Environmental Music Therapy in a Hospital Setting

Having always been interested in the power of music, I earned a masters degree in music therapy from New York University in 1982. Music therapy is simply defined as the conscious application of music for therapeutic purposes. Classically, music therapy is used in a variety of institutional and
private settings. I specialized in working in a hospital setting, using music to help patients and families cope with isolation, loneliness, pain, fear, depression, and loss. I have used my training as a music therapist in a multitude of ways, from teaching, performance issues, hospital and hospice settings, and in almost
anything else I do as a musician.

I also worked in a relatively new area of focus called "environmental music therapy" (EMT) at Beth Israel Medical Center in New York City. In a program established by Dr. Joanne Loewy, I worked in 3 different settings: the NICU (Neo-Natal Intensive Care Unit), the PACU (Post Anaesthesia Care Unit [also known as the Post-Operative Recover Room]), and on the Oncology Wing. I was hired because of my experience and ability, but also because of my use of the hammered dulcimer The hammered dulcimer is an ideal musical instrument to bring to these settings since it can be heard without amplification, yet is soft enough to be sonically appropriate for the hospital room or corridor. Its real sound, emanating from vibrating wood and metal, is soothing, yet has energy to connect with patients in altered conditions. I played almost exclusively with "soft" or leather-headed hammers that create a sort of bell-like piano/harp sound. The hammered dulcimer is portable enough to be carried all over the hospital without much effort, can be played sitting or standing, and fits nicely both in hospital corridors and in patient rooms.

As an environmental music therapist, my goal was to alter the environment in such a way that anyone within earshot, within my soundscape, could find some form of relief or respite from hearing the music I played. I picked up aural and visual cues from the surroundings, and I also attended directly to the needs of the staff, patients, and family members within the environment. Each of the three environments I was assigned to had its own set of environmental needs and problems. In all of them, patients, family, and staff suffered from fatigue and stress. The NICU environment was particularly loud and harsh, both from the alarms on all the various machinery that the babies are hooked up to, and from visitors and staff. The staff of the PACU suffer from being in a constant state of near emergency, with patients coming and going, each in a different stage of recovery from their very recent surgery. The Oncology staff were often depressed due to a recent death or difficult patient or family member. All the environments were often highly charged and chaotic, and everyone was highly stressed out.

I used the hammered dulcimer in countless ways, such as: to help babies fall asleep and to help their parents relax, to give doctors, nurses, aides, and clergy respite from the daily cares of work and illness, for pain reduction/relief, patient distraction, general sound control, staff support, meditation, grief facilitation, and more. I also caused the environment to become somewhat quieter by playing softer music. Some people tend to talk softer when there’s soft music playing. Playing music with the beeps and sounds of machines, helping to give them shape and form, made the noises less jarring and more manageable.

Part of what makes the hammered dulcimer ideal for this work is that it is a wonderful instrument for playing melody, melody with accompaniment or harmony, and for playing accompaniment while others sing or play other instruments. It can be played very simply and softly, and it can be quite rhythmic and
upbeat. I played a wide range of music, including traditional, classical, Broadway, popular, rock and roll, folk songs, original music, improvisation, and seasonally appropriate music (Christmas carols, Chanukah songs). I chose and learned repertoire based on my instincts, cues from the surroundings, and requests from either staff or patients.

The music endured long after I left. As I walked out, people were singing or humming, and there was a great deal more laughter and lightness that the music seems to leave behind. Sometimes as I would play, I would become invisible to my surroundings. Depending upon how busy and stressed each environment was determined the degree to which I receive any direct feedback. Sometimes the
music was received with great and active enthusiasm, and sometimes it simply floated over and through everyone. Whatever the immediate response, I knew that the music has a powerfully soothing effect on most within earshot—whether they knew it or not.

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