A Swedish study released this week finds that the heart rates of those who sing together synch up quickly, in relationship to the tempo of the song. The study was published in Frontiers in Neuroscience. According to the abstract, “We show how song structure, respiration and HR are connected. Unison singing of regular song structures makes the hearts of the singers accelerate and decelerate simultaneously. Implications concerning the effect on wellbeing and health are discussed as well as the question how this inner entrainment may affect perception and behavior.”
In this video, A Swedish researcher explains how heart rates become synchronized when people sing together.
The concept of entrainment is very familiar to music-thanatologists. While playing for people who are often unable to communicate with words, we follow the patient’s visible respirations during the music vigil. This provides an opportunity for the patient’s respirations and heart rate to move in relationship with the music being played on the harp or sung. Like the choir voices singing together, the music-thanatologist’s playing and the patient’s respirations and heart rate being to synch up, providing an opportunity for calm and relaxation.
This has always seemed quite intuitive to me. Although it sometimes seems strange or new to think of a harpist appearing in a hospital, I suspect that all of us have had the experience of listening to a piece of music for the sole purpose of changing our mood, and therefore our heart rates and respirations. Is there music you listen to for courage? For rest? For joy? Once you start listening, how soon can you feel the changes in your body?
For the last few days I’ve been listening to Krista Tippett’s remarkable conversation with Roshi Joan Halifax, founder and abbot of the Upaya Zen Center. Roshi Halifax talks about “edge states,” when caregiver are overwhelmed by their work in caring for the dying, and the numbness that can result. Roshi Halifax talks about the ways in which contemplative practice can provide healing.
Compassion’s Edge States: Roshi Joan Halifax on Caring Better (On Being, January 10, 2013)
“Deep in the Desert, Monks Make Transcendent Music” offers a glimpse into the contemplative musical life of the monks at the Monastery of Christ in the Desert in the Chama Canyon of northern New Mexico.
Dr. Ira Byock was recently interviewed by Krista Tippett in an On Being episode called “Contemplating Mortality.” You can read the transcript or listen to the interview online.
When I was a graduate student at Harvard Divinity School, I had the opportunity to do a summer field education placement at the Missoula Demonstration Project, a community-based organization in Montana that Dr. Byock co-founded. During that summer, I learned about the power of educating people about end of life care at the community level. This interview offers many of Dr. Byock’s reflections on how to die well, as well as stories of what patients and families have taught him.
A few weeks ago I was invited to be a guest on an NPR show called “The Jefferson Exchange,” in Ashland, Oregon. The producer and host had reviewed Music at the End of Life: Easing the Pain and Preparing the Passage and invited me to answer questions about the book and about music-thanatology. They also invited two local music-thanatologists, James Excell and Elizabeth Markell, to bring their harps into the studio to play music and participate in the interview.
It was more than a dream come true to be invited onto the show. I had never been on the radio before (let alone an hour-long live broadcast!) but after the initial nerves passed, the experience was truly enjoyable. It felt like an interesting conversation between the host, my colleagues, and the people who called and emailed during the show.
Here is the podcast: The Jefferson Exchange, September 8, 2010
I’ve been fortunate this summer to spend time in beautiful places with great libraries. One of the best reads of my summer was A Happy Marriage by Rafael Yglesias. A Happy Marriage is a biographical novel about Yglesias’ own marriage. He tells the story of life with his late wife, Margaret, in a sequence that alternates between the first three weeks of their first meeting, and the last three weeks before his wife’s death. Yglesias does not hold back in his revelations about the nature of his love for his wife, which is at times cruel or absent, and at other times expansive and redemptive. As his wife nears her final days, he struggles and ultimately fails to articulate his love to her. But Margaret is expressive to the end. “She had made certain to say good-bye, an eloquent good-bye. She had managed to tell him, despite all the obstacles nature and the human world had put in their way, that her love and his love had survived.” (p. 368).
Yglesias gave a wonderful interview on Fresh Air, addressing his life as a writer and the son of two writers. He notes that “it is true that if you come from a family of writers, you understand that there is always an assassin in the family.” He knows that he included stories in the novel that would have enraged his wife. A Happy Marriage is a compelling glimpse into the heart of a man struggling to create, care for, and let go of his thirty-year marriage.
Over the weekend I read “Letting Go” by Dr. Atul Gawande in the August 2, 2010 issue of The New Yorker. Dr. Gawande is a surgeon at Brigham and Women’s Hospital in Boston. The article focuses on the central problem he identifies not as the cost of end-of-life care but on “how we can build a health-care system that will actually help dying patients achieve what’s most important to them at the end of their lives.” (p. 39). Physicians often rely on patients to tell them when to stop curative treatment but patients and their families now have access to enormous amounts of medical research via the internet. This new access fuels patients’ desires to keep fighting for a cure. When physicians and patients are unwilling to give up hope for a cure, both may be surprised to find that the actual process of dying is filled with much more medical intervention – ventilators, blood draws, feeding tubes, catheters – than anyone ever wanted. The mystery of how to prevent this centers around the question of when the patient, doctor, and family should begin to accept that the process of dying has begun and cannot be stopped.
Dr. Gawande makes this point by talking about death as a war that no one wins. He points out that this type of war should be led not by Custer, but by Robert E. Lee, “someone who understood that the damage is greatest if all you do is fight to the bitter end.” He argues that physicians should recognize that patients have no experience with end-of-life care and need “doctors and nurses who are willing to have the hard discussions and say what they have seen, who will help people prepare for what is to come…” (p. 49).
It was a sad article with extended profiles of patients, both young and old, who received enormous amounts of unnecessary medical treatment at the end of their lives. For these patients, there seemed to be no one willing to play the role of witness and companion, to help them accept that while hope for a cure was gone there was hope for comfort, less pain, and for meaningful time with family and friends. As Dr. Susan Block, a palliative care expert, says in the article, this role is extremely important and very difficult. She tells Dr. Gawande that a family meeting to discuss end-of-life issues “requires no less skill than performing an operation.” (p. 47). She goes on to describe her experience talking with her own father, who surprised her with his desire to remain alive as long as he was able to eat chocolate ice cream and watch football on TV.
When I was doing my research for Music at the End of Life: Easing the Pain and Preparing the Passage, I was surprised to find that many of the physicians I interviewed were quite transparent about the limits of medicine in caring for dying patients. Several of them described the relief they feel when they are able to offer music-thanatology as an additional support once curative treatment has ended. They know that music will provide something when medication and medical intervention cannot. Gawande discusses the ways in which hospice has helped to “negotiate an ars moriendi for our age.” (p. 42). I am hopeful that this modern art of dying will rely heavily on the arts and on spiritual and pastoral care to provide courage to patients and physicians as well as a new kind of hope.
Dr. Gawande was also recently on NPR’s Fresh Air.