Music, a universal language in life and death
Posted by Margaret Pasquesi
Drawing on their musical and clinical palliative care training, music-thanatologists use harp and voice to address physical, emotional and spiritual suffering at the end of life. Using music prescriptively, they vary the tempo and tone of music to respond to changes occurring in a patient's body, like a slowing of pulse and breathing, in the final hours of life. During their visits — music vigils — they alternate sound and silence to help patients and loved ones relax and rest.
Music connects us universally. Some will say that it is music that makes us human.
Anthropologist John Blacking in his 1973 book, “How Musical is Man?” bemoans that Western culture music has become the domain of the so-called “experts.” However, when examining the cultures he had studied, music was simply a part of a person’s everyday life.
Music is part of everyone.
All living humans have the tempo of their heart rate and the depth of their respiration rate. But as we die, these mostly lyrical and robust waves change; with a shorter ambitus, a gurgling texture overlaying the breath, and a barely perceptible pulse. How can the living relate to this change, especially we when we in our technology-driven culture, don’t see ourselves as experts in either death or music?
A patient in hospice care named Innaya, whose name means “Gift from God” in Arabic, was actively dying. Her hospice care team informed Amira, her daughter, of this fact and I could see she was standing over her mother sobbing. It was Chandrath (“Night of the Moon”), the evening before Eid, the most holy day in the Muslim calendar.
Because of this high holy day, Amira was frantically trying to make and answer telephone calls to bring their community together to her mother’s bedside. Tears poured from her face onto her mother’s, she caressed her mother with phone in hand.
Although Amira did not speak English well, she understood the offer of the music through her tears. As one of JourneyCare's music-thanatologists, I started playing the harp immediately to help soothe her.
Fairly soon after, it was clear that she was not able to take the music in due to her anxiety. I ended the first suite of music quickly and shifted a “musical prescription” to helping Amira get physically comfortable, so she can attend to her mother.
I quietly dimmed the lights in the room, eliminating the bright, intense light casting over Innaya’s bed. Amira alternated between standing and sitting by her mother’s side, so I replaced the lounge chair with a folding chair and spoke to Innaya calmly, letting her know that I was going to lower her bed.
Amira was now able to hold Innaya’s hand from a seated position, and I let down the bedrail so she could rest her head on Innaya’s bed.
I moved Amira’s phone charger to the side of the bed she was sitting on and plugged in her phone, so she wouldn’t miss any important calls. Finally, I grabbed a tissue box and placed it on Innaya’s bed within her daughter’s reach.
I began playing the second suite of music. Amira sighed, exhaled in relief and took a deep breath. It’s as if once supported environmentally, she could move from frenetic weeping to a deep grieving.
She was able to put down her phone, let go of worrying over when their family would arrive, and focused on the fact that she was there now with her mother.
Her stream of consciousness shifted from "What will I do when you are gone?" to "I am so blessed to have had you in my life."
She noticed her mother’s respirations slowing and her anxiety increased once more. While I continued to play, I guided her through the process, letting her know that each small noise Innaya made was normal, and that she had not yet taken her last breath. Perhaps not understanding everything I said, she sighed again, and said, “Thank you.”
The music shifted and I added lyrics of grief and gratitude. Although it was in English, except for the word Allah, Amira held her mother’s hand and nodded as if in agreement. Once Innaya’s breaths had ceased, the Care Team nurse pronounced her time of death.
I played for a while afterward, until Innaya’s community trickled in to comfort Amira. I approached the bed and congratulated Innaya on doing a graceful job making her transition. I let Amira know that I would keep her in my thoughts and prayers as she adjusted to her mother’s new presence in her life.
We are all connected by music, moved by music, calmed by music, no matter where we are in the world, and no matter which strange angels bring it to us.
Note: Names have been changed.