Ask Us Anything About… Music in Medicine

Music is often heard in the hallways and patient rooms of Hershey Medical Center. Clinical, evidence-based use of music at the bedside can help with the healing process, while environmental music brings joy and creates community.

We talk with Jan Stouffer, Music Therapist and Claire de Boer, director of the Medical Center's Center Stage Arts in Health.

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Description – The video begins inside a therapy room inside the Penn State Children™s Hospital. The video starts with a women playing guitar and the camera pulls back to reveal three people standing. On the left is Scott Gilbert. In the middle is Claire de Boer, director of the Medical Center™s Center Stage Arts in Health. On the right, holding the guitar is Music Therapist, Jan Stouffer.

Scott Gilbert – From the campus at Penn State Health Milton S. Hershey Medical Center, welcome to “Ask Us Anything about Music and Medicine.” I’m Scott Gilbert. Music is actually a very big part of what happens here at the medical center and where we are right now, which happens to be at Penn State Children’s Hospital. You might have caught our latest “Penn State Medical Minute” just last week. It was released on Thursday on PennStateHealthNews.org and it was on this very topic. It was in that “Medical Minute” that we explored the many ways in which music is put to use in the hospital setting with two of our experts. They are Jan Stouffer, a board-certified music therapist; she is with us today. Jan, Hi.

Jan Stouffer – Good afternoon. Good to be with you.

Scott Gilbert – And also with us is Claire de Boer; she is director of Center Stage Arts in Health. Hi, Claire. How are you?

Claire de Boer – I’m well, Scott. How are you?

Scott Gilbert – Great, thanks. Thanks to both of you for being here today. So, music is really all over this place, and that’s something that maybe people may or may not realize, and that’s what we want to talk about today, especially from the therapeutic standpoint. We’ll start there, Jan. Tell us a bit about how music can be used in a clinical setting to help control pain and anxiety and things like that.

Jan Stouffer – Well, we assess each patient and find out their background information, their medical, clinical needs, their music preferences. And then we piece together music that is comfortable and familiar to them and play it in a calm, sedative manner on guitar, live, and sometimes we sing, sometimes we hum, but we use that music to help reduce their pain, reduce their anxiety. And actually, when we have patients that are on vital signs monitors, we can see their heart rates coming down, their breathing rate coming down, their oxygen levels in their blood going up, so physiologically we are seeing good things as well as the calming of the environment.

Scott Gilbert – You’re watching “Ask Us Anything about Music and Medicine” from Penn State Health Milton S. Hershey Medical Center.” Throughout this conversation, we welcome your questions about the benefits of environmental music and music therapy. You can place them in the comment field below this post and we will pose them to Jan and to Claire, and even if it’s after the fact, you’re watching this on replay, feel free to ask the questions, and we’ll get you an answer from one of them and post it as a comment as well. So, Jan, there’s a specific therapeutic purpose to so much that you do. In fact, when you wheel this cool cart of instruments that’s right behind us here into a room, again, it’s part of that patient’s treatment plan. Correct?

Jan Stouffer – Correct. We work with the doctors and nurses. They place orders for music therapy services for specific reasons, for the pain management, like you were just speaking about. Sometimes to help specific patients adjust to being in the hospital and cope with all the changes in their lives. Also for functional rehabilitation needs, we use drumming to exercise arms; we use singing to exercise lungs and speech. We might play wind instruments for the lung exercise, so it can be physical exercise and rehabilitation. It can be emotional needs. It can be managing pain. And we work closely with the doctors and nurses to determine what is most needed at any given time.

Scott Gilbert – I’m thinking of one time specifically I was with you for a media story. You were in with a patient, a pediatric patient, and the challenge was to get him moving, and you did that by pretty much setting up a drum set in his bed. Is there a lot of improvisation involved in what you do?

Jan Stouffer – A lot. [Laughs] A lot. We never know. Sometimes we’re meeting someone cold and we never know, you know, anything about them, so we find out, like I said, their music preferences, and this particular child just wanted to get his hands on drums. And we took what we had available, several different drums, placed them around his bed and got him playing along with the music, and we were able to get him focused and interacting so he was not focused on pain and being upset. He was not focused on being scared in the hospital, and, by having the drum set placed around him, he was moving and utilizing both arms, so therefore getting some exercise and some balance control and that type of thing.

Scott Gilbert – Back to that specific therapeutic purpose, very interesting. More to come on music therapy. I want to switch to environmental music for a bit and talk with Claire de Boer. She is, as I mentioned, director of Center Stage Arts and Health here at the Medical Center. So, Claire, tell us first about Center Stage and what it brings to the setting here.

Claire de Boer – So, Center Stage Arts and Health is a whole number, probably 12 different arts programs, and the general idea is to infuse the medical center experience with the arts, be they visual arts, performing arts, music, in as many different ways we can think of. So, we work with patients, caregivers, faculty, staff, medical students. Anybody who is part of the medical center hopefully has some experience with Center Stage Arts and Health.

Scott Gilbert – And when we go to the hospital, we don’t always expect to see fine arts or hear fine music in the hallway, yet that’s exactly what Center Stage brings to the hospital. Tell me about the benefits of that. Why do that? Why bring the music to, for example, near the main entrance? Someone walks in and hears that grand piano being played. What do they get out of it?

Claire de Boer – So many people who enter a medical center might be feeling some stress and some anxiety about the reasons that they’re coming here, and if you see a real live person playing lovely music, it’s a way to kind of soften the edges when they enter. It humanizes the environment. It encourages interaction that is separate from their reasons for being here, and the overall idea is just to bring a sense of community through music to our medical center.

Scott Gilbert – You’re watching “Ask Us Anything about Music and Medicine” from Penn State Health Milton S. Hershey Medical Center. I’m Scott Gilbert alongside Claire de Boer and Jan Stouffer, and your questions are welcome. Just add them to the comment field below this Facebook post and we’ll pose them to them in real-time or if you’re watching this in replay you can count on an answer to your comment or question after the fact, as well. Claire, we’re talking about Center Stage, and, tell me about the performances throughout the hospital and how those performances may be tailored to a particular part of the building.

Claire de Boer – So, our performances are professional musicians from our region and we choose musicians who are not only excellent at their instrument but also who play instruments that would be seen as, would be experienced as soothing, calming, or even cheering. And then we choose, we look at the, we listen to the instrument and watch the musician, think where would they best be suited. Some areas, like the surgical wait area, have a lot of nervous people in there who are waiting for their loved ones in surgery, and I think overall, they can use calming music. So we choose musicians and instruments that are a little bit softer and are not going to interfere with somebody’s, perhaps their need to have quiet, or to just help them relax a bit. Someplace like the main entrance, sometimes we’ll have something a little cheerier, just because it’s a public area and people can walk through and feel a little more happy to experience something joyful. So we just look– in a smaller area, it’ll be just one instrument, maybe an acoustic guitar, and in a larger area, we can sometimes have duos or trios. We just try to be sensitive to the population who’s going to listen to the music and also the physical space, so it enhances the overall experience.

Scott Gilbert – Of course, we are at an academic medical center. So much of what we do here is based on evidence-based approaches, and yet there seems to be some sort of intangible aspect to what both of you do. Can you talk a little bit about that, and obviously there is a specific therapeutic purpose, Jan, to so much of what you do. Yet, again there is the intangible aspect of this as well, isn’t there?

Jan Stouffer – Oh, definitely. We have our clinical goals that we are working on, but just like that memory that you have of the boy playing the drum set, when you have a person that you walk into their room and they are scared, their affect is very flat or neutral, they might even be hiding under the covers if it’s a small child, and you can bring them out and engage them with the music. You see a whole change in their face. They brighten, they light up, they begin to sing, they begin to play, and there are degrees of that, that you can’t chart in a note. It’s a feeling that the parents get, watching their child, or a sibling, or if it’s adults we’re working with, other family members, and we can just tell that that person is engaged, they are socially interacting, their spirits have been lifted or they’ve shared something meaningful that allows them to just feel better about being in the hospital.

Scott Gilbert – I know you have to make the distinction between do you want to go after a more sedative effect with your music or a more stimulative effect. That’s something you mentioned in the “Medical Minute.” Give us an example. Now, when we opened this segment, you were playing something that I think was a little more chill, a little more sedative. Can you show us an example of something that might be a little more on the simulative side?

Description “ Jan begins playing the guitar and starts playing Bob Marly “ Everything™s going to be alright. Jan explains as she speaks how the speed and rhythm can be changed based on the patient™s moods.

Jan Stouffer – Sure, sure. Well, we might [music] if we’re going in and someone’s favorite song is, if they like Bob Marley, and we’ve been doing “Three Little Birds” on a fun day it might be “Don’t worry ’bout a thing, ’cause every little thing gonna be alright.” And that’s the stimulative version. If I go in the next day and they’re having pain or nausea or difficulty sleeping, that’s still one of their favorite songs, so because I am a live music therapist I can change it and turn it into a 3/4 lullaby that is calming to them. “Don’t worry, about a thing” and so on. So you can take whatever song they like and change the properties of the music so that it becomes a calming lullaby regardless of age. And that’s the importance of having a live music therapist or live musicians versus playing CDs and recordings because once something is recorded, the only thing you can change is to make it louder or softer. And it is so important to have the flexibility and adaptability in the moment of the session and our hospital and the administration has recognized that and has supported having live music therapists on board.

Scott Gilbert – That’s fantastic. We have something coming up. Two sessions called “The Music and Rhythm Workshop Series.” Center Stage is involved with that. They are on December 15 and 22. That is being offered through the Cancer Institute, right? Penn State Cancer Institute. Claire, tell us a bit about what “The Music and Rhythm Workshop Series” will entail and who it’s for.

Claire de Boer – So, we have a sense that it’s not only pleasant to witness music, but also to make it, and we need to be able to offer that experience in a way that anybody can do it regardless of their musical ability. So we have chosen a musician who is a professional musician but also a teaching professor of music to create workshops for our cancer outpatients so it’s funded by the Cancer Institute. And those workshops enable folks to come and be part of a musical group regardless of their musical background and just experience the joy of music-making and we think also it helps build community, making music in a group.

Scott Gilbert – It sure does. Thank you for the information on that. If you would like more information about “The Music and Rhythm Workshop Series” you can find that on the “Medical Minute” at PennStateHealth.org. I’ll ask Jan to play us out with maybe a little bit of Bob Marley or something in the background or whatever you choose as we just kind of wrap things up here. And thank you for tuning in for this edition of “Ask Us Anything about Music and Medicine” here on the Facebook page from Penn State Health Milton S. Hershey Medical Center. Again, if you’re watching this on playback, feel free to pose your questions. It’s not too late for us to get some answers for you from Jan Stouffer, who’s our board-certified music-therapist, and Claire de Boer, who’s director of Center Stage Arts and Health here at the Medical Center. On behalf of all of us, thanks so much for tuning in.

Description “ Jan plays more music on her guitar and Scott finished the live stream.

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