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Boston & Beyond Update: Xenos Mason's Musician Clinic


In this blog post, we are following a Boston Alumnus. Xenos Mason was trained at Mass General Brigham in Neurology, but now at USC where he is faculty he has started a musician's clinic.



Our interview catching up with Xenos is below:



Stanley Tell me about your relationship to music


Mason

What a beautiful question! I always hesitate to call myself a "musician" because my relationship with music is more intuitive and less technical than many musicians. But music is one of the loves of my life. I have continued to play into adulthood because it brings me joy to make music, and I especially enjoy the community of an orchestra.


Music is also an opportunity for learning. I've wanted to learn to play the piano since I was ten years old, and always have felt it was "too late". As an adult I know that it is never too late to learn, and the piano has been an important journeyman for me. I am a technically proficient horn player, but with the piano I now have access to new types of expression and understanding. Jazz and blues harmony, composition, orchestration...all of these I understand a little more now through my new friend the piano.


But so far this is all to do with playing music, and not with listening! So, to that, I am not a passive listener; usually ambient music takes my attention away from my work and so I'm often forced to work in silence. I listen very intently to melody, and texture, and to the way an artist sounds a note or phrase, and how this might change through the piece. I often miss or ignore the lyrics of a song completely. But I can pretty closely reproduce the harmony or textural elements in my mind. Perhaps this is an indication of my "relationship" with music, that the emotional content is carried through melody rather than words, or rather than form. However I have a good friend who listens first and foremost to the form of a piece and enjoys Sibelius for this reason. I have learned a great deal about listening to music from this friend and from Sibelius. So, I suppose the answer to your question is that my relationship with music changes! But it is one of attention, learning, and love.


Stanley Tell me about how you see music influencing your neurology, and neurology influencing your music Mason When I was interviewing for a residency position, the director of a certain program in New York asked me why I thought that so many medical professionals were also classical musicians. I later learned that the most common answer to this question is about practice and dedication, and for sure this is an important similarity. My answer though was about communication. Any group of musicians - I know the orchestra best - is in constant communication throughout a performance, or even a rehearsal. This is as close to telepathic communication as I've experienced: it is a constant, millisecond-to-millisecond non-verbal communication and it's the only way that a performance seems "cohesive", as we respond to the subtle variations in playing (the emotion!) of our fellow musicians. This is at heart an empathic skill. It's directly transferrable to medicine, and good caregivers - whether nurses, doctors, or parents - are constantly tuned to this emotional bandwidth. So the similarities between music and medicine are in communication, most importantly. But neurology in particular? Of course I'm very interested in the perception of music, the relationship between language and music, the emotional content of music and it's ontology in our development as a species and how this relates to the brain. I am interested in motor control, in practice and rehearsal, in stress and how it relates to function and dysfunction in performance. But all of these are academic interests, and the human connection between music and medicine is far more important for me.

Stanley Tell me about the center/clinic you started and what part experiences in Boston came to shaping it

Mason

In residency I was aware of the longstanding BWH neurology clinic for musicians, though I never rotated there. It at least exposed me to the idea that a specialty clinic was useful, and feasible. I also maintained my interests in music through residency in part through the generosity of my mentors. Free BSO tickets, trips to the opera with Dr. Buonanno, and frequent concerts at the New England Conservatory were a way that we came together as a community, and I was always aware of who among our colleagues were musicians and music lovers. One of my co-residents and I shared a glimpse of shared appreciation during a Mahler symphony. We were sitting a few rows from each other, but both there because our program had provided us with the tickets. This is a lovely memory. During my fellowship I became very interested in dystonia. It is a mysterious disease with a storied history and fascinating current research into pathophysiology and treatment. Musicians and other highly-trained occupations can suffer from debilitating focal dystonia. In the musical community specifically, there is a horrible stigma associated with this condition: dystonia is seen as the death sentence for a performance career and so is imprinted with fear, and shame. I started the Musician's Neurology clinic at USC with a particular interest in dystonia, although I hope it becomes more of a "performance medicine" network for Los Angeles musicians. We are interfaced with the Thornton School, with wellness programs and physical therapy programs on the main campus and medical campus of USC, and with surgical specialties (ENT, orthopedics, neurosurgery) at the Keck School of Medicine of USC. I've designed the clinic to offer the standard resources from a movement-disorders specialist (pharmacotherapies, botox), but also to serve as a multi-disciplinary hub with resources in PT, OT, psychology, and procedural therapies. I have interest in developing novel therapies for dystonia, and in the future I hope the clinic can serve the community as an access point for innovative interventional and observational clinical trials. I am also very active with a group called "The Embouchure Project", which is a community organization dedicated to the treatment and study of "Embouchure Dystonia", which is dystonia specifically affecting the oral muscles in brass players. Of the various forms of musician's dystonia, affecting the hand, voice, or facial muscles for example, embouchure dystonia is particularly difficult to treat. Taking the multidisciplinary approach, this project, being coordinated by Gabe Radford of the Toronto Symphony Orchestra, is building a network of interested physicians and therapists across the county (California, New York, Maryland, and Massachusetts), with the goal of being able to offer a treatment pathway for affected musicians, to inform the public, and reduce the stigma associated with this condition.






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