When a harpist wearing blue hospital scrubs started playing the familiar strains of Pachelbel's Canon during Edith Zook's heart procedure, the scene couldn't have been more surreal.
Surrounded by cutting-edge medical equipment, the 83-year-old patient lay unconscious and sedated, with skinny electrode-equipped catheters snaking from veins in her right thigh and shoulder into her heart. They provided a conduit for a video monitor showing the squiggly waves of Zook's irregular heartbeat.
Like some weird sci-fi melding of heaven and high-tech Earth, the musician strummed serenely on her 4-foot Irish harp just a few feet away, while the patient snored and her doctor silently examined the ups and downs of rainbow-colored heart waves on the screen.
The music sounded lovely -- but it was meant to help heal, not entertain.
Zook suffers from atrial fibrillation, a fast, irregular heartbeat caused by mixed-up electrical signals generated by the heart's upper chambers. Zook's symptoms include unnerving palpitations and troubling fatigue that make her suddenly collapse without warning.
Her doctor, Abraham Kocheril, chief of cardiac electrophysiology at the Carle Heart Center in Urbana, says he has found signs that harp music might help sick hearts like Zook's beat more normally.
The theory is based partly on work by Dr. Ary L. Goldberger of Harvard Medical School showing that varied rhythms created by healthy hearts are similar to note patterns in classical music.
Kocheril's work also fits with a growing music therapy movement, whose supporters believe music can alleviate some of the mental and physical symptoms of disease.
"People know that music relaxes you. We're just trying to get more medical validation," said Kocheril's harpist and co-researcher, Dr. Jennifer MacKinnon, 35, a Chicago internist. She took up harp-playing at age 10 and as a child, used to play for patients of her father, also a physician.
Some enthusiasts believe the harp has special healing qualities, and Kocheril said resonant vibrations from live harp music may be particularly effective at regulating quivering heart rhythms. Other musical instruments and recorded music might offer similar benefits, he said, making a "music prescription" easier to follow.
"Potentially, there could be a prescription for music five days a week ... to keep the heart healthy in general and specifically to keep rhythm disorders under control," Kocheril said.
Although he doesn't foresee the elegant but unwieldy harp becoming a routine fixture during heart operations, others have used harpists in intensive-care units to help normalize sick newborns' heart rates, after surgery to reduce patients' anxiety, and during childbirth to soothe mothers in labor.
Psychologist and harpist Sarajane Williams uses the instrument to help patients deal with chronic pain from arthritis, fibromyalgia and other conditions. Patients at her Macungie, Pa., office sit in a reclining chair embedded with speakers that allow amplified vibrations from her harp-playing to reach deep into aching tissue like "a musical massage," Williams said.
She says the vibrations help relieve pain by stimulating circulation and relaxing patients.
Harp therapy also is commonly used to soothe dying patients in hospices.
Maureen Reilly, a nurse-anesthetist in San Antonio says the harp's effect on the body can be partly explained by a physics principle called entrainment. This concept describes the influence of one oscillating system over another.
Entrainment has become a buzzword in some New Age health circles, but the theory dates back to a 17th century Dutch physicist who found that pendulum clocks started ticking simultaneously when placed next to each other.
Jean-Jacques Slotine, a Massachusetts Institute of Technology scientist who has studied entrainment in mathematics and neuroscience, says it helps explain other effects on the human body, including how Parkinson's disease patients can walk more easily if they swing their arms. And it's plausible -- though not proven -- that entrainment might also explain how music affects the heart, Slotine said.
Dr. Mark J. Tramo, a Massachusetts General Hospital neurologist and director of Harvard's Institute of Music & Brain Science, said there was nothing kooky about the idea of entrainment and using music in healing.
Rhythmic music has been shown to affect heart rates and rhythms, but rigorous scientific evidence proving that those effects can help heal is needed, worthy, and scarce, he said.
Tramo said parts of the brain known as the mesolimbic system, involved in controlling emotions and reward-seeking behavior "can have a profound influence on the heart." Music's influence on that brain system and the auditory nervous system might help explain how it can affect the heart, he said.
Dr. Robert Eckel, president of the American Heart Assn., is a bit more skeptical about the use of music in healing, although he said there was no doubt that music could produce a calming effect that might decrease the release of stress hormones.
Still, he said the science was "immature" and that using music as a remedy might be problematic. "Do you play Led Zeppelin or Debussy?" he said with a chuckle.
Reilly said that patient preference was important and that playing music a patient disliked could have a negative effect.
She has used live, original harp music in the operating room to help calm patients. The soothing sounds help normalize blood pressure, and it works even when patients are under general anesthesia because their brains still retain a level of consciousness, Reilly said.
She also has published research showing that recorded music reduces blood levels of stress hormones, and in one of her studies patients having surgery while recorded music played needed less medication afterward.
Zook, a retired high school cafeteria cook from tiny Fisher, Ill., was dumbfounded when Kocheril told her he wanted a harpist to play during her procedure.
"I said, 'You've got to be kidding,' " Zook recalled from her hospital bed. "I thought it was kind of crazy."
Her two daughters were also incredulous, and a doubting son-in-law sarcastically asked, "Is Gabriel going to be in there with the trumpet?"
Zook prefers Christian and country music to classical but now says she just might become a fan of classical harp. "If it cures this, I will," she said smiling.
Kocheril has studied 15 patients with heart rhythm abnormalities and so far has written no prescriptions for music. But preliminary results are promising.
Zook's heart rate slowed and the beats were more regular during the music and for several minutes afterward. Similar benefits occurred with the other study participants, Kocheril said.
Zook awakened from the procedure and told the doctor, "I didn't hear the music," her daughter, Pat Zook, recalled. "And he said, 'Your heart did.' "