Sometimes...all that is left is Music

By Ray Leone, MMT, MT-BC 

Ray is a Board-Certified music therapist who directs A Place To Be’s medical music therapy program through a partnership with Inova Health Systems.

Music can be a very powerful phenomenon for someone who is in the hospital and is very ill.  And that is essentially why music therapy works in a medical setting.  I spend a significant amount of time in the Intensive Care Unit (ICU) and Oncology unit providing music therapy services.  Bringing music - to help with pain, anxiety, coping with an illness and to comfort - can be very powerful for all involved, including the caregiver…including me.  In these hospital units, I’m often times sent to see patients, and families, when there is nothing else that can be done for them.  When it’s time to think of “other options”.

-       There’s the patient who is on a ventilator, whose family members were just told that breathing trials are not working and they no longer have the lung capacity to breathe on their own.  And it’s time to consider terminal extubation.  Music can help process the situation.

-       There’s the patient in ICU, who is confused and delirious as a result of powerful medication.  And is extremely agitated because they don’t know where they are.  Music can help with orientation and relaxation.

-       There’s the patient receiving dialysis for kidney failure, who is in severe pain.  Music can help comfort.

-       There’s the patient in oncology who was just told that radiation therapy is not working and it’s time to consider hospice care. Music can help with coping and emotional expression.

-       There’s the family who is bedside, saying goodbye to a loved-one as they are actively passing. Music can help hold and create a sense of unity.

And in these units, where emotions and stress levels are high, often times the music therapy session becomes as much, if not more, for the caregiver (the wife, the husband, the mother, the son).  I was recently sent to see a patient in the ICU who was unresponsive and his breathing had been supported, for several days, by mechanical ventilation.  His wife was sitting quietly in the room and when I went in to provide some music, she smiled warmly and quietly said “hello”.  She appeared quite calm (maybe resolved?) as she sat, aimlessly looking at a magazine, off to the side.  I took out my guitar and sat next to the bed and after a moment I asked her what kind of music her husband liked to listen to.  She said that they used to enjoy going to see Broadway shows together “many years ago” and they still enjoy listening to that type of music.  When I started playing a few songs from some of the traditional musicals of yesterday, she put aside her magazine, went to the bedside and took his hand.  And she began to cry.  She was looking at his face, partially covered with tubing, and crying, seemingly releasing some much built up tension but also, perhaps, thinking of happier times.  It was a sad moment, but also a very real moment; very intimate.  A few moments prior she was sitting, distracted and somewhat removed from him, perusing a magazine, but once music was brought into play, they were connecting on some level.  She was connecting with him in a way that wasn’t really possible when the room was silent.  Did he feel her presence?  I certainly like to think so (I believe he did).  She certainly felt his.  And, there was music, providing a soundscape, taking her back, giving her a memory, allowing her to release tension, and allowing her to “be”, in the moment, with her husband.  How many more moments would they share together?  Music brought them together on another level.  

It always amazes me how quickly emotions rise when music, a simple tune, an old song, is brought into a heightened atmosphere such as a critical care hospital room.  Sometimes we just don’t know what tomorrow will bring or how we are feeling. Sometime we are confused and scared. Sometimes we don’t know what to say. Sometimes the medical staff is out of options.  Sometimes we just have to let go.  And sometimes…all that is left is music.

(*the stories presented in this blog are based on accounts and experiences and are not actual accounts and experiences)