What is music therapy, and why is it a vital part of care?
The idea behind music therapy is ingrained in our collective psyche. We all understand that music, no matter the genre, can be uplifting, engaging, transformative, and most important of all, healing. Sixty years ago, when the field was just burgeoning, music therapists faced an uphill battle to winning respect in the medical and patient communities. But now, it is standard practice for music therapists to be on staff at every hospital, especially children’s hospitals, where they are seen as essential.
At Children’s Hospital of Orange County, you’ll find three music therapists, including Creative Arts Supervisor Eric Mammen.
“Music therapy isn’t necessarily about the music,” he explained. “We use music to achieve a patient’s non-musical goals. Here at the hospital, we use music to engage children in self-expression, movement, relaxation, pain management, stress reduction, or even just getting them to stand up and play.”
Mammen has been a music therapist for nearly twenty years, and very early on, he realized that what he suspected all along was absolutely true. Music therapy is one of the greatest tools health providers have.
“One of my very first patients was a little girl who had just had her appendix removed. Three days later, she could go home if she got up and walked. That’s all she had to do. But she was terrified, she had a scar, she was scared to move.”
The girl’s doctors asked Mammen if he could engage with her. He played some music for her, and before long she was moving and having fun. “I got her standing up, and then we were dancing. All of a sudden she realized ‘hey, I’m standing! I’m walking!’ That showed me that what I was doing here was really powerful.”
Mammen likes to tell people his job is tricking kids all day long. “You don’t want to move your left arm? Okay, well, here’s a shaker. Then all of the sudden they’re moving their left arm.”
Music therapy is perhaps at its most powerful, however, when it comes to mental and emotional health. With older children, therapists will often try to engage their patients in songwriting, even if they never finish a song. The point is to get what is bottled up, off their minds and hearts. Recently, Mammen was working with a girl suffering from both an eating disorder and depression.
“Just through songs of hope and beauty, we were able to start a discussion about why she is doing what she is doing. Music opened that door to express her fears and what she is going through. She realized that it all ties back to her relationship with her mother.”
How are music therapists are using digital stethoscopes?
Ingrained in nearly every song, is some kind of percussion, perhaps driving those soaring vocals, or providing a rhythm to nod your head to, or just unobtrusively keeping the beat. Each person has their own internal percussion as well. The heartbeat.
In the past, when a heartbeat stopped, when a person died, that vital sound was lost forever. But now, thanks to devices like the Eko digital stethoscope, music therapists are capturing that sound, and preserving it in a remarkable way.
Mammen has started recording the heartbeats of terminally ill patients, and then incorporating the beat into a song that has special meaning to the family. He’s not the first person to do this, but perhaps the first music therapist to rely on the Eko to create a keepsake many families have told him they will treasure the rest of their lives.
Mammen got the idea about six years ago, from Brian Schreck, a music therapist at Cincinnati Children’s Hospital, who developed a way to attach a microphone to his stethoscope to record heartbeats.
“Back then, we rigged a stethoscope and put a lapel mic inside of it and recorded it that way. I needed my computer and a USB interface, wires, mics… But if I wasn’t there when a patient was passing, then we weren’t able to record the heartbeat. No one knew how to get into my computer and set up the system, so I started searching for other ways to record heartbeats.”
Mammen came across other digital stethoscopes, but found them cumbersome.
“And then I found the Eko digital stethoscopes. I instantly fell in love with the capability of being able to walk into a room with just an iPad and my stethoscope, and record the heartbeat. Then once the heartbeat was recorded, it was uploaded into the cloud. I could go back to my office, pull it into my computer, and then work on it there.”
Even better, is Mammen was able to teach other specialists to use the Eko, so if music therapists weren’t around, virtually anyone could press record and send the file to the cloud. Now CHOC has three Eko devices, a mix of the full digital stethoscope, and the CORE digital attachment, to capture sounds from infants.
“We often work in the NICU. The standard stethoscope covered their whole chest, so we attached the CORE to a NICU stethoscope.”
In March, Mammen will present what he has been doing with the Eko at the Western Region Chapter, American Music Therapy Association conference. In theory, it’s simple. He finds a portion of the heartbeat free of clicks and pops, and gently manipulates it to match the tempo of a favorite song. But the impact is complex, and often overwhelming.
“I have had a few families ask ‘can you play the song for us?’ When I play it in the room it’s definitely an emotional time. I have a really hard time keeping it together. We have worked with babies who were born essentially brain dead, but we were able to record the heartbeat before they passed. I’ve had some patients even give last messages to their family, like ‘hey dad, thanks for…’ Added to the song and the heartbeat, it’s… dramatic. I’m going to start crying just thinking about it.”
Mammen and his team get requests for everything from the instrumental version of “You Are My Sunshine” to Phil Collins’s “You’ll Be in My Heart” or “Fight Song” by Rachel Platten. Israel Kamakawiwo’ole’s “Somewhere Over the Rainbow” might be the most popular choice.
The sheer emotional power of the song is why Mammen usually gives the family a recording to take home rather than show it to them in person. And it’s this simple act, of having something final to give, that provides both Mammen, and the family, a sense of closure.
“When I first started here, I was working with a patient, and at the very end, when she was passing, I felt so helpless. I had nothing else to give to the family. When I learned about heartbeat recording I thought ‘wow, this is something I can do that will last past death.’ That’s why I was so excited to engage and learn and teach this.”
Recording heartbeats and weaving that intimate sound into music is also becoming a big part of hospice. And Mammen points out that songwriting with heartbeats doesn’t have to mark the ending of a life. “You can do it with someone who is healthy. Anyone can have fun and make music with their heartbeat.”
Perhaps as the field of music therapy continues to grow and embrace new technologies like the Eko, we’ll hear the heartbeat emerge in songs of celebration, as well as songs of commemoration.