Opinion: Whale songs: the sounds of love and loss as heard by an OB-GYN

I had a recurring nightmare as a child: floating alone in an open sea, the water quaking beneath me until a whale, roaring and howling, rose up and swallowed me whole. In real life, I first heard a whale song on solid ground, in an even scarier place: the intensive care unit. During my third year of medical school, my back pressed against the nursing station wall, I seemed to wilt as Jake’s mother’s wails filled the room. Guttural and uncontained, they undulated around the ICU, forming a kind of bass line; her gasps for air added staccato; her words, slurred beyond recognition, formed a double chord. Hours earlier, Jake (not his real name) had been playing soccer with his young daughter. Now, after an unexpected heart attack, he lay in a coma. In the deep oceans, whales produce groans, snorts, and howls so powerful they can travel hundreds of miles, yet so intricate they form music-like patterns. What I heard in Jake’s mother that day was a whale song for her dying son, deafening cries melted into globs of sound, so tender, yet with the ferocity to reverberate for miles. Poetry of some sort. Every medical trainee has an introduction to death. This was mine. I had attended funerals before, but their structure — program pamphlets, scripted eulogies, sandwich spreads — contained grief within something familiar. These were all rituals to honor the end of life, but a bit stoic. They were not a reckoning with death itself. The ICU was different. That day abruptly ushered Jake’s family into a new act, like a curtain dropping at intermission. Before the asthma attack, after the asthma attack. Before dad’s death, and after. In a far milder way, this was also a new act for me, a trainee realizing the limits of medicine like a child learning that her favorite superhero is a fantasy. Inevitable — necessary, even — but so painful in its loss of innocence. Now having just graduated OB-GYN residency, I have developed a trained ear for many kinds of “humanized” whale songs, especially the types sung by women. The quiet sobs of a woman in the emergency department at 2 a.m., her body expelling a much-wanted pregnancy, land like soft classical. The sharp howls after a patient traveling from abroad presented with a full-term fetal demise? That rang closer to punk rock, raw and searing, echoing down the halls. I recall one Friday afternoon in clinic, an elderly patient’s powerful cries after learning she had ovarian cancer — an operatic overture. The thing is, whale songs are not necessarily about death, but about loss of identity — as an imagined mother, as a person with hopes for what life may hold. They are as much eruptions of love for who we believed ourselves or our loved ones would become as they are the devastation when that envisioned future is taken away. Whale songs are expressions of loss — though also perhaps our most honest window into our greatest joys. While I wish whale songs on no one, they are ultimately for everyone. And we must learn to soften rather than recoil from their sound. Years ago, after Jake died, my instinct as a medical student was anger — clenching my teeth and jabbing a pen into my notepad, making a line of inky holes along the margin. Now, I have the courage to pause, stay in the room longer, and listen harder. Presence is an earned skill. It took work, not just time, to develop. I attribute this growth in part to repeated exposure, but most of all to learning how to listen with the attention of an artist shaping a nuanced chord progression. I am not a musician and have very little natural ear for rhythm — just ask my guitar-playing husband. Still, it makes sense that my brain understands grief through sound. Music has been shown to increase emotional perception, strengthen social connection, and help regulate mood. It may even carry physiologic effects like slowing heart rate and lowering stress hormones. By nature, my brain is listening for harmonies even with zero musical training. In practice, actually hearing rhythm within the cacophony of grief anchors me in the present, pulling me out of dissociation and into a shared vulnerability. It is no match against the shield of the white coat. After all, doctors are humans before they are doctors, and I often find myself wondering: Whose whale songs will I sing? And who will sing mine? Memory tends to lose sound quickly, but even years later, Jake’s mother’s wails play with the same staccatos and double chords. It’s no longer a childhood nightmare — the version where I am crept up on by a large beast — but rather a sign of humanity, of being reminded that I am just one among every human trying to find meaning in their place on this Earth. As a physician, I see it as a reminder that even when medicine can go no further, there is truth and meaning in the shared grief that surfaces. This summer, as I think of the new medical students and residents beginning their first days of training, memories like Jake’s mother’s cries are still sounds I carry forward with me. I wonder if some of them will soon hear their first “whale song.” To me, they are perhaps the rawest reminder that in medicine, we are privileged to witness, time and time again, the most honest forms of connection and the truest expressions of human existence. Perhaps whale songs — wail songs — are never truly lost if they were once truly heard. And I know I will keep listening. Caroline Cherston, M.D., grew up in New York City, where she completed medical school and OB-GYN residency training. She is now in the Bay Area pursuing a fellowship in reproductive endocrinology and infertility.