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The scene: A hospital room in the intensive care unit. The patient is in the bed and on a mechanical ventilator, multiple IV lines connected to him, and various bags of fluids and medications on a ‘tree’ next to the bed. He is being fed through a tube inserted into his nose. There is a large monitor with readings of his heart rate, respiratory rate, oxygenation, and blood pressure… the beeping is soft, but you feel at the base of your brain. A white board on the wall lists medications and times and other charted numbers in bold back and vibrant red.
Also present is a technician, performing an echocardiogram, sitting at a mobile desk with a big monitor with various displays. The expression on his face says that this is a serious and important procedure. The patient’s wife is quietly sitting in the corner in an industrial type chair… looking exhausted, and just staring off. The room is somewhat dark, gloomy, quiet with only sounds of mechanical ‘breathing’, the beeping from the monitor, and muffled and eerie ultrasound tones coming from the echo machine. There is one other element introduced (seemingly out of place?) - Me and my guitar.
From the first strum the mood of the room transformed. As the music started progressing—a ‘soundscape’ of chords and arpeggios—it gradually overtook the dreary antiseptic aura of the surroundings. The tones of the machines were now, purposefully, within the melodic structure, the key, of the music. And the beeping heart rate rhythm acted as a metronome, syncing with the music’s tempo. Again, purposefully - not masked by the music… incorporated. The initial light tension and dissonance that was introduced in the music gradually modulated to more soothing and harmonic themes. The music changed everything.
Now: The nurse, who frantically entered the room to check on meds, slowed when she saw me, and gave me a soft smile as she touched my shoulder. She seemed comforted by my presence. By the music’s presence. You could literally see her shoulders drop as she let out a breath and subtly rolled her head from side to side before performing her tasks. The technician occasionally glanced over at me and smiled while manning his machine. The ‘hardness’ in his face had subsided. The patient’s wife sat back in her chair and closed her eyes. She let out a sigh as her face softened. It seemed that she was finally getting some much-needed rest.
And the patient? Well… his heart rate slowly decreased, perhaps following the purposeful ritardando (gradual slowing) of the music. [The heart rate and/or the respiratory rate will often sync or ‘entrain’ with the tempo of the music. Then, when the tempo is slowly decreased, the heart rate and/or the respiratory rate will often follow, prompting a relaxation response. Even for patients on mechanical ventilation.] The entire mood of the room changed.
From the outside, it may have looked as if something in this scenario did not belong. Or, it may have looked ‘nice’ to have someone ‘performing’ some music for the patient. However, on the inside, it (the music) made a difference for all involved. On the inside, the music was presented with intention, clinically, and working towards achieving a goal—to help reduce anxiety. On the inside, music therapy was an integral part of the medical treatment plan - A non-pharmacological intervention based on scientific evidence and research.
On the inside, music… made a difference.
On the inside, music therapy… made a difference.
Music is the one entity that can truly help change an entire surrounding, especially in a high stress environment such as a critical care hospital setting. Music is an element that is simultaneously beneficial for patient, family, caregiver, and staff. Music is healing in a hospital setting. Music makes a difference. Music belongs. Music therapy belongs.
The healing power of music.
(The stories presented in this newsletter are based on accounts or experiences and are not actual accounts or experiences.)
Raymond Leone, MMT, MT-BC is a board-certified music therapist based in Northern Virginia and writes extensively about music therapy and music and wellness.
Did you know that if you hit the heart at the top or the bottom of this email you will make my day and it will make it easier for others to find this publication. Thanks!
Thanks for sharing this 🙏
Beautiful