Track 2, Side 2: Madame George by Van Morrison
For those times when you just need to regroup and recharge
My dad taught me every epic journey deserves a great soundtrack. My PalliMed Mixtape is the story of my Palliative Medicine Fellowship year, told in 15 songs.
Where do we go from here? I am always left breathless by the soaring heights of the outro guitar solo on Comfortably Numb. How do we regroup after Pink Floyd and keep moving forward on this mixtape? How do we recover from the emotions of the hospice house? We need a reset. Time to come down off the cortisol. Time to re-center. Time for Madame George.
I have been a lifelong Van fan (everybody okay if we just call him “Van”?), but I had somehow missed Madame George until a few years ago. It’s the second song on side 2 of Van’s 1968 masterpiece, Astral Weeks, and at first listen, it demands very little of us. If this is your first time hearing it, you’ll find it’s quite stunning in its simplicity.
We hear three chords strummed quietly on guitar at a slow pace—the progression never changes! A gentle accompaniment on the stand-up bass, a playful roll on a snare drum, and some accompanying strings and flute gradually join in as Van’s lyrics walk us through scenes from his hometown of Belfast, Northern Ireland. With its nearly ten minutes of soothing steadiness, we can feel our bodies and our minds progressively relax as the song meanders on.
When you fall into a trance / Sitting on the sofa playing games of chance…
And as you leave the room is filled with music / Laughing, music, dancing, music all around the room
But while the music of this song is very easy, Van’s words demand of us a little bit more. Van never offers explanations of his songs’ lyrics, often claiming that he, himself, doesn’t even know what they mean. But to my mind, Madame George, with its vivid descriptions of scenes from Belfast’s Cyprus Avenue and Madame George’s upper room, has at least one clear message, or rather, an invitation. This invitation comes not through heavy-handed moralizing or instruction, but through proximity and familiarity. The song invites us to look closely at a person on the fringes of 1960’s Irish society, to realize that this person matters, and to have empathy. That’s all.
Madame George, it seems, lives on the margins—an outcast of sorts. In Madame George we find a person who may not live like us, but who needs our love, just as we need Madame George’s. Van, in fact, famous for his verbal tics, can’t stop perseverating on the word love at several points in this song. He seems overwhelmed by it.
The love that loves the love that loves the love / That loves the love that loves to love / The love that loves to love the love.
Madame George, musically, is an energy-level reset, an emotional denouement from this hectic clinical life we live. A decompression. In fact, it’s a song I listened to on my back porch swing on repeat during my worst moments of ER burnout. It’s always helped me come down.
But it’s also an empathy reset. It’s a reminder. As I go about my days, my weeks, my rotations, am I trying to see the world through my patients’ eyes, through my colleagues’ eyes? Am I imagining how it feels to walk in their shoes? How well am I caring for Madame George? How well am I allowing Madame George to care for me? I continue to find that when I open my eyes to really see my patients, these healing connections can actually work in both directions. It turns out I can end up feeling more put back together, too.
…say goodbye to Madame George / Dry your eye for Madame George / Wonder why for Madame George…
Tell me, Crash Cart Campfire friends:
What songs help you regroup and reset?
How have you experienced healing connections with patients, family, friends, or even strangers?