Music in Hospitals: an alternative therapy

Article published in The Royal Society for the Promotion of Health

Music in Hospitals: An alternative therapy.

Much of the literature on the Sociology of Health and Illness makes the point that since physical diseases, or illnesses, are located solely in the body, it is only the body that is medically treated and not always the whole person, in effect separating the body from the self; "treating the body in isolation" (Freund, 2003, p.6). Or, as Sarah Nettleton (1995, p.3) puts it, "the body is isolated from the person, the social and material causes of disease are neglected, and the subjective interpretations and meanings of health are deemed irrelevant". Yet illness is also an emotional and social experience, one not addressed by the medicalising emphasis on the physiological aspect of the disease, the illness, the possible cure, the medication and the operation. Typical responses to illness include the loss of self and identity, anger, frustration, loss of dignity, feelings of isolation, and the stigma surrounding certain illnesses and disabilities (see Charmaz & Paterniti [1999]). If we consider the number of patients in hospitals, hospices, those being treated for mental illnesses, and add those living with pain, perhaps it is time for nursing staff and doctors to consider seriously alternative therapies which might assist with well being, provide opportunities of social connection and, through this, perhaps even hasten the healing process.

My research has led me into a new "alternative" therapy, the use of live music in hospitals, used in ways that aim to, and as Aasgaard (2004, p.148) puts it, "humanise the hospital community". I have been examining music in hospitals as a social activity and experience through an ethnographic study of Music in Hospitals.[i] My current research focus has been on the tacit skills of musicians, since performing under hospital and hospice circumstances requires skills that overlap with but are also different from performing in a "normal" concert.

One of the first skills I noticed, possessed by nearly all of the musicians I have seen to date is the ability to adapt to difficult situations and to be flexible when the unexpected happens. For example, at the beginning of a concert in a nursing home for cancer patients, the musicians, a folk duo with lively personalities, "bounced" into the room laughing and joking with each other and greeted the patients with words and smiles. This strategy fell flat, there was no visible response aside from one male patient who was drinking brandy. He raised his glass to them and said, "cheers". Quickly modulating the mood, one of the musicians replied "cheers but it"s a bit early for me", to which the patient responded, "well it stops the pain". The musician looked at him, gently smiled, and in a soft voice said, "well you enjoy it then". Although the musicians did not ignore the fact that one patient was drinking brandy at 10am, they also knew how to let it pass without too much comment. They then moved on, apparently seamlessly, to the next, wherein they introduced themselves and began to play; illustrating one of the most basic skills of the Music in Hospitals musician, "the sensitivity to know when close contact is welcome and when is not appropriate" (Lindsay in Kaye & Blee, 1997, p 29).
I have also seen the musicians use their instruments and bodies to focus attention and, to some degree, to afford a kind of physiotherapy. On one occasion in a hospice, at the start of a concert the trombonist started to play a slow and quiet melody swaying his body in small movements, he began to play louder and faster, still swaying in time, and then as the music went higher he lifted the trombone higher and side to side, getting faster all the time. Almost instantly the able-bodied patients raised their heads and moved them from side to side watching his every move, energised and clapping along. This shows not only the embodied use of an instrument but also the knowledge of how to structure energy levels and thus, to gauge what an audience can withstand. For example, if patients become energised, it is also important to calm them down before they return to the wards (see DeNora on the grammar of "aerobic exercise sessions", [2000]). At the end of one concert for people in a hospital who were all seriously ill, the guitarist completed a lively ten minute session and then began to play a very quiet and lilting melody, all the while smiling at the patients and swaying his head from side to side. As the melody went on he began to sway his whole body and guitar in time to the calming melody. I noted that all but one of the patients were mirroring his movements; the one who was not was nevertheless rocking her head and it was obvious that she was fighting to stay awake. As the melody developed, most of the patients were still moving their bodies with his but many had their eyes closed and were smiling. They looked peaceful and contented and I could see they were breathing deeper and more slowly. For me, it was astonishing to see how the gentleness of the melody and his bodily movements could have so much power over their reactions. When he finished playing no one moved, some patients were now sleeping, others just remained still and appeared contented. In conversation afterwards, a nurse told me that this musician "is better than any sleeping tablet we give the patients". These processes of entrainment achieved by these two very different musicians under quite different circumstances, illustrate how Music in Hospitals musicians find ways of drawing their listeners together, in this case bodily, as to create a physical communion across an otherwise atomised group.

My research aim has been to observe the effect of playing live music to patients and to assess this through observations and interviews with the patients" families, carers, and, when possible, patients themselves. My impressions so far at this early stage of research (I have completed 158 hours of fieldwork at 14 concerts, auditions and associated interviews in addition to documentary study) is that the concerts enable situations where patients can be stimulated both visually and generally, where they can be expressive, take part and take notice of each other, and where they are treated like whole beings.
[i] The idea for Music in Hospitals was conceived in 1946 by Sheila McCreery and after much advice from the medical profession, Music in Hospitals became established in 1948.

References:

Aasgaard, T. (2004) "A Pied Piper among White Coats and Infusion Pumps: Community Music Therapy in a Paediatric Hospital Setting". in Ansdell, G and Pavlicevic, M (eds) (2004) Community Music Therapy. Jessica Kingsley Publishers, London and Philadelphia.

Charmaz, K. & Paterniti, D.A. (eds) (1999) Health, Illness and Healing: Society, Social Context, and Self. An Anthology. Roxbury Publishing Company. LA, California.

DeNora, T. (2000) Music in Everyday Life. Cambridge University Press.

Freund, P.E.S., McGuire, M.B. & Podhurst, L.S. (2003, 4th edition) Health, Illness and the Social Body: A Critical Sociology. Prentice Hall, New Jersey.

Kaye, C. and Blee, T. (eds) (1997) The Arts in Health Care: A Palette of Possibilities. Jessica Kingsley Publishers. London and Bristol, Pennsylvania.

Nettleton, S. (1995) The Sociology of Health and Illness. Polity Press.

Next >