• NYO-USA: Practicing Medicine

    Josh Miller, MD, MPH, the National Youth Orchestra of the United States of America physician, gives an account of his time on tour with NYO-USA musicians and what it means to him as a doctor.


    In his 1927 address to students at Harvard Medical School1, Dr. Francis Peabody emphasized that in the practice of medicine, “the good physician knows his patients through and through, and his knowledge is bought dearly.” I have never had a more profound appreciation for this concept than now, at the conclusion of NYO-USA's inaugural tour.

    My time on tour with NYO-USA has been one of my life's most memorable and compelling experiences. As a musician, I was quite moved by the skill and passion with which each orchestra member performed throughout the tour. As a physician, I have found my practice of medicine to be wonderfully enriched by my experiences caring for these truly extraordinary cultural ambassadors.

    While the number of US doctors making so-called house calls has dwindled, my role as NYO-USA physician has allowed me the distinct privilege of reinventing this paradigm on an international tour. On our final day in St. Petersburg, Russia, I was awakened by a phone call requesting my assistance with a few musicians' medical concerns. With stethoscope in hand, I promptly left my room and traveled the halls of our hotel to visit each musician and address their needs. It occurred to me that few physicians have had the privilege of being delighted by a cellist practicing excerpts of Shostakovich's Symphony No. 10 in between patient rooms. Thrust out of traditional clinic surroundings, my medical practice included some of the world’s most legendary performance halls. Not many doctors have had the opportunity to diagnose strep throat backstage at the Kennedy Center or to help mend an overuse injury in a dressing room of the Royal Albert Hall.

    Just as the NYO-USA allowed me to broaden my physical practice surroundings, so too has my practice of medicine been greatly enhanced. At no other time in my medical career have I had the opportunity to understand and appreciate my patients' life experiences and passions the way I have on tour with these 120 gifted musicians. Since returning to the US and my routine patient care, I've found my day-to-day practice of medicine to be anything but routine. Awakened inside of me is a sense of inquisitiveness and curiosity for my patients that I have not felt since early in medical school.

    In his 1927 address1, Dr. Peabody went on to say that “time, sympathy and understanding must be lavishly dispensed, but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine. One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”

    Amidst the trials and tribulations of our modern day health care system, I can think of no better way to remain true to Dr. Peabody’s lesson then to remind myself of the unending passion and dedication of each of the 120 musicians of our inaugural National Youth Orchestra. I am deeply indebted to each of them and to Carnegie Hall for helping me revisit one of the oldest tenets of medical care.

    1 Francis W. Peabody. The Care of the Patient. Journal of the American Medical Association, Volume 88, pp.877-882, March 19th, 1927.

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