easier to converse.

• 27:17André Duqum?

  Yeah.

• 27:18Speaker 01

  Um, in, in a robot way.

• 27:20André Duqum?

  I mean, I feel like communicating the most effectively when I have like a few musician friends over and we're jamming. And it's just, it's just like a universal language.

• 27:32André Duqum?

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• 28:17André Duqum?

  So basically, it's good stuff. I use it because I care about what's happening under the surface, not just on top of it. For a limited time, try OneSkin with 15% off using code KNOWTHEYSELF at oneskin.co/nothyself. That's oneskin.co/nothyself. After your purchase, they'll ask where you heard about them and you can let them know we sent you. Link down in the description. I hope you enjoy. So yeah, so when music enters the brain, you have this chart here, I'll just pass it over to you.

• 28:47Speaker 01

  Yeah, it's okay.

• 28:48André Duqum?

  But you know it by heart.

• 28:49Speaker 01

  Yes, this chart basically means what are the uses, the applications of music medicine in a clinical context? What music has been used for as a narcotic? To modulate pain?

• 29:02André Duqum?

  So different types of music could be obviously a sleep aid, a painkiller, a brain stimulator.

• 29:07Speaker 01

  That's right.

• 29:08André Duqum?

  Boost your exercise, anti-inflammatory, antidepressant, mood enhancer, stress modulator, baby whisper, aphrodisiac.

• 29:18Speaker 01

  That's right. So it's very context dependent and very goal oriented, right? Whether the goal is for, if you were to use it for seduction in a romantic context.

• 29:29André Duqum?

  Yeah.

• 29:29Speaker 01

  Because now we know the, especially for females, for women, we are very, we're more acoustically triggered than male. Male is more visually, we're more visual, male are more visual animals. But going back on more on the clinical side, music has been harnessed and that's what a lot of my research does as well as a powerful way to modulate the human stress response, to decrease pain, both on a physiological level and also in pain perception as well. And of course, in modulating the release of stress hormones like cytokines, interleukin-6, for example, and even our inflammation response. So the data from our newest clinical trial,

• 30:14Speaker 01

  that's in 132 neurosurgical cancer patients, we're seeing a very pronounced decrease in the plasma level, so detected in the blood before and after. So we took two blood draws in these surgical patients the morning of their brain surgery. And we found actually a very beautiful 32% reduction in serum level cortisol. So that is very powerful if you compare it to the effect size of an FDA-approved pharmaceutical drug. That's, do you happen to know what the range would be?

• 30:53André Duqum?

  For a typical?

• 30:54Speaker 01

  Yeah, a pharmacological drug.

• 30:56André Duqum?

  Like an SSRI?

• 30:58Speaker 01

  Yeah, or for pain, or for blood pressure.

• 31:02André Duqum?

  I think when including the placebo.

• 31:06André Duqum?

  It's higher than thirty two percent, yeah? Or no?

• 31:08Speaker 01

  Uh, no, sometimes we get twenty percent, even fifteen to twenty percent.

• 31:13André Duqum?

  Okay. So then could you prescribe music?

• 31:16Speaker 01

  That's absolutely, yes.

• 31:17André Duqum?

  Amazing.

• 31:17Speaker 01

  And without, the best part, it's easy to implement without known side effects.

• 31:24André Duqum?

  Yeah.

• 31:25Speaker 01

  So some of these drugs could have very, very severe, like the one for Alzheimer's that came out about eighteen months ago. So it doesn't cause brain bleeds.

• 31:34André Duqum?

  Some of them are gnarly. It's like, we've all seen those ads on television, which is a whole can of worms in itself, that it's legal to do that. But the side effects of taking this medicine are blindness, death, puking.

• 31:47Speaker 01

  So music is a natural narcotic. And my research is trying to see, because music is so heterogeneous.

• 31:55André Duqum?

  Yeah.

• 31:56Speaker 01

  You heard the single piece I performed for you, right?

• 31:59André Duqum?

  Just a quick note on that, we're gonna splice it in later in this conversation. You guys are gonna hear a piece that May played, and almost brought me to tears. It was so beautiful, I'm excited for you guys to see it. And she also put a EEG cap to see what's actually happening in my brain while she's playing. But to go back to thirty two percent reduction, this is a different study than the sixteen compositional elements?

• 32:21Speaker 01

  That was a study designed to validate. So we isolated these individual parameters in music. You may be familiar with tempo, some of the more basic elements that were in prior literature.

• 32:33André Duqum?

  Yeah.

• 32:34Speaker 01

  But my team went above and beyond. So we really tried to quantify all of these additional variables. Temper, interpretation, or flexibility, rubato in the music. So rubato is a very unique feature for music. It's related to rhythm. And so if we think of heart rate variability, right, which is a critical indicator of your wellness, you know, before and during the pandemic, before someone was about to get sick, in the forty eight hour window prior to that, you would notice a significant drop, up to forty percent sometimes in HRV. So if you think of rubato-

• 33:11André Duqum?

  Which heart rate variability is like the variance in between, space between your heartbeat?

• 33:16Speaker 01

  That's right. So the more flexible.

• 33:18André Duqum?

  More resilient.

• 33:18Speaker 01

  The more resilient, exactly. So if, I can demo later.

• 33:23André Duqum?

  Yeah.

• 33:23Speaker 01

  But in in musical performance, you know, if we have a MIDI file, something that's computer generated or AI generated, you lose that flexibility or you lose the variance completely.

• 33:34André Duqum?

  That's really interesting. I would be curious if you ran the same trial with AI-generated music and see what the percentage in reduction of the cortisol that you're picking up in the plasma would be. Because I definitely can feel it, like AI is fundamentally predictable, like trained off large models and the internet of what's the essentially the average. And so it doesn't leave space for that humanity and that imperfection that really connects with people. What music were you playing in the study with the thirty-two percent reduction in stress?

• 34:06Speaker 01

  So it's a combination of, it's a playlist I had sent you. But just going back to what you were saying about the, you want a little bit of a surprise to keep the brain trained. So what's effective or what's magical about some of these classical compositions we use is it's a perfect mix of familiarity. You know, you do hear the theme return. So it brings that sense of comfort, even if you don't know the piece, right? Usually within that the frame, the structure, if whether you have a simple binary or ternary structure, you have the re-encounter of the theme, which brings the familiarity. But then every time it comes back, especially if it's a variation form, a little bit of novelty,

• 34:52Speaker 01

  variations are introduced. You may, Mozart may add a little trail or a little cadenza here and there. So our brain likes these little teases and that translates to elevated dopamine surges. If you play something that's very monotonous and completely predictable, it becomes, it can almost cause anxiety, especially if it's in a repetitive loop. We all have so sound machines, right? You can hear the same bird again, two minutes and thirty seconds in. So the difference between, let's say, in these environments, we put.

• 35:32Speaker 01

  Something from a country music track. First of all, lyrics could be very emotionally triggering and potentially in a negative way, especially if there is a memory trigger that may be traumatic. So we usually avoid using vocal music in these more critical care settings. But also, the length of a typical song, right, that's in other genres, they're usually two to three minutes on average. But we could carve out these slightly longer narratives with the classical music that we use. So again, to avoid repetition, but also to have that familiarity.

• 36:12Speaker 01

  And on the familiarity and comfort front, another element of the data we found to be very exciting is there was a 28% increase in the levels of oxytocin also detected in the blood using proteomics, metabolomics. So if you're familiar with oxytocin, with the neurotransmitter, it's a bonding

• 36:36André Duqum?

  Yeah.

• 36:36Speaker 01

  hormone, and it's usually secreted when you feel really a sense of comfort. So it's a very hard environment if you think of the preoperative setting, and they're about to have the patients about to have their brains operated on. So it's a very high agitation state. So to be able to see that increase signals that the music was really able to help calm the system and bring them into, activate the parasympathetic nervous system and deactivate the sympathetic nervous system.

• 37:09Speaker 02

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• 37:40Speaker 03

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• 38:09André Duqum?

  What's the difference if you take the same melodic structure, play it through a cello, through a violin, someone sings it, you play it on piano? What's the difference in terms of the impact on biology?

• 38:21Speaker 01

  That's a great question, and it is a question we have addressed in the Composition Element Study. So we had the exact same piece, and we chose the Rachmaninoff Vocalis. It's a very beautiful melodic work. So we had maybe seven or eight different versions, exactly as you described. Also, we have vocal, soprano and alto, we have different singers, and our French horn, so on a multitude of instruments. And then when the participants were asked, so it's still the same, exactly same piece of music, played at the same tempo, so we preserve all these other variables and isolating the single variable, which is essentially timbre, right? Or instrumentation.

• 39:02Speaker 01

  So that's when we found the cello and the middle range of the piano, middle lower range of the piano, which, you know, if you look at the vibrational frequencies, they align to the natural range of a mother's soothing voice. So those were perceived and selected in the responses to be most relaxing in the over 300 participants.

• 39:27André Duqum?

  That makes sense, especially for, I mean, in the yogic traditions too, any chanting or mantras and the using of your own voice to create that sort of...

• 39:38Speaker 01

  Vibration.

• 39:38André Duqum?

  Yeah, that vibration that's soothing. And then, so the higher ones were activating?

• 39:44Speaker 01

  The higher ones, while, you know, if the purpose is not... So I'm talking about relaxation right now.

• 39:49André Duqum?

  Yeah.

• 39:50Speaker 01

  Where the clinical aim is to downregulate the stress response, right? So we don't, we are trying to avoid music that may be overly stimulating and very intense. You know, if you think of the vibrato, the very intense vibrato in the upper register of a violin or the sound of a piccolo, it could be overly emotionally invasive. And also the human voice as well, especially if you may not, you know, when words are introduced, the brain mechanisms are completely different. And it's also more exerting and taxing, which means less relaxing for the brain to accept and process all that stimuli. So instrumental music is a little bit now more non-invasive.

• 40:35André Duqum?

  Yeah. Is that why you choose it? Because you, you've done studies with open brain, during open brain surgery, playing.

• 40:43Speaker 01

  It's a new trial during awake craniotomy. We're trying to measure the effects simultaneously.

• 40:50André Duqum?

  Both with the surgeon and patient?

• 40:52Speaker 01

  On the surgeon, on the patient.

• 40:53André Duqum?

  Fascinating.

• 40:53Speaker 01

  So to my knowledge, it's the very first study of its kind when trying to capture, again, quantitatively, what the acoustic environment, how important it could be. Because we don't know, maybe people have looked at the effects separately, but not in the same setting.

• 41:09André Duqum?

  If someone is sedated or even asleep, let's say they're in an environment that is completely silent versus something that's playing some of those lower resonant tones. I know, I mean, right now on YouTube, there are so many sleep tracks and solfeggio tones and different frequencies that people feel like they sleep better or stays deeper in their sleep. I know it's early in the findings of the studies, but for those that are actually under surgery, I'm curious, like, are you, what, can you share anything about what you're finding?

• 41:41Speaker 01

  The control group is now receiving standard of care. So that could be, you know, they could be even in the unconscious state, they could be receiving communications, which sometimes could be stressful, you know, if you hear a nurse talking about your case. Blood pressure is spiking and push more of this.

• 41:59André Duqum?

  Because you're subconsciously picking it up.

• 42:00Speaker 01

  You're still picking it up and now if we dilute that, that potentially stressful stimulus with something that's been shown, it's been demonstrated to be relaxing on a physiological level, at least help mask it. And the music we choose, usually there's a little bit of a narrative, so it can help transport the system, the brain into, you know, if you want to call it a meditative state. And it provides a healthy escape.

• 42:31André Duqum?

  Yeah.

• 42:31Speaker 01

  And so you don't have to be a classical musician. You don't need to know what the dominant chord is. That was one of the really illuminating part of the research. The largest impact, actually, we, in the data set, right, we look at associations, correlations between demographic variables, like level of education, gender, cultural background, prior exposure to different types of music preference. So we found that in those participants, they may have never ever attended a classical concert before. So they're not familiar with with this genre of chamber music. They don't know who Beethoven or Brahms are, but they actually report the highest level of anxiety stress reduction, which is very interesting.

• 43:16Speaker 01

  And females benefit a bit more. So there is a little bit of a gender difference. You know, females in waiting areas, they're more prone to elevated levels of anxiety. So, and going back to, remember when I said females a little bit more primed acoustically versus visually for male?

• 43:36André Duqum?

  There is, I'm gonna try to remember, I mean, it's a completely side tangent, but I saw someone share something on Instagram that kind of resonates with that because men fall in love with what they see and women fall in love with what they hear, which is why men lie and women wear makeup or something.

• 43:53Speaker 01

  I have, I have, yeah, that's right. So I tell my friends, right, especially those that are not in this area, instead of spending, you know, $250 on a bottle of cologne, although the smell, the sense of smell is, olfactory senses are very important, you really should cultivate a very mindful acoustic environment or soundscape, you know, if you have your.

• 44:15Speaker 01

  Love interest over.

• 44:17André Duqum?

  Getting the tips.

• 44:18Speaker 01

  You get all these powerful cocktail of neurotransmitter releases.

• 44:22André Duqum?

  Yeah.

• 44:23Speaker 01

  You don't have to buy even buy a cup of coffee to or alcoholic drink.

• 44:27André Duqum?

  Yeah.

• 44:27Speaker 01

  To do that.

• 44:29Speaker 02

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• 44:59Speaker 03

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• 45:28André Duqum?

  We can be subconsciously lowering their CRP and boosting their endorphins. So fascinating. One aspect I might have referred to earlier before we were recording is sci-matics. So this whole field of sound made visible to me is super intriguing because it talks about. And it explains and shows visibly how. Sound has a mathematical geometric, physical component that you can actually see when you put sound and vibrate it on a plate. And it takes certain shapes. I just think this whole field of sound and music as medicine. We're just at the infancy of really discovering the power that it can have.

• 46:10André Duqum?

  So I wanted to just show you this quick like and we'll throw it on screen like a. 25 second little clip showing the sci-matics. So just hold that and then click play.

• 46:43Speaker 01

  Wow, that's beautiful.

• 46:46André Duqum?

  It's very fascinating that like, we just don't know a whole lot.

• 46:51Speaker 01

  And the geometric, and they are all very symmetric, right?

• 46:53André Duqum?

  Right.

• 46:54Speaker 01

  As you look at the patterns, that reminds me, if you look at a cello string, a violin string, all the intonations, all the notes are on a guitar string.

• 47:03André Duqum?

  Yeah.

• 47:03Speaker 01

  So, and all the frequencies, they have a mathematical ratio. So, this is not my field, by the way.

• 47:10André Duqum?

  Yeah, yeah.

• 47:11Speaker 01

  So, I don't know how much I want to go into it.

• 47:13André Duqum?

  It's just, it's so fun.

• 47:15Speaker 01

  It's your passion that I can tell.

• 47:17André Duqum?

  I mean, this is one little interesting aspect, I think, to just bring in here. I just think it's interesting because your brain, obviously, is enveloped in cerebral spinal fluid, and your body is mostly water. And vibration forms these lattices, you know, what you see in these geometric structures. So, when we listen to music, like, what's happening internally into every cell in our body? And how is that corresponding to the neurochemical cascade that's affecting our mood regulation? And all of it, you know, it's so fascinating.

• 47:51Speaker 01

  That taps into the more visceral impact, yeah, of music. That's why instruments like the cello, right? If you talk to a cellist, they'll tell you the, you know, the direct vibration of the cello or of your instruments over here.

• 48:03André Duqum?

  Yeah.

• 48:04Speaker 01

  They can send that physical contact. And we pianists don't have that luxury. It's still very tactile, you know, we make contact with the keys, but we don't really feel the core of the vibrations of the whole instrument.

• 48:18André Duqum?

  This kind of goes into a whole field where, like, ancestrally, like, all these various indigenous communities across the world use various different instruments for healing, for medicinal purposes, for communal purposes, from drumming to various different string instruments. And...

• 48:38André Duqum?

  I think it's very much so a lost art. What you're speaking to in the modern day, like the shamans would have been the highest kind of people on top of different cultures and societies. Today it's scientists, right? We speak the language of science in the stay in age.

• 48:51Speaker 01

  But the healing was from the very beginning of time. The root of music therapy or music medicine could be traced back to 4,000 B.C. And then later on, Aristotle, Plato, they all wrote about music in a healing context. So it's nothing new. And then, if you look at before World War I, World War II, there was kind of a disconnect with the westernization. So now we have these expert musicians, right? And then you have the non-musicians. If you think of everything from Renaissance to the Romantic period, your 19th century, 18th century, a lot of the performances, they happen in social settings. So amateurs played all the time.

• 49:32Speaker 01

  So it's not like you have a disconnect within that spectrum, right? Where you have the elite professionals, and then you have these people that don't know what they're doing at all. So it was more similar to sports, unlike basketball. Everyone is willing to get into a game, right? You don't have to be an expert athlete.

• 49:52André Duqum?

  I think, I mean, I'm curious to get your perspective on the difference from somebody who listens to music versus plays it. I strongly encourage everyone who's listening that doesn't play an instrument to pick up something and to start, even if it doesn't come naturally to you. There's a lot of interesting instruments that are way easier to play that are just one scale, from different handpans to, you know.

• 50:11Speaker 01

  Handpans are wonderful. And again, on the vibration side, it's very healing. And then a lot of people familiar with sound healing, sound therapy.

• 50:20André Duqum?

  Even like, you want to pass me this guy?

• 50:22Speaker 01

  So I remember, ah, one of my favorite childhood memories. So my mom is Buddhist, and I went to lots of different temples growing up. We would go at least twice a month. So the one of the temples that were near my house in Shanghai, it had a huge gong, you know, there was um, it also had the bell that that drapes down with this giant rope.

• 50:45André Duqum?

  Yeah.

• 50:45Speaker 01

  So I remember just wanting to, so you get to only strike it once. Everybody is standing in line and then I wanted to be near it. Does you feel that just impact of the waves in the air?

• 50:57André Duqum?

  Yeah, I know. This is a perfect example of that.

• 50:59Speaker 01

  It reminded me of that.

• 51:01André Duqum?

  This is like a wave chime. Um, it just C and G, but I will see how good the mics pick it up. But it's a perfect example too of you can feel what's happening in your body, especially in person when you listen to this. But it's a super interesting sound.

• 51:42André Duqum?

  Similarly with those tuning forks. So now now we're getting into the.

• 51:45Speaker 01

  You can artificially induce these crescendos and diminuendos just by the directionality of the.

• 51:51André Duqum?

  And you feel it here. Actually, you wanna you wanna try it? You wanna see how it feels in your hand when you move it? Cause it's actually really like uh.

• 51:58Speaker 01

  And you know, in in some the the chakras, right? If you have, I won't go into that event. Okay, so which one is the C? Probably this is.

• 52:15André Duqum?

  And then when you move it, you can feel like the.

• 52:17Speaker 01

  Oh.

• 52:25Speaker 01

  Yeah, she got a little closer.

• 52:29André Duqum?

  We're becoming sound dealers. No, it's, it's, it's, these tools are super fun to play with. Even if you could toss me these tuning forks. I mean, you see these things in.

• 52:38Speaker 01

  You're hearing me now.

• 52:39André Duqum?

  Yeah. Hey, as you give, so, so you shall receive.

• 52:44Speaker 01

  Yeah, that's.

• 52:45André Duqum?

  I wonder if the mics will, will pick these up too. But I just find it so interesting.

• 52:52André Duqum?

  You can obviously place these on different parts of your body and.

• 52:57Speaker 01

  Does, do each one of these correspond to a different chakra?

• 53:01André Duqum?

  I, they, I think so. I mean, let's see, there are seven, so they must, you know? I think they, they, they correspond to different parts of the body.

• 53:10André Duqum?

  Like, you know, different sound healers and shamans would use different.

• 53:18Speaker 01

  I feel in my finger a vibration, but you don't.

• 53:21André Duqum?

  Yeah, if you smack it hard and then put it really close.

• 53:24Speaker 01

  I have a perfect, I have perfect pitch, so I should be able to tell them.

• 53:29Speaker 01

  G flat.

• 53:30André Duqum?

  Yeah. Wow, so you have perfect pitch.

• 53:33Speaker 01

  It's a curse because I can't listen to a cappella groups. Either go out and tune together.

• 53:39André Duqum?

  Okay, all right. Put, put down the witchy tools for a moment. I'm curious to ask actually about that because I've heard from a few different folks that you can play complex, high information music in utero up to the first six years after birth and actually train perfect pitch. For people that don't know perfect pitch, obviously, like you see red, you know what that looks like, you can hear a middle C and know what that is by.

• 54:05Speaker 01

  You hear a car horn, you can identify a frequency or a note on the piano.

• 54:09André Duqum?

  Right, after learning what the notes are, then you can correspond. So because you, I'm assuming because you played since you were very young, that's probably why you have.

• 54:17Speaker 01

  Also tonal language speakers, like Mandarin speakers are, have a higher probability of developing, naturally developing perfect pitch.

• 54:27André Duqum?

  Interesting.

• 54:27Speaker 01

  As well. So when I was a year old, I actually was one of. I was involved in one of the perfect pitch studies in the Coxai lab. And there are different levels of perfect pitch. There are people that can tell between 440 and 442. So depending on how close you can get to, I think it's a very small fraction of the population that are really these absolute perfect pitch folks.

• 54:50André Duqum?

  So if I went and played a couple of polychords or different things, would you be able to? Would you be able to pick out the different notes? Really?

• 54:57Speaker 01

  Yes, go ahead.

• 54:57André Duqum?

  Okay, I have to go do this now.

• 55:01Speaker 01

  Yeah.

• 55:01André Duqum?

  Wow, alright.

• 55:03Speaker 01

  Now I feel silly, because this is like a little party trick, you know?

• 55:06André Duqum?

  No, but it's great.

• 55:10André Duqum?

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• 55:55André Duqum?

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• 56:25André Duqum?

  Alright, so I won't go too crazy. I'm just curious. So obviously.

• 56:31Speaker 01

  Oh, C.

• 56:36Speaker 01

  F#? C# E?

• 56:40Speaker 01

  Oh, F# AE.

• 56:45Speaker 01

  Yeah.

• 56:48Speaker 01

  That's like a pentatonic scale, almost.

• 56:50André Duqum?

  Yeah.

• 56:55André Duqum?

  What about?

• 56:58Speaker 01

  Uh, the bass is an F sharp.

• 56:59André Duqum?

  Uh huh.

• 57:00Speaker 01

  The top is an A.

• 57:03Speaker 01

  And then A, C sharp, E, A, that's just an A major chord, G sharp.

• 57:15Speaker 01

  Am I passing? Oh, that's a bit from B. The top, the top is still the same. We have a D and E. So B, D, E, A.

• 57:28Speaker 01

  How's that?

• 57:29André Duqum?

  Yeah, it was good.

• 57:30Speaker 01

  Okay. Low, oh. Wow, we have some augmented. That's a low E.

• 57:38Speaker 01

  D. F. G sharp or C sharp? E?

• 57:46André Duqum?

  Wow.

• 57:47Speaker 01

  Yeah.

• 57:47André Duqum?

  So fascinating.

• 57:50Speaker 01

  Oh, E flat?

• 57:59Speaker 01

  We have validated.

• 58:01André Duqum?

  She's proved herself.

• 58:02Speaker 01

  I have proven myself.

• 58:05André Duqum?

  So fun. It's like a little, it's like a little test at school.

• 58:08Speaker 01

  I haven't done it in like nine decades.

• 58:10André Duqum?

  You passed the test.

• 58:11Speaker 01

  I haven't been tested.

• 58:12André Duqum?

  I'm jelly.

• 58:13Speaker 01

  It's like a party trick.

• 58:14André Duqum?

  It's, it's very hard to be able to train that later in life, right? Relative pitch.

• 58:17Speaker 01

  Later in life, yes.

• 58:18André Duqum?

  Relative pitch would be more useful for most musicians, but perfect pitch.

• 58:22Speaker 01

  But, but I mentioned it's earlier. It's very hard for me to listen to a cappella groups that they all go on a tune together. It's very torturous.

• 58:31André Duqum?

  Yeah.

• 58:32Speaker 01

  So.

• 58:33André Duqum?

  Getting back to the whole brain situation. Now, we've, we've explored a couple of different tangents. When we hear a lot about like left brain, right brain stuff these days. And you, you share how music is one of the most powerful ways to be able to have a whole brain activity and actually strengthen the connective tissue in the corpus callosum between the two. Why is that, why does that matter? Why is that important? And how does it differ, listening versus playing?

• 59:00Speaker 01

  So first I'll just describe a little bit of the functional and structural differences in a musician versus non-musician's brain. Of course, there are different levels of musicianship, right? Whether you have an amateur or.

• 59:13André Duqum?

  Yeah, there's me and there's you.

• 59:16Speaker 01

  Well, the benefits are immense as well, even if you're not a professional. So pianist's brains are, for example, differently. They're different from violinist's brain. And you could probably guess which brain is more symmetric, pianist's brain or violinist's brain?

• 59:33André Duqum?

  Pianist.

• 59:34Speaker 01

  And why is that?

• 59:35André Duqum?

  I mean, you're using both hands, not that you don't on violin as well. But there is a, you're playing notes with both hands.

• 59:48Speaker 01

  The tasks are more similar, the demands are more similar on a muscular level. And for violinist, would you venture to guess which hemisphere is larger?

• 1:00:00André Duqum?

  I would say for most, because most violinists are, what, right-handed with the bow?

• 1:00:06Speaker 01

  And then?

• 1:00:06André Duqum?

  So I would say their right hemisphere is probably more active because they're playing with their left hand.

• 1:00:10Speaker 01

  That's right, exactly. So that's sometimes up to, you know, the gray matter volume, up to thirty percent larger in the in the motor regions. And so that's a tremendous difference. But pianist's brains are structurally very, very symmetric. So if I were, someone were to perform an autopsy on my brain, they would be able to tell, without having any background information, that I was a musician before I died. And that's the only type of brain where they could differentiate. And if you look at any type of profession, that's the only type of profession.

• 1:00:47André Duqum?

  And what is that, how does that correlate to the rest of your life?

• 1:00:50Speaker 01

  Right, so if we're looking at, on the neuroplasticity side and also on the neuroprotective side, if you had, there was a longitudinal study in twins, so pairs of twins. They looked at the effect size of, you know, over, I think, three to four years of instrumental music training and how decades later it could help your brain and protect it against neurodegeneration and cognitive decline, so Alzheimer's, dementia. So the effect size was, actually, before I review it, do you want to take a guess?

• 1:01:25André Duqum?

  Maybe sixty percent?

• 1:01:29Speaker 01

  Sixty four percent.

• 1:01:29André Duqum?

  Is that right? Let's go. Okay, I got lucky.

• 1:01:33Speaker 01

  Doesn't that blow your mind?

• 1:01:34André Duqum?

  That's insane though. That's huge, yeah.

• 1:01:36Speaker 01

  And if you look at, there's nothing, there's really no other, no activity that could have that type of tremendous enhancement and protection against aging, right? If you look at, so because it protects the brain in a multitude of different ways. So music could be anti-inflammatory. We already know through stress regulation and even music listening over after just three to five minutes, it can enhance a variable called global brain efficiency. So basically, it's, it brings oxygenated blood flow to all these critical regions in your brain that may be associated with memory retrieval, communication, emotional regulation, executive decisions. So it's like a whole symphony, right?

• 1:02:19Speaker 01

  So the music or musical stimuli, they help coordinate the communication among all the different disparate regions in your brain that may not otherwise work together. So we found in our EEG data that the GBE, the global brain efficiency can increase for one hundred seventy five percent, meaning the communication gets faster and more efficient after just listening to music and during our live in hospital concerts.

• 1:02:45André Duqum?

  So how does that correspond with cultivating empathy as well?

• 1:02:48Speaker 01

  Yes, so empathy is one of the regions that's, and also mentioned earlier in the surgeon's study, right? That's, so going back on a humanistic level, music making and music listening help unify us under one roof, you know, people from very different cultural, religious, socioeconomic backgrounds. We don't have to have any other common interests or even common language.

• 1:03:14André Duqum?

  We've all felt this, whoever's gone to live music or performance, the whole audience can melt into one thing, right? That's empathy.

• 1:03:21Speaker 01

  Literally, our, you know, our cardiovascular, our neuro rhythms mechanisms, they start to align after a few seconds, two minutes of exposure. So, and that we can now, we can be able to visualize that in real time in some of my studies because we actually project the data. On the screen, where we have a diet or triad of volunteer, mostly non-musician participants, it could be surgeons or cancer patients. And then we see that their brains actually start to synchronize. And while exposed to music, they don't have to be familiar or have to have a prior preference for the music. But there's something very inherently impactful and human about the music.

• 1:04:02Speaker 02

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• 1:04:33Speaker 03

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• 1:05:02André Duqum?

  So earlier, you did a performance. I did also a performance. I basically just put on a helmet. But you put on this EEG cap on me and you played a really beautiful piece, which I want to cut to now to show. And then we can come back and talk about what actually happened in my brain as you played that piece. It was very beautiful and I really appreciate it. So special to be able to do this as a job. Like, it's really meaningful.

• 1:05:27Speaker 01

  Front stage seat.

• 1:05:27André Duqum?

  Yeah. So yeah, let's cut to that now and we'll show what

• 1:05:32Speaker 01

  Sounds good.

• 1:05:32André Duqum?

  the unitive brain experience looks like in real time. Then we'll talk about it.

• 1:05:36Speaker 01

  Sounds good.

• 1:05:39André Duqum?

  All right, so May, I'm now gonna be your guinea pig.

• 1:05:43Speaker 01

  That's right.

• 1:05:44André Duqum?

  I'm your, I'm now your research patient. What are you gonna put on me? What is this thing?

• 1:05:49Speaker 01

  So I bought a portable piece of equipment from my lab at MD Anderson. This is a dry electrode wireless EEG cap. So electroencephalography, which measures your brain activity using these electrodes that make contact with your scalp. And additionally, this state of the art technology is really amazing because it allows us to measure your cardiovascular activity as well.

• 1:06:19André Duqum?

  All right, doc, hook me up. The things I do for this podcast. So all these electrodes that you're tightening to make contact with my scalp is essentially you're gonna be picking up the different

• 1:06:32Speaker 01

  Signals.

• 1:06:33André Duqum?

  Yeah, like electrical signals from my brain to determine what brainwave states I'm at or where they're changing, contrasting to as you play the piece on piano.

• 1:06:42Speaker 01

  Right, so we can capture both region-specific changes. If you're a musician and you're improvising, usually the patterns emerge from the right side of your right hemisphere. They may migrate to the left when it becomes more memorized.

• 1:06:55André Duqum?

  Good, we're about to find out if I'm brain dead, yeah?

• 1:06:59André Duqum?

  Okay, so yeah.

• 1:07:00Speaker 01

  We are seeing now your live data. And this is, I'm going to pull the screen up where you will see the raw data. And so I mentioned there 20 electrodes are placed on your scalp.

• 1:07:12André Duqum?

  So we'll be able to see the live changes as you're playing what's happening in the contrasting neurologically?

• 1:07:18Speaker 01

  That's correct. And then I'll ask that you minimize, you don't have to freeze or tense your body.

• 1:07:23André Duqum?

  Yeah.

• 1:07:23Speaker 01

  But you minimize movement because otherwise we will, some of the changes will be due to

• 1:07:29André Duqum?

  Yeah.

• 1:07:29Speaker 01

  motion artifacts.

• 1:07:30André Duqum?

  Okay, all righty. Take us away.

• 1:09:13André Duqum?

  ...

• 1:22:01Speaker 02

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• 1:22:32Speaker 03

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• 1:23:01André Duqum?

  So good. Wow. That's powerful.

• 1:23:06André Duqum?

  So I'm curious for those that listen, that set some time apart from their day to sit down and actually listen and feel the changes that we're going to talk about right now. But what happened? If we pull up the Brain Map right now, what's happening to the different parts of my brain that are lighting up or down-regulating when you play a piece like that as it has different movements?

• 1:23:25Speaker 01

  Absolutely. So I want to profit that your question by saying there are very different modes of listening, right? We have the type of background listening. You know, if you're dining in a fancy restaurant, you have background music. But then we also have intentional and mindful listening. So to receive the full benefits of a piece like that, where it really has a very clear narrative arc and has a lot of emotional modulations, lots of different mood states. So you have to imagine it's, you know, the demand is similar to watching a movie. So you need to give it at least comparable amount of attention as you would to watching a movie that you set the time to do, rather than just, you know, doing other tasks.

• 1:24:11Speaker 01

  And so that piece is called "Ballade" in B minor by a romantic composer called Franz Liszt. I chose that because it really demonstrate the full range of mood states and very polarized emotions that the music will invite you to experience through this journey. And it's different from tuning to, I love in my free time, listen to a lot of jazz. And we talked about this before. Also, I love, I have a very eclectic taste in music, whether it's Bill Evans, Billy Eilish, Bob Marley, David Bowie. I love them all.

• 1:24:55Speaker 01

  But this piece that you heard, it has a really...

• 1:25:01Speaker 01

  You know, distinct narrative arc. So you may hear, I'm curious, did you hear the theme coming back several times? And there is this angelic element.

• 1:25:11André Duqum?

  Yeah.

• 1:25:11Speaker 01

  Almost a call from heavens.

• 1:25:13André Duqum?

  And returning back to like the kind of stormy.

• 1:25:15Speaker 01

  Very stormy, very tumultuous. So through that, you know, your body goes between the sympathetic and parasympathetic nerve system and also on a neural side, you may shift between the default network, going through semians into the executive network. Maybe some moments you really don't like, or you find it too invasive, which is all very normal. And these reactions will shift as you get familiar. That was your first exposure to the piece, right? And the amount of dopamine, you know, endorphin, all the serotonin surges, they may differ depending on if this is your first time listening or your 10th and 20th time.

• 1:25:54Speaker 01

  So if going on the neurotransmitter side, if you are familiar with the piece, and if you recall, towards the end, there's that very triumphant climactic section. So if your brain anticipate at the arrival of that section, it could produce a very massive hit of dopamine that may be even comparable, not quite like, you know, that's induced by drugs, but higher than eating your favorite piece of chocolate. So you've heard of the chills, right? The goosebumps you could do.

• 1:26:24André Duqum?

  Yeah, I got chills. I definitely think it was stronger than chocolate. Somewhere between chocolate and MDMA.

• 1:26:30Speaker 01

  Oh, okay. Wow, that's, oh, I'm so, oh, I'm so happy to hear that. But, but the really cool aspect, I think most people may be surprised to hear is that, you know, your sensitivity to this type of stimulation actually increases over time. So that's when you become more familiar with the music, unless if there is a traumatic memory tied to it. If your, your favorite song by, you know, that the Beatles, that's your breakup, that's a song you used to listen to with an ex, you don't, you don't want to listen to that again. That's different. But let's say you have a healthy relationship with a piece of music or something. And as you cultivate the relationship throughout your lifetime, you become more attached to it.

• 1:27:12Speaker 01

  And so you fall, you can fall more and more in love with, with same piece of music. So you become more sensitized to it and then your tolerance actually decreases. That's the opposite mechanism for almost every, any other type of experiential stimulation you can get, which is really unique.

• 1:27:31André Duqum?

  I'm curious how you can build that association to help you enter flow state more, because whether it's playing or listening to it, we all seek that state where we have a lack of self-consciousness, where we kind of disappear into our work, into what we're doing. And we've heard and we've experienced in our lives, but great athletes and musicians, I love that scene in the movie Soul where everything disappears and it's just him floating at the piano. And music, for me, is one of the strongest access points into that, outside of just a more formal meditation practice.

• 1:28:06Speaker 01

  Absolutely.

• 1:28:07André Duqum?

  What's actually happening in that flow state?

• 1:28:09Speaker 01

  Our EEG data shows we have provider surgeons and they come and become our experimental subjects. So we see an increase in theta brainwaves, which is associated with creativity. So to enter flow state for a musician will be very different. The demands will be very different and the conditions will be very different versus for a listener, right? If you're writing essay, writing a grant, or you're performing surgery and you're putting music on as a background to train your brain to go into flow state. So going back to the surgeon side, let's say they have very heavy mental loading going on, right?

• 1:28:51Speaker 01

  They may be coming in the middle of a very busy day of having to do two, three surgeries. So the music helps them deactivate from that state and tap more into... What we also have seen is they tap more into areas like the parietal region of the brain, which is with multisensory integration and the insular, right? Which is... Although EEG cannot monitor deeper brain regions like the amygdala, we have done also FMI studies, like the one surgeons, the one I mentioned earlier to you. But for musicians, to enter this experiential fusion state, which is very elusive, but

• 1:29:36Speaker 01

  it's really incredible when you really lose track of time. So several conditions have to be met. So one is you have to have full command of what you're doing on the technical level. So it becomes mostly muscle, motor memory driven.

• 1:29:54Speaker 01

  And you almost have to reduce that level of meta-awareness, which actually a lot of, I know through meditation, we try to achieve that where you become hyper-aware of everything.

• 1:30:06André Duqum?

  Metacognition, aware that you're aware.

• 1:30:09Speaker 01

  Right, so that's actually not a good thing for musicians when we're trying to go into flow state. Because then all the lot of these minute, hyper-technical details become very evident. You notice the way your fingers are moving. Almost like I remember when I was little, you know, learning to write Chinese characters, which could have many, many strokes. If you stop to see the whole character as an image, as a whole, as a totality, and you start to focus on the individual details, you lose track of how to write that character. So that happens during performance. On the other hand, so you want to have complete command of the technical aspect, but then you also want to be in tune with the environment as well.

• 1:30:52Speaker 01

  So there's a difference between practicing in the practice room, which you could get into flow state, but it's not as wholesome of a flow state as you would get when you have an audience. So that live energy actually helps. It helps me a lot. Some of the best, most memorable moments where I experienced this experiential fusion, which is a form of flow state, was during live concerts in large crowds.

• 1:31:19André Duqum?

  Does that feel like a spiritual experience for you?

• 1:31:22Speaker 01

  It does, it does. And it's, you really become, as cliché it sounds, you become one with the music and you don't feel the physicality of the music.

• 1:31:35André Duqum?

  Yeah, you're not playing the music as much. The music is sort of playing you.

• 1:31:39Speaker 01

  And you become an embodiment of the music. Yeah, exactly, of the music self. And some of our audience members also, listeners of these concerts have told us that, you know, they really forget they have, they just came from a chemotherapy appointment. So it's very beautiful how we get to connect and hear their experience.

• 1:31:59André Duqum?

  I wanted to actually read you this quote from Bach.

• 1:32:02Speaker 01

  Oh, okay. I hope I know this.

• 1:32:04André Duqum?

  Yeah, because he was quite a spiritual human being and, you know, wrote Glory to God solely on all of his transcripts or manuscripts. "The aim and final end of all music should be none other than the glory of God and the refreshment of the soul." Have you heard that?

• 1:32:22Speaker 01

  I have heard of that, yes.

• 1:32:24André Duqum?

  I mean, he's one of the most mathematical composers ever to exist, and he's saying the whole point is spiritual. And whatever people have in terms of spiritual or religious beliefs, it does feel like music in a time where things seemingly increasingly feel divisive and separate is like one of the greatest medicines for us all collectively.

• 1:32:45Speaker 01

  And human universals.

• 1:32:47André Duqum?

  Yeah.

• 1:32:48Speaker 01

  So interestingly, a lot of the composers list, Beethoven, they became more religious or religious if they were not, they didn't start off being religious toward the end of their lives.

• 1:33:01André Duqum?

  Yeah. The, another incredible, have you heard of Inayat Khan? He's a Sufi musician and poet. I have a book from him, The Inner Life and the Mysticism of Sound, I'm gonna give you.

• 1:33:17André Duqum?

  So he's an Indian classical musician, became a Sufi teacher, brought Sufism to the West in 1910. And he wrote a lot around music as like a spiritual medicine. And he wrote, "The use of music for spiritual attainment and healing of the soul, which was prevalent in ancient times, is not found to the same extent now. Music has been made a pastime, the means of forgetting instead of realizing God."

• 1:33:43Speaker 01

  That's right. Oh, that's very beautiful. I'm very fond. And so on the opposite end, you know, music, especially because going back to the environment I work in, right? When I first, if you try to bring a program like this in a large institution, a lot of clinicians or policymakers, they think of music as a pure form of entertainment or just an art form, something aesthetic. But now we know it's so much beyond that.

• 1:34:15Speaker 01

  And in the healing context, you know, that's music has been healing us for since four thousand B.C. and really since the beginning of humanization. And we know that babies, they remember music they heard in utero. Because so there were an experiment they conducted in infants, right, that I think when they were twelve month old. And they were able to detect or differentiate the pieces, the songs they heard while they were in utero and pay more, show more interest and attention in compared to novel music. So that the memory was there before anything else. So it's really incredible. And in the healing context, also in the in the human connection context as well.

• 1:35:01André Duqum?

  Yeah, there is this, you have this slide also, just to like, really ground it of the, you know,

• 1:35:08Speaker 01

  The neurotransmitter release.

• 1:35:10André Duqum?

  Right, like what's happening when we're paying real attention to a musical piece versus TikTok, or drug addiction, or your favorite food, what's happening neurologically? We don't have to get too much into the science of it, but I'm curious, what, what is one fundamental shift you wish everyone listening right now made to their relationship to music?

• 1:35:28Speaker 01

  I think music has been made into, you know, just type of mass consumption, right? It's just one of the many types of stimulations, brain stimulators that we can purchase. So it's very commercialized. And but going back, you know, going back to what you were referencing earlier on the spiritual side, if we really look at the root of music could be, it's really a part of the human universal, and it impacts us so viscerally. And so it should really be perceived as much more than entertainment. So I would advise much more intentional listening. And many of you are being may

• 1:36:09Speaker 01

  already do that, you know, curating your own playlist based on that may help align with the circadian rhythm, you know, everyone should have a morning playlist and bedtime playlist, depending on your preference. And also for the outcome, right? So we design very different.

• 1:36:26Speaker 01

  Music programming, if the targeted cohort is dementia versus, you know, stroke recovery or intraoperative or someone that's just having a bad day and need a little pick-me-up. So being very intentional and mindful in selecting your acoustic environment is very, very important.

• 1:36:50André Duqum?

  Well said. I am excited to explore conversations like this more on the podcast. I think it's very helpful and really important work that you're doing. And I know at times felt frustrating where these different aspects of you hadn't yet come together. And now your life's path and purpose, very much so, is in informing people and what you're finding by bringing the two together. And I think it's a great permission slip also for anyone who's listening right now and feels stuck between choosing multiple paths, that you can really trailblaze and carve your own way. So it's really cool that what you're doing, yeah.

• 1:37:24Speaker 01

  Thank you.

• 1:37:24André Duqum?

  Yeah.

• 1:37:26Speaker 01

  Big admire of your work as well. And other piece of advice is if you ever feel stuck, you know, music is, for me personally, is movement. And it's a moving meditation. That's why I'm very drawn to a flow type of yoga as well. So it can really help, you know, especially if you gravitate toward rumination. And everybody experiences anxiety to a different extent, right? Because of what's going on in the world right now. So I would say strategically harnessing that, very easy to implement and free resource. You don't really need to spend a lot of money, you know, and go out of your way to curate anything special,

• 1:38:09Speaker 01

  but just being very mindful in curating your acoustic environment can go a long way.

• 1:38:15André Duqum?

  Yeah. Amazing. Well, we're gonna leave links down in the description where people can look more into your trials and your work. And yeah, I hope you start going on more podcasts. I saw you somewhere online, reached out. I'm so happy I did. And I think this is the start of many more different media appearances for you and sharing your work with the world. So yeah, that's it. Do you have any last messages before we head out?

• 1:38:38Speaker 01

  No, thank you for, and I'm so glad you responded so strongly to the piece I shared.

• 1:38:44André Duqum?

  Yeah, no, it was so beautiful. All right, everyone, please let us know in which ways this episode has resonated, connected with you personally, and what changes would then stem from that. I'm curious. For me personally, playing music and getting really intentional to the music that I'm listening to and the different frequencies that are being embedded in our subconscious mind, to leveraging it for relaxation, or more higher energy stuff is something I'm very passionate to keep on looking into and leveraging. And yeah, so that's all. Thank you so much.

• 1:39:21Speaker 01

  Thank you so much for having me.

• 1:39:22André Duqum?

  Until next time, be well. All right, we did it.