The Heart of Music therapy

A couple of years ago, I was approached by a film producer interested in documenting and telling short stories about wellness. His goal was to tell stories of wellness and integrative medicine from a variety of perspectives and music therapy had captured his interest. I spent a number of months working back and forth with him and his team, discussing music therapy and wellness from my perspective and what I thought was important to tell. In order to best communicate what I thought was most valuable to share, I began to write patient stories from memory. I found that it was easier to send snippets of meaningful moments from music therapy sessions to his team in between our scheduled conversations. I didn’t know how else to communicate the complexity of the experiences I had had. The project with this documentary team never panned out for a variety of reasons – but one reason in particular seemed clear: the vastness of music therapy cannot be documented within 3-5 minutes. Not fully, anyway.

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Returning to work after being furloughed was not an easy preparation or flawless transition. No matter your role or your specific experience, being asked to not return to your job is an immediate reduction to your self-worth. I spent a lot of time during my furlough focused on what the bigger picture was of what I wanted and how to best use that unexpected time. I also gave myself a fair amount of grace to relax and mope. During my moping phases, I questioned my efficacy as a music therapist and my professional priorities often and from every angle. When friends and family would ask what I thought I would do if asked to return to my job, I kept coming back to the heart of my work – serving people in the way I best know how to do.

When I eventually returned to work, I set new boundaries and I made clear statements. I was open and honest about my experience of being furloughed, but I moved forward. I refocused my presence on my patients and their families and I began to hear their stories again.

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As I was preparing for an in-service presentation this week, I opened our team’s music library to search for some patient recordings. I became a little lost in the weeds of organizing things when I found myself immersed in our collection of Heartbeat Songs. A Heartbeat Song is an intervention employed to build legacies with patients and families and is often used to document a journey – whether it be a difficult treatment, like cancer care, or to preserve the memory of someone at the end of their life. Music therapists record the heartbeat through special stethoscopes and often will pair a cover version of a significant song chosen by the patient and family while using their heartbeat to serve as the drumbeat.

When I joined the team, I remember being so overwhelmed with the concept. I didn’t know how to introduce the idea of recording a heartbeat of a dying patient to a family member and the editing process seemed time-consuming and daunting. Eventually I became comfortable with the intervention, ultimately focusing on re-educating staff about how to maximize the intervention’s benefits throughout a patient journey and not just as a final offering at the end of life. To me, the Heartbeat Song was another patient story waiting to be told. I wanted to ensure that we were not telling stories of a death, but instead, of the life.

As I sat listening to these various Heartbeat Songs, I was flooded with the heart of music therapy in a more tangible way than we often get to experience. So much of our work is in the moment and is ultimately fleeting. We remember the stand-out moments throughout our career, but we forget so many things. I opened the patient stories I had written two years ago and was immediately contented. I document patient “stories” every day in the medical records but I don’t often revisit stories of the work that I did in a narrative form. Here were clear examples of music therapy making an impact on someone and more often than not, on many someones.

As I continue to journey back through my own memories and begin to consider what these patient stories can offer to others than myself, I will share a simple one here from years ago so that maybe you too can find some contentment.

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Hospice Care – 2013: Woody was a gentleman who lived in an upscale nursing home in Orlando. I was referred to Woody to help with socialization, relaxation, and motivation to interact and engage. Woody was known to our hospice staff and his nursing home staff as being reclusive and isolative. Woody was unable to get out of bed on his own and rarely agreed to leave his room. Because of his difficulty with getting out of bed, he tended to make excuses to not do things for himself. Woody was estranged from his family and was largely alone. I believe he had one family member or friend who occasionally visited and offered support, but had withdrawn throughout the years due to Woody’s difficult temperament.

In my time with Woody, I offered many of his favorite songs, typically patriotic, but most specifically the Battle Hymn of the Republic. I had never known how many verses there were to that song prior to working with him but I now have them memorized. Woody had played the clarinet in his high school marching band and loved marching songs. Woody also loved classical music, which is often difficult for me to replicate on the guitar at the bedside. There was, however, an upright piano in one of the living rooms, only a few doors down from Woody’s room. For a few weeks, I coordinated with Woody, his nursing home staff, and our hospice team to get Woody out of his bed, into his wheelchair, and down the hall to the piano. For weeks, I arrived at Woody’s room, expecting him to be ready (having communicated with the staff earlier in the day), and he was still in bed. Woody took a few weeks to work up the courage to get out of bed. When we finally made it happen, I provided some classical pieces on the piano, but mostly Chopin, as that was one of Woody’s favorites.

Woody only made it out to the piano one time. Although we continued to offer that service, he chose to remain in his bedroom. We continued to sing Battle Hymn of the Republic at each visit until he died. Woody continues to stand out to me in memory because the power of his love of music inspired Woody to step out of his comfort zone. I remember playing Chopin on the piano rather poorly at the time, and feeling guilty for that, but for Woody, this was his only instance of hearing some of his favorite music, live, at the piano at the end of his life. Even when reflecting now, I am humbled by how the intentionality and simplicity of the music moved Woody.

May the stories our patients tell remain at the heart of our work in music therapy.