President's Message

The Power of Music

Steven Fugaro, MD

When one contemplates music and medicine, a number of thoughts come to mind. Many physicians possess wonderful musical talent and employ music as an avocation as well as a means of entertaining the less talented among us. The study of the interaction of the brain and music has challenged neurologists over the years. Psychologists have marveled at the effect of music on the mind—not to mention that numerous extraordinary composers have also had significant psychological conditions. (Charles Ives and Robert Schumann are just two examples.) Finally, music has been used as a therapeutic instrument for thousands of years. Dr. Oliver Sacks, the prominent neurologist, regards music therapy as a tool of great power because of its unique capacity to organize or reorganize cerebral function when it has been damaged.

All of these topics are explored in greater detail in this issue of San Francisco Medicine. My own experience with music in a medical context was quite recent. I had the opportunity to view music being employed as therapy in the Healing Harp Program at both California Pacific Medical Center and Marin General Hospital. This unique program, sponsored by the Institute for Health and Healing, enables harpists to play in hospital waiting rooms, in the NICU, for cancer patients undergoing chemotherapy, and for patients in their last few moments of life.

In a bed at the end of a ward, a patient lay dying, attended by her family and friends. In the room was a harpist, playing a small portable harp—a 19-string, seven-pound Westover Adian harp. The atmosphere was a far cry from the usual technological bustle of the hospital ward. Instead of the chirps and beeps of the various bedside machines, the lilting sound of harp music floated through the air. As she played lullabies and Gregorian chants, the mood was serene and remarkably peaceful. The patient, who had been agitated and was breathing rapidly before the music began, was by all appearances quite calm. The family members seemed quite comforted by the tranquil sounds of the harp as they awaited the inevitable.

I was struck by the contrast between this tableau and what we as clinicians usually observe—the somewhat clinical, cold, and institutional end-of-life setting in most hospitals. At a presentation by the Healing Harp Program, Portia Diwa (one of the Harp supervisors) described how harp therapy has helped patients reduce pain, lower blood pressure, regulate breathing, decrease anxiety, and feel spiritual comfort. She remarked on how often the gentle playing of her harp would result in patients being more comfortable, over and above the effects of pain relievers, sedatives, and tranquilizers.

The rigor of the program is also quite impressive. The Institute for Health and Healing at CPMC offers internships in the Healing Harp Program. These internship require a 500-hour commitment over a one-year period for both training and clinical practice. In addition to playing at CPMC and Marin General, harpists in the program also play for patients at home and in hospice programs (see page XX for an article describing the role of music in Hospice by the Bay).

In recent years integrative medicine, with guided imagery, acupuncture, massage, meditation, and music therapy, has slowly begun to achieve a greater level of acceptance in the mainstream medical community. Music therapy, whether with a harp or with other instruments, clearly has a role in helping our patients in ways that are beyond our usual areas of expertise as physicians. And providing music to our patients has the power to augment our most important roles—as healers and comforters.

For more information regarding the Healing Harp Program, please contact Susie Shipley at (415) 925-7623. To find out about music therapy in general, the American Music Therapy Association, at www.musictherapy.org, is an excellent resource.