While medicine is a noble calling, it doesn’t always scratch that creative itch. Michael Ehrenreich, MD, is the medical director of SOMA Skin and Laser in Millburn, N.J., and chief of the division of dermatology at Newark Beth Israel Hospital, but his credentials don’t stop there.
He is also the writer, lyricist, and composer of “Medicine: The Musical” — a theatrical production that chronicles the trials and tribulations of first-year medical students … in song.
Ehrenreich has started a Kickstarter campaign to bring his dream to Broadway (well, Off-Broadway).
I spoke with Ehrenreich about the show, med school in general, and the allure of the open stage.
Following is a transcript of the conversation:
Wilson: I’m joined today by Dr. Michael Ehrenreich. Dr. Ehrenreich is the Medical Director of SOMA Skin & Laser and Chief of the Division of Dermatology at Newark Beth Israel Medical Center. He is also the writer, lyricist, and composer of “Medicine the Musical.” Dr. Ehrenreich, thanks very much for joining me on Doc-to-Doc.
Ehrenreich: Thank you so much for having me with you today.
Wilson: Before we dive in, lets listen to a brief clip from “Medicine the Musical.”
Male Performer #1: Things today, Professor, they’re re not how they used to be. I used to make my rounds on the self-seeing rounds, I took all the time I needed until the task was completed. Yes, I signed out those bills. Yes, I buried those skills. But I got the respect for this hard-earned intellect. Now, I hump these halls like [INAUDIBLE].
Wilson: Dr. Ehrenreich, medicine ain’t what it used to be. It’s an interesting way to open this. What were we looking at there? Who was performing that?
Ehrenreich: I think that we all know a guy kind of like that, we have all bumped into somebody. In that scene, there is kind of an older doctor and he is encountering the professor rounding with his students, just kind of in front of all the students and oblivious to what their response might be. He goes into this, “Medicine ain’t what it used to be.” Then the professor who really loves medicine with a passion, despite any changes or difficulties he’s having, kind of goes on to defend it.
It’s interesting. Most of “Medicine the Musical” has no basis in fact. None of this happened to me. But this one scene actually was inspired by a real event when I was an intern. I was rounding. It was in the middle of the night with cardiology, at 3 in the morning, and some doctor comes out of our stairwell and talks to the attendee that I’m with, and he says, “Had you known it was going to be like this 20 years ago, wouldn’t you have just killed yourself?” The doctor that I was with, rounding with residents, turns to him and says, “No, absolutely not. We have it better than 99% of the people.” That moment stayed with me and that was the inspiration for that one particular moment.
Wilson: After all this time out of medical school, do you think you identify with that attending physician more than the older, curmudgeonly doctor?
Ehrenreich: I was not part of a generation before mine that has seen a lot of changes. Medicine, for me, is the current state of the world. But you hear from the doctors who are little bit older than me about how things are changing. But I still feel very much that it’s a privilege to practice medicine and that no matter what’s happening in the world and the changes in the environment, that we have a great profession. We have it better off, in many ways, both professionally, job satisfaction on what we’re doing, the good that we do in the world, as well as financially. We have it better greatly than many people, and we should be thankful.
Wilson: Let me ask. When did this start coming up in your head? Have you been thinking about this since medical school? Or is this a more recent invention?
Ehrenreich: The idea of a musical about medicine was in my head since medical school. None of the concepts, none of the songs that are in the show today were conceived of then. It was always just kind of a joke that I would have with my wife that medicine would make a great musical. I would hum some stupid song sometimes.
But then, about a year and a half ago, last summer a year ago, my wife and two kids went away for a week to visit our parents. I was left alone and in the evenings I had more free time than I usually do. I sat down and I just started writing. I wrote half of the show in a week; it really just kind of flowed. I finished it in about 3 months, the entire show beginning to end, books, lyrics, and music.
Wilson: “Medicine the Musical” follows first-year medical students, right? Can you give us a brief overview of the plot?
Ehrenreich: Yes. If it follows a group of first-year medical student through their first year of school. There are trials and tribulations, both with the academics and the rigor of the education, as well with their personal life, the baggage that they bring with them. It’s not … for those that have gone to medical school, which would include most of our viewership here today, many elements will be familiar. You’ll also, of course, recognize places where I took artistic license to communicate what I was trying to get across.
Wilson: What do you think is the main focus? What are you trying to remind people, like me, who went through medical school, or show people that didn’t have the privilege of going through medical school?
Ehrenreich: I think that the main element really is how difficult it is. For people to appreciate the audience in general, not physicians, to understand a lot of the pressure that both medical students, as well as physicians in the real world, are under. It’s very easy for people, patients, and the community to forget that under the white coat doctors are people. This is a human element, I feel, to medicine. The history of the medical students, their drive to accomplish what they want to accomplish, the obstacles that stand in their way, they all come across.
Wilson: I often tell my medical students this when I’m rounding with them, and I believe this, I think medical school is potentially the most stressful part of all of medicine — including internship and residency — because you’re under just so much scrutiny. Everything you do is graded and stuff. The intern is covering 20 patients and sort of gets a pass if they aren’t perfect when they present the clinical history, but the med student is under a spotlight the entire time. It’s a tremendous amount of pressure.
The musical deals with this in some pretty heavy ways. I want to play a clip from a song called, “One Cut,” which is a surgeon talking to a medical student.
[ONE CUT CLIP PLAYS]
Male Performer #1: In the house of medicine, surgeons are kings. Hence, today you are princes. Yes. So who will make the first decision for me? Blake? Perhaps my son will? Step up. Show them how it’s done.
Blake: One cut. One cut of the night.
Wilson: Dr. Ehrenreich, take us through that. What’s happening in that scene? In that scene, there is a medical student, Blake. Up until this point, he has kind of been the bad guy, the gunner medical student through all this. He is actually in this scene with his father, who is a surgeon. In this particular scene, we learn that Blake never really had the drive. He never wanted to be here. He was succumbing to pressure from his father. In this scene, obviously, I did take a lot of artistic license here. He is in the operating room assisting and he makes the decision to accidentally nick himself with the blade to get out of doing the procedure and potentially never having to do anything like this again.
Blake: The blade slipped.
Male Performer #1: Okay, get him out of here. Get him out.
Wilson: It’s not something that you saw in your own training, but it’s something evocative of some of the pressures, especially that children of doctors might feel.
Ehrenreich: Right. I mean, certainly I never did see anything like that, but one of the lines there where — it’s not in that scene that you’ve mentioned, but it’s again from his father — he talks about you have two choices in life, you can either be a surgeon or you can waste your life. That is something that I have actually heard said.
Wilson: I think I have heard similar sentiments myself. Now, it’s not all focused on the trials and tribulations. There are some lighthearted moments in the musical. My favorite, I think, was a song you wrote called “Objective Structured Clinical Exam.”
Male Performer #3: There has been this sort of pain that’s been pressing at my chest. Sometimes when I’m walking, but mostly when I rest.
Female Performer #1: How would you describe its nature?
Male Performer #4: Is it sharp or is it dull?
Male Performer #5: I need an accurate location. Is it high or is low?
Female Performer #2: Is it left or is it right? Worse in the morning or at night?
Male Performer #5: Take a breath. Now hold your breath. I’ll count to 10. I’ll tell you when.
Female Performer #3: How long have you had this problem?
Female Performer #1: How long does each pain last?
Male Performer #6: Do you have gonorrhea?
Wilson: This has got to be the first wrap about fake patients that I have ever heard. What’s the inspiration there?
Ehrenreich: Everybody, I think, has done an objective structured clinical exam, or an OSCE. I just wanted to capture it. I think that a lot of the world that they don’t understand this kind of clinical training. It kind of brings you inside a little bit and you kind of see the simulated patient scenarios and some of the things that you go through. It is obviously musical. But the two scenarios that are kind of referenced there are actually two common OSCE scenarios that are kind of woven into there. I just wanted a fun way to bring that across.
Wilson: The goal is to bring this potentially off-Broadway. You’ve got a Kickstarter set up that will link to raise funds. How is that going and what level of interest have you seen?
Ehrenreich: Yes. What I did after I finished writing this is, I had to figure out what do you do with this. I’m not from the theatre world. This is an anomaly. I started kind of learning about how Broadway works and theatre works. The first step I did was organize that stage reading that you’re showing the videos from. But then I looked at the economics and the financials of trying to bring a show to Broadway.
Now, Broadway is a $10 million type of endeavor. It’s beyond the scope of what I’m trying for. But off-Broadway, kind of a first class production could be done for a few hundred thousand dollars, or even less, a more minimalist workshop production. I’m doing this Kickstarter to raise enough money to do it. Pretty much, whatever we raised, that’s going to be the scale of production. If we raise hundreds of thousands of dollars, it’s going to be a first-class, off-Broadway production. If we raise less than that, it will be more of a workshop or more of an off-off-Broadway production.
I launched the Kickstarter about 2 weeks ago or so with a minimum goal of $20,000, which would be enough just for the minimum kind of workshop production. We’re a little bit more than halfway to that goal right now.
Wilson: Are you working on a sequel? Are we going to see “Residents the Musical,” or “Fellowship the Musical,” “Exhausted Attending the Musical?”
Ehrenreich: No. I’m not working on a medical sequel. I do have another show, though, that we’ll be doing a stage reading of in April. It has nothing to do with medicine though.
Wilson: Well, best of luck. It’s amazing work. I hope to see it off-Broadway. We’ll link to the Kickstarter. Thank you very much for joining me today on Doc-to-Doc.
Ehrenreich: Perry, thank you so much for supporting this show and taking an interest.