Podcast: How Music Has Made Me a Better Surgeon

Dr. Peter Liou: My name is Peter Liou. I’m a transplant surgeon at NewYork-Presbyterian at Columbia. And when I’m not at work, one of my biggest passions is to be able to play the piano.

Courtney: Welcome to Health Matters, your weekly dose of the latest in health and wellness from NewYork-Presbyterian. I’m Courtney Allison.

Recently I had the pleasure of visiting Dr. Peter Liou at his home to talk about how music has helped to make him the surgeon that he is today. He also played some beautiful pieces for us and shared what it means to him to sit at the piano after a long day.

It was a wonderful discussion about how the instrument he began playing as child has  stayed with him, and what playing piano has taught him about life and being a doctor.

Here’s our conversation.

Courtney: So Dr. Liou. Thank you so much for having us here in your beautiful home with your piano behind us.

Dr. Peter Liou: Absolutely.

Courtney: So you’re a transplant surgeon at NewYork-Presbyterian and Columbia and you’re also an accomplished musician. So we’re excited to dive in and talk about the intersection between music and medicine. But to start, what do you enjoy about being a surgeon?

Dr. Peter Liou: So, it’s very exciting. What is so nice about this job is that every day is different. So, you know, today we’re doing this podcast. Yesterday I was in Chinatown seeing a bunch of my patients. Tomorrow I’ll be doing a big surgery with Dr. Kato. And Thursday I’m also seeing patients. And then next week I’m on call. So like every day is different and exciting.

Courtney: And so, when did you start playing music?

Dr. Peter Liou: I was four years old. I remember my mom and my dad, we lived in Cleveland, Ohio. I grew up there. And they took out a lot of savings and borrowed a lot of money to purchase an upright piano. And at the time it was a big thing for us. And I was four and my mom thought, well, I mean, it can’t just sit there, we have to have somebody play it. So she asked one of the piano teachers who actually happened to go to my church whether she would be willing to teach me. And so that’s how I started.

Courtney: And what made you stick with piano? I think a lot of kids learn piano and don’t stick with it.

Dr. Peter Liou: That’s a good question. I mean, I have always loved playing and I remember when I was, you know, six or seven, my mom would always tell me that I had to go to bed, you know? Like, it’s bedtime. And I would say, no, I wanna practice more. And I think at that point it was probably a way to avoid going to sleep.

But, I’ve always had a joy in playing and being able to make music. My sister also played, but she also sang and it was so much fun, growing up, accompanying my sister while she sang. And so, like, music making was always a big part of our lives.

Courtney: And how do you think this dedication maybe prepared you for med school, for your career as a transplant surgeon?

Dr. Peter Liou: There’s so much about music that really prepares you for a career in medicine. My piano teacher would always say, you have to think about it. You have to use your brain. So it’s not just about blind repetition. And I think very, very similarly, in a career in medicine, especially in surgery where we’re training to use our hands, you have to really think about how you’re going to do that and how you’re gonna manipulate the tissue in order to accomplish what you need.

Of course, you know, growing up it was a lot of difficult lessons, a lot of crying, a lot of failures. But I learned to have a thick skin. I learned to be able to learn from my mistakes and my failures. And I think that’s also a very, very important thing to do as a surgeon.

Courtney: And you mentioned a piano teacher. Can you tell me more about her?

Dr. Peter Liou: Yeah. So I met Miss Olga when I was nine years old. My piano teacher at that time was moving away to California and we were looking for a new teacher. And this piano teacher, Ms. Olga, was teaching at one of the big music schools called the Cleveland Institute of Music.

It’s one of the big music schools in the country. And she was known to teach children and to be a very reputable teacher for pedagogy, which is young children. So we were very nervous, but we ended up meeting her and she accepted my sister and I as her students. She ended up becoming one of the biggest influences of my life in all aspects, and really has taught me so much about myself.

Courtney: So, how so? How has she influenced you?

Dr. Peter Liou: I think one of the most important lessons that she taught me was never to accept mediocrity. And she would never bend her standards for her students. She would always hold her standards as the highest possible and her students had to meet that. I mean, of course there was empathy, but every piece that I played, she wanted me to play to the best of my ability and more, you know, so even if we got to 95%, she wanted me to play at a hundred percent.

So she kept on pushing and pushing and, you know, she did something that I also carry forth with my own trainees today, thinking that, again, talent can get you so far, but the will for discipline and hard work will get you all the way.

Courtney: Do you remember a piece of music that you really loved early on?

Dr. Peter Liou: So one of the pieces of music that I… it was probably a pivotal moment for me because I was going through a very rebellious time as a 10th grader, if you can imagine, as a high school student. Like, thinking, like, I was actually having kind of a crisis with piano and not feeling I was gonna do it.

And, like, nothing that I played satisfied my teacher. But she assigned me a piece by a composer named Brahms, and it was the first Brahms piece that I’ve ever played.

It was called an intermezzo, Opus 118. It’s one, actually one of the last pieces that Brahms wrote. And it was a piece that, I was able to feel myself in it, and I was able, I felt like I was able to express my voice through that piece.

And I remember playing it. And it was the first time that, in a recital, that my teacher, who again means the world to me and her approval means the world to me, she cried when I played it.

Courtney: Wow.

Dr. Peter Liou: And it was very touching for me too because it almost meant that everything, all the hardship and effort and for me was worth it in the end.

Courtney: And so you recently had the opportunity to travel the world to learn about transplant medicine.

Dr. Peter Liou: Yes.

Courtney: Can you tell us about that? Where did you go? What did you learn?

Dr. Peter Liou: Yeah, so, I’ve been at Columbia all my life, since college, actually. I never left. I want to see how other people do things. And so, Dr. Kato generously gave me three months off last year to be able to travel the world.

I visited nine transplant centers in Europe and in Asia. And it really was eye opening to be able to see some of the  most incredible, amazing, famous surgeons in the world that do transplant. And to be able to talk with them, discuss things with them, question them, argue with them. So it was definitely a wonderful experience.

Courtney: So you were recently called in to assist with the first robotic liver transplant in New York, at NewYork-Presbyterian/Weill Cornell Medical Center. Can you tell us about that experience?

Dr. Peter Liou: Yeah. Oh my. So, Juan Rocca is an amazing surgeon. He’s at Cornell and he’s been planning this and thinking about it for a long time. And we’ve talked about it, him and I, about how we were gonna proceed. And I remember it was, I believe the night before, he called me, he’s like, what are you doing tomorrow? And I said I have some meetings, I think I have to see a patient. He was like, can you, you know, block out your schedule, rearrange it so that you can come, because we’re gonna do, you know, we’re gonna try this robotic liver transplant?

And, of course, it was so exciting. The next day I think I biked, I usually bike to Cornell because it’s easier for me to go across. So I remember biking as fast as I could because I actually had to do a surgery at Columbia the morning. And right after I kind of booked it over to Cornell.

So these are robotic liver transplants. Normally in a liver transplant, you make a big incision from one side to the other to open the abdomen up. But a robotic liver transplant basically involves just five little tiny holes. Right?

And then you make a 12 centimeter c-section scar right near the bottom, and then you take the diseased liver out, and then you put the new liver in through that c-section scar. You put it all the way up in there, and then you sew all the connections with the robot.

And, you know, it is, as with all firsts, it’s, you never know. But, you know, again, all of the planning and the thinking happened, Dr. Rocca did all of that. And I brought some of the experience from Saudi Arabia where they did a lot. And so I had certain ideas also that we were able to incorporate into the transplant.

And I remember, so once we unclamped and we saw the liver turn pink and have color, and I was like, wow, we really did it. And it was really amazing to be part of that team. So I was very fortunate and also grateful to Dr. Rocca and Dr. Samstein for the ability to be a part of that experience.

Courtney: Wow, that’s amazing. Could you describe performing a surgery?

Dr. Peter Liou: Yeah, so for me, all of it is in the preparation. Right before the surgery, I usually will look at the patient’s images, a CAT scan or an MRI, looking at the tumor that I’m about to cut out or the patient’s anatomy or the blood vessels and what I think will be difficult and I anticipate will be a challenge and what will be straightforward, and how I plan my incision and how I think those kinds of things will go.

But you know, a surgery is not just, you know, you go in and you do it. It’s all the training. You know, the nine years of my training and continuous training as I’m a faculty member now, all the things that I’ve learned and I put in that I’ve learned from my bosses and from other people around the world that I was able to do and to be able to incorporate all of that experience and the training into what I’m about to do for this patient.

Often, a lot of surgeons will say, you have to check your emotions at the door. But I think it’s ultimately inevitable, like we have to embrace and we have to, you know, confront the life experiences that we bring, to be able to help us with our craft and to help us pour all of that into the way we do surgery.

So it’s really about that preparation and pouring everything that you have into that moment. And it’s very similar to music, right? It’s everything that you’ve learned, your lived experience from since I was four years old, first touching the piano until now, that goes into the music making of those three minutes or four minutes.

Courtney: Do you consider surgery an art?

Dr. Peter Liou: Absolutely. Of course the ultimate goal of surgery is to be able to help somebody, right? But you are in an operating theater, you know? In a certain sense it’s also a performance. You know?

Another, I think, big similarity is that a lot of surgery is done before the actual operation even takes place. It’s the planning, it’s the thinking about it, it’s the preparation and the also the years of preparation that went into it, right? That allows you to be able to have that performance right there. And for music, you know, classical music, any kind of music, it’s the same thing. It’s one moment, right in time, that is a performance, but it’s really the lifetime experience of the performer that goes into that two minutes or three minutes of music.

And I think that that’s something that for me is very similar and that’s what makes surgery an art.

Courtney: How else has music impacted your life as a surgeon? Any other ways?

Dr. Peter Liou: Music has taught me a lot about failure. When I was growing up it was a lot of hard lessons, a lot of crying. I remember one of my teacher, I really didn’t prepare for a piece of music for a lesson. And I played a piece and it was horrible. I knew that it was horrible, but I didn’t prepare anything. And I remember after maybe about 20 seconds, she stopped me and she said, get out. And I, of course, as a, I think 11-year-old said, or 12-year-old, I said, my mom paid for the lesson, so –

Courtney: Where am I going?

Dr. Peter Liou: Yeah. Where am I going? And, she, I think she was taken aback. So she said, okay, play again. And then after another 30 seconds, she stopped me. She said, you did this wrong, this wrong, this wrong. Now get out. And then of course, you know, I left. So there was a lot of that, you know, a lot of hard lessons.

And I remember participating in some music competitions, piano competitions, and I, you know, a lot of them I didn’t win. You know. So those were, I wouldn’t necessarily say they were failures, but, you know, I wasn’t successful. But it was the idea of being able to learn from those mistakes. What are your weaknesses and how you can overcome them?

And also, don’t settle for mediocrity. Don’t be okay with, ugh, I think this will be okay. You have to really strive for the best that you can be. And I think that really has taught me a lot about being a surgeon. And you have to continue honing your craft and continue getting better.

Courtney: Well, what was it like going back to your piano teacher after that kind of tough lesson?

Dr. Peter Liou: She never let me off on that one. Every time you think, oh, I can get so far because my natural talent has gotten me this far. I think of her voice in the back of my head, you have to keep going.

You have to push yourself a little bit more, a little bit harder. Don’t stop, like, don’t be distracted by other things. You have to really put all your effort into it to be able to achieve what you really want to achieve.

Courtney: It sounds like she really made such an impact.

Dr. Peter Liou: Oh, a hundred percent. I mean every major moment of my life has been impacted by music. You know, being a physician, you really have to have a heart, to be able to devote so much of your awake, sleeping time, you know, I fall asleep sometimes dreaming of surgeries and how I’m supposed to do certain things. I mean, sleeping, awake, everything is devoted into this career and to serving other people.

I think to have a hobby or a passion on the side, to be able to do something for yourself. I think it’s restorative. I think it recharges you so that you can go back to work the next day to do it all over again, and to be able to serve other people and help others.

Courtney: Maybe you could say more about playing to unwind, because I think a lot of us go home and we watch Netflix, you know, and we zone out. You’re coming home and playing this beautiful music. Can you talk about what that feels like?

Dr. Peter Liou: Yeah, so for me, playing is not just about sound and it’s not just about music. It’s about the emotions and the experience that I evoke for myself when I play certain things.

I don’t think I ever played through a piece, even if I’ve played it hundreds of times, that sounds the same. And it really depends on my mood. You know, if I came home after a very successful surgery, my feelings might be different from when I came, when I come home from a very exhausting, very difficult, challenging surgery or when I came home, you know, feeling lonely or will come home feeling a different feeling.

The same song or piece that I play might be interpreted in different ways. But that song is a vehicle that helps me channel some of my emotions and process my emotions. So that’s what I think is the most help for me. The way a piece of music, regardless of what it is, helps me process or understand what happened to myself during that day.

Courtney: I’m wondering if there’s any big moments, any meaningful moments in music for you over your life that had an impact on any choices you made?

Dr. Peter Liou: One of the highlights of my musical career was actually when I was in high school, I won a concerto competition. A concerto is basically a piece that is written for a solo instrument and an orchestra.

And I was able to play a piano concerto as kind of the end of my high school, you know, right before graduation, at one of the most beautiful halls in the world, Severance Hall in Cleveland, with the Cleveland Orchestra.

And it was really a big moment of my life. I played for more than 2000 people. And it was both obviously nerve wracking but also exhilarating. But it was one of those moments that really  taught me a lot because I remember at one point of the piece, the third movement, I was playing, and suddenly the string broke, one of the strings of the piano broke. And I could hear it snap. And at that moment, you know, you have 2000 people sitting in front of you with the orchestra of more than a hundred people sitting, you know, on both sides and you’re in the center. And I remember thinking like, oh no, you know, I could stop or I just have to keep going. And of course, you know, it was a split second, but you had to just keep going and play.

And every time you ran into that note going on forward, I could hear the snap, but I just had to keep going as if nothing happened. And that’s like surgery, like music, like life, you know, when something hits you, you have to just keep going. You have to pick yourself up and keep going.

Courtney: Oh my gosh, that’s so profound. You have to pick yourself up and keep going.

Well, Dr. Liou, it’s been so amazing to talk with you today and hear about music and medicine. Thank you so much for your time and the gift of you playing the piano for us.

Dr. Peter Liou: It’s my pleasure.

Courtney: Our many thanks to Dr. Peter Liou. I’m Courtney Allison.

Health Matters is a production of NewYork-Presbyterian.

The views shared on this podcast solely reflect the expertise and experience of our guests.

To learn more about Dr. Liou’s work with patients, check out the show notes.

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