Music's feel-good factor is well known, but now the medical world is finding out its effects may be more widespread.
Music effects miracles
In a sun-filled walkway at London’s Chelsea and Westminster Hospital, a young woman recovering from serious leg injuries makes her painful way on crutches. ”You’re doing great,” says her physiotherapist, ”Only a few more steps to go.”
Their destination is a vibrant Brazil inspired canvas by artist Richard Smith. Once there, the patient puts on head phones and, with a growing smile, begins to move to the Latin American rhythms she is hearing. Then the pair continue their painstaking journey – this time towards a huge sculpture.
“I could still feel the pain,” says the patient, visibly more relaxed, “But it helped to blank it out when the music was dramatic.” The physiotherapist is equally positive: “We are using the incentive of the music to go a bit further off the ward every day.” This is one of 15 artworks – each linked to a specially-composed piece of music – rather like an audio guide in a gallery. The Rhapsody Project, commissioned by the hospital trust’s health charity, uses music’s powerful therapeutic powers, not only to promote healing in the patients, but to help health practitioners to do their job more effectively and to relax carers.
Professor Mark Bower, at the National Centre for HIV Malignancy at the hospital, is impressed. He says: “It is a valuable tool, aiding patient rehabilitation. Most of my patients are living with both cancer and HIV, and their treatment is often followed by prolonged recovery. The audio guides can be used to encourage their progress and spur them on to the next goal.” The guides are part of a raft of music-related projects at the Chelsea and Westminster – where music is an integral part of healthcare, not an add-on. The multi-million-pound upgrade of its accident and emergency (A&E) department making it London’s flagship department, incorporates an innovative programme of digital music. This is designed to support patients, families and staff, and reduce aggression, in one of the most stressful areas of the hospital.
Music's therapeutic effects on health
“Everything we do here comes from research,” explains Daisy Fancourt – who manages the performing arts programme at Chelsea and Westminster Health Charity. “We engage in full consultations with staff and align all initiatives to health systems inside the hospital.”
London is not alone in this. Clinicians and medical establishments round the world are waking up to the fact that music’s power is not just about the feel-good effect described by English playwright William Congreve in 1697, when he said, “Music has charms to soothe the savage breast”. Music can have measurable therapeutic effects on health. The simple physical act of taking part can be therapeutic, as has been proved by teaching wind instruments to asthmatic children, in the UK-based Bronchial Boogie scheme. This boosted lung function, leading to a drop in asthma-related school absences from 35% to 5%. Access to music is certainly recognised by professionals in the hearing impairment field as providing an emotional connection for a deaf person to their families and communities – the ability to hear a wedding song, or for teenagers to be part of ‘the scene’. As such, it is a vital factor in psychological well being.
For this reason MED-EL, the hearing implant company, invests heavily in improving its devices for music listening and performing purposes. Head of Rehabilitation, Joanna Shepherd says: “Music is a key and integral part of the hearing experience, which helps develop listening skills and auditory memory, in both adults and children. We know it provides a direct bond between people, and we want to restore that bond.”
Music may slow the heart
But growing evidence is showing that access to music may also have an effect at a deeper biological level. Abraham Kocheril, MD, at Carle Heart Center in Urbana, Illinois, USA has demonstrated that classical music played on a harp may slow the heart rate of patients sedated for electrophysiological examinations.
Says Kocheril: “What’s amazing is, we are seeing an effect, and it’s consistent from patient to patient.” His study also found that diseased hearts acted more normally under simulated stress, if music was played before the stressor.
Powerful effects are not just specific to the harp, but exist across the range of music genres, according to another passionate advocate of its clinical use, Claudius Conrad – He is a surgeon specializing in diseases of the pancreas and liver at The University of Texas MD Anderson Cancer Center – and also a trained concert pianist. Whilst working at Massachusetts General Hospital in Boston, USA, he used musical material from rap to classical – personalized to individual taste – with critically-ill patients in A&E, and showed that it could decrease key hormone responses, blood pressure and heart rate.
He has also published research, using recordings of slow movements from Mozart piano sonatas played to very sick patients, to demonstrate that music significantly reduced the amount of sedative drugs needed to achieve comparable levels of sedation, compared with controls.
Music as a kind of medication
Conrad says: “I believe that music needs to be in the same category as medication when treating seriously-ill patients.” If results such as these are coming forward, why aren’t all hospitals embracing the power of music as a cost-effective (and pleasurable) aspect of health care?
Evaluating music using scientific and medical criteria, seems to be the key. How does one put an art under the medical microscope in the same way one does a drug? It is an argument that needs to be won, to begin to persuade health economists and providers.
In this, Chelsea and Westminster Hospital has been a leader. Work by medical researcher Dr Rosalia Staricoff, at the hospital in 2004 suggested a range of positive effects across a range of different clinical areas, including oncology, maternity and trauma services (see ‘What music can do‘, right). Her 2011 review of these results with Steven Clift at Canterbury University UK, based on 103 studies, only underlined the benefits of musical interventions in clinical areas.
Harcourt says: “The key is to understand the impact of music. Some people ‘get it’ straight away, but for others, we need to get the evidence and the statistics.”
What music can do
Chelsea and Westminster’s top music findings:
• In maternity, labour was 2.1 hours shorter for women in the presence of art or music
• Chemotherapy patients showed a 32% decrease in the stress hormone cortisol when listening to music, and reported a 31% decrease in feelings of depression
• Surgical patients needed 0.83mg per kg less anaesthesia in the presence of music, and levels of the stress hormone cortisol were 48% lower
• The length of hospital stay was one day shorter on average for surgery patients in the trauma unit in the presence of live music and art
• HIV patients showed an increase in the number of CD8 cells (an important type of white blood cell) following live music
• Two thirds of staff said that the arts influenced their decision to apply for a job at the hospital, or to remain in their current position