Stroke

I was working in one of the stroke wards, where staff had asked me to play for a lady whom they knew likes music, let’s call her Amelia. In the bed next to her was a young woman, “Sarah”, whose parents asked if I knew any Abba. As I gently sang Fernando, Amelia slowly got up from her chair, and making firm eye contact with me, came towards me. The look in her eyes was one I felt could only be described as Love.

She came close to where I stood, and, being very careful to not disrupt my guitar playing, put her right hand on the back of my left hand, and her left hand on my right elbow, continuing to look me in the eye. As I carried on singing, she led us in a very gentle dance, which had Sarah’s mum in tears. Staff were watching, enthralled, and “ah”-ing, and the feeling I had was one of great tenderness, intimacy, and even romance between us for those brief moments.

After the song, Amelia spoke to me, and though she had difficulty with language (a common effect of stroke), and the actual words she used didn’t make sense, her tone and expression clearly told me of great appreciation and gratitude for this very special interaction that we had shared.

I then felt like singing Moon River, and Amelia stayed close and sang along, word perfect, to the whole song. This is a phenomenon we term Fluid Singing, where someone no longer able to speak (common in dementia as well as stroke), can sing all the words to a familiar song. It’s not seen all that often, but when it is, it’s remarkable to see, and, I imagine, gives the person a great sense of re-connection.

Critical care

We’ve only just started working on Critical Care wards and as a musician, you wonder what impact you can really have for people in such an extreme situation. It can be quite intimidating and nerve wracking to enter these bays and rooms and begin playing.

This week, we entered a High Dependency Unit where we’ve been asked to run a pilot scheme and were immediately made to feel very welcome by the staff. Two of them asked us if we could try playing for a lady who has learning disabilities, who had been very restlessness and vocal in expressing her distress and anxiety. As we approached her room there were about nine members of staff around the door. We went in and she was vocalising repetitively and seemed very confused and restless. We said hello and she asked us our names and we began playing. She became quite emotional and teary and asked a nurse at the door to come in and be with her. They held hands and the nurse sang along softly with us. We continued playing and over time, she settled down, relaxed, closed her eyes and fell asleep. We quietly left the room and saw all the staff had been watching, clearly happy to see the lady at peace. “That was amazing” said a consultant.

Critical Care

We recently began working in Critical Care wards at Nottingham University Hospitals, a completely new area for us, and one in which very few musicians are working. Over the first few sessions we’ve had some wonderful feedback, a friendly welcome and great response from the staff, and some memorable interactions, such as this one with a young woman, currently unable to speak due to a tracheostomy.

She had heard us in another part of the ward, and as James approached her she mimed playing a guitar. James greeted her and began playing and singing I Wanna Be Like You. She immediately began moving her shoulders to the music and James soon offered her a shaker for the rest of the song, which we could hear another patient behind curtains joining in with. James then brought the instrument box closer, and she chose the glockenspiel, the two of them then having a jam together which developed into The Lion Sleeps Tonight. Two doctors came to look at her charts and looked very pleased to see their patient enjoying herself. Other staff were also observing and smiling at the engagement, and a neighbouring patient was smiling in his sleep.

Next out were the Wah-Wah tubes, which can be very hypnotic and captivating, and there was a musical conversation between the two of them, while I played a simple and familiar chord progression. This became a song, and then another, and another, without interruption, while their conversation continued, the patient being fully absorbed in the activity. When it ended, she stood up and hugged us both, and wrote “it made me feel very relaxed and happy”.

 

STROKE

We entered a busy stroke ward where visitors and patients were gathered. One patient was on her own looking very bored and a bit upset so we decided to play a Beatles song in a slow and soothing way for her and the general space. She immediately looked at us and smiled. As we played, some visitors had to move to accommodate a patient’s care and they came nearer to us to watch and listen. One visitor and the patient started singing along quietly and she started tapping her hand and becoming more animated. Then she started tapping her foot and suddenly she became very excited and was beaming away. As the song ended she couldn’t contain her excitement any longer and burst out saying “That’s the first time I’ve moved that foot.” We’re just beginning to find out how our music can help people in these wards. [March 2017]

STROKE

We started playing for three female patients in a bay on a stroke ward. Several staff were present, and one lady woke up and immediately smiled and engaged with the music. Unable to speak, she was clearly appreciating the music, raising her hands, moving in time and nodding approval for us to continue. Very moved, a nurse came over, knelt beside her, held her hand, sang along and encouraged her to sing too. We played Wonderful World and she began vocalising and as the song progressed her vocalisations matched the words more and more. By the end of the song she managed “I Love You”. The nurse was overjoyed and so was she, continuing to use her voice lots to try and communicate. Two members of her family arrived and were clearly moved as we sang Wonderful World again, her words noticeably improving as we went along. The nurse commented afterwards that this had been a real breakthrough, saying “to see my patient respond so well to music is priceless”. As this unfolded six other members of staff were watching and really enjoying the moment. Over the subsequent weeks this patient always asked for us to visit her, with family and staff telling us how excited she is before we arrive. Each week she sings a bit more of each song as her speech improves and plays along more on shakers and the xylophone. As a nurse said at the end of one session “That’s the power of music.”

Stroke

Dave (not his real name) was a patient whose severe stroke had caused him to lose the use of all four limbs, and his speech. We had seen him and played to him a couple of times, with what we thought was very little response, but the staff said he was loving it (we have many examples of staff recognising a reaction we haven’t picked up on in people we don’t know).
On this occasion we were told by a staff member that Dave is very good at communicating Yes and No, and can spell out words, using his eyes. Wanting to play Dave something from his youth, I began playing Hotel California, which I thought he was bound to know. Before I got more than three chords into the introduction he was beaming with recognition, and when we got to the chorus his mouth was moving and he was clearly doing his best to sing along. When we’d finished Dave tried to speak but I couldn’t make out what he was saying, so I asked him to spell it out. H – O – R – S …horse? Horse With No Name? Yes! I’ve never learned the song but knew it well enough to “blag it” and Dave seemed very pleased. The next time we went there I had the chords and words with me to do it properly for him.
The last time we saw Dave, he had family visiting and we had not approached, but before we began to play, I overheard that he was spelling out “horse”. His family seemed confused by this, but I knew he was requesting his song, so we sang it again, with his family joining in. Dave and his family were all delighted with this shared activity and special moment of reminiscence and connectedness.

B47

In a bay we played for three ladies, Marc kneeling close to one alert lady, and James playing near two ladies, one of whom was in bed and very frail and distant. Very quickly the frail lady’s arms came up, dancing/conducting with the music and she made strong eye contact with James. The third lady who had been verbally aggressive earlier, calmed down and held the frail lady’s hand and talked to her soothingly.
Later a member of staff asked us to play for the frail lady again explaining that she had given up on life months ago and that music was one of the only things she still responded to. As soon as we played her arms came up again and she made strong eye contact and the member of staff held her hand with deep care and affection. Several nurses and doctors were watching and were clearly happy and moved by the scene.
When we stopped one of them started dancing and singing Wimoweh and passed a shaker to another patient who started playing. We joined in and two doctors in their office started singing and laughing too.
The music moved everyone in different ways but connected everyone together in joy and compassion.