Without Music, Life Would Be A Mistake.

Why Nietzsche knew music is cheaper than therapy

Michele DeMarco, PhD
9 min readJun 30, 2020

See a dog upon the road

Running hard to catch a cat

Car is pulling to a halt

Truck behind me doesn’t know

Everything is in the balance

Of a moment I can’t control

And your sympathetic strings

Are like the stirrings in my soul…

I could go at anytime

There’s nothing safe about this life.

— Anytime, Neil Finn

The first time I heard Neil Finn sing these lyrics I was standing at the kitchen counter in my family’s home on Martha’s Vineyard. I couldn’t say what day it was or what kind of food I was preparing or whether there was light pouring in through the surrounding glass doors or thunder shaking foreboding skies. What I do remember is the chill that ran like spiders through my spine, and then a dizzying wave — the kind that awakens something primal and forces your eyes closed. Mysterium tremendum et fascinans — the existential mystery that overwhelms, frightens, and fascinates all at once. I had read about it, understood the concept, even felt its effects once or twice in my life, but never from music — until that moment, and it was entirely heart stopping. Who would have known?

Some years later, Neil was again singing this song to me. Again, it was summer — only then, I was standing at the bathroom counter in locked combat with a Corian sink. I had just purchased a home in Newburyport, Massachusetts. Ever impatient to make the place mine, I decided I was perfectly capable of hoisting the vanity from its stand and hauling the engineered beast out the back door, down a rickety and narrow staircase, and into the garage. It seemed like a good idea at the time, as do most things when youthful enthusiasm is on your side. In retrospect, it was the moment when I realized that “anytime” was the ultimate price for life.

Oh, a storm is threat’ning

My very life today

If I don’t get some shelter

Oh yeah, I’m gonna fade away.

— Gimme Shelter, Rolling Stones

Seventy-two hours after mastering the Corian gorilla, I was lying on my back on an operating room table so narrow that even I, hovering at a hundred pounds, was teetering. The room had glistening white walls and shiny steel cabinets, and a paper screen hung in front of my chest, and a monitor was suspended from the ceiling.

“What are all those things that look like spiders,” I slurred happily buzzed, thanks to light anesthesia.

“Those are your coronary arteries,” said Dave, the kindly nurse who was standing at my head, monitoring my vitals.

“Which is the one trying to kill me?” I asked, adjusting myself to get a better look.

“Try not to move,” he said smiling. Then I heard him say, “She needs more …she’s way too coherent.”

I’m not sure I ever did get “more” of whatever drug Dave was referring to, because within a matter of moments, Mick Jagger’s hallowed wail was bouncing off the OR walls. Then came a boom. Then a figure in green appeared out of nowhere, holding his arms up by his head. Everyone in the room — the medical techs, nurses, newly minted Fellows and excitable interns — all snapped to attention. Then, I heard the green man yell over Keith’s guitar solo, “Let’s rock and roll!”

Kenny was his name — well, that’s at least what the patients and staff called him. It was hardly the salutation of some other surgeons whose need for authority was firmly planted in the use of a proper title. And Kenny was what I was instructed to call him when full consciousness returned some hours later in the ICU at Massachusetts General Hospital. “You’ve had a heart attack,” he said, smiling incongruently to the topic at hand. “A pretty nasty and rare one. But I fixed you up … We don’t see your kind around here very often. Everyone’s all excited.”

Boom, swish, swish.

Boom, swish, swish.

Pound, pound, pound, pound.

Boom, swish, swish.

Boom, swish, swish.

Pound, pound, pound, pound.

The next day I was on a gurney, heading to radiology. I passed beneath a sign pointing the way to the MRI. When we got there, a few people gathered around and hustled me from the mobile bed I was laying on to the one at the mouth of the ominous beige tube. My head was pounding. Apparently a heart attack at age thirty-three, for no identifiable reason, with no risk factors or family history to speak of, wasn’t enough to test one’s limits — physically and mentally. Some time in the course of that morning, I’d developed a raging migraine for which treatment, I was told, had to be delayed.

“We need to assess the health of your aorta and carotid artery,” said the tech, “to find out if there’s any indication that your vessels are at risk of giving out. Do you have a problem with claustrophobia?” he asked, lacking Kenny’s comedic compassion.

You’re f***ing right I do! I wanted to yell. I got stuck in an elevator when I was ten, and ever since have hated confined spaces. In all honesty, the reason I didn’t scream in protest had nothing to do with maintaining decorum. It was more that finding words at that moment, let alone speaking them, was like a knife slicing into my scalp. I somehow managed to get out a muffled “yes.” So they gave me a sedative and then stuffed me through the metal hole.

“Breathe in and hold it for ten seconds,” said a lulling voice from beyond. “Now turn onto your right and breathe in again.” What is this, an online yoga class? I thought. How can I uninstall this app? But again the migraine forced my silence. I moved as instructed, inhaling and exhaling on command. Taking direction after direction. Waiting and wondering. A minute is a lifetime when life hangs in the balance.

F*** you, I wanted to yell again — to who or what didn’t matter. I had reached my limit, one foot over the edge, the fall into oblivion a burning desire. My patience for this situation, and frankly, for life itself at that moment, was saturated beyond capacity. I was happy to give myself over to eternity, if it made the pain in my head and the weight upon my chest go away. I closed my eyes, searching for darkness, and instead all I could hear was sound. Boom, swish, swish. Boom, swish, swish. Pound, pound, pound, pound. Over and over. It wouldn’t stop. Was it the machine scanning my life-preserving artery to find out if it, and subsequently my life, was going to irreparably tear to shreds? Was it the eternal heartbeat of life beckoning me to come back? I couldn’t say. All I know is that I’m still here.

I want to live where soul meets body

And let the sun wrap its arms around me

And bathe my skin in water cool and cleansing…

And feel…feel what its like to be new…

— Where Soul Meets Body, Death Cab For Cutie

Death Cab For Cutie is one of my favorite bands — hearts and smarts, gentle yet powerful, edgy and soulful; what’s not to like. What’s curious was that “Where Soul Meets Body” was the first song that randomly came up when I got onto the treadmill at Cardiac Rehab some three months later.

Yes, I said cardiac rehab — the group notoriously spurned by cardiac patients as a waste of time and a “senior’s pick-up joint,” as I once heard it called. The place where balding, barrel-chested men and thick, grey-faced women, with grandchildren older than me, go to be educated about the dangers of a diet that consists largely of doughnuts, drinking, and dessert.

“Try replace’n sow’wa cream with Greek yo-git,” said the stout nurse with a hard-core Boston accent.

“Why live?” said Frank, the seventy-two year-old investment-banker-turned-part-time-fisherman on the exercise bike next to me.

In fairness, cardiac rehab was anything but a waste of time. It was utter comic relief — a Samuel Beckett play spotlighting the absurdity of human existence.

“Just because you’ve had two hip replacements doesn’t excuse the fact that you’re only doing three miles an hour and I’m doing four and a half. Keep up or get off old man,” I once told Grover, the eighty-two year-old who had triple bi-pass surgery and an appetite for the ladies.

“I’d give my heart ten times over if only I could get off again,” he said, smiling.

I listened obsessively to Where Soul Meets Body in the weeks and months after my heart attacks. (I forgot to mention that I had a second heart attack a week after the first— this one brought me to the precipice of existence). I listened to this band especially in cardiac rehab, because it was there where my body and soul both fought and came together: fear and trepidation of doing too much, of it happening again, of never being what I once was; of becoming the shell of my former self; of enduring a life without meaning; combined with seemingly small accomplishments, like lifting a five pound weight, which, I admit, made my heart sing with hope.

Please, remember me…

At Halloween…


As in the dream…

With misery…

Who the hell can see forever…

— Trapeze Swinger, Iron And Wine

My heart attacks, like any others’ heart attacks — like anyone who has faced a significant challenge or loss, setback or transition, or crisis of faith — tore at the fabric of my being: Who am I? Why am I here? What’s the point? Why should I care? Do I actually care? Who do I want to be now?

The following October, three months into life post-heart attacks, was my ex-in-law’s golden anniversary. “Fifty years deserves a trip to Paris,” they told us with smiles on their faces. “And we want our family to come along…on us.” An all-expense paid vacation for two weeks to the City of Light and the surrounding countryside sounded like far better medicine than the triple blood thinning regimen that had turned me into walking bruise. “We understand if it’s still too early for you to come,” they said empathically. The hell it is, I thought, and determined to talk to Kenny.

“Just don’t be stupid,” he told me, leaning against the exam room wall when I mentioned the trip. Again, he was flashing that knowing and compassionate smile. “Take it easy on the hills. Get others to lift your suitcase…”

“And enjoy the wine,” I interrupted. “I hear it’s good for your heart.”

He smirked and nodded. “You don’t have a sword of Damocles hanging over your head. Go live your life. If it happens again, which we hope and expect it won’t, come back and I’ll fix you up…Just don’t wait three days this time before coming in.” (Mistake number two after yanking out the Corian sink.)

I boarded the plane in early October with a lightweight bag, a translated printout of my medical history, as well as the name of Kenny’s French-surgeon-friend, “just in case,” and a feeling of calm that I hadn’t had — in truth, ever. You see from the time I was young, I feared the unknown, the darkness — the fact that life here on earth has a shelf life with no identifiable date, but that beyond that is anyone’s guess. The idea of death was anathema to me, and yet the idea of forever too much to conceive.

I buckled into my seat, took out a piece of Juicy Fruit gum, and tried to forget that eight years prior, my brother-in-law died tragically on a commercial airlines flight. And for the first time it was easy to do. I watched out the tiny, oval window as a man waved his arms to guide us backwards. I sighed loudly when we turned, stopped, and waited for those ahead of us to take flight. And when the engines roared and the cabin shook and we motioned forward, first slumbering, then accelerating, and finally lifting off, I closed my eyes knowing that “ I could go at anytime.” And that even in the midst of sun and warmth, a “storm is always threatening my life.” That the “boom and swish and pound” that we all will experience at some point is nothing more than the natural rhythm of life that keeps us awake and alert, yet also lulls us into existence. And that “body and soul” work to reveal each other, and go hand in hand, like inseparable lovers, or perhaps even like adversaries who need each other, and sustain each other, when both are under threat.

When we reached 30,000 feet and the seatbelt sign went off, and I realized that the ascent wasn’t going to cause my heart to blow open again, I turned my iPod to another favorite artist, one whose lyrics never fail to capture the beating heart of life, the colorful panoply of human experience, and whose sound both slays and stimulates with every note. “Please…remember me,” sang Sam Beam of Iron And Wine, “happily…fondly…at Halloween…mistakenly…as in the dream…with misery…seldomly…finally…who the hell can see forever…” Who the hell would want to? I thought, sipping the wine Kenny agreed I could enjoy. It only would kill the dream.

The spectrum of things that lift us up, soothe our soul, offer a balm, provide meaning, and call us into existence is infinite. But as Nietzsche said, “Without music, life would be a mistake.”



Michele DeMarco, PhD

Award-winning writer, therapist, clinical ethicist, and researcher specializing in moral injury. I talk about the stuff many won’t. micheledemarco.com