Thursday, July 20, 2017

Schulman - Waking the Spirit

Providing first-had evidence for Dr. Oliver Sacks’  (one of the founders of the Institute for Music and Neurologic Function) assertion that, “Nothing activates the brain so extensively as music,” Andrew Schulman tells his near-death story and how he was rescued by music. Waking the Spirit: A Musician’s Journey of Healing, Body, Mind and Soul (A. Schulman, 2016) provides both the personal story and the research behind how music has been used to assist in pain management, aid the healing process, create calm that lifts patient’s spirits, and reach patients so ill that no one expected to ever reach them again.

Music has been understood as a way to aid physicians and patients all the way back to early Egyptian, Babylonian, Indian, and Chinese cultures. When Schulman was declared “code blue,” his wife turned in desperation to music; the “lights were out” metaphorically when she realized that Andrew’s ipod was in the room with his favorite music ready for intervention. It was ultimately Bach’s Saint Mathew Passion that renewed Andrew’s consciousness and began the long process of recovery. This experience was so powerful that he began playing music for the critically ill as soon as he had recovered enough to play guitar again – in his words, “an act of collateral kindness” that would transform him and the many lives he would contribute to saving.

The early days of Schulman’s recovery presented challenges. He wasn’t sure if the impact of surgery and trauma left his brain functioning at levels to allow him to perform the intricate, artful music that he loved. The beauty of the brain and the way it functions is that the ability to perform music can come back when cognitive and motor areas reconnect. But the best music therapy is very personal. Experimentation with different styles and moods of music with patients revealed that music familiar to each was best and that, in general, soothing music is most effective in healing. More specifically, soothing music in a major key, with a steady medium tempo, sonorous harmony, and musical lines that play in and around each other are best.

One of the reasons that music is essential in patient care is that hearing is the last sense to go when we die. Thus, it is very important to realize that a critically ill patient may hear and comprehend even though there is no other evidence of life. As Schulman advises, “Always assume someone is home. And the power of music to get through to the patient can be the key that opens the door.” Particularly with music that has brought great pleasure to the patient, reflected in the chills experienced in beautiful passages, dopamine is released into the body naturally which has great power to awaken the spirit. Even with patients suffering from Alzheimer’s disease, music can get through because musical memories are stored in procedural memory, the same place routine and repetitive activities are stored. Even when memory of contemporary experiences are lost, the music stored in procedural memory can be accessed.

Dr. Richard Kogan, clinical professor of psychiatry at Weill Cornell Medical Center and artistic director of the Weill Cornell Music and Medicine Program, once lectured on the psychological state of famed composer and pianist Sergei Rachmaninoff. He noted that after the failure of Rachmaninoff’s Symphony No. 1, he fell into a deep and unproductive depression that, once broken through therapy, inspired one of the most moving and popular pieces of classical music ever composed – Rachmaninoff’s Piano Concerto No. 2. The point made by Kogan was that “artists who used their music to alleviate their own suffering composed some of the greatest music ever written, which in turn has the effect of ameliorating the suffering of others.”

The power of music in medical therapy is enough in itself but its effectiveness also sheds light on how musicians perform. Those who wish to minister to others must back away from their role as performers in order for patients (and all listeners) to experience music at their own emotional and cognitive level. Losing oneself in the music reduces the chance of a performer ‘losing it’ in performance. This losing oneself in the art overrides the distraction of an audience, unleashing a musician’s internal sensations and ability to deeply engage as an artist. Schulman also learned that the act of playing music for others was self-healing; it was a perfect rehab regimen of repetition, concentration, intensity, and focus on healing others.

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