From the New York Times

Doctors Promote Healing, With a Zing of the String of a Harp



ALBUQUERQUE, Dec. 15 The only light in the room is the flicker from the wall-mounted television, thankfully on mute. I watch a car salesman walking through a used car lot mouthing his pitch. Propped by pillows, David lies against the rail of his hospital bed.

His right side is paralyzed by a stroke, but he wears a crooked, serene smile. Patrice Repar sings "Misty" in a wispy alto, accompanying herself on a portable keyboard.

After the last chord, David struggles to clap, bringing his good arm across his chest, thumping his sunken shoulder. "I always wanted to be a lounge singer," he haltingly told Ms. Repar. "Being sick isn't me. It hurts to talk. I lost that ability, but I still get my point across. I'm still funny as heck."

Ms. Repar, a former rock 'n' roller from Canada, now is the composer and musician on the faculty of the University of New Mexico who also directs the Arts in Medicine program at the university's hospital here. These days, her passions are the unlikely mix of computer-generated electronica and singing lullabies to patients like David.

I met Ms. Repar several years ago when she recruited me from teaching residents at the medical school to help teach a course for university freshmen. The course was called "Medicine and Culture," and Ms. Repar, Dr. Peter White, a professor of English and American studies, and I spent six months creating a curriculum that combined literature, music and medicine.

One day, after class, Ms. Repar proposed bringing musicians and artists to perform and work with patients and staff members at the university hospital.

The idea, she said, had been brewing for a while, ever since she took a course in palliative care. "I was touched on the shoulder by death when I was living and teaching in Quito, Ecuador, and I ended up being hospitalized for a long time," Ms. Repar said. "That led me to want to explore the arts and dying, and the arts and healing."

Healing under the arts in medicine program started very slowly, but the hospital staff has become accustomed to Ms. Repar's team of "roving rejuvenators" wheeling Yamaha keyboards past a nursing station, or a harpist unpacking her instrument in the emergency waiting room, or a yoga instructor setting up in a doctors' lounge.

Nurses and the cleaning staff members have their shoulders massaged. Children waiting in the emergency room color with an art therapist, while a graduate student in music plays her harp. Nurses write free verse over lunch. And several doctors who are members of the Swamp Coolers, a bluegrass band, play a Bill Monroe tune outside the cafeteria.

Herbert Spencer, the British philosopher and sociologist, said, "Music must take rank as the highest of the fine arts as the one which, more than any other, ministers to human welfare."

A pilot study reports on a group of bone marrow transplant patients at the University of Rochester Medical Center. Twice a week, they took part in music and imagery relaxation sessions, and indicated that they felt significantly less pain and nausea than a control group.

Those in the musical sessions also began producing new white blood cells two days faster than those in a comparison group. The National Institutes of Health is financing a larger study.

Several studies have shown that harp music in cardiac care units reduces anxiety, pain, blood pressure and respiratory rate, and a study of 40 cardiac surgery patients reported that those exposed to music secreted half the level of stress hormones as the control group.

Recent advances in basic neurobiology research have established a close link between the brain's hearing and emotional centers, said Dr. Mark Jude Tramo, a neuroscientist who is director of the Institute for Music and Brain Science at Harvard. "The anatomical and functional connectivity of the brain's auditory systems and emotional systems underlie musical aesthetics," Dr. Tramo said. "The effect of music on emotions may, in turn, influence autonomic and immunologic systems in ways that affect and help the body's natural responses to disease."

But, he emphasized, music should not be considered a first-line therapy.

A patient at the university hospital wore a scarf that only partly obscured surgical staples and Steri-strips covering most of her brow and temple. She said she had had 44 operations to repair a total of 10 congenital brain aneurysms.

Ms. Repar furnished her with drawing paper and colored chalk, but also offered to tell stories or play the flute. She unwrapped a carved wooden Sioux Indian flute and began a haunting improvisation. At the end, the patient said she had dreamt of angels.

"It's sometimes the case that they don't want music," Ms. Repar said. "But they really want to tell their story, or maybe they don't want to talk but would love for you to sing them to sleep." Ms. Repar said music therapy helped people escape a bit. "I think music takes us to another place," she said. "And from that place, our world and life view changes. There are more possibilities doors more open than shut more light than dark. It's an experience of the abstract. Music is just understood by everyone. It's from somewhere else, and it takes you somewhere else."

My life would not be the same without music and playing the fiddle with the bluegrass Fiasco Brothers. Lately, I've branched out. I'm playing jazz standards with three other physicians, and Balkan and Middle Eastern music with another ensemble. I figure I'm hedging my bets. If I need to be hospitalized, all the bands are on notice. You've got a gig.


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