Right Treatment Requires Right Diagnosis

If I had gone into medicine instead of music, my income would likely be considerably higher than it is.

That statement is obviously true, and it is true for a reason. Not only do physicians train for longer than I did (my time in school was similar to that of an M.D., but I did not have the residency afterward), but most spend more on that training. Even more importantly, physicians risk more in the practice of their profession. While all medical doctors seek the improved health of their patients, success in this endeavor demands not only good intentions but accurate diagnoses combined with effective treatment. The consequences of an incorrect diagnosis and/or misapplied treatment can be catastrophic, and as a result, good physicians not only must carry expensive malpractice insurance, but also the weight of a conscience burdened with questions of life and death on a regular basis. As a musician and music teacher, I never deal with such weighty matters, and that is one reason why I am not compensated like a physician. I consider that a reasonable tradeoff.

There is, however, one key similarity between the work of a physician and the work of a music teacher: the importance of accurate diagnosis. I learned many years ago that error correction in music practice—whether individual or ensemble—consists of a simple three-step process: detect, diagnose, remedy. The player or conductor first hears the problem, then (usually through repeated hearings of a passage) identifies the source and likely cause of that problem, and based on that diagnosis prescribes a solution or remedy. The middle step—the diagnostic step—is the vital one, and when it is poorly executed or omitted altogether the entire process fails. A common scenario in both individual and group practice is the absence of that step, so that the process consists of detection and then immediately proceeding to a remedy, which is some variant of “do it again and hope it’s better.” To be sure, sometimes repetition to gain greater familiarity is the appropriate remedy, but more often some underlying problem must be identified so that it can be effectively corrected.

One version of misdiagnosis I often see in my applied students is the failure to recognize timing problems. These problems are obvious in students who struggle to keep a steady beat or to count rhythms correctly but are harder to rightly identify in students without obvious rhythm or beat problems. With these students, the ill-timing is very slight and manifests itself as minor problems with the breath (feeling of too little air or excessive tension), embouchure (chipped notes), or articulation (delayed or explosive attacks). All of these are essentially problems with coordination, brought about by the poor sense of timing. Without accurately diagnosing these as timing issues, students are left spending hours in the practice room trying to fix their embouchures, tongue correctly, or take better breaths, all to no avail because the underlying timing issue is still there. Fix the timing, and many of these issues will evaporate. If any “actual” breath/embouchure/tonguing problems remain, they can then be addressed.

So how is the timing problem to be solved? The first step is simply to identify it correctly, to understand that the matter to be addressed is timing/coordination, not these other issues that flow out of it. Secondly, work to establish a stronger sense of time, understanding that what I am talking about is “feeling the beat” in an internal, really visceral sense. Metronome use can help, but sometimes drum machine apps are even better, often combined with tapping the toe, marching in place, or otherwise moving to the beat somehow in order to promote this “felt time.” Thirdly, breathe in and out in time, in a single motion that does not stop. Holding the breath between the inhalation and the beginning of the note introduces a hitch into the process that will result in a chipped note, a delayed or explosive attack, or a feeling of tension that makes it seem like one has too little air. In other words, failing to time the breath well leads to one or all of the issues I mentioned in the previous paragraph. Make sure your sense of time is solid, and then breathe and play in coordination with that sense of timing.

The Breathing Book by David Vining

A resource that really helps with this is The Breathing Book by David Vining, which is available in editions for all brass instruments as well as voice and some woodwinds. While Vining discusses the physical process of breathing, much of the book has to do with the timing and coordination of the breath and its effects on other aspects of playing. The positive effects of getting this right extend to all the matters I’ve discussed here.

When I was a young student, I wondered why so many of our music events were referred to as “clinics,” as I had known that to be a medical term. But we music teachers are, at our best, diagnosticians, and so the word appropriately describes what we do to identify and fix students’ problems. Maybe we’re not all that different from physicians after all, but I’m still glad that playing the trombone is rarely a life-or-death affair.

About Micah Everett

Micah Everett is Associate Professor of Music (Trombone/Low Brass) at the University of Mississippi, Principal Trombonist of the North Mississippi Symphony Orchestra, Tubist/Bass Trombonist of the Mississippi Brass Quintet, Bass Trombonist of the Great River Trombone Quartet, Assistant Editor (Audio/Video Reviews) for the International Trombone Association Journal, and an S.E. Shires trombone artist. He is the author of THE LOW BRASS PLAYER'S GUIDE TO DOUBLING, published by Mountain Peak Music, and released his first solo recording, STEPPING STONES FOR BASS TROMBONE, VOL. 1, on the Potenza Music label in 2015. In addition to his professional work, he maintains an avid interest in the study of the Bible and of Reformed theology. He holds doctoral and master's degrees in music from the University of North Carolina at Greensboro, a bachelor's degree in music education from Delta State University, and a certificate in systematic theology from Puritan Reformed Theological Seminary. The ideas and opinions expressed here are not necessarily shared by the employers and organizations with which the author is associated.
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