Friday, August 19, 2016

A healing environment

On Wednesday the Diane Rehm had an hour-long discussion of the role of music in medicine. Some of the things she and her panel discussed:

Andrew Schulman is a classical guitarist. He labels himself as a medical musician, not a musical therapist. That's because a musical therapist is a therapist first, guiding the patient through physical or mental therapy using music. A student of MT studies a lot of therapy.

But a medical musician is a musician first. Schulman is a resident musician at both Berkshire Medical Center and Mount Sinai Beth Israel Hospital in New York. He takes his guitar into the Intensive Care Unit and plays for patients. He does it because his life was saved in the Mount Sinai ICU. While performing in the hospital he can adjust his music to the patient and the needs of the moment. He can also supply music when a patient is dying and the family has come to say goodbye.

Schulman describes his stay in the ICU. He had surgery and went into shock. He was revived and put into a coma. For three days he went downhill. His wife saw his iPod and had an idea. She played a favorite piece of Bach – and he began to stabilize.

Yes, patient-chosen music has a real effect on the body. It reduced the need for pain medication and sedation. It shortens hospital stays. John Powell, musician and author, describes the body as having a built-in pharmacy. Music can affect what the body dispenses out of its internal pharmacy. Music also has a real effect on the brain. Language will stimulate particular parts of a brain, but music engages wide areas of the brain.

Dr. Marvin McMillan is a trauma surgeon and was a part of Schulman's care and saw what music did to Schulman. McMillan now recognizes the ideal environment of an ICU. But that isn't the standard ICU, with its bombardment of machine noises, blasting TVs, and alarms. There are so many alarms that serious ones – like a disconnected respirator – are ignored. This is not a healthy sound environment for a patient. Time to reorganize the ICU with input from the musicians and those who know healing environments.

This page of the Diane Rehm Show includes the prologue of Schulman's book Waking the Spirit. In it he describes playing for the patient that prompted him to write the book. It is worth a read.

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