Sasha Mattock Reflective Essay for Musicians in Healthcare Mentoring Programme Delivered by rb&hArts and Sound Connections

When Words Fail Music Can Often Speak

My experience of shadowing for 6 months with the music team (rb&hArts) at Royal Brompton & Harefield NHS Foundation Trust. My background is in psychology, wellbeing, inclusive arts and special educational needs and disabilities (SEND). I currently work as an advocate for children and young people with SEND as well as a freelance artist facilitating dance and movement workshops with children, young people and adults with SEND. I applied for this programme as I have always wanted to bring the arts into hospital spaces and having played in brass bands and orchestras for over 15 years I felt the benefits of music for me and wanted to find a way to share that with other people. I am really fascinated by the effect that music has on people and because of my interest in wellbeing I was really excited to be part of, experience and witness how music helps with this in a clinical setting.  

In this essay I will reflect on my learning by programme and artist, ending with some notes on the mental health impacts of this work and concluding with some final thoughts.

Vocal Beats for 0-16-year olds: Heather McClelland, Bellatrix and MC Zani

(singing and beatboxing)

My first experience of shadowing was in Rose Ward with young children, I wasn’t quite sure what to expect, I just saw the clinical handover notes and the two Musicians make notes about who to visit when. I realised very quickly that having a bank of songs is really important and that they need to be suitable for children. It was really amazing to see how flexible the musicians were, sensing when to play music and when to teach a little.

There was one moment when the parents of a girl of about 13 told us that she could sing but she was too shy to show us. After spending 5 minutes with us she opened up and played us a video of her singing. I realised just how powerful a 5-minute interaction with music and encouragement can be, she was able to be brave and share her talent with us. I learnt that it is ok to repeat a song if children like it and adding moments of improvisation can be a great way of creating a space for children to have a go at playing music.

We also worked with a young person who was non-verbal, teaching him to the beginnings of beatboxing. We found a way to communicate using counting on our fingers and the left hand meaning one sound and the right hand meaning another. We were able to enjoy music together and use creative ways to communicate. I realised that there are many different ways to explain and teach your practice. This is something I have taken away with me.

Finally, we worked on one ward with a girl who was unable to sing but loved to dance. There was an opportunity to create hand dance moves together and help engage more of the arms, shoulders and neck. 

Each moment was so different and so beautiful and opened my eyes to many different opportunities.

The second time I shadowed on Rose Ward felt quite different to the first time, there seemed to be less children in and many of them were at school so there were less families to work with. 

There was a 7-year-old boy who wanted to join in playing music and loved trying out all the different instruments. He also wanted us all to squeeze into a tiny space and learn ukulele there. I saw several different ways that the musicians used to engage the children for example using numbers to represent each finger, string and fret. 

There was a really beautiful moment when we entered a ward where all the curtains were closed and started playing for one family whose little girl was really happy and clapping when we started to play. This led other families to pull back their curtains so that the whole ward was opened up and three of the families all joined in the same song Old McDonald. This showed me that sometimes no matter what words you use it is hard to change a place from feeling isolated to feeling like a community however music enables people from many different places to share a space, connect to the music and connect to each other. 

The final thing I watched was a 14-year-old having a beatbox lesson. She was very shy at first but had had one lesson before. After 5 minutes her voice became louder. She wasn’t so worried about making mistakes and seemed to really enjoy it. She had also practiced since her previous lesson. This highlighted that not only did the musicians add something to her life in the moment we were with them, but also there is something that lasts for longer as she chose to spend some of her own time to beatbox. 

Throughout these sessions parents and carers film the musicians and like to document what is happening. To me this highlighted just how special the moments were as they want to remember them and possibly share these moments with others. 

Musicians in Residence: Adrian Garratt (violin) at Harefield

It is so fast paced with Adrian, so many different places are visited in one afternoon. Creating a character is really important - his tuxedo highlights that he is there to do something professionally but different to the medical team. I think this enables him to connect with the patients as they are intrigued as to what he is doing there.

Shadowing Adrian I saw how he began the conversation with a patient, he always asked an open question ‘what can I play for you?’, ‘What music do you like?’, ‘What would you like to listen to?’ This made it possible for him to play to nearly every person, as people were given the permission to hear music on the ward. It also helped a conversation to start as it wasn’t as easy for people to say no. Mostly people reacted very positively to the offer and thought it was amazing, whereas some were a little unsure but after giving it a go every single person was grateful and enjoyed the experience. 

I noticed how important it was to be at the eye level of the patients where possible so as not to be towering over someone in a bed. Adrian did several different things to make this possible, he crouched down, found a chair to sit on, stood at the end of the bed. There was never any pressure for people to say yes to Adrian and although at first the rejection was a little hard to take I realised we were giving patients a choice and empowering them in a situation where there may not be much choice. 

Speaking with and playing for people bought up so many different emotions, some people laughed, some cried, some wished their friend was there with them, some said it made their day, some wanted it quiet and some didn’t want us to leave. I realised that there is no one way to go into each conversation except to being open with the person you are working with.

There have been a few moments that stood out to me, one where another relative was singing Elvis Presley song ‘falling in love with you’ in a bed across the room and we picked up on this and joined in softly with her. It was a really beautiful and emotional moment as her grandad was unconscious and rather than talking to him she decided to sing. For a moment the hospital drifted away and we were playing this lullaby and able to provide support without having to say a word.

For my last session with Adrian I was able to take my Cajon in (box-shaped percussion instrument) which was quite an exciting experience as we were able to play together, I really enjoyed following Adrian and working out what I could play. 

We played some jigs together which worked very well and seemed to really lift the spirits of others as they are quite lively.

It was lovely to find another person to play with and I would love to do this in the future as I felt we could support each other through music as well as the patients.

One thing that was quite challenging shadowing Adrian was going into the intensive care unit and seeing people that were quite unwell and not always able to respond to hearing the music.

Adrian mentioned a few times that I am very good with lyrics and keep a lot of them in my head. When doing something like this in the future I will take something to be able to search the lyrics so that I can sing more of the words such as an ipad or phone. 

Vocal Beats for 17-25-year olds Harefield and Musician in Residence: Stac Dowdeswell (singing and ukulele)

As Stac works with young people up to 25-years old on adult transplant wards at Harefield you never quite know how many people you are going to play for or teach a lesson to. This can feel a little tricky and quite unknown as even if there are people to work with they might not want to or be well enough to have a session. 

One of my sessions shadowing we only played for one person in the first hour and spent a lot of time waiting around and I felt like I hadn’t learnt much and that reaching people was impossible and that there was no point being there. But after reflecting a bit more on it I realised that so many things actually happened. People had the opportunity to engage in music, they had a choice which was listened to where they said yes or no which can be quite unusual in a hospital setting. They can speak to someone else who is a little more removed from the situation. There is also space to show their emotions without there being any judgement.

I learnt so much in this session, the first person we visited who would normally participate was feeling very poorly and couldn’t cope with the thought of having a lesson. I realised the journey to recovery is quite intense, you can be feeling better some weeks and then get worse with another infection. As musicians going into these spaces we have to be aware that we don’t know very much about the people we are playing for and teaching. We therefore have to be very in tune to each situation and not make assumptions.

I remember one person we offered music to declined us the first time and then when asked again a week later he said actually some music and talking to people would be lovely as there are only so many Netflix episodes you can watch before you get bored. It was lovely to be there and see him close his eyes while he listened and then afterwards he shared a bit of his story, he had been going to the gym and felt very fit then started to feel a bit weird but couldn’t tell what it was. He spoke to his dad who suggested that he go to the doctor and they caught him just in time, he could have had a heart attack. 

On another occasion one of the lessons that Stac taught was for a young lady who was just about to leave as she had made quite a good improvement. The conversation was fascinating as I wasn’t sure if she wanted a piano lesson or not at first. I think maybe she wasn’t either. However, giving her the space to talk gave her more confidence to sit behind the piano and have a go. For her it felt like music was something she could try because she had a lot of time. It may not be something she wants to do every day, but it was a change for her.

Shadowing Stac at Royal Brompton is another very different experience - there is a lot of one to one work and a lot of conversations. Stac creates space for people to share and open up; listening whilst also keeping it quite light. I really understood that music can often be the gateway to help people open up and feel safe in doing so. There was a beautiful moment just before we finished where we sang for a couple ‘will you still love me tomorrow?’ They shared so much between them and after it said that they had had a really hard day and that hearing this music was just what they needed. 

Singing for Breathing: Elisa Jeffery at Harefield Library and Uxbridge Bailey Hall

Singing for Breathing was a very different and valuable experience. In this there was a definite structure that Elisa had beginning with a warm up, sharing some information about how we sing, practicing 1/2 songs and then cooling down. She highlighted to me that singing is about the body as well as the voice. Yet, within this structure there was real flexibility. Seeing two classes I was able to see how Elisa adapted the sessions depending on the needs of the group. She kept the sessions very light and playful and at the same time a lot of learning was happening. 

As movement is also a big part of my practice it was really amazing and eye opening to see how much movement Elisa used in her warm ups, we went ‘skiing’, we found our centre of balance, we shrugged and circled our shoulders and arms, we drew smiley faces with our nose to name just a few. As well as this there was also some mindfulness in terms of grounding and sensing the floor and being present with it. I will definitely take some the techniques that Elisa used and incorporate them into my practice. 

Vocal Beats for 17-25-year olds Royal Brompton: Heather McClelland (singing)

Shadowing Heather teaching singing lessons to young people with cystic fibrosis was really beautiful. The first lesson I watched I remember the young lady was a little nervous but quite up for it. I thought they were so brave as they had never sung before. Especially as they didn’t know that singing lessons were even a possibility while in hospital. The person we worked with had just moved from the children’s ward into the adult ward which is quite a transition for a young person from having school and parents allowed to stay, to being in an isolated room without the play team checking in.

The second time I shadowed Heather there were two young men that agreed to try singing lessons for the first time. Heather wanted to teach them a different way to breathe to help their lungs strengthen. She tried one technique standing and explained it a lot and the young person found it a little hard so she adapted it and used mindfulness as a way to access it. This helped me to understand that sometimes the reason someone has difficulty understanding something is because there may be too many words or it sounds more complicated than it actually is.

Heather had so many different techniques that she used to work with to keep the young people engaged and not feeling embarrassed, she was always encouraging and let them make the final decisions. She also checked in with them constantly to make sure that they were ok with what was happening. After reflecting on Heather’s practice, I identified several points that will be really important in my own practice:

• Identifying the end goal and working out with small steps what we can do to get there
• Believing in yourself and your ability in order to hold the space so that you can check that everyone understands and that whatever the outcome that is ok
• It’s ok to make mistakes; learn from them and carry on
• Being confident enough so that they trust you and go with what you are trying to do

Mental Health

For me I have also been fascinated in the mental health side of performing, listening to and connecting with music in a hospital ward partly through my background in psychology. Having spoken with many of the musicians about this I see there are many different approaches to working though the emotions which may appear while working in a hospital setting. Some of the coping strategies included:

Speaking with someone close after a challenging experience to go though it to get it out of your mind. Acknowledging that musicians need to have barriers and create space as it can sometimes be a lot. It may also be that no matter what has happened at home this work takes you somewhere else and can be really enjoyable and worthwhile. It’s knowing when to stop and take a break Knowing when a situation is more challenging  and being able to express that Feeling that you are able to give something back . 

Final Thoughts

This journey has taught me so much and highlighted how something that may seem small and insignificant such as playing music to someone for 5 minutes can change their day and change yours. It has helped me to see that music can be a bridge to starting a conversation and helping people to open up. It may look like something different in each place on each ward but in fact the music allows for connection and a sense of belonging in places that can often lead to loneliness and isolation is something really powerful and changes the experience for every person on the ward for as Hans Christian Anderson said, “where words fail, music speaks”.

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.