It was a busy day in the Salmon Creek emergency department (ER), and I was weary wanting the long shift to end. As I documented one of the many patients’ visit that day, my head rested alongside the cold block wall separating me from the marbled atrium where patients and families waited for care. Conceived just ten years before and award winning for its’ beauty, the atrium contained a grand piano allowing volunteers, guests, patients, staff and others to tickle its ivories at will. Weary and ready to go home, Étude Op. 10, No. 3 began to infuse the wall. I succumbed to Chopin, and for a moment, my thoughts went outside the ER to a softer gentler place. When I returned, I was better, and it was time to see another patient. Music and medicine are not strangers.

“Music has healing power. It has the ability to take people out of themselves for a few hours.” ~Elton John

Music in Evolution

Theoretical approaches differ regarding the origin and function of music. Music along with dance originated most likely for rituals. The ubiquitous nature of music reveals its ability to give pleasure and value to humans. Music is an enigmatic influence to human behavior, that unlike most common behaviors, does not reveal a plausible or practical motive to survival or procreation.

Scholars argue whether music has an evolutionary place in adaptation. An article by Huron discusses music in evolutionary adaptation linking music to the theory of evolution by natural selection. The author explains that evolution is thought of as purely physiological and not psychological. However, it is not just our immune systems and elbows that are formed by evolution. Rather, it is our attitudes, characters, emotions, perceptions, and cognitive functions that are shaped by natural selection. Evolution becomes successful when traits are adaptive to the organism’s environment. One might wonder how music making aptitude has avoided the hatchet of evolution.

Steve Pinker, a renowned contemporary cognitive psychologist, believes that music is an evolution or adaptive by-product. Pinker is well known for coining the term “auditory cheesecake” in his reference to music rather than the “main dish.” Neuroscientists have held that language and music are separate up until recent years when new theories have supported a contrary view. In fact, music develops with language, even helping in language development.

Music in Antiquity

Hippocrates, the founder of ancient Greek medicine and “Father of Modern Medicine”, used music as a focused natural approach in the treatment of diseases. Music and drama were used as management tools in the treatment of illness and in the improvement of human behavior. Hippocrates observed clinical signs and made rational conclusions. He valued the need for harmony in the individual, social, and natural environment.

Music has a far-reaching history that is currently being developed and researchers continue to examine evidence left behind. For example, the didgeridoo, thought to originate in Northern Australia, is suggested by researchers to be one of the oldest instruments at over 40,000 years.

Music as Medicine

“Americans spend more money on music than on sex or prescription drugs” ~ Daniel Levitin

Peter Gabriel declared that “music should provide us with an emotional toolbox.” Alan de Botton believes this “emotional toolbox” can transform our daily lives. Tricia Fox Ransom’s capstone (MAPP10) gives us tools for the “toolbox” explaining how the lyrics of music increase emotions and meaning. She helps children through the non-profit Purple Songs Can Fly by creating a tangible symbol for the hope of healing. Pediatric patients record their own original songs that can then be shared with friends and family and flown around the world.

Music is used as therapy. The definition of music therapy by the American Music Therapy Association (AMTA) is “the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.”

Music therapy is designed to:

• Promote Wellness
  Manage Stress
  Alleviate Pain
  Express Feelings
  Enhance Memory

• Improve Communication
  Promote Physical Rehabilitation

Medicine is not just for patients. Doctors who practice the healing art of music
and medicine have come together to form The Longwood Symphony Orchestra
(LSO). In Scales to Scalpels, Wong informs the reader in how these medical marvels, a group of more than one hundred health professional volunteers, in Cambridge, Massachusetts, not only benefit from playing, but are better medical providers, also. The author gives us a peek into the life of the orchestra members asserting that music and medicine are complementary. Wong contends that a day will come when doctors will write prescriptions for Bach or Haydn “the way we now write for amoxicillin or Ambien.”

A clinical pathologist who plays clarinet in LSO talks about a time when a gunshot victim with a bloated abdomen had been given over one hundred units of transfused blood. She explained that this patient needs treatment and that, “you can’t stand there and cry” and, “you put all that grief in your music.” Wong explains that medical providers are notorious for compartmentalizing feelings. Music is a healthy arena to express and let bottled up feelings flow.

Dr. Alice Cash, a medical practitioner and clinical musicologist, has worked as a professor at the University of Louisville, School of Medicine for the past 43 years. She has a United States patent for her unique method of using music for perioperative patients. She also teaches people from all walks of life to use music to improve, energize and vitalize their lives.

Conclusion

The link between music and health extends across time and place. The jury is out as to the origins of music being an evolutionary vestige or a nonadaptive pleasure seeking form. Musicologists and anthropologists remind us that all human culture responds in some way to music and dance. Music has soothed, comforted, healed, quieted and energized humans with its rhythm and sounds for as long as we know.

The ancient Greeks believed in sound mental and physical health and music was part of their healing process. The power of music has been well recognized as promoting mental and physical well-being. Knowing this, it is reasonable that music has a therapeutic place in the practice of medicine. My shift
closes this Friday the 13th with a full harvest moon lighting the Portland sky as the Salmon Creek ER is infused with Debussy's Clair de Lune.