Irene (not her real name) was my patient for many years, and during a routine visit she showed me a lump on her abdomen which turned out to be metastatic pancreatic cancer. I went to visit her one afternoon in hopes of offering her some comfort. The day I visited her was sunny and cloudless, but when I entered the mobile home, I was ushered in by her daughter into a low-lit room with all the shades drawn. Irene was lying in bed surrounded by photos of her children and grandchildren. I inquired about her family, and she shared what life was like growing up as a child in Ireland. I played a few songs for her on my viola, but she had one musical request – “Humoresque” by Dvorak. I felt bad that I did not know this piece from memory or have the music with me, and I apologized for not playing it for her. She died within a few days of my visit, and her daughter telephoned me asking me to play Humoresque at her Rosary Service. Of course, I agreed.
It was a rainy night, but the church sanctuary was packed with over 200 people. I removed my viola from its case at the back of the church sanctuary hoping to play and then make a hasty escape. However, Irene’s son intercepted me, and invited me to play in the front of the sanctuary. The delightfulness of the music triggered smiling expressions on the congregants as it somehow reminded everyone what a vivacious and friendly person Irene had been. Irene’s son did not want me to leave after I played. He welcomed me to sit next to him for the rosary service and asked me to play some additional music for the conclusion. I chose a reflective piece called Meditation on a Theme by Thais by Massenet. After the final note of the music resounded in the church, it was followed by an unearthly silence. The music, together with the rosary service, evidently managed to touch many souls. I felt a sense of comfort because I was able to express a second good bye to Irene.
Medical Benefits of Music
Music has profound effects on our mind and behavior, and medical professionals have begun to harness the neurological effects of music to promote health and well-being of their patients. One of the first ideas of how music affects the brain was published in 1995. It was called “The Mozart Effect.” It claimed that listening to Mozart could improve IQ. Subsequent studies found the effect was minimal. However, children who learn to play music develop neurological benefits which persist until adulthood. Music listening in older adults has been associated with improved cognitive function. Music therapy has been useful to help stroke victims recover speech, and music has been used in patients with Parkinson’s disease to help gait and balance. Patients who listen to music while undergoing cataract surgery are found to have lower blood pressure and heart rate. In patients with post-operative pain, listening to music has been associated with reduced requirement for opiate drugs which suggests that music stimulates the release of pain relieving substances in the brain.
Plato believed, “Music gives a soul to the universe, wings to the mind, flight to the imagination and life to everything.” When people are suffering with terminal cancer, depression, or chronic pain, music therapy has been found to improve quality of life and mood. Whenever I have gone to visit patients at end of life, I have brought along my viola and played a few pieces. I like to think my viola playing provides a few minutes of distraction from the burden of illness. I think as we age and maybe recognize our own mortality, senses are heightened, which enhances the appreciation of music. We can listen in ways we did not before. For friends and family members of Irene, her favorite piece of music helped them to remember her as a vibrant person, and provided a sense of closure. In the congregation of 200 friends and family, music united everyone.
It should not be a surprise that the ancient Greeks assigned the roles of healing and music to one god, Apollo. Before there were medicines, music might have been the best therapy to offer to any ill person. Playing music for patients has become one of my favorite interventions.
For additional information about Music As Medicine, please see the excellent review article by Dr. Harvey Simon in American Journal of Medicine, February 2015.
Jerry Saliman, MD is a volunteer internist at Samaritan House Medical Clinic in San Mateo. He retired from Kaiser South San Francisco after working there more than 30 years. While at Kaiser SSF, Dr. Saliman was also Chief of Patient Education. He received the 2012 “Lifetime Achievement Award” given by the Kaiser SSF Medical Staff. He plays viola in the Peninsula Symphony, and he accompanies Hashirim choir with his violin.
Editing acknowledgement: Ellen Saliman
Neither the PJCC or our guest columnists provide medical advice, diagnosis, or treatment. Please make your health care decisions in partnership with your health care provider.