Music for the dying.

• Author: Hollis, Jennifer L.
• Position: Column

[ILLUSTRATION OMITTED]

I began my education in music and end-of-life care nearly twenty years ago, in the fall of 1996. As a music-thanatologist, I play harp and sing to dying patients using a prescriptive process. Rather than playing familiar songs, I use the raw materials of music, such as melody, rhythm, and harmony, to create music that is individually tailored to each patient. During a music vigil, I can adjust the music, moment by moment, to address the patient's symptoms and needs.

Although the typical music vigil is about half an hour long, I once played a music vigil that lasted several hours. Many family members were in the room and the vigil included music, stories, and conversation. A nurse indicated when she felt the patient was taking her final breaths. The patient died accompanied by her loved ones, music, and attentive medical care.

I noticed the silence that often follows death. The air in the room was calm and still as we all took in the profound truth that one persons breaths had stopped and one heart no longer beat. This silence was followed by a shift to movement and phone calls, planning and paperwork. The deep time of death ended, and the time on the clock started up again.

Just then, one of the family members said she did not want to talk to anyone and asked me to play the harp. I began to play and watched as she sat by the bed, taking a few more minutes with the person she loved. After a short time she turned to me and said, "It's OK. I can talk to people now. Thank you."

Neurosurgeon and writer Paul Kalanithi writes in his memoir, When Breath Becomes Air, that once he was diagnosed with a terminal illness he realized that the physician's primary role is something far more tender and subtle than an all-out war with illness: "[T]he physicians duty is not to stave off death or return patients to their old lives, but to take into our arms a patient and family whose lives have disintegrated and work until they can stand back up and face, and make sense of, their own existence."

The harp music offered this family member a protective space, where, in the face of her grief, she could gather herself together.

Playing harp and singing offers patient care that is not just for the body, but also for the whole person. It is medicine not just for the patient, but also for her loved ones and perhaps even for her physicians. The music can support and accompany everyone as they wait and watch, whether death comes right away, or...