Music and Medicine

 

Musical Healing
A physician-turned-orchestra conductor prescribes song.
by Samuel Wong ’88
Samuel Wong conducting orchestra

In a dark corner of a veterans’ hospital lies a man exiled from this world. He barely moves, eats little, does not speak, recognizes no one. His face, a stubbly mess, shows neither pleasure nor displeasure—just a constant indifference ever since a stroke devastated him ten years ago. An artery in his left brain had ruptured, spilling a river of blood in his head, drowning out reason and memories, clogging his once brilliant mind. His family left him long ago.

Now this man lies on a miserable cot, vacant and opaque. He looks a decade older than his 67 years. His face is gnarled and unshaven, his streaks of white hair are in disarray, his mouth is twisted and drooling. His eyes stare at the fluorescent light above, an artificial brightness that never varies.

Face to face with him, I start singing an old Anglican hymn, “Come down O love divine.” His face stirs with recognition, his eyes begin searching, his breath quickens, his right hand twitches. I sing another verse, and another. I now see his face wince, question, beg, protest. His breathing has become irregular, his face human. His mouth tenses in an effort to speak; warm tears soak his eyes.

Every week I would sing to this man, and every week I would witness a remarkable awakening. He never spoke, but would join in the singing of hymns with his feeble, eggshell voice. It was as if after years of hibernation, he was starting to thaw, to move, to live again. Through this window of music, a ray of light seemed to shine from the outside world directly onto his soul.

Throughout history, music has been used to invoke God, call armies to war, marry, bury, baptize, and express the sublime and the beautiful. The Bible describes David’s playing his harp to ease King Saul’s physical and mental suffering. Today, as we discover its boundless potential, music is used in hospitals and clinics to alleviate pain, reduce anxiety, reclaim lost memories, enhance learning, and restore order, beauty, hope, and meaning in patients’ lives. I have always believed in the tremendous power of music to reach the soul and to promote physical and emotional wellness. After leaving medicine to pursue a full-time career in orchestra conducting, I return sometimes to the corridors of healing, this time bearing song.

On a Tuesday afternoon in the Bronx, at Beth Abraham Hospital, where neurologist Oliver Sacks founded the Institute for Music and Neurologic Function, I am leading a music session with six patients. After starting with some simple harmonies and a slow rocking rhythm on a Yamaha keyboard, I invite Molly,* a 76-year-old aphasic from Dublin, to improvise a little ditty. “Oh Danny boy, how I miss you, my Danny boy,” she sings, her voice strong and eloquent. Just a moment ago she could not speak the simplest words. Next Rosita, briefly lucid and coherent from her dementia, sings in Spanish, “How much pain and suffering we must forget, my love, after all these years.” And then, as he stares down at his confining wheelchair, Robert, a rotund black man, joins in, “Oh yes, how I miss my Emily, and my son in Alabam, how I wish I could walk again, then I could walk to them.”

And so the musical improvisation goes, stitching memories, yearnings, and sorrows together in a motley quilt. United by adversity, loneliness, and disease, six people—from Ireland, Cuba, Jamaica, and New York City—pour their hearts out in song.

An hour later, I am beating on a xylophone with joyful abandon. New harmonies and rhythmic variations emerge as 15 chronic neurological patients play guitars, maracas, tambourines, and tom-toms. Some are in wheelchairs, some are on gurneys, others are sitting by IV poles, but all are beating, strumming, shaking, making a joyful noise.

Rocky, a young black man with multiple sclerosis, perks up at the reprise of a song, letting out a salvo of excitement on his snare drums. Marino’s eyes glow with recognition and pleasure as he shakes his maracas even more vigorously, seemingly free of his Parkinsonian tremor. Rose laughs, lifted from her depression, as she senses the infectious rise of tempo and spirit. Rules of the house: every- one must play or sing, no matter what instrument is wielded or what position is assumed. No infirmity is too great for this chamber music.

In a recovery room on another floor of the hospital, Mrs. Miller, a plump, retired schoolteacher who has just had her gallbladder removed, wakes up gradually to her favorite Mozart piano concerto. “I play K. 466 whenever I feel anxious or distraught,” she tells me. “The music dissolves my pain and worries. I came into the world listening to Eine kleine Nachtmusik, and I will go to my Maker with the Lacrymosa of Mozart’s Requiem.” The right music, in the right setting, transports her, she says, to a different plane of consciousness.

Reports and anecdotes from around the world support Mrs. Miller’s beliefs about the healing benefits of music. Studies covering everyone from delivering mothers to cancer patients have demonstrated the phenomenal soothing power of music, which can speed recovery, ease pain, and reduce anxiety, stress levels, and even arterial pressure.

In England, patients who listened to classical music while undergoing local anesthesia recovered more quickly and reported fewer complications. In Canada, patients exposed to 15 minutes of soothing music needed half the sedatives and anesthetic drugs that other patients required. In Poland, patients with severe headaches had significantly less need for medication when exposed to concert music for six months. And in Japan, surgical patients listening to music just before anesthesia had increased levels of alpha brain waves and decreased levels of stress hormones.

At the University of Colorado, researchers were able to reduce patients’ mean arterial pressure, both systole and diastole, by playing “sedative music.” In Austin, Texas, women had a decreased need for anesthesia during childbirth when listening to music. In Provo, Utah, babies who regularly heard live singing gained more weight and were released from the intensive care unit three days earlier than those who didn’t. In a study in three New York hospitals, babies exposed to Brahms’ Lullaby six times a day were ready to go home a week earlier than controls. And at UMass Memorial Health Care, harp music is prescribed in lieu of tranquilizers for cancer patients.

Perhaps more impressively, music has proved effective in treating a range of neurological and psychological disorders. Researchers in Colorado found that a half hour of rhythmic stimulation each day improved cadence, stride, and foot placement in stroke patients. A University of California, Los Angeles study showed a 59 percent reduction in auditory hallucinations in hospitalized schizophrenics who listened to music. A music professor at Northern Illinois University taught patients with Parkinson’s disease to play the harp in groups; many of these patients achieved remarkable fluidity and freedom of movement. Other studies have found significant increases in concentration, learning, and lucidity among children with learning disabilities and autism.

I have witnessed musical miracles at Beth Abraham Hospital, where familiar songs are played to stroke and Parkinson’s patients, resulting in remarkable fluency of movement and gait. And I have seen music engender other awakenings. A movement from a Mozart piano concerto, a phrase from a Schubert lied, a chorus from Handel’s Messiah, and a Cole Porter love ballad have all brought about total lucidity and humanness, if only for a moment.

With music, those whose true selves have been locked away can feel whole again, regain the self, and recall a world inhabited by loved ones, filled with passion and longing, and ordered by knowledge and learning—a world that resonates with meaning. To patients with deranged memory, music can be a Proustian mnemonic. Faces, words, and names seem like loose pieces of timber, scattered, meaningless, floating aimlessly down the river of time. No matter how much patients try with medication, physical therapy, and reading, they cannot hold these pieces of wood together again. Music can be the key that releases a flood of memories—not just randomly, but as part of a coherent picture.

Music does not lead us by the hand, but initiates our walk in the right direction, builds bridges to carry us across devastated landscapes, and sustains us in our inner search when we fatigue from repeated effort. Because music bypasses the usual circuits of word retrieval, facial recognition, list recollection, and mathematical calculation, a beam of light shines directly onto our emotional core. Raw, uncut, and unstoppable, music burns a seal into our hearts, wrenches our guts, makes us shudder with fear or sing with joy.

We can stop listening, but we cannot stop hearing. Ever since we were in the womb, we have heard the primordial, incessant drumming of our mother’s heartbeat, a rhythm that is emblazoned into our neuronal circuits, pulsating daily within our core. This internal music has never left us and is the key to unlocking primitive memories and reconstructing our internal order.

If music can be used to recover memories in Alzheimer’s patients, why not in the surfacing and treatment of post-traumatic stress, rape, child abuse, and amnesia? If music can uplift the depressed, why not also the aged, the restrained, the immobile, the spiritually disaffected? If music can bypass language to reach the emotional core of those in the throes of disease and devastation, why not also the emotional core of those maintaining their well-being?

Down the hall from my music group of neurological patients at Beth Abraham Hospital, Connie Tamaino, the director of music therapy, is playing accordion for Edward, a life-loving black gentleman who suffered a severe stroke. His left hand is contracted and stiff, his left leg lifeless and heavy on his wheelchair pedal. His speech is halting at best; at worst, he cannot get anything out, and his eyes glare with effort. He can see the words as if on a page, but he cannot release them into fluent speech. And yet, when he sings, lyrics come effortlessly. Even when he stops singing, if he simply thinks about singing, his words arrive more easily.

“It’s gotta be you!” he sings, as he gesticulates with his right hand, almost conducting, with delirious freedom. When the music stops, he wrings his hands and sighs. “I ccc-can’t, ccc-can’t ggg-get...Ach!” He is stuck again. But when he starts to sing his sentences, his fluidity returns. He has come a long way since his stroke. With music, he has regained fluency, dignity, and meaning in his compromised life.

Samuel Wong ’88 is music director of the Hong Kong Philharmonic, the Honolulu Symphony, and New York City’s Mannes College of Music.

This article appeared in the Summer 1999 issue of the Harvard Medical Alumni Bulletin.

Photo: Gary Hofheimer


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