This qualitative case study revealed the modes of communication employed between members of a professional string quartet during rehearsal and performance. Six modes of communication and two levels of attunement were revealed. The modes of communication were interpreted as verbal and nonverbal: instruction, cooperation, and collaboration. The levels of attunement were interpreted as sympathetic and empathetic. Results indicated that the members of the string quartet were able to become empathetically attuned and produce spontaneous musical variations during performance. These spontaneous musical variations were interpreted as examples of empathetic creativity. Participants confirmed researcher interpretations of the six modes of communication, sympathetic and empathic attunement, and empathetic creativity during member checks. The authors propose that spontaneous musical variations are examples of empathetic creativity. The findings of the current qualitative case study support the findings of a previous study conducted with a jazz sextet (Seddon, 2005). Implications of the findings of the current study for small group communication and creativity are discussed.