Melodies to Heal
Music intervention helps critically ill patients
Andrew Schulman, right, plays with Eric Despard at BMC with Dr. Marvin McMillen in the background and Elena Fyfe, surgical physician assistant.
Photo by Christina Rahr Lane
For 40 years, Andrew Schulman has played classical guitar in venues like the Palm Court at the Plaza Hotel and Carnegie Hall. The last seven years, though, his stage has been much more intimate as he has made the rounds of three hospital ICUs, two in New York City and one at Berkshire Medical Center (BMC). This latest gig is his most challenging and most rewarding—for it’s the same arena where music saved his life.
These “medical residencies” grew out of Schulman’s near-death experience and Dr. Marvin McMillen’s interest in the healing environment. Although a study a few years back published in The Lancet showed that listening to music before, during, or after surgery reduces patients’ pain and anxiety and decreases the need for pain medication, the ICU hadn’t been a place where many musicians played.
A “medical musician,” as Schulman and McMillen call it, is different from a music therapist who might, for example, work with newborn babies, chemo patients, and children with asthma. A medical musician is a concert-level professional who has had medical training and is part of a medical team in an intensive-care unit. The critical-care environment is unique because the music must sound as clear and precise as a recording so as not to agitate the patient or the unit. Achieving this goal and striking the right emotional balance can be challenging.
“Music can be as important as a ventilator in an intensive-care unit. It can be as important as a dialysis machine, or as important as the medications we treat people’s blood pressure with,” says McMillen.
And it’s important that the musician checks his or her ego before entering the ICU. Musicians aren’t just playing for the person who is ill; family members and the staff are also in need of music to help them relax and get a break from the intensity of the situation.
Schulman says music saved his life eight years ago at Mount Sinai Beth Israel Hospital in downtown Manhattan. At 57, he was admitted as a terminal “Code Blue” patient with circulatory collapse following a pancreatic-tumor excision. His wife, Wendy, had an iPod loaded with music. Something moved him when he heard Bach’s St. Matthew Passion, and, miraculously, he survived his ordeal.
McMillen, director of the surgical ICU at the time, knew that Schulman wanted to return there and play for patients. He gave him permission to do so and, six months later, Schulman was back with guitar in hand. He now has logged nearly 1,800 hours of playing time in the ICUs. His book, Waking the Spirit, was released a year ago and is now available in Australia and New Zealand. It will be translated for release in Turkey in June and China in early 2018, and a paperback version of the book will be released in August. Schulman is now touring again, performing and talking about the power of music to heal the body.
McMillen moved his practice to the Berkshires in January 2016 to work at a community hospital and further develop the medical musicianship. Although music is piped into the ICU through of Spotify and Pandora at BMC, McMillen believes live music is a better “prescription” for patients’ well-being. In January 2016, he had Schulman talk to doctors and other specialists during grand rounds. Next, Schulman played in the Critical Care Unit so that the staff could see him in action. Now, the last week of every month, Schulman drives to the Berkshires, and McMillen puts him up. In addition to playing three days a month at BMC, Schulman is also the resident musician in the Critical Care Units at NYU Langone Medical Center in New York City.
“Music takes you out of this hostile, unfamiliar world and reconnects you with life,” says McMillen, 67, chief of preoperative care at BMC.
Musicians work with several different types of patients: those in pain and under sedation; older patients who are confused; those who are recovering; and those who need a ritual of saying goodbye.
“There’s no question that music decreases the need for pain control and sedation,” says McMillen. “With older patients, especially in ICU, there’s a significant decrease in ICU psychosis when music is introduced.”
Schulman and McMillen have created the Medical Musician Initiative, with BMC as their sponsor. McMillen also received a small grant from New York City’s Kaplan Foundation. He hopes to expand the program so it runs throughout the month, and he and Schulman are creating a textbook and curriculum, with the goal of having a course formalized and certification awarded for what might be called Certified Medical Musician (CMM). They have already raised the interest of schools like the University of Minnesota, University of Wisconsin, and Boston University, which already is building a relationship with BMC and has close ties to the area with Tanglewood.
Schulman is eager to start training others. On July 24, two groups of individuals, musicians and physicians, will be a part of a workshop. So far, the musicians include Eric Despard, music director at Southern Vermont College with three decades of professional concert experience, whose wife is a two time survivor of cancer; Peter Argondizza from Long Island; Richard Francis, a cellist from Maine; and Michael Bard from Washington, D.C.
“This workshop is an opportunity to see whether they are interested in this, and how it would work as far as teaching, and we’ll go from there,” says Schulman. He and McMillen are putting together a glossary of what musicians need to know when they walk into an intensive-care unit.
“We know the medical side of it, and some of us have been patients, and we realize how a trained musician can bring something to the table,” says McMillen, himself a kidney-transplant recipient. “We’ve got everyone’s attention, and now we need to make it teachable, marketable, sustainable.”