By Erin Tribble
In 2009, I watched the German film Vision: From the Life of Hildegard von Bingen about the 12th-century Benedictine abbess known for her musical compositions, scientific writings, and mystical visions. One scene that has stayed with me depicts a nun on her deathbed surrounded by her community, with several of them playing stringed instruments.
Music to facilitate healing and transition has always made intuitive sense to me, and I’ve incorporated music into my chaplaincy practice for many years, primarily through singing. More recently I began learning to play harp, mainly as a therapeutic instrument. Imagine my delight, then, when I became director of pastoral care at Mercy Medical Center in Baltimore and learned that the department has a well-established therapeutic music program. Even better, our two certified music practitioners (CMPs) play the harp! They are both paid members of our pastoral care team and together provide 10 hours per week of therapeutic music for our patients, families, and staff. They are both certified through the Music for Healing and Transition Program, one of several programs that train and certify musicians to provide live therapeutic music to support healing and/or transition from life to death.
Many people, including myself, use the terms therapeutic music and music therapy interchangeably, but they’re not the same. Music therapy involves actively engaging the patient. With therapeutic music, the goal is to create a healing environment where the patient can simply listen to the music. Many patients become so relaxed that they fall asleep, at which point the music practitioner quietly slips out of the room. Dialogue and conversation are intentionally limited to facilitate emotional and spiritual spaciousness.
Therapeutic music practitioners are trained to play in a variety of styles to suit different needs. Patients with memory issues benefit from familiar music, while those with pain, anxiety, or who are dying benefit more from improvisation. Practitioners always observe the patient and adjust musical elements to meet patients where they are. This may involve simplifying an arrangement, changing from minor to major keys, or adjusting tempo and rhythmic patterns. Sessions typically last between 20 and 40 minutes.
When I talk about our pastoral care department to new employees, telling them about our music program is my proudest moment. It is such a clear expression of living out our understanding of healing as a holistic process. I want our staff and providers to know that we offer this additional healing modality that is non-invasive, non-pharmacological, side-effect-free, and shown to be effective for reducing cortisol, increasing oxygenation, lowering blood pressure, stabilizing heart rate, and altering pain perception.
Clinicians can make referrals through our department, and all of us on the Pastoral Care team have been educated about how to identify and refer patients who might benefit.
Recently, one of our CMPs told me about a young patient who was a physician recovering from a cancer surgery. While our CMP, Cathy, played for her, the woman broke down in tears. Cathy checked in with her, asking, “Shall I keep going”? The young woman wanted her to continue. Afterwards, the chaplain who had called Cathy in told her that, until that moment, this patient had not faced or released any of her pain and distress over her diagnosis.
Patients and their loved ones often tell our music practitioners about feelings of peace, comfort, closeness to God, and hope. Our clinical staff also benefit from similar feelings and the assurance that their patients’ emotional and spiritual needs are being tended to in such a powerful way. During the pandemic, when close contact with patients was limited, our music practitioners had time to focus on the staff, playing in hallways and corners where many people could hear them. The effect was so positive that periodic staff support, especially during Nurses’ Week and in times of high stress, is now a regular part of our practitioners’ routine.
Our nurses have been great advocates for our music program, as have some of our surgical oncologists. Reaching physicians on a broader scale has been more challenging, partly because we have annual turnover of our medical residents.
Another challenge has been funding. Our therapeutic music program has been funded by donations and grants from its beginning in 2007. The money has ebbed and flowed, which means the total number of hours we can offer has fluctuated over time. Last year, I had to cut hours to three per week, while our foundation was reaching out to individual donors and preparing a grant application to an outside foundation that supports integrated spirituality and medicine. In the end, our program was awarded a generous sum of money that enables us to significantly increase our hours.
Not too long after receiving this news, we received additional funding from the father of a patient who died from ovarian cancer. He and his wife were present when Cathy entered his daughter’s room and played the harp for them. He said that his daughter relaxed for the first time since receiving her diagnosis, and that his wife fell asleep.
This man started a foundation in his daughter’s honor and was so moved by that memory of the harp music that he was calling various music schools in the area to see if he could hire a harpist to send to Mercy. A person at one school explained that he needed a harpist trained in therapeutic music.
Eventually, the director of individual giving at our foundation explained that we have our own therapeutic music program and that he would not need to find someone else. This man now plans to give to our program annually.
To see the support for our program come full circle is gratifying. Therapeutic music serves an important role in healing and transition, and I am proud and humbled to have a part in that.
Erin Tribble, BCC, is director of pastoral care at Mercy Medical Center in Baltimore, MD.