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Musician, Heal Thyself
A native of Turkey, Bastepe-Gray had played several instruments as a child before earning a medical degree at Hacettepe University in Ankara. She came to the United States in the 1990s for a medical fellowship, but fell in love again with the guitar and enrolled at Peabody.
When her injury became too painful to ignore, she visited a variety of doctors who conducted tests on her nerves and told her everything was fine. This included a 19-hour drive to a specialist who said simply, “Take it easy.”
“It was hard to convince people I actually injured myself playing the guitar,” she says. “So for 19 hours on the drive back I thought to myself, what does ‘take it easy’ mean?”
After doing her own medical research, Bastepe-Gray devised a new practice regimen. She set a kitchen timer to ring after 20 minutes of practice and then took a 10-minute break before starting again. She also decided that if she couldn’t get a passage right after five tries she would consult her teacher. “That cut down on banging my head on the wall,” she says, “and hoping that it would break before my head did.”
“ Injuries are heartbreaking,” says guitarist Bastepe-Gray “I know what I went through psychologically. And I have seen many talented musicians give up their art.”
After eight weeks, her pain had subsided, and she was able to perform at her recital. “Injuries are heartbreaking,” says Bastepe-Gray. “I know what I went through psychologically. And I have seen many talented musicians give up their art.”
Maria Lambros was nearly one of them.
A violist and Peabody chamber music instructor and faculty member who has performed in string quartets around the world, she has actually rehabilitated two serious music-related injuries in her career. The first, a painful case of tendonitis, struck just after she graduated from the Eastman School of Music. After meeting with several doctors and alternative medicine practitioners, she discovered that her left hand technique was slightly off. She spent an entire year rehabilitating the injury and changing her left hand technique.
Until then she had never considered the possibility of injury. “It was the whole invincible thing,” says Lambros. “I thought it couldn’t happen to me.”
It made her second, more recent injury to her right shoulder even more stressful. For now she was married—to Michael Kannen, Peabody’s chamber music director—with a teenage son and a demanding teaching and performance schedule. This time Lambros suffered a torn labrum, bone spurs, bursitis, and what’s known as a frozen shoulder—all most likely from overuse of her muscles.
“I tried to play through it for quite a few months,” she says, “but the pain eventually prevented me. I couldn’t drive or push a shopping cart. I had to have surgery. It was a hard time of life to go through that.”
David Shulman, a physical therapist in Baltimore, helped Lambros rehabilitate her shoulder so she could play again—a process that required 18 months. Shulman, a one-time professional clarinetist, has lectured at Peabody and treated musicians for 30 years.
“When playing an instrument,” he says, “you’re always in danger of injury because you’re constantly overworking your muscles. People don’t understand that. They will come to me with an injury and say, ‘I’ve been playing 15 years and never had a problem.’ I tell them, ‘Well, now it’s 15 years of overuse. Your body tolerated it to this point. Now it won’t.’”
Musicians play through pain, Shulman believes, because they don’t understand the potential danger of long-term repetitive play without care of the specific muscles.
“They’re also in a bad position,” he says. “A student can’t stop lessons. You certainly can’t stop in the middle of a performance because your forearm feels tingly or your pinkie doesn’t work. Your career is on the line, so you push your limits.”
Even as a preteen, Kyley McClain understood that. Today the residence life and student activities coordinator at Peabody, McClain sports a pair of long scars on her left elbow that tell a painful story many musicians can relate to.
A native of Princeton, N.J., McClain played piano and violin as a child before gravitating to the double bass. At 12, she experienced a tingling and numbness in the fourth and fifth fingers of her left hand—akin to a constant pain from hitting the funny bone.
“I went to numerous doctors,” she says. “No one could figure out what was wrong. Some thought it was carpal tunnel syndrome. One said it was tendonitis, just rest it you’ll be fine. One doctor said, ‘If you could never play your instrument again what would you do?’ which, to me, was like the end of the world. I’d decided playing the bass was my lifelong dream.”
Tests on the nerves in her arm were always inconclusive, but after a year of frustration she heard of a Harvard doctor specializing in neuropathy in musicians. McClain recalls visiting the doctor in his home near Boston. Because she hadn’t brought her double bass, the doctor asked if she could play his piano. After she played, he tested her muscles.
Between the time she started playing and finished, she says, “my muscle strength had decreased so much that the doctor said you need surgery right away.” Startled, she remembers one calming moment. “The doctor was also a concert pianist and he lifted up both his elbows and showed me he’d had the same exact surgery.”
That doctor was the Johns Hopkins–trained Michael Charness, currently an associate dean at Harvard Medical School, an assistant dean at Boston University School of Medicine, and chief of staff of the VA Boston Healthcare System. One of the most knowledgeable doctors in the relatively young field of performing arts medicine, Charness came to his expertise literally by accident.
While pursuing his medical degree at the Hopkins School of Medicine, he spent his spare time playing classical piano. Often he prowled the halls at Peabody looking for a room with a second piano and a duet partner. When he moved to the University of California, San Francisco, as a neurology resident, he continued to practice the piano up to three hours a day.
“I noticed my hands starting to get a little bit less responsive,” he says. “It got worse as I played more and more.” He asked his neurology colleagues for help, but none could see anything wrong.
“We did nerve conduction studies,” he says, “but mine were always normal. People cocked their head a little bit when I said I was having trouble. They couldn’t tell what I could tell so easily. I was aware of a detriment enormous to my playing. It was like that for two to three years.”
Eventually a neurosurgeon who played violin in Charness’ chamber music trio offered an opinion. He had a trapped ulnar nerve—something not immediately apparent to all of the nonmusician neurologists Charness had seen. The violinist-neurosurgeon operated and fixed the nerve. A grateful Charness was able to return to playing, he says, “at the level I had before.”
Injured musicians started asking Charness for advice. He was just launching a laboratory research career and wasn’t seeing patients. So he began seeing a few of them in the back of his research lab. Before long, orchestra members from around the country were paying visits. Eventually he and other doctors at UCSF established a health program for performing artists—the first such clinic on the West Coast. When Charness moved to Harvard in 1989 he established a performing arts clinic, headquartered today at Brigham and Women’s Hospital in Boston.
