Music is probably the only real magic I have encountered in my life. There’s not some trick involved with it. It’s pure and it’s real. It moves, it heals, it communicates, and does all these incredible things.
Tom Petty
A man I hardly know confessed his love for me today. While we stood at his walker, his standard-issue gown slipping below the talcum skin of one slim shoulder, we swayed in time to a Tom T. Hall tune. If you love somebody enough, you’ll go where your heart wants to go. A smile opened on Mr. Wally’s face and his cloudy eyes brightened. “I feel like a flower in bloom! I love you, darlin’! I love you!”
I knew it was his touch of dementia talking, but there was no confusing his sunny mood, his newfound strength, and his enthusiasm for participating in therapy. The week prior, Mr. Wally was sullen and reticent to get out of bed. But since I began playing his favorite country songs during our therapy sessions, he’s become more engaged and alert. Our strengthening exercises on the side of the bed and challenges to his standing balance at a walker have now become our time to “dance.” But he’s not the only one who benefits from listening to music; my day is made more fun and my sense of purpose in my job is restored.
As an occupational therapist working in a long-term critical care hospital, or LTACH, I encounter patients who are chronically ill, often elderly, suffering from dementia or mental illnesses such as depression, PTSD, and anxiety. Many have been hospitalized for two, three, four months, and more. The isolation that accompanies such lengthy hospital stays only serve to exacerbate their symptoms. For many patients, our hospital is the last chance to improve. A few of these patients will be lucky if they gain the strength to go to a nursing home. Luckier ones will advance to inpatient rehabilitation hospitals, and eventually home. Rehabilitation specialists working in LTACHs are poised to give these patients their last push toward the hope of recovery or, at the very least, a taste of dignity and joy in the face of a lifetime of institutional care.
There’s no shortage of research on the impact music has on our physiological, mental, emotional, and behavioral states. Given such knowledge, and with a global library at our fingertips that apps like Spotify and Apple Music offer, I wonder why music isn’t incorporated more readily during rehabilitation treatments. It’s easy, it’s cheap, and it may be one of the most effective compliments to rehab to help combat the loneliness and apathy a long hospitalization stay incurs. Even in acute care settings, where treatment times may sometimes be as short as eight or ten minutes, a single song lasting three or four minutes can easily be integrated into an ADL session or rote therapeutic exercises, in or out of bed.
It helps to know your demographic. In Mississippi, where I live, we have a predominantly rural population and large African American communities. I keep classic blues, R&B, soul, and country singles in a playlist, and count on the likes of Johnny Cash, Otis Redding, and Sam Cooke to spark delight. But music isn’t appropriate for every patient. For some, it can be another distraction to the blessed quiet they often crave to counter the constant coming and going of staff and the monitors’ annoying alarms. For these patients, sometimes restful silence is the best music. Other times, music simply isn’t welcomed. I was once memorably reprimanded by a patient when I asked if I could play him a song. “I don’t want to hear any of your damn music! This ain’t no nightclub!” Asking first is key.
For those patients who can’t identify their preferences or who can’t communicate them, I have options ready. Even my penchant for instrumental and ambient music—my go-to music to recover from a particularly stressful day—has helped instill ease in those patients struggling with anxiety or those whose precarious medical status makes anything more lively seem inappropriate.
Hospital stays typically involve pain, confusion, fear, boredom, and anxiety. Devoid of creature comforts, familiar routines, sights, and sounds, and barraged by strangers moving in and out of an individual’s personal space, hospitalization can erode a person’s sense of humanity and dignity. Outside of the physiological and cognitive benefits of music, rehabilitation specialists are in a perfect position to offer patients a few treasured minutes of pleasure and, in the best-case scenario, such as Mr. Wally’s, rekindle hope and human connection.
Classic Soul and R&B
“I Can See Clearly Now,” Johnny Nash
“Tell it Like It Is,” Aaron Neville
“Lean on Me,” Bill Withers
“Midnight Train to Georgia,” Gladys Knight and the Pips
“Sitting On the Dock of the Bay,” Otis Redding
“Everyday People,” Sly and the Family Stone
“I’ll Take You There,” The Staple Singers
“What a Wonderful World,” Sam Cooke
Classic Country
“That’s How I Got to Memphis,” Tom T. Hall
“King of the Road,” Roger Miller
“Witchita Lineman,” Glen Campbell
“Rocky Mountain High,” John Denver
“Mama Tried,” Merle Haggard
“On the Road Again,” Willie Nelson
“I Walk the Line,” Johnny Cash
“Mamas Don’t Let Your Babies Grow Up to Be Cowboys,” Waylon Jennings & Willie Nelson
Instrumental
“Opus 20” Dustin O’Halloran
“Night After Sidewalk,” Kaki King
“Improv #10 – One Last Thought,” The Daydream Club
“Remove the Complexities,” Peter Sandberg
“Cello Suite Number One in G Major,” Yo-Yo Ma
“Because This Must Be,” Nils Frahm
“Day Dream,” Joep Beving
“Small Memory,” Jon Hopkins
by Jane Newkirk
Jane Newkirk has worked as a cook, bread baker, visual artist, and art gallery owner. Her poems have appeared in The Night Heron Barks, JAMA, and Intima: A Journal of Narrative Medicine. She currently works as an occupational therapist in a long-term acute care hospital in Jackson, Mississippi.
Artist Instagram: https://www.instagram.com/janenewkirk_writer/