I have written in this column before about medical humanities and the value of doctors studying literature, art and movies. In this article, I want to attempt something a little more adventurous: to write about music and religion in that context too. Writing about music is especially challenging because, by its nature, music expresses what words cannot. It may be even more risky to address religion since people sometimes lose interest when they read about a faith that is not their own or indeed about any faith at all. Bear with me: I will provide a link to the piece of music so you can actually listen to it if you want—and also let you know about a movie where you can hear it. As for the religious part of this article, I can reassure you it is mainly about sex.

By looking at these different forms of cultural expression, I hope to show how they can enrich our work as doctors. They all have the potential to point us to ways of understanding the world that are richer than anything that medicine can offer by itself. More important perhaps, they also help to promote what is sometimes called ‘cultural humility’. This refers to the practice of self-reflection and self-critique in relation to the ingrained assumptions, prejudices and stereotypes we all hold. Cultural humility is being emphasised increasingly in medical education so that doctors can learn to approach patients from other cultures with appropriate respect for their different traditions and world views.¹

The piece of music I want to draw attention to is by the 18th-century Venetian composer and Catholic priest Antonio Vivaldi. Even if you aren’t a classical music fan, you will almost certainly know his ‘Four Seasons’ which one hears endlessly as a jingle in advertisements and even when call centres put you on hold. You are less likely to have heard his setting of Psalm 127 from the Bible, although if you have any connections with Judaism, Christianity and Islam, you may well know the psalm itself. In English, it begins ‘Unless the Lord builds the house, the builders labour in vain’. Further on in the psalm, it becomes apparent that it is not really about literal house-building but more about building a house in the sense of a dynasty.

In Vivaldi’s setting of the psalm, there is one extraordinarily beautiful aria or song—perhaps one of the most beautiful in the history of music. It is sung in Latin, but in English the words are simply: ‘For he grants sleep to those he loves. Children are an inheritance from the Lord; a reward, the fruit of the womb’. The most exquisite performance I know is by the French counter-tenor Philippe Jaroussky. It is only around 3 min long, and there is a link to it in the first reference below.² You may choose to pause and listen to it now, although you may derive more from it if you read the rest of this article first. All the verses of the psalm appear below in the original Hebrew, probably written 2500 years ago, as well as the Latin translation used by Vivaldi and an English version (see figure 1).

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Figure 1

Psalm 127 in Hebrew, Latin and English.

SUBTLE ALLUSIONS TO SEX

When you listen to the aria, you may form the impression that it is more of a romantic or even erotic song than a religious one. In fact, the distinction between these may not be as clear as most people living in the west in the 21st century might assume. Although this isn’t mentioned in standard biblical commentaries, scholars from different faiths have pointed out that the psalm is full of subtle allusions to sex. Consider, for example, the two sentences the aria is based on. At first sight, they seem unconnected, since the first is a statement about the Lord granting sleep, but is followed by another that speaks of children as the fruit of the womb. The connection becomes more obvious if you think of the English phrase ‘to sleep together’: sleeping doesn’t always mean being asleep. It may be a euphemism for sex. Or look at the lines just before this in the psalm: ‘In vain you rise early and stay up late, toiling for food to eat’. Taken altogether, a summary of these verses might be: ‘Hard work can increase your crops and your profits, and help you to build a lovely house and grand estate, but only another kind of exercise will produce a dynasty. For that, you may need to stay in bed’.

In other eras, such allusive ways of addressing sex have been taken for granted, and in many cultures they still are. A sermon by the great Christian theologian Saint Augustine included an account of the psalm as follows: ‘I think the prophet has handed us something like a wrapped parcel, so that we don’t lose heavenly happiness by pursuing temporal, earthly well-being’.³ That may sound innocent enough, except that the Latin word translated here as a wrapped parcel (‘involucrum’) is really the military word for a shield-case. It was generally paired with the word for the sheath of a sword, which happens to be ‘vagina’—commonly applied as a metaphor to something entirely different by the Romans, and by doctors ever since. In the same vein, the modern Jewish commentator Marc Zvi Brettler points out that the Hebrew word for quiver, appearing near the end of the psalm, may also reflect vaginal imagery. He speculates that the psalm might have been used by women as a prayer for fertility.⁴

CONTRADICTIONS AND COMPLEXITIES

It so happens that Vivaldi’s aria also features prominently in a wonderful French movie called ‘Tu seras mon fils’ (‘You will be my son’) directed by Gilles Legrand.⁵ This tells the story of a fashionable winemaker who thinks his only son is rather wimpy and wants to pass on his estate on to the more masculine and aspirational son of his estate manager. I won’t give the plot away, but it isn’t a spoiler to let you know that the winemaker ends up dead. You know this from the beginning of the movie because it opens with the scene of his cremation, with Vivaldi’s setting of the psalm on the soundtrack. I guess the film-maker was hinting to viewers that the owner of a chateau who plans to disinherit his son might come to a sticky end. He presumably understood that the psalm was not about sex for its own sake, but stresses the importance of procreation and inheritance.

As these related works all demonstrate, listening to music, reading significant texts or watching movies can expose us to ancient and modern wisdom about the core aspects of life, like sex and procreation, succession and inheritance. We also encounter contradictions and complexities that we might otherwise never be challenged to think about. If we can learn to grapple with the humanities in this way, I hope we may also learn to approach the people we treat who seem different from ourselves—on account of their faith, culture or for any other reason—with the same degree of curiosity, attentiveness and openness to surprise. And now, please enjoy reading the whole psalm, listening to the music and maybe even seeing the movie!