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Music, Madness and Medicine

By Lloyd Sederer, M.D.

Imagine if your psychiatrist played concert piano, including the works of Beethoven, Tchaikovsky, Schumann, Gershwin and Mozart? Meet Dr. Richard Kogan, a Juilliard-trained pianist who went on to Harvard College and Medical School, trained in psychiatry at New York University Medical School, and now practices psychiatry as a faculty member of the Weill Cornell Medical Center in New York City.

I met Dr. Kogan at one of his extraordinary performances, which he gives some 50 times a year around the world. At this one, instead of simply playing a piano concerto with orchestra, he told a story about a famous composer who suffered with mental problems — frequent among highly creative people — while illustrating the composer’s work by exquisitely playing excerpts from his compositions. That evening, Dr. Kogan told the story of the 19th-century Russian composer Pyotr Ilyich Tchaikovsky, whom we know for  “Swan Lake,” “The Nutcracker,”  “The 1812 Overture” and  “Sleeping Beauty” among many other extraordinary creations. Dr. Kogan recounts Tchaikovsky’s story as a chronic, severe depressive and homosexual, both deeply anathema to cultural acceptance in his time. As he plays some of Tchaikovsky’s music, we see how the composer struggled with his mood disorder and tried to hide his sexuality, succumbing to both in what possibly was suicide, while still at a creative peak, at the age of 53. Kogan “s performances also recount the lives and music of Gershwin, Schumann, Beethoven, Mozart, Chopin, Rachmaninoff and Leonard Bernstein.

Dr. Kogan’s musical and medical career has had a very unusual trajectory. A gifted young musician, he studied at Juilliard, the renowned conservatory in Lincoln Center in New York City, before going to Harvard College, where he moved between music and premedical studies and roomed with Yo Yo Ma, the famed cellist, playing as part of a trio with him and violinist Lynn Chang. Kogan, Chang and Ma remain friends today. When it came time to decide where life would take him after college, Kogan never doubted going to medical school. He remarked to me that Apollo was the Greek god of medicine and music, and shamans have long had one foot in healing and one in the charms of music. In other words, there’s no need to choose between them, because both can be possible. When it came time to select what specialty he would train in after medical school, there, too, he had no doubt. He smiled and said that the more those in hematology or endocrinology said they offered what medicine was really all about, the more he knew he wanted to be a psychiatrist.

About 10 years ago, Dr. Kogan was asked to do a symposium at the American Psychiatric Association on mental illness and musical creativity. That launched his career as a raconteur. While some psychiatrists and some musicians  “bristled” at his stepping out of each profession’s traditional format, with doctors asking,  “Where are your PowerPoint slides?” and musicians insisting that he stop talking and just play music, it was a  “revelation” for him: he knew he had found yet another calling. Now he believes that exploring the psyches of composers makes him a better interpreter of their scores, and that understanding the role of music in our lives makes him a better psychiatrist.

There is no piano in Dr. Kogan’s office, nor does he treat only musicians and artists. He explains,  “My job is to help people reach their creative peak, “ which clearly means more than music and the arts. I did not think to ask him whether he treats any Wall Street hedge fund executives.

When I asked Dr. Kogan who his musical heroes are, he said, without hesitation, that they are Beethoven and Mozart. As he elaborated, I realized that it was their resilience and endurance that made them his heroes, not (only) their music. Beethoven became deaf and transcended that seemingly unimaginable obstacle to produce ethereal music. Mozart, a wunderkind, a child prodigy beyond imagination, stayed on the creative road and became a mature master of music composition. Dr. Kogan smiled and said,  “You can almost make the case for considering Mozart a  “late bloomer.” I suppose we see the psychiatrist in Kogan speaking as his heroes are those who overcame adversity, who endured and mastered far more than ordinary challenges.

When I asked Dr. Kogan what else matters to him, he said that it is trying to destigmatize mental disorders. If geniuses can have a mental illness, then maybe mental illness is not shameful, especially if a mental disorder is part of the creative and inspirational process, he added.

Music and medicine remain inseparable for Dr. Kogan — in his concerts and psychiatric practice. In his latest endeavor as Artistic Director of the Weill Cornell Music and Medicine Program, a position he took on last year, he proudly remarks that he has the opportunity to enable medical students and doctors, much like he has had, to live a life where neither need be left behind.

Always aspiring for himself what he wants to achieve with his patients, Dr. Kogan continues to expand himself, his music and his medicine.  “I want to help humanize medicine, to bring more of the person into medical and psychiatric practice,” he declared. With all of us concerned about medicine losing the patient while treating the laboratory and imaging results, it is a good thing we have doctors like Richard Kogan who open our ears and eyes to the symphony that is humanity, in his case played by an ensemble of music and medicine.#

Dr. Lloyd Sederer is the medical director of the NYS Office of Mental Health.



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