The Best Hour of the Week: A Patient Describes the Effects of Music-Thanatology

James Excell is a music-thanatologist in the Rogue Valley in Oregon.  This remarkable interview with patient Dene Bish demonstrates the power of music-thanatology to relieve pain. She suffers from Multiple Systems Atrophy.  Describing her time in the music vigil she says, “The pain goes away, tremors die down, tension is less, my breathing evens out. It’s the best hour of the week.” 


Edge States –

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)

Music-Thanatology featured in Portland, OR news story

This is a great introduction to music-thanatology, with scenes from the bedside of patient visits and interviews with music-thanatologists. The video quality is not great, but it is still easy to see the beauty in these moments.

During one of the interviews, my colleague Laura Moya, who was a loan department manager before she trained as a music-thanatologist, jokes that, “Loan department managers don’t sing very often.” I’m a strong believer that most people have a secret artists’ life. Many music-thanatologists had very different professional lives before they decided to provide music for the dying. This video offers an interesting portrait of the meaning most of them find in their new work.

Music at the End of Life in Harvard Magazine’s “Off the Shelf”


One of the challenges of being a new author is self-promotion.  In the six months since Music at the End of Life was published, I have sent letters, emails, and review copies of the book to as many people as I can think of.  Some of these efforts have led to great responses from colleagues and loved ones, as well as Connecticut College and The Jefferson Exchange in Ashland, Oregon. Other letters and emails have gone unanswered. 

A few months back, I sent a copy of the book and a letter to Harvard Magazine, the alumni magazine for Harvard University.  Their website gives extremely clear instructions about how to submit books for review.  These instructions include a gentle reminder that they receive a high volume of requests, and the “Off the Shelf” column includes only a very small number of the books submitted. 

Several months went by since I submitted my book.  When each issue arrived, I carefully read the “Off the Shelf” column, trying to determine whether or not my book would fit in with those listed.  Then last week, the November December 2010 issue arrived, and my book was included!  Needless to say, I did a big dance around my kitchen.  I can’t be certain, but I would bet that this is the first time that “music-thanatology” has appeared on the pages of Harvard Magazine.


In yesterday’s New York Times, philosopher Arthur C. Danto wrote a piece called Sitting with Marina.  Marina Abramovic is a performance artist doing a retrospective called “The Artist is Present” at the Museum of Modern Art in New York.  She sits at a small table, across from an empty chair.  Anyone can sit in the empty chair, for as long as they want.  The show is nearly three months long, and there are long lines every day to sit with her.  Some people come back again and again.   

Photographer Marco Anelli has taken more than 1000 portraits of the visitors, documenting the length of time they remain in the chair.  The faces are open and expressive as they gaze at Abramovic.  There are a wide range of ages, including children.  Many of the faces are grief-stricken or weeping.

Occasionally, a music-thanatologist has remarked to me that even if they didn’t have a harp or couldn’t sing, they could still offer a vigil for a dying patient.  One of my colleagues speaks beautifully about moving from music into silence.  On occasion in a vigil I have put down the harp and sat in a silence that felt just as transformative as the music.  I have a similar sensation as I look at these photographs.  The faces in some of these portraits offer a particular presence for Abramovic.  There is calm, sadness, and longing.  The intimacy is startling, and seems so unintentional that I wonder if it has to do with the nature of being human.

I’m left with questions: What are these strangers looking for, sitting with a stranger?  Are they giving or receiving?  What happens in that silence?  There is a quality of suffering in the photographs of Abramovic which draws me in as well.  She looks serene, but worn out.  There is a is a real kinship here between what I experience in the music-vigil, and in these images: two strangers sitting together.  One suffers, one gazes, and neither has words to rely on as mediator.