Sarah

Reaching People Through Song


“Oh I can’t hold a note!”
“I’d better not sing, it’ll start raining”
“Oooo you’re so good, you should be on X-Factor!”

So often we have been met with comments like this. It seems to be assumed that regular, every day people cannot sing, and that if you can, or do, or are comfortable trying, you are someone special and should be put on a stage. Within the last twelve months, I have been part of three events in three different healthcare settings that demonstrate the importance of singing in making deep impact connections with other human beings, where the spoken word often fails.

The first of these was a young boy waiting in hospital for a procedure and needing some cream in preparation. The cream needed to be placed on his hands and elbows with bandages. This was not painful, but he appeared understandably anxious and unable to remain calm. We began singing a jolly upbeat song (Zamina) quite loudly, to meet his intensity, volume and energy. Mum was sitting with him and encouraging him, with the promise of a visit to McDonald’s later on. All of this initially calmed and engaged him, but he soon started thinking about what was going to happen to him, and started crying again. I decided to try changing the words of this song to make them about him and the special bandages he was having put on. This made him think differently about his bandages and smile a little, and altered his mood and energy. As the nurse completed the preparatory procedure, the young boy was smiling and looking at his bandages with a bit of pride and pleasure, as if the song had validated them and made it ok. The nurse stated that the music and song had really helped her finish the task.

The next event was in a different hospital, one morning, with a family comprising a young male patient, Mum, Dad, and little baby boy brother visiting. As we entered the room we started playing Twinkle Twinkle Little Star. After a few moments of listening and looking, Baby started vocalising whilst looking at me. I moved closer and got down on the floor nearby. I vocalised as best as I could the same sounds back to him and maintained good constant relaxed eye contact, open mouth, and smiles. He continued vocalising with me whilst I was singing words. Then I sang in the baby’s words “ye ye, ye ye” to the tune of Twinkle. There was instant recognition and reciprocation – good confident eye contact and vocalising with me, not just at me, including some copycat exchanges, intermingled with little bits of the melody of the song. Then ensued some smiles and giggles and real joy in Mum and Baby (sitting on Mum’s knee). This is the youngest person I have ever sung with and I really feel that we made quality music together on this day.

The final example of singing together came during a short session of playing music for a group of eldery people with dementia in a care home. There were at least 17 residents and 2 members of staff sitting round in a circle facing inwards, no one talking to one another. As usual, there was a lot of shouting out and getting up and wandering around prior to the music. As we started, with some gentle tunes, trying to match the volume and energy of the room, but trying not to be too loud, there was some joining in clapping, lots of smiling round the room and looking at each other. We started singing “Oh my Darling, Clementine” (a choice made by one resident’s continual quoting of the lyrics and rhythms of the song), and the room changed. There were at least 6 people singing the same words in the same time in the same song in the same room – a real sense of shared experience, working towards the same goal. Unable to see each other, talk to one another, or share most other activities, these elderly people seemed positively engaged in this activity together with smiles.

Our voice is very personal to us. It is part of our identity and gives an indication as to who we are and where we are from. It is the product of vibrations made by tiny tendons being contracted and relaxed inside the voicebox, as air flows from the lungs and out through the month and nose. It is developed and formed on the way by the shape of that unique individual’s vocal tract. In order to be able to develop the voice over time, the vocal folds need to be flexed and exercised regularly in order to develop the control of the sound quality, the pitch, the breath and, with all of that, the confidence to allow your singing voice to be heard. Most importantly though, it is not about perfecting the use of the voice, but about the true benefits of taking part…..

Professor Graham Welch, Chair of Music Education at the Institute of Education, University of London, has studied the developmental and medical aspects of singing for 30 years. He found that the health benefits of singing are both physical and psychological. “Singing has physical benefits because it is an aerobic activity that increases oxygenation in the blood stream and exercises major muscle groups in the upper body, even when sitting. Singing has psychological benefits because of its normally positive effect in reducing stress levels through the action of the endocrine system which is linked to our sense of emotional well-being. Psychological benefits are also evident when people sing together as well as alone because of the increased sense of community, belonging and shared endeavour.” www.heartresearch.org.uk.

I believe it is important to keep facilitating opportunities for people to use their singing voice more and learn to feel comfortable with this, developing their skills through experiencing the benefits of song, especially in healthcare settings. Just because you are not Adele or Robbie, why would you deny yourself these life-changing moments? To baby, Mum and Dad’s voice is the best in the world.

Sarah Matthews

10th October 2016

Lift Music…..

Working one day in Leicester in October 2014, we spent some time on a Ward playing for a whole Bay to listen to. There were several families there who had obviously been waiting for some time, for a procedure or surgery. The curtain was closed around one bed, but when Dad heard the music he threw back the curtains and made encouraging comments. His little boy was about 3 years old and quite shy to begin with, but with gentle encouragement and plenty of time and space, he found the confidence to have a go. He tried the shakers to begin with and then progressed on to the glockenspiel. We played Diamond Day and a few other pieces that engaged each family.

After playing Waltz vor Polle in the bay next door, it was time for this little boy from next door to go down to theatre. He was waiting in Dad’s arms by the reception desk, crying and becoming increasingly upset. We came over to him again, still playing, and immediately got his attention and he stopped crying. As we started Wind The Bobbin Up, Dad said he became much more relaxed and calm in his arms. We offered to play and sing as they went down to theatre, and they all liked this idea a lot … our young patient still very much calm and relaxed.

As we walked off the ward, down the corridor to the lifts area, we switched to Twinkle Twinkle, as I thought perhaps if we were unable to go down in the lifts with them, Mum and Dad would be able to continue singing. … But we all fitted in the lift … and as the doors opened on level 3, to a very surprised audience awaiting the next free lift, everyone smiled. Still our little friend was engaged with the music and quiet.

Finally, we reached the doors to the theatre waiting area and left this family. A tired, grateful father said thanks and the doctors smiled in appreciation.

Having Something to Say

Our first visit of the year to Nottingham QMC in January 2014, and Rich and I went into E40 Ward first thing in the morning and checked with staff for advice on where to start playing and who to work with.

We walked right to the end of the unit, passing a sleepy patient on the left who was having a good cuddle with his Mum and watching TV. We met a lively little girl who listened to our music first of all, and then joined in with actions and singing and then happily explored the box of instruments, each one in turn, fully. After playing with all that we had to offer, she then showed us a squeezy plastic concertina that belonged to the hospital, which she had been enjoying the previous day.

Our sleepy friend next door had been listening all the way through this interaction and had woken up a bit now. We began playing Waltz vor Polle for him, and then a melody that he knew, The Star of the County Down, as Mum told us that they were a family who sang a lot of folk songs together and that was one they knew. His attention was then drawn to our box of instruments and he tried out the frog, various shakers and the cabassa. There was no speech from him during this entire time, but a little smile had begun at the corners of his mouth and Mum indicated that was a very good step forwards for today. Our engagement started to come to an end – Mum commented to us that he nearly said goodbye – and tried to encourage him to sign and say bye to us. Just as we were potentially finishing our interaction, another young man returned to the same bay from some kind of treatment, with his head wrapped in a bandage. He was crying upon his return, but saw and heard us as we started another piece and he joined us with shakers and smiled.

After this piece, we had a little time out, cleaning our instruments in the play area adjacent, and this second boy starting really crying as his head was obviously uncomfortable. The crying became more intense and we decided to start Sunshine, and played for the whole room. By now, the first young boy’s father had arrived from parking the car, and Mum was telling him how their son had engaged with us and nearly spoke. This seemed to be something of note regarding his stay in hospital.

The whole room was engaged with our piece – parents singing, the multi-coloured toy bear was being made to dance by the first little boy – he himself wriggled on the bed – the tears from the boy in the other bed stopped. The song ended and some toast arrived for the second boy, so he could focus on something nice to eat. The first boy started talking to us a lot – it was fairly jumbled speech, but had the rough overall meaning of saying he had done a lot there and was tired, and he lay down on the covers with his bear as if to rest. Mum and Dad seemed delighted.

We both walked out of that ward with tears in our eyes, and had to take time out to reflect on the whole engagement and change our mood ready for the next patients. We do not know what was happening in terms of the illnesses or traumas of these two children and their families, but we left with the distinct impression that we had made a huge difference that day. Somehow the music, incorporating sung words, had reached the first little boy in some way that speech could not. He was perhaps more relaxed and able to respond to the song verbally than he could before to the spoken word. A connection was made – we don’t know how temporary or permanent, but it felt like one of great impact at the time.

Later we learnt from the Headteacher of the Hospital School that she had spent some time with the parents of this young man, and it had indeed been an important day where his speech had occurred for the first time in a long while.

A Moving Musical Experience.

One visit to a Children’s Hospital in November 2013 we were passing through one ward on our way to work in another, or so we thought……we were spotted and invited into one young patient’s room by his Mum.

She already knew us and knew of our work, as we had met before when her older daughter had been in the same hospital previously. Recently, her young baby had been having difficulty in passing faecal matter over the last four days and as a result was constipated and unable to take in much milk when hungry. He was crying in Mum’s arms as she struggled to get him to drink 30 ml of milk, and then appeared in pain.

We entered the room and played a variety of suitable pieces from our repertoire. The doctors came by the room and went away again, encouraging us to stay as if to see what result might occur from our music…..we stayed about 15-20 mins. The baby calmed and Mum was able to lay him down for a rest. We left and went off to another ward where we worked for the rest of the morning.

On our way back through to break for lunch, we put our heads around the door of the room with Mum and baby. She reported that the little one had had a massive bowel movement, had taken some more milk, and had slept for the rest of the morning uninterrupted.

Seeing Things Through

Tuesday 9th July saw Richard Kensington and Sarah Matthews of Opus, out on the sunny roof in the play area of a Children’s Hospital. There were many patients enjoying the sunshine with parents and visitors and staff. We met one little girl dancing around with a tennis racket in a pretty white dress. We played for her, and others present, and allowed time for everyone to get accustomed to the music and instruments in that space.

Wind the Bobbin Up seemed appropriate, with voice and actions and instruments. We sang together for a while, and other patients joined in and began exploring the musical instruments in our box. The Mother of the little girl said that it had been a great way to kill time and relax a bit whilst waiting for her operation. I checked which ward they were going back to, thinking to myself that it might be possible to follow through this little girl’s day, and help her later. They were based in a ward that we had not visited yet.

After spending quite a while longer out on the roof, singing and playing to patients in the ball pool, up the stairs and down the slide, on the bikes, and other activities, we settled in the shaded area with one young man who was very interested in exploring the xylophone with patterns and a variety of tonal combinations.

When he had finished, we wandered back into the ward, and found the little girl from the roof ready in her operation gown, crying in her Mummy’s arms whilst waiting to go down to surgery. We began with Twinkle Twinkle and gained her attention again. She stopped crying and listened more calmly. Dad told us she really liked Row Row Row Your Boat, and made a few suggestions for variations to the words, which we were happy to incorporate. Then it was time to get into bed and go down the corridor to surgery. I checked with Mum that she was happy for us to stay with them and follow them down the corridor to the lift area. Mum was very keen for us to support as she commented she was amazed at the effect of the music on her daughter, and herself also.

The staff arrived and it was time to process down to the lifts. Rich and I played The Grand Old Duke Of York and sang as we followed the family out of the bay and through the ward and across to the lift area. The little girl was listening and stayed calm. We left them as the lift door closed, and Mum was saying she could not believe how the music had helped in making the while process go more smoothly and with less stress.

Rich and I went about our business for lunchtime and the early part of the afternoon. Finally we worked our way back to the bay where we found the little girl had returned from her operation and was calmly coming round from the anaesthetic and having a drink. We were able to choose gentle pieces to ease her back to reality in a relaxed way.

When I gave Mum and Dad our business card and asked if they would like to comment on how the music had affected their day, they said they definitely would and it had made a huge difference!

St George’s Day

 

We were working on a ward in Leicester Hospital on Tuesday 23rd April and played our way round to a corner room where the door was wide open. Inside there was a little baby all dressed in green pyjamas. When he saw us he looked quite anxious – Who were these People? What were they carrying with them? And what were they going to do?

 

I was reminded of the training we had recently been doing with musicians in healthcare, and the ethics we had discussed. I knew I wanted to provide some nice music for this young man to enhance his stay in hospital, but was very aware I did not want to alarm him. He was in a very vulnerable position, with assisted breathing equipment, in a seated position in bed, with no adult he knew nearby.

 

We decided to play Twinkle, with no eye contact, just letting the music reach out to him and then observed his reactions. The music became part of his environment and more normal to him. He appeared to relax and began to smile intermittently.

 

My intention was then to help him feel more comfortable with us being there and thereby allow him access to more music and to enjoy himself.

 

Slowly, but surely, the smiling became more frequent, movement increased with stretching, reaching, sitting up and leg extensions – dancing as much as he could. He started to tip his head back, mouth wide in a silent laughter and caught my eye with glee – as if teasing me. Eye contact now not a threat to him, we shared quite long gazes.

 

I left him apparently relaxed and smiling and his nurse came by and shared the moment with us. I was reminded of how important eye contact is at the right time and with the right intensity, and felt so glad I had my training to help me make this interaction successful for this little baby and indeed a lovely experience for both of us.

Day of Dance

Tuesday 29th Jan at Leicester Children’s Hospital, working with Sarah Steenson and Nick Cutts. We began work playing on Ward 12, progressed through to Ward 28 and finished the morning in Ward 14. A busy morning that finished quite late. The afternoon was productively spent only on Ward 10 for the whole time. I was very pleasantly surprised by the amount of movement to music on this particular day, all day long…..

 

A father joined us in our music, singing to his daughter in her wheelchair initially. She was smiling so much that her gas breathing mask kept slipping off. We played Twinkle Twinkle, and a few other songs, and then progressed to a gentle waltz with the suggestion that they might share some rocking movements together. Dad needed no encouragement from us really and for several minutes the two of them engaged in lovely eye contact and moved back and forth with the wheelchair rolling to and fro on the floor fullly engaged in a beatiful dance.

 

Over to another ward, and we met up with an enthusiastic mother and her autistic son. She spent quite a while talking to me about how she had worked with her son in his early youth to develop his tolerance to touch, and this was evident as they danced together to our music while we played a mixture of Polkas, Hornpipes and Schottisches in the waiting area and outside their private room.

 

Another ward led us to meet a family with a toddler sitting in a toy car. She listened to our playing and started to wiggle from side to side. Her dancing developed and became more exaggerated. Nick started to sing “I’m in a Dancing Mood” which enabled us to progress through the song, changing the lyrics to suite the occasion – “I’m in a Singing Mood” ….”Wiggling Mood” etc etc.

 

Just around the corner, we found a mother and little baby, seemingly with some learning difficulties, and across the other side of the room a young girl in a wheelchair with the most amazing stripey tights on! We played Twinkle Twinkle and the mother sang to her baby and held her in the closest hug in her arms, and began to dance. Those stripey tights also started moving in time to the music. We played the Mazurka de St Pierre and Off to California, and there was much movement to be seen and pleasure exchanged just by the sharing of those musical moments.

 

In the afternoon we met up with a male patient we had seen before the previous visit and shared some music on the guitar. We all had a similar experience today with the young man playing on Sarah’s guitar with her as we sang. Nick then approached with an improvised song and music in Em. The chord progression was predictable enough for me to join in with an improvised melody. The lyrics Nick created were all about the patient’s name and how the song was made specially for him. The patient beamed with joy and his upper body became energised enough to lean away from the pillow and move about in the bed to the music.

 

In all the days that I have worked in hospital so far, I don’t think I have ever noticed quite as much of a physical response by so many people on the same day. Just coincidence? Maybe it was the way we were playing this day – I cannot say. But I did go away thinking of the uplifting feeling that I know I get when I have been dancing – the positive hormones that are released when you share music and movement with another human being – and I felt very strongly that we had brought a pretty special cultural dimension to these people’s day in hospital.

 

 

 

 

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“Can we sing another song?”

Working in Derby Children’s Hospital with Nick Cutts and Rich Kensington today we played our way along the upper wards in the morning. We met a young patient who was so relaxed and open about her music and singing, she just couldn’t get enough of making music with us.

We started with “Yellow Bird” as an instrumental piece and then a sung song. The patient and another friend in hosptial were both offered a shaker instrument to join in with – which they both did with great joy in their faces – sometimes fast, and then slow, and then stopping to listen to the music on its own.

I smiled at the patient and asked if there was anything that she liked to sing – to which the answer was certainly “yes”. She said her favourite was “The Wheels on the Bus”. Oh great we know that one – and we sorted out which verses we could cover. This young patient, lying on her back for medical reasons, unable to sit up, joined in and led the song, thinking of new different verses with Mum’s help. Her voice was quite confident and happy and clear, such that a group of doctors standing nearby on their rounds, stopped and looked up from their work.

“Can we sing another song?” came her voice, at the end of that one…..we decided on Five Little Speckled Frogs, and encouraged her to help with the counting. She was not quite so confident with the words on this one, but none-the-less made every effort to join in with us.

She then became interested in my violin and I moved around the other side of her bed and showed her the instrument. She plucked the strings with such care and sensitivity. Then I explained how to touch the bow, and with Mum’s hand on one end of the bow, hers in the middle and mine at one end, we drew the bow back a forth across the D string.

“Can we sing another song?” she asked, whilst still bowing the D string on the violin…..Twinkle Twinkle in D major of course, worked really nicely. She played so gently and sang the words at the same time.

So lovely to meet this young patient – to listen to her voice and share those musical moments. The fact that we were in hospital did not really matter – the fact that she was lying down didn’t seem to hinder her participation and indeed, leadership in the music.

We did indeed sing another song.

Elevator Music….

I was working in Nottingham QMC Children’s Hospital on Tuesday this week with Rich Kensington and Sarah Steenson. We found ourselves en route from level B back to the top floor to pack our things away at the end of the day.

However, our playing was not over for the day yet!

We waited for the lift…..but the first one to arrive was rather full with surprised but welcoming faces who wanted us to ride in the lift with them, but there was not enough room…..we waited for another.

The next lift arrived with room for all three of us, even though there were about 6 members of a nursing team who obviously knew each other and worked together. One said, “Oh Elevator Music” as we got in – and that was it – I had to play something.

We only had time for one A part of the Valse for Polle before it was their stop, but in that short time, the group were smiling and laughing together and got out of the lift singing the beginning of the second A part of the tune.

A lovely example of how having real instruments with responsive musicians in hospital can provide many places with different sorts of interactions, and sometimes in the most surprising of locations.