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VOL. 10, NO. 2 
FALL 2021 

 

BOOK REVIEW 

Can Music Make You Sick? Measuring the Price of 
Musical Ambition by Sally Anne Gross and George 
Musgrave 

Jonathan Kuuskoski 
University of Michigan 

ABSTRACT:  Jonathan Kuuskoski reviews Can Music Make You Sick? Measuring the 
Price of Musical Ambition by Sally Anne Gross & George Musgrave. 
DOI: doi.org/artivate.10.2.158 

Instability for musicians transcends financial precariousness; the industry 
itself seems predicated on blurred lines and perennial uncertainty (p. ). 

We all know that making a career in music isn’t easy. The field is hypercompetitive, full 
of uncertainty, and high-risk. A common principle in the work of mentoring aspiring 
professionals, then, is to reinforce the idea that they must dream big and stay the course. 
Achieving success requires diversifying capabilities, hustling through the early years, and 
maintaining an open mind to every potential opportunity. Disappointments are inevitable, we 
tell our mentees, and carving out a satisfying, sustainable, and impactful career will demand grit, 
creativity, and an unwavering belief in yourself. Sure, that might seem hard, but we hope each 
new musician we work with will look back one day and say, “Yeah, that was worth it. I’m a 
stronger artist and human being having gone through those early struggles. Thank goodness I 
went for it.” We want to believe that they all have a fair chance at finding individual pathways 
to success. 



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2 

But what if our understanding about the potential payoff of a music career is askew? What 
if an artist’s commitment to the hustle has ramifications that could undermine their mental 
health and wellbeing? What if the price of ambition is higher than we think, regardless of how 
successful we become? These are the compelling questions at the heart of the very well-
researched new book Can Music Make You Sick? Measuring the Price of Musical Ambition by 
Sally Anne Gross and George Musgrave (University of Westminster Press, ). 

The book tackles three goals—an empirically-driven understanding of how artists today 
experience their career development, an interrogation of the conditions within the industry and 
how they impact aspiring artists, and a critical evaluation of how those realities may impact our 
professional training of future artists and music workers. The book takes a two-part, 
methodological approach to the analysis of these complex, interrelated questions. The authors’ 
initial study of , professionals across the UK represents the largest survey of its kind ever 
conducted. Executed in partnership with Musicians Help UK, Gross and Musgrave sought to 
understand the degree to which music workers experience mental health conditions, specifically 
anxiety and depression. The results were staggering. According to their findings, music workers 
are three times more likely to have experienced anxiety and/or depression than the general 
public. Digging down into more specific detail, musical artists are roughly  percent more 
likely to experience depression and anxiety versus other music industry workers, in particular 
younger artists (under the age of thirty-five). Women reported  percent higher rates of anxiety 
and depression than men—approximately three-quarters of the female population in the survey 
experienced these conditions.  

For the authors, uncovering the dire realities facing music professionals led to a second line 
of inquiry that in many ways drives the central thrust of this book. Gross and Musgrave 
augmented the survey findings with forty qualitative interviews featuring a variety of music 
professionals—from performers to producers and educators, as well as with industry executives, 
medical professionals, and even addiction treatment specialists. Rather than settling on some 
generalized observations about how industry forces might influence the ways consumers 
perceive and define artistic success, these interviews aimed to understand how musicians 
themselves actually feel about the work they do. This dive into prevalent perceptions of artists 
on their own circumstances, and the resultant impact on their emotional well-being as they 
navigate a difficult (sometimes unforgiving) profession, is the dimension that sets this book 
apart from other research studies.  

While not aimed at the casual reader, each chapter of the book functions as a self-contained 
treatise on one element of the ecology that is under consideration. The density of the prose is 
counterbalanced by a detailed table of contents, with subsections listed for every topic, which 
proves immensely helpful for the reader. This text can thus function as a reference document 
for specific topics as much as it serves as a detailed research analysis. This reviewer especially 
appreciated how the authors incorporated information relevant to our COVID- context—
presumably just before the book went to press, given the publication timeline. The book is one 
of the most up-to-date resources available on an essential subject and should be required 
reading for all music business programs.  



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Divided into six chapters, the core pillars of Gross and Musgrave’s investigation are their 
questions of assessment: How do artists evaluate the status of their labor, of their personal and 
professional value, and of their relationships? What do they value, and why, across those three 
dimensions, and what do the findings reveal about the realities of making music a career? 
Naturally the resulting analyses are complex, and—this reviewer believes—provoke essential 
questions about the future of arts entrepreneurship education and research. The most 
omnipresent revelation is that musicians pursuing a career in the field process their efforts 
through a combination of internal and external filters that are contaminated by two neoliberal, 
techno-positivist mythologies. 

The first of these mythologies has to do with the way the economics of the twenty-first 
century music industries impact our consumption of music. We often hear, in general terms, 
how the transition into a digitized music culture has democratized the creation and distribution 
of music. There is undoubtedly more music being created than ever before, and more flexibility 
for listeners to follow their curiosity within the endless song databases proliferated by today’s 
streaming giants. But as consumers gain, producers and creators of content feel the pain. Gross 
and Musgrave spend a considerable amount of time unpacking the contrary forces that are 
inevitably coupled with our overabundance. As it turns out, more isn’t necessarily better. For 
example, abundance is symptomatic of overproduction, which reflects both an intuitive 
understanding that the supply for music laborers greatly outsizes demand in essentially every 
type of job, and results in an ongoing depreciative pressure on prices. The challenges of 
monetizing music in a digitized consumption landscape, then, are paradoxically revealed to be 
both democratic and Darwinian. Everyone has access to distribution platforms, but it’s now up 
to each individual artist to carve out an audience. It makes sense in most contexts to expect that 
oversupply, coupled with nearly free access to a product, would drive down the price of 
consumption, leading to increased competition, and (likely) industry consolidation. The 
authors deftly critique the consequences of this hypercompetition, and the precarity it fosters 
across the board. Our music industry infrastructure, which has bowed to the digital consumer’s 
expectations, poses an immense burden that “plays out on the bodies and in the minds of 
musicians and music producers” (p. ). Artists bear this pressure in a variety of ways, and 
many feel both personally responsible for their failures and powerless to shift the industry itself.  

But how is an artist even supposed to figure out whether they are doing well or poorly? 
How should they feel about their careers? Today, artists are asked to reconcile a commitment to 
“utmost self-belief” with “conscious but controlled self-doubt” (p. ). One can’t help but sense 
that many artists in this study felt burned by the false promises of our industry and paid mental 
and physical prices along the way. This second mythology, that success is tied to exceptionalism, 
comes crashing down under the weight of Gross and Musgrave’s analysis, which draws richly 
from cultural economics, the psychology of creativity, and the media theory of communicative 
capitalism. Take, for example, the observation that subjects in the study regularly reported 
feelings of inadequacy or failure, regardless of their levels of objectively measurable 
achievement. Even incremental successes, the status quo of any arts career, are often perceived 
as missed opportunities. As it turns out, the precarity of pursuing music makes it very difficult 



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to relish the day-to-day process of building a musical career. In that context, artists are 
undermining their own sense of worth. This gap between expectation and achievement throws 
music workers into a cycle of disempowerment over their futures, and the sense that they need 
to keep hustling at all costs. 

These findings turn on their heads some of our most prevalent assumptions in the field of 
arts entrepreneurship. In our work we often propagate the notion that if an artist is talented, 
hard-working, and savvy enough, they will “figure it out.” They might just need a few 
extramusical tools to do so. In failing to define success in more grounded ways, because we are 
steeped in the dominant fantasy of meritocracy, we may advance the toxic concept that 
individual artists are in full control of their destinies. One powerful assertion of this book is that 
the “successes (and failures) of musicians are not isolated incidents of genius rising to the top” 
(p. ). In contrast, the interviews consistently highlight the complexity of what it means to even 
define success, and how one’s race, social class, access to capital, and preexisting connectivity to 
the industry bolsters incredible advantages. The implication is not that entrepreneurship 
training is worthless—rather that we must more fully account for these other factors, which 
often supersede even the savviest application of entrepreneurial tools and tactics. As an example, 
Gross and Musgrave posit that career training norms at present may be feeding the idea that 
creating content trumps all other priorities. Their research has found that falling into that trap 
not only erodes one’s sense of self-worth, it also often strains every personal relationship in a 
musician’s life. Artists fail to break that cycle of diminishing returns because, while the entry 
costs to making music have lowered (thanks to the rise of the internet), exit costs remain 
extremely high. Why? Because musical and personal identities are intertwined. As they say, 
“[music workers] can’t quit because making music ‘is’ them” (p. ). What might happen if we 
questioned the assumption that the comingling of these identities is essential for finding artistic 
satisfaction and sustenance?  

The conclusion of the book focuses on answers to these questions, presenting ideas for how 
we might manifest a more equitable and sustainable music infrastructure and reverse the 
dominant, negative pressures that are harming music workers. It seems clear that the nature of 
the industries as a complex adaptive system makes a one-shot solution impossible. While Gross 
and Musgrave readily admit that simple infrastructure solutions are difficult to realize, they do 
introduce points of entry for further investigation that span personal wellness tactics, public 
policy strategy, and even legislation. Each of these warrants further investigation. In particular, 
the miniature case study on Lil Peep and the debate surrounding “duty of care”—the degree to 
which managers, labels, and other support players should be held responsible for individual 
artists’ behavior and its consequences—is fascinating and deserves a more fully-fledged analysis.  

The authors ultimately circle back to discuss their roles as educators and examine how 
tertiary training programs can make a difference. This book asks professionals in arts 
mentorship and education—the so-called keepers of the faith—to become seekers of the truth. 
In doing so, perhaps we will realize that the limitations of our music economy shouldn’t be 
viewed as weaknesses. In fact, reevaluating our own attitudes toward the status quo could begin 
to reflect more critical metrics around professional success, and might be essential to developing 



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the kind of pedagogy that would prepare our students more realistically for their futures. That 
work will also challenge us to design a more ethical professional development training pipeline, 
and to reject the mythologies interrogated in this book. After all, if the three most important 
relationships in an artist’s professional life (to their own status, to their creative work, and to 
other individuals) are all in peril, the final question for us is fairly simple. Can we, as the stewards 
of tomorrow’s changemakers, do better? If we care about the future of the performing arts, the 
answer must be yes. 


