Knowing what type of music will enhance the psychological and physical wellbeing of patients relies on empathy and intuition. There are two things that are always necessary for this type of work – appropriateness of musician, and the appropriateness of musical selections. Empathy (personal and musical) is of great importance. First and foremost, a hospital musician needs to survey the situation, and identify whether a patient would be happy to listen to or engage with music. In some cases, this can be quite obvious (a smile, a curious stare, parents directing attention of the children, a willingness to engage in conversation). For example, the other day a hospital teacher informed us that a teenage girl was struggling to complete a piano composition for her school exams, and would be delighted to meet Opus musicians for some inspiration. We created the opportunity for the young girl to develop her ideas, and encouraged her to feel confident in improvising as together we instigated a medley of improvised musical waltzes. Although focused on one patient, it was clear that others on the ward were happily watching.
In other cases, whether a patient is open to listen to or engage with music is much less obvious. In this situation, a gentle and tentative approach is best. It might also be appropriate to ask if they would like to hear a song – giving the option to a child patient (who often does not have choices concerning medical interventions) can perhaps be liberating. For example, the other day, a young child looking a little unhappy and fatigued was cuddling up to her mother in the corner of a ward. Her mother was clearly delighted to see musicians coming over to pay special attention to her little one, and this enthusiasm from mother triggered a little smile from the fatigued girl. We gently played ‘Yellow Bird’ as they happily watched, midway handing over a shaker to the little girl who (despite her tiredness) wanted to join in. At some point, her curiosity about the accordion led her to ask about it, and we let her press a few keys – which perhaps made the connection a little more personal. After this, realising she probably might want to rest, one of us asked if she would like some more music, or if she had enough for that day. She chose to rest, and looked happy as we gently said “thank you for playing, and goodbye”. Knowing how and when to end a musical interaction requires a good sense of empathy and intuition.
We have a range of musical pieces that we can play and improvise with. Sometimes a well-known and catchy song might be in order. However, sometimes, a well-known piece can evolve into a new and totally improvised piece of music – which can be equally effective and appropriate. According to Vescelius, “discrimination in the choice of music is essential; in ill- health one does not enjoy a musical banquet but a musical specific” (Vescelius, 1918).