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Music and Health

Taking time to be with people

A big part of our work as musicians in hospitals is to be there as a musician and a human being spending time with other human beings, to make music for and with them and to create a cultural venue within a clinical environment.

We often get asked if it is emotionally difficult to spend so much time in hospitals, especially with children. There are, of course, always emotional moments in our practice, and we allow ourselves to be emotional as part of our professional practice, indeed it is important that this emotion becomes part of our music-making to allow us to be ‘in-tune’ with the patients, visitors and staff with whom we work. We must always be careful, however, that we do not project our own emotions onto others – this is also part of our professional undertaking.

It is, however, more normal for us to work with the well-part of the person, to enhance and support the cultural, vibrant, and well part of the person. Medical staff work hard to take a holistic approach to their work, however, they are principally there to treat the illness. We are hugely privileged to be able to take the time for this approach, one which seems to complement and support the work of the hospital staff so well.

Over recent weeks, we have seen this human-to-human approach work so well. In Sheffield Teaching Hospitals, working with elderly patients and those with spinal and neurological injuries, we have recently been able to take more time to explore musical interests with individual patients, to support them in singing and playing musical instruments with us, and to rediscover their creative and cultural selves. Medical staff have observed and taken part in some of these sessions, making new, human-to-human contact with patients and seeing new potential despite their illness or injury. It is fantastic to be able to support these new patient-staff partnerships.

In children’s hospitals, the time spent with individual patients and their families becomes special time, time for a parent and new baby to bond in a neonatal intensive care unit, time for ‘normal life’ to resume if only for a moment, time for music 🙂 When doctors, nurses and other hospital staff become part of these interactions, the space and relationships within the hospital change completely, and we are all human beings together.

Leo Tolstoy wrote (What is Art, 1897):
‘… In order correctly to define art, it is necessary, first of all, to cease to consider it as a means to pleasure and to consider it as one of the conditions of human life… Art is a human activity consisting in this, that one man consciously, by means of certain external signs, hands on to others feelings he has lived through, and that other people are infected by these feelings and also experience them.’

It’s wonderful to be able to share music-making, a ‘condition of human life’, with all those we encounter in hospitals.

More feedback

This time from some of our artistic young participants taking part at children’s hospitals around the region…

Some feedback from the past 2 weeks…

Here’s a small selection of feedback from children’s hospital patients and parents from the past two weeks….

Thank you so much for the musical experience this morning. What a lovely surprise…… it was fantastic that you came in with your instruments so that both children and adults could have some much needed stress relief, entertainment and engagement.

It’s made my stay memorable and I really liked it cause of the guitar as I love them. Thank you.

‘J’ really enjoyed the music. He joined in and enjoyed looking and learning about the different instruments. Thanks for taking his mind off being in hospital.

Your music and songs have really helped cheer my daughter ‘A’ up. Any myself too. It was great to see her smile. You have brought her happy memories back from her holiday. We were all really interested in learning about your instruments. I think you may have encouraged her to get back into her dance now. Also you have helped relax her prior to her MRI today. Thank you. She keeps humming WACKA WACKA and smiling. Thank you very much.

I enjoyed it, thanks very much. It was my first time playing the violin. I liked the sound. OPUS played very well.

‘B’ was in bed when you came in still feeling quite drowsy. Now she’s up and about feeling happy.

The music was a lovely surprise and very calming for the children. ‘J’ especially enjoyed using the instruments and making up his own music.

I have seen the musicians in our daycare ward and in outpatients. It was clear to me that the music was enjoyed by all and so very well received. I was particularly impressed to see the children participating.

It was fab, really cheered everyone up and brought everyone together.

Thank you so much. Wow, what a wonderful lift to all of our days. “We are not poorly any more” Well maybe only a little. Please continue with your wonderful music. x

It’s clear from the great feedback we are receiving that our aim of creating cultural venues within the hospital is really working, allowing children, parents and staff to share music-making together, and within communities of wards, bays and families. Thanks everybody for your feedback, including some fabulous pictures which I will try to post soon 🙂

A Good Musical Experience – Wednesday 21st Nov 2012

Nick and I began playing in the Sunflower waiting area – three children aged around 8 years of age were waiting, a little bored, and seemed eager to join in.

We sat down and played a tune for them to listen to – they gathered round immediately – Nick began to give out percussion instruments.

We turned to Gallopede (one of our favourites for facilitating participation). Each child joined in with their own rhythmical pattern with the music – Nick led them for a while and showed a slightly more complex patttern to try.

We changed the dynamics – we led – they led.

The tempo changed – with different leaders here again.

Nick tried a different style – could we slow things down and change the mood with a waltz? We played Valse vor Polle – and the children changed what they were doing and matched the style.

Finally our musical friends found our box of musical instruments and had a little session exploring some of the sounds that could be made on each of them – including trying out my violin and bow.

I felt that the interaction had been successful and complete, and thought it best to start packing the instruments away, with their help. It is always good to have a thought for when a session should finish – before anyone gets overexcited – end with positive experiences.

This felt like a really good all-round musical experience and it appeared as though the children involved had really been engaged and enjoyed it for about 20 minutes.

 

Reflective moment

Sarah, Rich and Nick sharing a reflective moment after a day at Derbyshire Children’s Hospital visiting medical and surgical wards, Accident and Emergency and Neonatal Intensive Care.

Assessing impact in a different circumstance

While in the hospital Nick and I were asked by a member of the play team to come and play for a little girl who was distressed and in a state of discomfort. She was suffering from involuntary movements in the limbs and mouth. He legs would kick out and at the same time her jaw would spasm.

 

When we arrived at her bedside at first there were a few people round the bed. We started playing and there was little discernable effect. The play specialist picked up the girl from her bed and sat down with her on a chair. Her father arranged cushions around the play specialist so that the girl was supported. Her father then left and we played. I was sitting on a small chair in front of the play specialist and the girl and Nick was to the side. We played for about 10 minutes and we sang and the play specialist joined in. Gradually through the singing the girl made eye contact with the play specialist and this continued for the rest of the interaction.

 

The small area we were in became a bubble of calm. The girl’s gaze was fixed on the play specialist as she lay there in her arms. We continued to support the interaction changing songs, accompaniment and sounds. Her involuntary movements became less. From where I was sitting I could see perfectly the read out on the heart rate monitor that the girl was attached to. From the time that the singing started her heart rate went down by 10 bpm and continued at this lower rate for the whole 20 – 25 minute period we were with her.

 

A group of doctors came over to examine the girl and as soon as the singing stopped and the eye contact was broken, her heart rate went back up and the involuntary movements returned.

 

Sometimes it is hard to assess the impact of what we do, other times it is there plainly to see.

Assessing Impact

While working in hospital the other day Nick and I found ourselves robed in plastic aprons playing to a young boy in an isolation room. He was disabled and had limited sight. He looked about 7 and was lying on the bed wearing only a nappy with various tubes coming out of him and rocking from side to side seemingly agitated and in a state of discomfort.

 

We stood at the end of the bed and played for him. We started off with something quite upbeat to match his agitated state and then gradually changed what we were playing as he seemed to calm down. The rocking and movement became less and what we were playing seemed to be calming him. As we were playing a doctor came in and carried out a process involving syringes and tubes that were taped onto the boy. This took a few minutes and we continued to play as the process went on and after it had finished.

 

We continued to soften our playing and the boy became calmer and calmer and eventually fell asleep. As we left there was a feeling of calm in the room and gone was the sense of agitation and discomfort present when we arrived.

 

I was left wondering to what extent the music had calmed the boy and how much the medical process had resulted in him falling asleep. This ambiguity can leave a strange feeling at first. As musicians we hope that our music has a positive impact on everyone we encounter but when we work with people in hospitals there is so much that we don’t know about the patients circumstances that often we have to content ourselves with not knowing the impact of what we do or even in some cases if there is an impact. This requires the development of a certain resilience based on confidence in what we do and our ability to carry out this work sensitively and appropriately.

 

In a circumstance like this two words from our training come to mind: Beneficence and non-maleficence. Keeping in mind that what we do must have a benefit or at least must not be harmful to the patient. In the case above I was sure that the music was not causing any discomfort to the boy, I was guessing that he liked it and hoping that it was soothing him. I couldn’t be sure that the music had sent him to sleep but that didn’t matter.

Chickens and Frogs

On 7th Oct, as part of our usual Wednesday work around Puffin Ward in Derby Children’s Hospital, we overheard a young boy in isolation, crying and thoroughly focussed on the marks that appeared to cover his body, itching and quite distressing him. He had toys all over his bed that seemd to be new – still to be unwrapped – but not distracting him from his discomfort.

We started playing an upbeat version of the “Valse vor Polle”, in 4 time – this did not seem to connect with him. Richard suggested we play something different – something with a gap in it…….an interesting suggestion – why would the space in the music grab someone’s attention more than continuous sound?

We started to play “Who stole my chickens and my hens?” leaving a rest in the music after each line of question in the song. After about the second time, he turned to look at us playing through the doorway. Still crying, but with gaps in his noise now, so he could hear when the music continued. Slowly but surely, his crying sounds resided and he started talking to his Mum about tthe chickens in the song – what a silly song!

There came a request – something about a frog? Nick fetched our speckled frog guiro instrument and we started playing and singing “Five Little Speckled Frogs”. We had only got as far as frog number 3, and he was smiling and opening his new toys, calmly and more relaxed.

We left them smiling, playing with new toys, and with their atmosphere changed at least for the time being. It appeared as though this young man was sufffereing with chicken pox, and we had sung songs about speckled things and chickens – only we saw the funny side to this – he did not notice at all, but seemed to benefit from the change in his day.

 

Music in Healthcare Settings Training

It’s the final day of our 5-day music in healthcare training today, and we’ve had a great time exploring the skills and competencies required to deliver this work alongside a fabulous group of trainees. We’ve spent time in the training room exploring, alongside many other things, repertoire, improvisation and ethical principles behind this practice. We’ve also spent a couple of afternoons at Derbyshire Children’s Hospital, playing music for and with patients, visitors and staff on surgical and medical wards, in the neonatal unit and in A&E. Final day today bringing all our learning and experiences together. Many thanks to our trainees for embarking on this journey with enquiring minds, a spirit of adventure and enthusiasm, and a real passion for this practice.