A musical prescription for pain

By Sara Freund

A few notes trigger the deep ache of sadness or the stillness of serenity. A particular song rushes a memory to the forefront.  Melodies spark inspiration and awe.

Music is medicine for the bad days, heartbreak and even for the dying. Music-thanatologists embody that exact idea by playing harp at the bedside of those who are dying.

During a session, called a music vigil, a patient becomes “the conductor and the soloist,” said Tony Pederson, a music-thanatologist at Midwest Palliative & Hospice Care Center in north suburban Glenview.

Music-thanatology exists within the broader specialty of hospice care. Clinicians learn to use music as a prescription by uniting voice and harp to change with the patients physical and emotional needs. Music-thanatologists tailor musical rhythms and chords to a patient’s physiology, assessing pain level, respiratory distress, and pulse.

The harp is an ideal instrument for this caring approach because it offers a variety of musical options.

“Most instruments are melodic; you can only play one note at a time. The harp is different; it has a large musical tool kit. It’s portable. It’s not electronic. And the resonance of it is particularly pure,” Pederson said.

Only two schools in the U.S. offer training to become a music-thanatologist, said Pederson’s wife Margaret Pasquesi. The husband-wife team are both certified music-thanatologists.

There are about 90 music-thanatologists worldwide and 56 of them are certified, said Elisabeth Mistretta, senior communication specialist for Midwest Palliative & Hospice Care Center. Practitioners certified through the Music-Thanatology Association International “have chosen to take a test that credentials their skills,” Mistretta said.

But those with the training can practice without certification, she said.

Pasquesi also practices at Midwest Palliative & Hospice Care Center where an international conference of music-thanatologists gathered this fall.

Around 35 of them participated in the three-day conference and discussed musical technique, new literature, what changes in health care mean for their profession and how to balance emotional demands of their work.

Music-thanatologists confront grief on a daily basis and, for some, that can be emotionally draining.

“When I’m in that hard situation, the thing that has struck me is that those people are grieving because they love the person that is leaving. I’m a stranger and I get to witness this profound love,” Pederson said.

Pederson initially worked in a nursing home with Alzheimer’s patients when he discovered music-thanatology. He had a patient who was experiencing a lot of pain towards the end of her life. He and others on the treatment team tried treating her with massage, essential oils and quietly talking but nothing worked.

“At first she was curled up in a ball and very distressed. Then the music-thanatologists sat with her for 45 minutes and when they left, she looked so serene and completely changed physically,” Pederson said.

Pasquesi heard about music-thanatology on the news and was fascinated by the idea that music could physically affect the body. Around the same time, a close friend was dying of breast cancer and was having allergic reactions to pain medication. In an attempt to alleviate her friend’s suffering, Pasquesi arranged for music-thanatologists to visit. That was in 1998, after Pasquesi began her journey into music-thanatology.

“Not only did the music affect my friend Jenny but it affected everyone around her. She was so young people didn’t know how to be with her when she was dying. This music-thanatologist who came helped mentor all of us on how to be with a dying person. People knew it was okay to be quiet but also laugh and tell jokes.”

Photo Caption: Tony Pederson, Margaret Pasquesi and other music-thanatologists gathered at the Midwest Palliative and Hospice Care Center in Glenview for an international conference devoted to their profession. Photos by Sara Freund/MEDILL