Ann Dowdy offers a brief introduction to music-thanatology.
Music-thanatologists Laura Moya and Andrea Partenheimer were recently featured in the Catholic Sentinel. Music-thanatology has been integrated into care at two Providence hospitals in Portland, Oregon for more than a decade. As Fr. Bruce Cwiekowski, Director of Spiritual Care at Providence Portland Medical Center, puts it, “Music thanatology reminds us that this is as sacred a moment as birthing, despite the sorrow.”
The patient featured in the story, Richard Redmond, was reluctant to allow music-thanatology into his hospital room. A 92-year-old retired Navy officer, he was not a particular fan of soft music. But once he experienced the music vigil, he asked that the music-thanatologist return. His son noted his own experience of relaxation while listening to the music.
It is sometimes challenging to introduce music-thanatology. Where else can we experience music tailored specifically to us, to our breath, to our facial expression and heart rate? How often does a stranger with a harp share intimate moments of saying good-bye to our loved ones? But when the door is opened, even slightly, to music-thanatology, patients and families most often have an experience of beauty, reverence, and calm that transforms their initial skepticism and invites music to continue to accompany them.
Music-Thanatologists Elizabeth Markell and James Excell were featured in yesterday’s Mail Tribune. They work for the palliative care service at Rogue Valley Medical Center in Medford, Oregon. The article highlights one of my favorite things about music-thanatology: in spite of music-thanatology’s unusual appearance, it is extremely effective for patient care.
Reporter Chris Conrad writes, “It might sound like New Age mumbo jumbo, but Sue Kilbourne, RVMC’s clinical manager of medical oncology and palliative care, says music-thanatology can play a significant role in easing patient suffering. ‘We have seen such positive results from music-thanatology,’ Kilbourne says. ‘We now have nurses and even doctors who are recommending the musicians to patients. They believe it really does improve patient outcomes.’ The musicians are required to fill out medical observation charts with each patient. The hospital is collecting the data to share with other organizations looking to expand their palliative care programs.”
The idea of music-thanatology as “new age mumbo jumbo” is not surprising. I heard many variations of this idea when I interviewed medical professionals for Music at the End of Life: Easing the Pain and Preparing the Passage. Many noted that they had to experience firsthand the effect the music had on their patients before they understood the efficacy of music-thanatology. But once they did, they became extremely interested in offering the modality to more and more of their patients.
It is difficult to imagine the sounds and feeling of a music-thanatology vigil without this firsthand experience. But it is possible to get a small taste of it. If you are curious about the sounds of the harp, I’d recommend listening to a few samples from my extremely talented colleagues in Everett, Washington, Jeri Howe and Dia Walker. Their CD, Beauty Awaits, is a gorgeous and meditative collection. Take a few minutes and be transported.
During the season of All Saints and All Souls last month, Rose Udics of Church of Our Saviour in Arlington, MA reviewed Music at the End of Life: Easing the Pain and Preparing the Passage. I was touched by Rose’s thoughtful reflections on the possibilities of music in end of life care. I am grateful for her kind support of music-thanatology as well as her willingness to allow me to reprint her review here:
Letting Go of This Life
Though not all of us will become saints whose bodies may be revered, we can be sure that we all will die. As Jennifer Hollis reminds us in Music at the End of Life: Easing the Pain and Preparing the Passage, if we are fortunate to have time to prepare, dying need not be extremely scary or stressful. In particular, music can physically and emotionally help ease the way for the dying and their families as they move to their next state of existence.
Hollis, president of the Music-Thanatology Association International (and COS member), has written a profoundly beautiful and personal book about spiritual journey, vocation, and ministry to those nearing the end of life in this world. Far more than an account of her own personal path, however, Hollis’s book offers a fascinating history of the emerging field of music-thanatology. The field was founded just forty years ago but has origins in medieval times, when monks at the monastery at Cluny would sing psalms or chant prayers for a dying brother, members of the community never leaving his side until his death. She describes what training is like for today’s aspiring music-thanatologists (“First, build a harp!”—though other instruments or none at all may be used), examines the spiritual and emotional demands on practitioners (who may have never witnessed a person’s death), and provides great insights into the challenges of incorporating spiritual care through music into the entrenched traditions and routines of hospitals, nursing homes, and hospices. She notes how music-thanatologists differ from music therapists or therapeutic musicians. She also includes research on the palliative effects of music-thanatology on a patient’s physical condition—reducing pain and agitation and easing respiration, even in the comatose.
The heart of this book for me were the many unforgettable stories about the effects of music vigils on families and the dying. Music vigils have healed family rifts, enabled families members to approach the topic of withdrawing life support, and created space for their grieving—and also, surprisingly, their laughter—at the time of their loved one’s death. Likening music-thanatologists to spiritual midwives, Hollis’s stories also show how music vigils change staff members’ attitudes at care-giving facilities. As one chaplain said, “When I . . . have done patient care following a vigil, it’s really amazing. It’s like the groundwork has been laid for just an awesome conversation. Really honest conversation.” One music-thanatologist believes it can change the medical “culture”: “What we noticed is that when we started bringing music-thanatology into the patient rooms, all of a sudden, the nurses would say things like, ‘Would you leave the doors cracked while you’re playing?’ . . . they wanted to be part of that care that was just offered. So it started to change the conversation. It started to change where medicine had no goals around being with people who were dying. All of a sudden [the nurses and social workers] started talking about making them more comfortable . . . We noticed that rather than avoiding the care, they wanted to be a part of something that they perceived as tender, loving, and beautiful. [It] fulfilled a deeper need they had, as healers.”
Hollis, an accomplished harpist who ministers at Lahey Clinic in Burlington, Massachusetts, writes, “I am called make this small offering, with my homemade harp, and my own voice, and as much love and compassion as I can offer.
“People often ask how I can be a music-thanatologist. My answer is that the other side of grief is love—a deeply human, beautiful, striking, everyday love. The privilege of being present with dying patients has offered me insight into mystery—the mystery of loving family and friends, the brevity of life, and the courage ordinary people demonstrate every day. It is true that I witness a tremendous amount of grief at the bedside. But I also witness the love people have for one another and their tender struggle to express it in words, gestures, stories, or simply a look. It is pure grace to be invited into the presence of this love—a man stroking his brother’s forehead, a granddaughter whispering stories to her grandmother, an elderly man gazing at his wife of 50 years, friends gathered around a bed, holding hands.”
When the time comes, may we all be so lucky to have someone like Jennifer Hollis or another music-thanatologist helping us let go of our life here, gently and lovingly.
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.