When perusing through the articles on this web site, I was drawn to Nicholas Kofie's article entitled, "Reflections on a First Time Experience With a Coma Patient". It caught my attention because I have had some personal and professional experiences with people in coma states.
When I was in my teens, both my brother and then later my father had different accidents that put them both in intensive care for a while with comas. (Luckily they both came out of them fairly quickly.) I especially remember being with my dad in intensive care when I was 19 years old. He was unconscious and many of the nurses told us to talk or even to sing to him if we wanted to, as long as it was in a loving and peaceful manner. They had heard about and personally witnessed many coma patients who had reported upon waking that they had heard loved ones and/or medical staff talking about them, and some had even heard music as well. I sang some familiar songs to him that we both liked. These songs had always had good memories about hiking in the Rockies attached to them. He came out of the coma, and later on he told me that he remembered people talking and singing to him, but it was hard for him to recall details. But it was comforting to him. Who knows if it helped him or not, but I doubt if it hurt him. It definitely helped me deal with my feelings of anguish and helplessness at the time.
I have also been working in rehabilitation with adults with traumatic brain injuries for a long time as a certified brain injury specialist/counselor (CBIS), and although I have not worked with coma patients in this work, I had to study and learn about coma and brain injury in order to pass the CBIS exams. I remember coming across numerous coma case studies in the medical literature that were similar to the ones that the nurses had told me about years before.
Currently I am doing my first year music therapy practicum and internship at a hospital north of Boston. There I have been working with my supervisor with two patients who have been diagnosed with minimal consciousness state for many years. I believe that this term is used with people who are in a coma state, but who demonstrate some meaningful, although sometimes minimal, response to sensory stimulation and human contact. For example, sometimes they can visually track people when they walk into a room, or occasionally smile at people with seemingly meaningful direct eye contact. But there is still so much more we do not know about people's experiences in comas and minimally or diminished consciousness states. Given all of this, I was curious to read about Mr. Kofie's experience using music on a coma patient.
Mr. Kofie's work with a coma patient in Kumasi, Ghana was very interesting. Given that there were not any certified music therapist coming forward to work with this coma patient, even after his condition was advertised in the local news, I was impressed by this man's courage and dedication to travel 250 km in order to try to help this man as best as he could with music. The whole story is quite intriguing and inspiring, and well worth reading.
However, at the end Mr. Kofie put forth some interesting and valid questions for the readers to answer and discuss. Rather than try to give my answers to these clinical questions, as I am only a first year graduate student, I will leave that up to more experienced music therapist. But one question stood out to me that I would like to address here. He asks his readers, "If I had encountered a failure and embarrassed myself, would I have had another opportunity to redeem my profession?" (Kofie, 2005). The issue about professional failure and embarrassment is a real one, especially since we are in such a new profession. I am assuming that most of us in this field really want to help people, as well as to have our relatively new profession understood, validated and supported.
But what really stood out to me in this question was his definition of "failure" in this case. I do not doubt that his efforts probably helped this man come out of his coma sooner than later, even though no one can empirically prove this. Thus, indeed he was successful. However, what I would like to stress here is simply this; if a coma or minimally conscious patient does not come out of a coma with the help of music therapy efforts, is the work considered a failure? Even if it does not end up leading to a return to full consciousness, as could have been the case here, does caring for a patient, by providing tactile and auditory stimulation and genuine human contact, in and of itself make it worth all the effort and time? If it is at all possible that we might be providing a better quality of life to these patients, even though it may seem unlikely to some, is that not enough to consider this therapy as being successful? I know that getting real results and even cures for people in this work is a good and noble aim as well. Nevertheless, does caring or walking with a patient on part of their journey count as being "successful"? I think it does.
All I can say is that after my two personal experiences with comas in my family, then studying it, and now working with my two minimally conscious patients at my music therapy internship, I strongly believe that this kind of work is helpful and stimulating to them. Nobody can know for sure, but there have been so many testimonials from former coma patients that claim they remembered what was being said and what was going on around them while in a coma state. Sometimes it was upsetting to them, and other times it was comforting to them, depending on what was going on around them.
Intuitively I feel that when I sing and play the guitar to my patients at the hospital, and genuinely hold their hands and talk to them, that sometimes they really feel like they are with me for a few moments. It is very moving to be a part of; I get direct eye contact and a smile sometimes when singing and play music and holding their hands. Sometimes I even see a few tears rolling down one patient's face when The Beetles' music is being played. My dad also remembered me singing and talking a little, and it certainly helped me to deal with my sadness and helplessness. So for all of these reasons, and more, I would just like to say that I believe this work can be considered successful, even if they remain in a coma and/or in a reduced consciousness state. Indeed, it is amazing that he woke-up soon after he worked with this man. Nevertheless, I think Mr. Kofie was successful beyond this, because he really cared for and about this man and his family, and genuinely tried to help him.
About Sonja Granskou
Biography
First year graduate student at Lesley University in Cambridge, Ma.
When perusing through the articles on this web site, I was drawn to Nicholas Kofie's article entitled, "Reflections on a First Time Experience With a Coma Patient". It caught my attention because I have had some personal and professional experiences with people in coma states.
When I was in my teens, both my brother and then later my father had different accidents that put them both in intensive care for a while with comas. (Luckily they both came out of them fairly quickly.) I especially remember being with my dad in intensive care when I was 19 years old. He was unconscious and many of the nurses told us to talk or even to sing to him if we wanted to, as long as it was in a loving and peaceful manner. They had heard about and personally witnessed many coma patients who had reported upon waking that they had heard loved ones and/or medical staff talking about them, and some had even heard music as well. I sang some familiar songs to him that we both liked. These songs had always had good memories about hiking in the Rockies attached to them. He came out of the coma, and later on he told me that he remembered people talking and singing to him, but it was hard for him to recall details. But it was comforting to him. Who knows if it helped him or not, but I doubt if it hurt him. It definitely helped me deal with my feelings of anguish and helplessness at the time.
I have also been working in rehabilitation with adults with traumatic brain injuries for a long time as a certified brain injury specialist/counselor (CBIS), and although I have not worked with coma patients in this work, I had to study and learn about coma and brain injury in order to pass the CBIS exams. I remember coming across numerous coma case studies in the medical literature that were similar to the ones that the nurses had told me about years before.
Currently I am doing my first year music therapy practicum and internship at a hospital north of Boston. There I have been working with my supervisor with two patients who have been diagnosed with minimal consciousness state for many years. I believe that this term is used with people who are in a coma state, but who demonstrate some meaningful, although sometimes minimal, response to sensory stimulation and human contact. For example, sometimes they can visually track people when they walk into a room, or occasionally smile at people with seemingly meaningful direct eye contact. But there is still so much more we do not know about people's experiences in comas and minimally or diminished consciousness states. Given all of this, I was curious to read about Mr. Kofie's experience using music on a coma patient.
Mr. Kofie's work with a coma patient in Kumasi, Ghana was very interesting. Given that there were not any certified music therapist coming forward to work with this coma patient, even after his condition was advertised in the local news, I was impressed by this man's courage and dedication to travel 250 km in order to try to help this man as best as he could with music. The whole story is quite intriguing and inspiring, and well worth reading.
However, at the end Mr. Kofie put forth some interesting and valid questions for the readers to answer and discuss. Rather than try to give my answers to these clinical questions, as I am only a first year graduate student, I will leave that up to more experienced music therapist. But one question stood out to me that I would like to address here. He asks his readers, "If I had encountered a failure and embarrassed myself, would I have had another opportunity to redeem my profession?" (Kofie, 2005). The issue about professional failure and embarrassment is a real one, especially since we are in such a new profession. I am assuming that most of us in this field really want to help people, as well as to have our relatively new profession understood, validated and supported.
But what really stood out to me in this question was his definition of "failure" in this case. I do not doubt that his efforts probably helped this man come out of his coma sooner than later, even though no one can empirically prove this. Thus, indeed he was successful. However, what I would like to stress here is simply this; if a coma or minimally conscious patient does not come out of a coma with the help of music therapy efforts, is the work considered a failure? Even if it does not end up leading to a return to full consciousness, as could have been the case here, does caring for a patient, by providing tactile and auditory stimulation and genuine human contact, in and of itself make it worth all the effort and time? If it is at all possible that we might be providing a better quality of life to these patients, even though it may seem unlikely to some, is that not enough to consider this therapy as being successful? I know that getting real results and even cures for people in this work is a good and noble aim as well. Nevertheless, does caring or walking with a patient on part of their journey count as being "successful"? I think it does.
All I can say is that after my two personal experiences with comas in my family, then studying it, and now working with my two minimally conscious patients at my music therapy internship, I strongly believe that this kind of work is helpful and stimulating to them. Nobody can know for sure, but there have been so many testimonials from former coma patients that claim they remembered what was being said and what was going on around them while in a coma state. Sometimes it was upsetting to them, and other times it was comforting to them, depending on what was going on around them.
Intuitively I feel that when I sing and play the guitar to my patients at the hospital, and genuinely hold their hands and talk to them, that sometimes they really feel like they are with me for a few moments. It is very moving to be a part of; I get direct eye contact and a smile sometimes when singing and play music and holding their hands. Sometimes I even see a few tears rolling down one patient's face when The Beetles' music is being played. My dad also remembered me singing and talking a little, and it certainly helped me to deal with my sadness and helplessness. So for all of these reasons, and more, I would just like to say that I believe this work can be considered successful, even if they remain in a coma and/or in a reduced consciousness state. Indeed, it is amazing that he woke-up soon after he worked with this man. Nevertheless, I think Mr. Kofie was successful beyond this, because he really cared for and about this man and his family, and genuinely tried to help him.