Aiden Maier Reflective Essay for Musicians in Healthcare Mentoring Programme Delivered by rb&hArts and Sound Connections
Over the last year I have had the wonderful opportunity to learn first-hand about the latest developments in music-making in healthcare settings by shadowing the experienced musicians working at Royal Brompton & Harefield NHS Foundation Trust. As a music practitioner (guitarist and vocalist), working in healthcare settings was completely new to me, and the programme at these hospitals provided me with an exemplary model. Yet before starting I had not realised how many different settings existed there and how varied the work being done there was - in fact the musicians I was shadowing often remarked about how little they knew of what each other were doing. I had the opportunity to observe the different approaches needed to meet the needs and challenges of the patients in different areas of the hospitals, came away with a strong idea of which area of the field my skills would fit best, and was able to gain practical experience leading musical activities with expert guidance.
Whilst shadowing, it became clear that an important part of working as a musician in residence on hospital wards was the ability to win people's confidence by creating some kind of immediately beautiful sound. Time after time the musicians would enter a shared ward offering music and be met with skeptical looks. However as soon as Heather McClelland or Stac Dowdeswell began to sing in their refined voices, or Adrian Garratt played his first lyrical notes on the violin, patients' faces would light up and a long conversation or requests for further music would inevitably follow. Particularly as these visits mostly took place in the evenings while patients rested, the musicians often had to take the initiative to prove that they had more to offer than just another annoyance in a busy space.
In contrast, the visits to private rooms usually began with a conversation and it could take some time before any music was heard. The choice of music played would come out of those conversations, as requests from patients or the musician picking up on something that had been said, and the private setting often opened up the opportunity for musical interactions such as patients and musicians singing together or musicians giving ukulele lessons and lending instruments. While the musical interactions here usually had a more personal connection with the patients, there also seemed to be less opportunity for the musicians to introduce themselves directly through their music and here it was more common for them to be turned down at the door.
The children's ward again demanded a new mode of working from the musicians in residence. Most of the rooms were shared by multiple patients and their families, but here people rarely needed any convincing, as shared music-making was already such an important part of the day-to-day life of families with young children. This openness was clearly also due to the way the musicians built continuing relationships with many of the patients, and to the efforts of the ward's excellent Play team to support music-making there. For example, use of the ward's play room which made group music-making possible without disturbing others.
A soft-play area in this room was also one of the only places the young patients, particularly a number of rambunctious boys, whose windows looked out on a large park they were not allowed out to, could let out their physical energy. While their behaviour was often at odds with the calmer music sessions they sometimes interrupted, it struck me that more physically demanding musical movement activities could be an ideal way to release that energy in the limited space available.
On the children's ward the immediate winning effect of an impressive musical performance was perhaps more obvious than anywhere else - I cannot remember a single child who was not in awe of Bellatrix while listening to her beatboxing for the first time. At times the musicians also worked closely with the clinical staff, distracting children during uncomfortable medical procedures. As many of these doctors seemed to be on rotation rather than being permanently based in Paediatrics, they were often grateful for some help from someone experienced at holding children's attention.
Of course, the multitude of overlapping activities in the hospitals means that there was no end to the different situations that musicians working there could find themselves making music in, from playing soft lullabies to patients in intensive care to taking on more of a performance role playing in waiting rooms, and the staff throughout the hospitals also clearly enjoyed their presence - welcoming them onto each ward or even singing to them as they passed in the corridors.
These contrasts between the different spaces of the hospitals were also an important part of one of my most memorable experiences, while shadowing one-to-one singing sessions on the adult cystic fibrosis ward with Heather one late-December evening. Earlier that day we had been in the hubbub of the children's ward, busily playing and singing non-stop in the warm, communal environment created by the play team and families there. Moving to the purely clinical environment of the adult cystic fibrosis ward, where the nature of the disease and its treatment necessitates isolation between patients, presented a stark contrast, particularly because the patients who invited us in to sing with them that night were so young - only a few years beyond the transition from children's to adults' wards at sixteen.
However, everyone we met was also surrounded by family, who had created warm, comfortable spaces within the rooms. One particularly moving session that night was with a young woman, who had only just been diagnosed earlier that week, and her mother who was clearly quite upset. However, she was a dedicated singer and it was wonderful to be there as Heather shared the therapeutic importance of what she (and her mother) had been doing for years to counteract the disease she had just been diagnosed with, and to finish the evening piecing together the harmonies of some favourite Christmas carols between the four of us.
The most useful part of being able to make all these observations for me has been the opportunity to see where my approach as a music practitioner could best fit in. I do not consider myself able to create one of those immediately beautiful sounds which I heard instantly bring a room of patients together in a group conversation, nor the non-stop energy needed for working on the children's ward, but I did feel my practice fit in well with the regular Singing for Breathing sessions held at the hospitals, which support the therapies offered to people with long-term lung conditions in a low-pressure, non-clinical environment.
While the sibling Singing for Breathing music leaders, Ed and Elisa Jeffery, held the sessions through their own significant musical abilities, their role also involved meeting the combined challenges of keeping a community singing group together, and all happy with the same repertoire, whilst keeping an emphasis on lung health as they coach amateur singers. I spent most of my time with Ed and the Brompton hospital group who warmly welcomed me in. Through a period of intensive mentoring from Ed, I built up to leading a full session with the group. I was able to apply my experience working with other community music groups, but relied on Ed's knowledge and experience to make sure that every part of my session was supporting healthy breathing.
As well as offering an informal route to learning breath control techniques through another enjoyable activity, it was clear that the communal aspect of regular interaction with a familiar group of fellow patients was also an important aspect of these groups. During my time shadowing, the founder and former Head of Arts at rb&hArts, Victoria Hume, was visiting the Trust to gather material for The Singing Hospital - a participatory composition celebrating Singing for Breathing as the longest-running singing for lung health programme in the UK.
From the interviews and conversations gathered for The Singing Hospital, what struck me most was the way these groups had met the challenge of building a sense of community and shared experience with a group of people that is constantly in flux. Of course, this is also an important outcome of the music being made elsewhere in the hospitals, but the challenge is greater there, as there is no regular group of people meeting over a long period of time.
As a composer myself, I began to wonder if some of the Victoria's creative methods could be applied to a project of a similar documentary and sharing nature aimed at building a sense of community and shared experience between people in different parts of the hospitals, even if they may never meet in person. This could take the form of a collection of songs chosen by different patients, family members and staff, which could form a shared repertoire between the musicians in residence working in different areas. Rather than a performance, a recorded medium such as a podcast could be more accessible, and recordings of performances of the chosen songs could be intermixed with patients' stories about their choices or their experiences in the hospital, or even newly written music drawing on those stories. In fact, song sharing was already apparent during my shadowing - I remember a ‘Unicorn Song’ Heather had written with a young patient was popular across the children's ward.
These are only loose ideas for now, but I hope to continue working in healthcare settings with an eye to building up to larger projects along these lines, and my time at Royal Brompton & Harefield NHS Foundation Trust has certainly opened the door for me.
rb&hArts and Sound Connections are currently recruiting for the next cohort of music mentees with five spaces available.
Learn more and find out how to apply here.
DEADLINE EXTENDED to 23rd October 2019.