ALS and Pop Music.

My mother has always maintained that if she had to pick one occupation that best suits me, it would probably be a DJ at a rock station or a record store manager. (My typing teacher in high school told me I had a bright future as a secretary, but that is a different story). I have more of an aptitude for music than sports, radiology, or just about anything else. If my life depended on it, I'd rather play Rock and Roll Jeopardy than Radiology Jeopardy. Not that I'm a musician—far from it. I am on record as stating that I have the most musical talent of anyone in my immediate family. Unfortunately, this is the equivalent to saying “in the kingdom of the blind, the one-eyed man is king.” My musical talents are more akin to the movie High Fidelity. John Cusack's character could have been me.* I have several thousand CDs and hundreds of LPs (remember those?), which are now all MP3s on my various iPods. At different periods of my formal education, I spent more time in record stores and at concerts than in libraries or study halls. But, as time passed, it became more and more difficult to follow new music with my family, job, and various home improvement projects. My albums and cassettes are stored in boxes in my crawl space. That being said, I have more music now than I could ever listen to, so maybe it is pointless to keep trying to “discover” new artists. With a 7-year-old son and a 3-year-old daughter, I rarely attend concerts like I used to, but recently I took a one-night sabbatical to see a concert in Chicago by one of my favorite duos—Lowen and Navarro. I'd bet most of you have never heard of them, which is truly one of the injustices in pop music. They have more talent in their little fingers than Britney Spears, Jessica Simpson, and Justin Timberlake combined. (Those of you who haven't heard of the latter three either, well never mind, just keep reading). Not that L&N are alone, I've long lamented the fact that the music business is filled with people who are long on talent and short on recognition. I began listening to Lowen and Navarro as a medical student when Todd, one of my college friends, sent me a mixed tape (remember those?) with “Walking on a Wire” and “The Spell You're Under” included alongside songs by other bands such as the Replacements, Hoodoo Gurus, the Cult, and Love and Rockets. I liked these songs immediately, although they didn't seem to fit very well with the other music I liked at the time. Lowen and Navarro reminded me of another duo I grew up listening to in Hawaii, C&K (again, unless you live in Hawaii, I'm certain you've never heard of them either). After a lot of searching, I found their debut CD and listened to it over and over again. Ultimately, they found a niche in my music collection. They weren't exactly “cool” or “fashionable” like most of my other music. Funny thing, though, over the years I continued to listen to their CDs and can't remember the last time I listened to some of these other bands. I'm not sure I'll ever listen to Jesus Jones or the Trashcan Sinatras again. I'm not sure what I was thinking when I bought the CDs initially. I recently bought one of L&N's recent CDs and on reading the liner notes was saddened to learn that Eric Lowen had been diagnosed with ALS. We occasionally treat people with this disease in our IR section, typically with gastrostomy or some type of port for enteral nutrition. I couldn't help but wonder how a musician would face such a diagnosis. Do you continue to perform? Do you try a different profession? Most musicians are a different breed—as Lowen himself notes, “This job is not a chosen one, it chooses one.” L&N are serious about what they do and excel at it. Their somewhat wry musical creed has long been “We try not to suck.” Good words to live by. Eric Lowen was diagnosed with ALS in 2004. Given the unpredictable temporal course of the disease, I wasn't quite sure how he would or even if he could perform in concert. I had seen L&N on several occasions in the past, and usually they sounded even better live than on their studio albums. As a physician, I wondered how the audience would respond to a musician with ALS. I was not disappointed with the band, their performance, or the enthusiastic response of the audience. It was impossible not to acknowledge the “600-pound gorilla sitting in the room,” but it did not cast a pall over the evening. Lowen admits that he is not the guitarist he once was. As he noted several times, “The God of upper motor neurons is unpredictable.” It made no difference. His voice is strong and the melodies continue to inspire. It was in many respects a magical evening filled with laughter and probably some tears. L&N share a chemistry on stage that is easily apparent. They behave pretty much like brothers, and if they're not close friends in real life, they've fooled me. You can learn a lot about people by asking them what type of music they like. People occasionally ask me what type of music I like to listen to. I've never been able to give a straight answer or really classify my taste in music. It is rather eclectic (or maybe schizophrenic)—for instance, in my car CD right now I have In the Wee Small Hours by Sinatra, Hot Fuss by the Killers, Why Try Harder by Fatboy Slim, All The Time in the World by L&N, Abbey Road by the Beatles, and A Love Supreme by Coltrane. During the concert, Eric Lowen described his musical taste, and I realized his description pretty much coincided with my own. Despite having an opening act and (at times) background singers who were analogous to the Dixie Chicks, he admitted, “I don't really like country music. And Butterfly Kisses makes me want to puke. But I do like a good song.” One of the benefits of being a physician is perspective. No matter what our problems are at the time, typically they pale in comparison to the ones of our patients. (Unless you've built your practice around Botox injections, which consists of a different set of problems.) If seeing and treating patients with life-threatening illnesses doesn't keep you grounded, nothing will. Working in our capacity, it is relatively easy to appreciate your health, family, and all the little things that can be taken for granted. It is rare for many nonphysicians to have a glimpse of this type of perspective. This concert was unique in that it gave the audience our perspective. The music was a bonus. So what are my top-five Lowen and Navarro songs? Walking on a Wire, Broken Moon, All the Time in the World, Constant as the Night, and The Spell You're Under. If you like a good song, do yourself a favor and pick up an L&N CD—you won't be disappointed.