Friday, July 7, 2017

"Hospice Music: A View From The Scroll, Singing and Playing and Walking Through The Valley"...

For nearly three years now, I have been a "volunteer musician" at an area home care and hospice facility.  

My first and only previous experience was to visit and witness the awarding of a lifetime achievement award to a longtime colleague. I got a hurried call about his transfer to the  hospice and the impending award presentation, and the urgency of his terminal condition that forced its presentation.  I remember the the day and occasion so well because it was my birthday and I had been up late reading and grading semester final exams.

I got to the facility just in time for the presentation and played briefly for the family members gathered (quite a few, as he was from a large family). Needless to say, the rush and varieties of emotion in that space were thick enough to cut with a butter knife, but the time was very special. As I was leaving the facility, one of the nurses at the main desk asked me if I volunteered very much at facilities like the hospice. I said that I had not, even though my experiences playing at churches, schools, community centers, hospitals and various special gatherings over the years are so many that I can only remember the most unusual ones!!  (My colleague made his transition three days later.)

At any rate, I went away affected in such a way that I couldn't have anticipated in terms of profound discovery about myself, what I do as a musician, and the rare space that music fills when played in a hospice (NOT hostage!!) situation. 

What follows is a listing of thoughts I have journaled over the past two years of volunteer music making (NOT performing!!):

I. "Perspective" 
My mantra, always uttered silently as I open the front door and step into the main lobby: "I will NOT leave this building in the same shape as I walk in".

Sound tends to "garrison" a space; music informs, reforms and transforms its resonant space in ways only the space itself and the receptive humans beings listening within it can fully appreciate. Every place of permissible access can be or become a place to play when the need arises "to catch and caress the moment"...a hallway, extra room or lobby.  The experience of visiting and playing is without a consistent description of duties: I can honor a patient who has died alone--by playing for the nurses who prepare the body and necessary paperwork for the morticians; I can play for families who linger by the bedsides of their loved ones; I can play for those patients, whom through the prevenient grace of God can wiggle their feet, toes and fingers, moan along, blink and flutter their eyesMost of the patients I meet and/or play for...on a one-time basis.  Some patients get the honor and pleasure of a repeat visit, but those who do are a very small minority.  While it may appear that my volunteer performances are primarily done for the patients, they also serve an indescribably valuable therapeutic purpose and function for the nursing and counseling staff.

I played for a gentleman whose outlook on his terminal illness was one of such "defiant optimism" that he began doing sit-ups in bed while I played for him!!

One woman I played for was a patient "on respite status", meaning that she was able to get out of bed on her own, even though the nurses generally advised against her doing so. I played two selections for her...unaware of her unique self-ambulatory status. When she tried to get out of bed, I stopped playing and reached forward to try and help her. Thankfully one of the resident nurses noticed and rushed in to help get her back in bed.  Needless to say, my brief bedside performance was brought to an end all too soon!! (Reminder to self and future volunteers: patients who are bedridden...don't need to wear too many layers of clothing in bed!! 'Just sayin'...)

II. "Getting Thrown Out" (Well, not in the sense of heated argument and altercation!!)...
One afternoon I was playing for a woman, who appeared to be listening with silent but apparent non-interest.  I usually play an average of two (2) selections; I had made it through the first selection, and was midway through the second when she called out to me quite abruptly: "STOP!! I DON''T WANT TO HEAR ANYMORE"!!  Needless to say, I was rather startled (and slightly frightened) to hear her call out like that; I quietly stood up, bid her a pleasant evening and left the room. As I stepped into the hallway, there were two young ladies standing nearby. Their grandfather was in another room down the hall. He was a man of the Buddhist faith, and he too was "nearing the end of his earthly shift"; his family and visitors chanted prayer chants for him around the clock. Some of the shift nurses told me later that they too had learned some of the chants themselves on account of the ritual's endless repetition.  The young ladies were taking a break (from the chanting) and had been listening to my playing "prior to receiving the patient's order to cease and desist"!!  They both complimented me warmly for my playing: "Sir, that was so lovely; your music was so beautiful". Honestly, I had been thrown into "blushing mode" by then because I'd had neither the time nor the "cushion of opportunity" to process the bluntness of the woman's command!!  Wiping the perspiration from my brow, I (humbly) accepted their compliment and quietly replied, "thank you".  What had felt like a near-insult in one moment had turned into a glowing, almost angelic intervention of speech, otherworldly comfort and encouragement. (Note: I neither saw nor ever got a second chance to visit or play for that woman again.)

III. On another afternoon, I was requested to play for the family of a female patient, her children and grandchildren: The following information I discovered afterward and wrote down...and then went home...
I arrived and greeted the family and sat down to begin playing. The patient's oldest daughter had said that she had been unresponsive until then, but as soon I began playing, she lifted her head and started moaning. She was actually singing (in spite of never having had a nice singing voice, according to the daughter), and while doing so began to relax. As she continued "relaxing", one, then two and three nurses were called into the room to attend to her.  No more than 3-5 minutes passed as I continued to play but I could tell that the emotional atmosphere of the room was shifting.  She passed on while I was playing.  I have no explanation of "what" the music did inside her body as her earthly life transitioned into eternity; but I know that it "rendered vehicular service" on a level of which I have but a pedestrian acquaintance at best. I was only there to play a song; what the song did once its tones reached the ears and emotions of that dying woman only the Lord fully knows and can give true essay.  (Here's the kicker: as I spoke briefly with the bereaved family members, I discovered that she didn't want "Amazing Grace" played at her funeral, and what do I sit down and start playing?? Bingo!! I guess I got the tune out of the way for her...as "traveling music"!!)

IV*. "Small World: Two Degrees of Separation...Literally" 
*(This paragraph is written in memory of a colleague whose name I can't use, even though I met her years before. It is but one of several such instances that I can recall.) 
I met this colleague during my "rookie year" in higher education. She worked with new faculty members who setting up their respective optional retirement plans (ORP) with the state university system. Of course when you're just starting out, the most remote concern is the details of one's retirement portfolio (but that quickly changes!!). Her name was on the room list this particular week, so I went to her room to play for her even though I hadn't put all the puzzle pieces of memory together. The puzzle came together within minutes as I greeted and spoke with her husband. I played two movements of solo Bach, and not too long into my visit I could sense that I had played enough. As I closed the door to her room, I caught a glimpse of her husband cupping his tear-streaked face in his hands.  She passed away a week later.  Much more time needs to pass before the true power of this hospice reunion manifests itself.

V. "Playing Solo Bach, Playing Practically...And The Music Of The Beyond (Notes Always In Development")...
Johann Sebastian Bach (1685-1750)....was an immensely gifted musician, organist, composer and "culminate keeper of the flame of High Baroque musical excellence"...was also a Lutheran who infused the articles of his Christian faith into the simple and complex musical structures that seemed to flow from his quill pen "like an apple tree produces apples in season", as Ludwig van Beethoven was quoted as saying.  The music for solo cello is indeed unique for its spinning of a single melodic line daring to emulate a spider spinning a web.  The "human" sound also emulates the tone of voice many fathers have and use, particularly when the emotions of comfort, encouragement, love, acceptance, meekness and kindness are so needed.  Since there is such a longstanding tradition of performing the suites in their entirety, the thought of doing such isn't far from my mind when volunteering.  However, the truth of simply "being" at the bedside of a sleeping (or awake) hospice patient is this: the situation creates the rules.  Playing Bach may work in many situations, but the idea that playing such in ALL visiting situations is presumptuous, and dangerously insensitive and self-serving. Therefore, I try to avoid playing that much Bach as if in a performance mode as much as possible.  Even if pleasant family members in need of a sonic boost ask for a performance, an entire Bach suite isn't what they have in mind!!

VI."Chatter With The Nurses"!!
I learned after about three months of volunteering that there are three groups of folks who are "in residence": 1) the patients, obviously; 2) the families of the patients; 3) the administration and nursing staff. One of the biggest and most endearing "surprise bonuses" of the hospice volunteer experience is the unexpected connection to the nurses that results via the music!!  The standard hospice nursing work shift is twelve (12) hours, and NO two days are exactly alike!!  In those three months I became a strange "resident cushion" for the patients, family members and loved ones in time of need and parting.  I became a "celebrated volunteer"...MUCH faster than I could've anticipated!! (NOT what I'd planned...then again, what does one "plan" in the face of this?)

"Family be's Family, too!!: Occasionally I will be referred to a patient's room crowded with relatives, all welcoming but the kids are in "show and tell therapy mode", too!!  I've learned that asking them the question "who's the boss here"?? goes a LONG way in keeping order!!

"Sleeping Beauty": I played for a patient and visiting family.  One of the visiting sons complimented me on the soothing sound of my cello saying, saying: "it almost put me to sleep"!! So I played one more selection, a Bach minuet (WITH the repeats!!); by the time I was finished, "he who gave said compliment"...was in La-La Land"!! OUT LIKE A LIGHT"!! 

VII. Unexpected Applause... 
While playing for some patients who "appear" to be asleep, I've had a few to awaken and compliment me with applause!! I also occasionally see fluttering eyelids, wiggling toes and moving fingers!! That's the patient's nonverbal translation of saying "I hear, I see and I recognize that"!!

Some days I'm playing as soon as I can get unpacked; on other days it seems like I have time multiplied. One week I played in eight of the twelve rooms...and I was there less than two hours!!  Some visits are barely five minutes, and I've had visits last nearly forty-five minutes...and some mighty fine hymn-sing sessions have "broken forth" as well!!

VIII. Mo' better unexpected...
I played for and talked at length with one patient for nearly 45 minutes (NOT the routine for most visits on most days!!); he had been brought to the hospice and advised that he would live 24-48 hours after arriving.  He told me that it was his FORTIETH DAY at the hospice!! We both shook our heads at the mystery and magnitude of living, the joy and beauty of music when played informally but still with excellence and sincerity. Our conversation was "molto grazioso", a musical term meaning "overflowing with grace and appreciation".  The quiet and tragic irony that I have grown accustomed to when dealing with most other hospice patients is the "one and done" feeling that is the reality.  His amazing story of "endurance" is both endearing and enduring, but he informed me of his impending transfer back to his home (not in Durham), and the transfer is to happen within the week.  So a pleasant first meeting turned out to be a "veiled farewell" between two people meeting in the most unusual of circumstances.  Profound...and "beyond sad"... 

IX. "Bach, Schubert and Mahler Remixed...in Two Parts"
A. A rare musical moment had playing at hospice yesterday: played solo Bach for a patient and spouse, only to be informed in conversation that said patient had rearranged the mantle photos (of family, friends, etc.)...and placed a picture of Gustav Mahler in the midst of them all!! I managed to "quote and improvise" some of the Songs of A Wayfarer" (which he recognized) and some of the Adagietto from "Five"... I wonder if such coincidentally shared cognizances and experiences could be screened somehow; but I know if they were, that would spoil the magic and profound beauty of the meeting and the moment...

B. I've had three (3) most unusual opportunities to visit and play for the same aforementioned patient and his wife.  The wife is with her husband almost round the clock, and the visits have become a rare and profound encounter with a man who discovered opera and concert music via a homemade radio he built as a youngster.  I've played all the familiar Mahler symphonic melodies that I can manage to fake without embarrassment (even though there is really no such thing as "being embarrassed" in the sharing of music at a hospice); however, I've found a new affinity for the lieder of Franz Schubert, who is also a favorite of the patient for his massive vocal output.  His love of Schubert, Bach and Mahler (in no particular order) appear to have me in a web of expectable attachment through the very act of sharing what I do: none of us know when "that last visit" is to be...and so I just "do what I do", and remember to visit his room to give one of his last and most enduring human faculties some small and yet HUGE comfort and aesthetic "pleasure". The fact of our impending closure was given a jolt one Monday when another patient in the room across the hall passed on in the midst of our visit (I had visited the latter patient briefly the previous week after another lengthy visit with the "Schubertophile"!!).  The more I come to this place, the more profoundly I regard the quality of the time I devote to this act and activity.

X. Barry White, Thelonious Monk and....
When I went to play at the hospice last week, one patient's room had a Barry White CD playing. I quietly slipped into the room and joined the CD Love Unlimited Orchestral Jam!! Those kind of musical "conversations" don't happen often but I relish the uncommon joy of such participation when they occur!!

XI. Following through on Return Visits...
When at the room of a hospice patient, I always quietly knock and slowly open the door.  Often one or two family members or friends will be visiting quietly, but on this particular occasion one man was sitting in the room beside the patient, who was sitting up in bed watching the television.  When seeing that the door had been opened by my hesitant greeting, the patient announced with a quiet firmness, "Either come in or get out".  At that point I identified myself as a volunteer musician, and assured them that any extraneous musical sounds coming from the other rooms would most likely be me.  The man was speaking to another person via smartphone, and quickly pointed to an earbud in his left ear.  I quickly noticed and sheepishly gestured to both patient and visitor that I would come back later. Ninety minutes later I had packed up after having played in three other rooms (mostly to solitary sleeping patients, but the next to last was my enduring "Schubert/Mahler patient")...and I remembered my promise to come back and check on the patient in aforementioned room, "The Earbud Room").  I paused, thought out loud for a second and re-unpacked for one more visit to the patient in Room Ten.  I knocked and slowly entered, but this time was warmly greeted, both by the patient and the man who'd been talking on the phone, who turned out to be a special therapist on temporary assignment to the patient there. A second male assistant and the shift nurse were also in the room.  A test was about to be administered to the patient, so my return was just in time!!  I quickly sat down on the arm of a couch right by the door, and proceeded to play the Bach Minuet in C that I learned back in the Suzuki cello days as an eleven-year old (!!)...'and I pushed the tempo along so as not to delay that impending test any longer!!  Upon finishing my performance, all present in the room applauded with warm appreciation and laughter, and I went home feeling thankful and satisfied that I had kept my word to people whom I'd met and interacted with for the first time, silently knowing that I may not meet them there ever again..."but that I'd still be coming back to check in on them later".

XII. Epilogue: My "Schubertophile" patient passed away after nearly seventy days in hospice. His loving wife was at his bedside; I played for him "for what became the last time"...two days before he passed.