Art, wine, and medicine

William Shakespeare (Fig. 1), English playwright, poet, and actor. Many things influence the growth and quality of grapes including climate, soil, disease, the clone of the vine and the use of pesticides. One of the issues that may influence grape quality, and about which little is written, is the influence of music on vines/grapes. My eye, on this subject, was caught recently in Tuscany, when I came across a vineyard called Il Paradiso di Frassina, makers of Brunello di Montalcino. The oenologist Carlo Ciqnozzi apparently plays Mozart’s (Fig. 2) music daily to his vines and claims that the vines grow more vigorously [1]. Whereas this claim is obviously difficult to verify, it may well be true if the soothing effect of that composer’s music on humans is anything to go by! Mozart’s premature death is a subject of interest to music lovers and doctors; however, recent evidence suggests that he died of renal failure [2]. There is no doubt that listening to music while imbibing the beautiful nectar can add to one’s pleasure. The scene from the film ‘Bottle Shock’ (director Randall Miller 2008), where Miguel Sandoval is drinking wine while listening to Maria Callas, is especially enchanting. William Congreve’s 1697 play the ‘Mourning Bride’ contains the famous lines: ‘Music has charms to sooth the savage breast’ and this is as true now as when it was written, although it may sound a little colonial! To bring matters even further, the composer and environmental activist Ryuichi Sakomoto (Fig. 3) (the doyen of electronic music who died in March 2023) has written ‘Suite for Krug in 2008’, a three-movement symphony inspired by drinking Krug, Clos du Mesnil 2008 and Krug, Grande Cuvée 164th edition. Although originally conceived as an advertisement for Krug champagne, I am sure you could drink any good champagne while listening to Sakamoto’s symphony and one would enhance the other. As well as writing electronic music he was a renowned writer of film scores, the most well known is probably the score for Bertolucci’s The Sheltering Sky (1990) [3]. What has all this got to do with haematology? Hypertension is a huge problem in the developed world, and even though it involves blood vessels and their content, I do not think most haematologists pay much attention to this problem. There have been numerous studies to demonstrate that listening to music can have a beneficial effect on elevated blood pressure [4]. Unfortunately, most doctors show little interest in this type of intervention and solely concentrate on curative modalities. Although curative interventions are of great benefit to patients, the level of anxiety and depression suffered by these patients is rarely addressed in clinical practice. As most physicians have not experienced prolonged periods of isolation or sensory deprivation while enduring severe and sometimes life-threatening illness, this may explain their lack of interest in such phenomena. Could it be that other art forms have a beneficial effect on other medical conditions? Art therapy, as defined by the American Art Therapy Association, is a mental health profession that enriches the lives of individuals, families, and communities through active art-making, creative process, applied psychological theory, and human experience within a psychotherapeutic relationship. Although art therapy has many beneficial effects, it requires patients to have adequate cognitive ability and mobility and be able to cooperate with the healthcare professional. However, art

'The man that hath no music in him, is fit for treason, stratagems, and spoils……Let no such man be trusted' William Shakespeare (Fig. 1), English playwright, poet, and actor. Many things influence the growth and quality of grapes including climate, soil, disease, the clone of the vine and the use of pesticides. One of the issues that may influence grape quality, and about which little is written, is the influence of music on vines/grapes. My eye, on this subject, was caught recently in Tuscany, when I came across a vineyard called Il Paradiso di Frassina, makers of Brunello di Montalcino. The oenologist Carlo Ciqnozzi apparently plays Mozart's ( Fig. 2) music daily to his vines and claims that the vines grow more vigorously [1]. Whereas this claim is obviously difficult to verify, it may well be true if the soothing effect of that composer's music on humans is anything to go by! Mozart's premature death is a subject of interest to music lovers and doctors; however, recent evidence suggests that he died of renal failure [2].
There is no doubt that listening to music while imbibing the beautiful nectar can add to one's pleasure. The scene from the film 'Bottle Shock' (director Randall Miller 2008), where Miguel Sandoval is drinking wine while listening to Maria Callas, is especially enchanting. William Congreve's 1697 play the 'Mourning Bride' contains the famous lines: 'Music has charms to sooth the savage breast' and this is as true now as when it was written, although it may sound a little colonial! To bring matters even further, the composer and environmental activist Ryuichi Sakomoto (Fig. 3) (the doyen of electronic music who died in March 2023) has written 'Suite for Krug in 2008', a three-movement symphony inspired by drinking Krug, Clos du Mesnil 2008 and Krug, Grande Cuvée 164th edition. Although originally conceived as an advertisement for Krug champagne, I am sure you could drink any good champagne while listening to Sakamoto's symphony and one would enhance the other. As well as writing electronic music he was a renowned writer of film scores, the most well known is probably the score for Bertolucci's The Sheltering Sky (1990) [3].
What has all this got to do with haematology? Hypertension is a huge problem in the developed world, and even though it involves blood vessels and their content, I do not think most haematologists pay much attention to this problem. There have been numerous studies to demonstrate that listening to music can have a beneficial effect on elevated blood pressure [4]. Unfortunately, most doctors show little interest in this type of intervention and solely concentrate on curative modalities. Although curative interventions are of great benefit to patients, the level of anxiety and depression suffered by these patients is rarely addressed in clinical practice. As most physicians have not experienced prolonged periods of isolation or sensory deprivation while enduring severe and sometimes life-threatening illness, this may explain their lack of interest in such phenomena.
Could it be that other art forms have a beneficial effect on other medical conditions? Art therapy, as defined by the American Art Therapy Association, is a mental health profession that enriches the lives of individuals, families, and communities through active art-making, creative process, applied psychological theory, and human experience within a psychotherapeutic relationship. Although art therapy has many beneficial effects, it requires patients to have adequate cognitive ability and mobility and be able to cooperate with the healthcare professional. However, art therapy may also be of benefit to individuals with dementia and other cognitive disorders.
Will a reduction in anxiety/depression result in a more rapid cure rate? No, it certainly will not, but it might make the time in the hospital less fraught for patients. As I have said, most doctors pay little attention to this aspect of medical intervention in the adult setting, but it might be very important. In order to investigate the role of a multimedia intervention in a bone marrow transplant unit, several colleagues and I set up a randomised, prospective study called 'Open Window' to interrogate the effect of an art intervention on anxiety, depression, and the expectation of the bone marrow transplant procedure [5].
When qualitative data were analysed, patients in the intervention arm commented freely on their likes and dislikes about the 'Open Window' project and how it made them feel. An unexpected finding was the opportunity provided for patients to discuss 'Open Window' with staff and visitors rather than their medical complaints.
Those participating in the intervention arm had significantly lower levels of anxiety and depression compared with patients in the control arm. Participants in the intervention arm also reported a significantly better experience of the transplant procedure when compared with those in the control group. We concluded that this art intervention had had a positive influence on health-related quality of life and patients' experience of having a bone marrow transplant. The details of the study can be found in reference [5]. Despite this study's results, doctors from Singapore to the NIH in Bethesda, USA, showed little interest, although nurses, psychologists and psychotherapists found it extremely interesting. Musical intervention may also have a beneficial effect on the immune system [6,7].
Music plays a major role in all human cultures: it is listened to and played by persons of all ages, races, and ethnic backgrounds and can influence physiological processes that enhance physical and mental wellbeing. Music therapy can be used as an adjunct to other medical treatments or in a more informal way be incorporated into an intervention such as 'Open Window' [8]. Overall, changes have been observed across various immune response biomarkers, including leukocytes, cytokines, immunoglobulins, and hormones and neurotransmitters associated with immune response. As Rebecchini says [6], music has begun to be taken seriously in healthcare settings as research findings have started to link the beneficial effects of music on stress to a broader impact on health.
There is no doubt that the focus of medical treatment is now on cure, especially of malignant diseases, for which patients are extremely grateful. Recent developments in the use of immune modulators have significantly reduced the toxicity associated with chemotherapy. The treatment of severe benign or malignant disease often requires prolonged periods in the hospital. Although outcomes may or may not be associated with a cure, it is incumbent on the medical profession to attempt to improve the quality of life for patients without compromising potential curative medical interventions.
Whether or not musical or other art interventions have any influence on vine/grape growth/ripening remains to be fully elucidated; however, the experience of listening to music while imbibing the beautiful nectar can add to one's enjoyment.