Soul Therapy
The oncology department at our hospital is like a fine oncology department should be: friendly and supportive staff, expedited tests and results, patient-centered care and comfort support. In addition, each Thursday afternoon, a music therapy session takes place on the oncology unit. Patients and house staff are invited to come. I have to tell you, it is no Beatles concert and the attendance is low.
I am not a great believer in music therapy sessions; nor are the patients. However, I do believe that music can change your mood. If I am sick or feeling down I just turn on my IPOD and listen to some of my favorites artists, such as Paul Simon, Jacques Brel or Mozart. My terminally ill patients look to do the same thing. They frequently have their own radios or mp3 players at the bedside. I try to offer comfort by providing maximum pain control and boosting their moral with antidepressant medication when needed. I also have discovered the power of a smile and the effect of human touch.
I understand the general concept of music therapy, as two of my friends study the profession. One friend told me about how he used to visit the elderly and would play their favorite tunes, and the other friend worked in an institute in the Black Forest of Germany. He would treat spasticity by playing a harp which has been placed directly on the affected muscle. According to him, the vibrations transmitted from the harp would relax the spastic muscles (In my head I was thinking, "Have they not heard of Baclofen or Botox?").
However, I was still curious about what went on in the mysterious music therapy sessions in the backroom (ours that is); where strange yet enchanting sounds seeped out of the door.
So I Asked About It
Carey, one of the music therapy interns, explained to me that the goal of these sessions is to make patients feel better and accelerate the healing process that we, the doctors, provide. Each participant is asked to play the music instrument of his/her choice. The music therapists then start the session with one beat or rhythm and then the others follow. Sometimes this produces a nice harmony and other times a more chaotic melody will transpire and instill laughter throughout the room. She assured me that the end result is always pretty much the same. As she continued to speak, I imagined myself in a room with wannabe musicians, banging my head on the wall... While my mind still wandered, I caught onto something she was saying, "The patients and the staff could really benefit from thirty minutes of relaxation. During this time, they could put aside their anxiety and pain. Almost all participants feel better afterwards."
The services are available for everyone. For patients who are too sick to attend the sessions or those who would like a private one, music therapy students or interns will go in the patient’s room. The patient and the volunteer can play the instruments of their choice. The harp is the most popular selection, others prefer the guitar. Patients feeling angry prefer the drums.
This sparked my curiosity, so I asked Carey, "What if they are too weak to play the drums?" And she explained without conviction how she thought one could not be weak and angry. She continued with saying, "I had a patient who was very weak but requested to put the drum on his abdomen and for me to strike it."
I noticed from time to time that a music therapy intern played piano in the hallway to provide relaxing background music. On this particular day, the intern complained to me about the lack of participation. She expressed frustration with the reluctance of people to attend music therapy sessions. Knowing what I knew now about the elusive back room sessions, I tried to think of a reason for such poor participation. Everybody likes music, usually. Then I thought about my own experiences. Many times I was asked if I would like to participate, but I always declined with a smile, saying that I was very busy. That, of course, was not always true. I actually felt embarrassed to go to music therapy...
So this time I said I would go and I was going to invite my patients to come with me. One patient answered "no...no...not for me, pappy," and another just looked at me and smiled. Another patient had understandable pain. Others wanted to rest or to be with family. To my surprise, Mr. V understood, in my modest Spanish, the purpose of music therapy and said he would be glad to attend, despite his weakness.
He sat there, requested a couple of Spanish songs and chose a bongo drum. His weak, amyotrophied hands were striking nervously on the drumhead. He appeared joyful. Despite his advanced metastatic cancer, he looked to be actually enjoying the Latin beats. I still felt awkward but I stayed. It was clear to me, watching this session take place, that what I failed to give my patient was being provided by the music therapists.
He then started singing with a tremulous voice. I was captivated by this man’s optimism. Suddenly he stopped singing to ask one of the young music therapy interns to dance. She blushed. He assured her that his wife would not mind. She smiled and took his hand. Her face was shining. They danced together to the Latin rhythm, slowly, with his frail and thin bony body shaking. I was afraid his bones would crack. Watching him, I wished I could share in his joy, and then it struck me! Here was a dying man. He was dying and he knew it; but he was still happy. Two months ago when he found out about his cancer, he went back home in South America. He went to say goodbye to his family. I imagined him there having the same simple joy of life. I wished I could have more joy in my life from a simple occasion like this. I was amazed how he could put aside his many problems and just enjoy.
Five minutes later, Mr. V sat down. He asked me to take him back to his room. He was tired. I took him back, connected his IV fluid and helped him into his bed. He held my hand with both of his and thanked me. After a moment of satisfaction, I redirected my thoughts. It was not me that he needed to thank! I needed to thank him and the music therapists. They both reminded me of the simple pleasures in life.
On my way back to the back room, Carey called me. She wanted to show me her favorite instrument, a large rain drum. She struck it and a shiver went through my spine, solidifying the experience... When the day was over, I thought about Mr. V and music therapy. I wondered if I still needed my trip to Peru after all.
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