Lessons learned....

From my previous post I have been thinking a lot about what exactly I did to earn such a wonderful email. I have been working with the previously mentioned patient for four months now and while I have seen a HUGE change in her I also realize that I am learning a lot and have much further to go. However, lessons I have learned about being a music therapist include the following:

1. Don't be afraid of the silence.
    Learning about therapeutic techniques, I'd assume you have heard people say "Don't be afraid of the silence" but that is an exceptionally hard lesson to learn. But IT IS SO TRUE. Be calm. Take time to gather your own thoughts. Recognize that the patient you are working with may need time to process their thoughts and feelings as well. Let a question hang in the air awhile. If you don't get an answer it's ok, you can move on. But if you wait you may just get an answer you weren't expecting. Don't just string every song you can possible think of together so to avoid the silence, because in reality - you are avoiding the therapy as well. We aren't there to just play a bunch of songs and "perform"... the music is there to assist the therapy. And I'm really coming to realize that a lot of therapy is being done in the silence.

2. Don't rush.
     This particular patient takes a while to gather her thoughts and then vocalize them. I watch another person interact with the patient once and she talked and talked to the patient but she didn't take the time to really sit and patiently listen. I have learned to just sit and wait and listen. If I don't understand what she is saying I ask her to repeat herself (which can be a painstakingly long task) or I give myself time to process and think harder about what she might have said (which reinforces the first point).

3. Don't assume you know anything.
     I don't even know 1/16th about music therapy. It amazes me that even in my 5th month of internship I am faced with new situations or new challenges - with patients I have been seeing for 5 months! Read, read, read. When I went back and read about Parkinsons Disease I understood this patient that much more.

4. Be present in the moment.
      I am exceptionally lucky to be an intern right now. I do not face the pressures of "productivity" that my supervisors and the other professional do. I can sit with my patients and spend as much time as they need with me. Sometimes that means I am with someone for 10 minutes, and other times I am there for 2 hours. I don't know what would be the "correct" time but I am glad I don't have to look at my watch and worry about fitting everyone in on one day. Sitting with the patient and being present in the moment not only allows me to be more relaxed and attentive, but it also communicates to the patient how important they are and that they are cared about.

There are more things I've learned but for now, these are good starting points... and one that I want to talk about will likely take up it's own post. So! Be sure to check back soon.

After silence that which comes nearest to expressing the inexpressible is music.
~Aldous Huxley

BEST.EMAIL.EVER

I am truly not trying to brag or wave my flag or toot my own horn or however the euphamism may go...

BUT!

I recieved the best email of my life this morning and wanted to share. I am so incredibly humbled right now. I am so PUMPED to feel like I actually can make a difference. This patient is the patient I am working with on a case study right now, trying to show that while a client may be declining (this patient has a Parkinson's Diagnosis) music therapy can in fact improve self esteem, depression, and ultimately Quality of Life. This makes me feel like it's WORKING! Aaah! Music therapy R-O-C-K-S.

Anyway... here's the email (name and location has been edited to comply with HIPAA) if you are still reading this far into my rambling:

________________________________________________

Ann-

I made a social work visit to [patient] yesterday at [assisted living facility].  She was in a crabby mood but that’s besides the point.

She kept asking “where is the music lady?” and later started calling you by name!  When I was leaving, she said about 3 times, “make sure ann knows where to find me.”

Just thought you should know what a great job you are doing and what a difference you have apparently made for [patient]! Keep up the good work!

________________________________________________

<3

Seniors say the darndest things

Today we went to a new facility that I will be taking over during the rest of my time at Seasons. One of the facility's employees wanted to see music therapy in action, so off we go to see some the patients signed on to our services. We get settled into a quiet room, the patient was sleeping peacefully. As I start to play the patient's roommate walks in - having freshly showered. In order to give her some privacy my male audience excused himself from the room, and closed the curtain around myself, my advisor, and the patient. As I hear him close the door behind him, I also hear the squeaky clean resident yell after him, "Suck my d***!!" I look over at my advisor with what I am sure were eyes as big a saucers and holding back a laugh.

Throughout the rest of the session, thinly veiled (one hospital curtain separation) commands such as
"shut the hell up" wafted over my improvised guitar playing. But then the kicker came...

The roommate pulled back the curtain, looked at us, whipped the curtain back into place, called out, "EAT MY SHORTS!!" and stormed out.

I couldn't make this stuff up... even if I tried.

Support for this blog is brought to you by...

Today is mine and Mr. Bean's anniversary. We have been married 2 whole years. And all you professionals out there are probably wondering why in the world I am writing about my saucy love life on my professional blog but there's a reason. And I'm getting to it.

He doesn't always WEAR his glasses and for some reason feels
the need to be clean shaven at times but you get the idea.

I have to give credit to Mr. Bean. This man allowed his crazy bride to start school to become a music therapist a mere 3 weeks before getting married. This man supported the notion that not only could I go to the University of Iowa (with a 2 hour commute), continue to work a full time job, and pull off what was sure to be the wedding of the century. He listened to me stress over seating arrangements, stress over homework, and stress over planning a youth ministry program (that was my former area of employment). He took on the financial burden of a wedding and then said "Sure why not" to the burden of paying for school out of pocket (no loans = yay, no financial aid = boo). He worked multiple jobs to support not only his business, but my dream, and to provide for us. AND THEN! When I wanted to intern at Seasons Hospice, he moved with me and started a new career.

Why? Because he believes in and supports my dreams. He has proofread papers, bounced around session plan ideas, and helped compose songs that assist children in hearing and pronouncing the difference between "p" and "b". He who has been playing the guitar for years, who has more patience in his little toe than I have at all, calmly teaches me music and silently listens as I figure things out. He went to extracurricular lectures with me, got excited when he'd hear my professor on Iowa Public Radio or listen to a podcast talking about music therapy, and listens to be me babble about my days at Seasons. He is genuinely interested in everything I am doing and learning. He pushes me to be the best I can be. And for that I owe him an incredible amount of thanks... and it just so happens that I can't help also giving him all of my heart.

So my dear readers... the question today is:

Who inspires and supports you? Who is accompanying you on your walk to be a great music therapist? There are tons of people in my life who are helping me grow and become the best ME, but today is the day I celebrate marrying my #1 fan. I am so blessed... lucky... undeserving. I am eternally grateful.

Remembering September 11

When the United States of America was attacked, I was a senior in high school. The announcement was made over the PA system during what was the end of our 2nd period class... my class was unruly and of course we did not hear the announcement. It wasn't until my 3rd period class - choir - that I watched and understood what had happened.

After the bell rang and we passed to the next class the hallways were full of people and their reactions. Disbelief was written all over the walls as I met with my girlfriends. And I remember hearing people shouting their plans to enlist as soon as the day was over.

As we drove home to our families, I remember sitting at a stop light as local radio station B-96 played a remixed version of Enrique Iglesias' "Hero".

Friday as we prepared for this terrible anniversary, B-96 debuted a new tribute. The song choices are interesting... the differences and similarities between the two. When I think about all I've done and become over the past 10 years, I cannot help but think of my decision to go into music therapy at the forefront. it makes me want to reread Caring for the Caregiver: The Use of Music and Music Therapy in Grief and Trauma. It's a book of reflections on the New York City Music Therapy Relief Project which was an effort to care for those effected by the September 11th attacks.  

What do you remember from that day? What are your personal or professional reflections. How has September 11th impacted you? Who you are? What you do? What are  you doing today in remembrance?

Professional music therapists... what are your MT plans for remembering September 11th, if any?

Midterms

We interupt this blog for a brief musical interlude. Shaking your hair, air guitar, and all out rock star behavior is allowed and encouraged.

Thank you. You may resume reading this post.

Half way there! Holy COW! Where did the summer go? There are days when I feel like I did back in June... brand new and uncertain. But there are just as many days where I feel like I've been doing this forever. Not "forever" in a bored/burnt out sort of way but rather a confident, self assured professional sort of way. It's hard to believe the growth and change I have undergone in the fleeting three months I've had so far as an intern. It's hard to imagine that in just three more I will be preparing for the board certification exams and looking for jobs. It's sad to think that I might not find a job in hospice, which in all sincerety I have come to love. It's exciting to think of all the other possibilities and populations I could start working with. It's especially exciting to start earning a paycheck again... my husband loves that idea.

It has been three months since I started my internship.As I hit the midterm point of my internship, I am amazed at the growth and change I have undergone. My guitar skills have grown by leaps and bounds. My comfort level with patients has shocked me. My documentation skills have come a long way and I see that crossing over into my every day conversations. When people ask me about music therapy I am able to explain the profession more and more clearly, more concisely, and feel more confident doing so.

Don't get me wrong though, there are times when this internship can be challenging. Of course! It can be emotional, it can be frustrating trying to learn music and refine my music skills, and finding the balance or pacing in a session. I am learning to be more comfortable with other professionals, collaborate with them when working with clients, and communicate my opinions, ideas, and observations. I am working really hard to see set backs and challenges as a great indicator that I am at the half way point and after an initial improvement it is time for even more growth. I am being pushed even further and I know that it is for my good. The challenges are making me a better therapist, and I really appreciate that.

You may now press play for the 5th time again and resume the party.

"Hospice is like a box of chocolates"

I have really come to understand that in hospice, you never know what you're going to get.

I have a client who I just love. He is hilarious. Apparently, he is exceptionally inappropriate with other people who care for him (earning him the title of "dirty old man") but with me he's just downright funny. I ask if he would like some music and he says yes. Then, before I even get the guitar case open he hollers, "Well, come on then!" or "Let's go!" He sits and listens to the music with his eyes closed and responds after a song has completed by saying, "That was beeeeeeautiful" or he'll comment, "That was an oldie but goodie". Sometimes he'll say, "You left me in left field with that one". I'm really not sure how to take that last comment...

On the other hand I see a client who is always in bed, normally asleep, and NEVER responsive. He's a hard one to see because while it's easy just to play some improvised bedside music, its frustrating because it's hard to tell if he even hears it, let alone responds positively.

Last Thursday, I went to go see this client. It was my last stop of the day and the facility is close to home so it's easy to stop by on my way out in the morning or on the way back in the afternoons. I signed into the facility, made my way up to the patient's floor, and found his bed empty. Inside I thought if this guy died and no one told me, I'm going to be frustrated. I ask a nurse passing by where the patient is, and she directs me down to a common area where I have never been before. And there he is! Sitting up in a broda chair. Awake, alert, and oriented x1. WHAT?! I hardly even recognized the man. I introduced myself and he responded! Said a very clear yes to wanting music and talked to me through the entire session. Yes, he was also talking to a few hallucinations, but where did this come from?! He SANG ALONG with a few songs and when I placed my guitar on his lap for vibro-tactile stimulation, he even tried strumming a few times on his own!  I was flabbergasted. We had such a great time together talking about his past and singing songs that I stayed for longer than I have ever spent with him. The time flew by!

I think I floated home... thinking about how different each day is for everyone. You have to go into each session as if this will be the last time you see that patient and do the best for them every time. And honestly, once you think you have someone "all figured out"... you don't. You never know when something will happen from "out in left field".

Yes, hospice is like a box of chocolates... you never know what you're going to get. 

and it's really oh so sweet.



Hi ho, music therapy here...

Today I was playing around with my guitar and playing "The Rainbow Connection". Who doesn't love this song? Seriously.


So, in honor of Kermit I thought I would share about the "Music Therapy Connection(s)". I heard about a music therapist named of John Lawrence, MMT, MTA. His blog is very interesting and has a TON of great information. Also, Mr. Lawrence has been keeping a list of music therapy bloggers, I just updated the list to include this blog as well as Morgan's. If you know of a blog that is missing from the list please add it!


ALSO! Don't forget to catch up on your reading over at Twitter by checking out #musictherapy and of course you can follow me @anniewalljasper and check out my Music Therapy list (which I will continue to add to!)

Don't forget to share your favorite posts from Prelude with everyone 

by clicking on the share buttons at the bottom of this post!

I would have never guessed...

This morning when I woke up and got ready for another day at internship, I thought about music. I ran through the quickly becoming memorized songs in my mind. I sang "Paper Moon" as I showered, reviewing the Dm and Cm7 chords in my head. As I drove I thought about "Chatanooga Choo Choo" and "Boogie Woogie Bugle Boy"... and how I need to learn more Frank Sinatra.

As we drove to Elgin to meet an imminent patient, who had just signed up for hospice, I thought about creating an environment that would be comforting and peaceful for someone who may die while we were there. As we read over her chart before going into her room I read "90 years old" and preped for my favorites "All of Me" or "Sentimental Journey". I never would have guessed that when her daughters talked about her that she would be described as being someone who while ironing her clothes "jammed" to Van Morrison. Someone who introduced her daughters and even granddaughters to The Doors. We were informed that her new favorite song is "Save a Horse, Ride a Cowboy".

We talked with the family for a while. Then played a few things... "Proud Mary", a few Beatles songs, as we sang "Brown Eyed Girl" I held the patients hand, stroked her hair, and sang close to her ear (she had lost a lot of hearing previously). Then in between songs I looked up "Save a Horse..." on my blackberry

** Thank you technology**

My supervisor looked at me and asked, "Do you know it?"

"You bet!" I replied.

**Thank goodness I went to Monmouth College (ie: cornfields) and fell in love with country music**

It's actually pretty easy to play on the guitar as long as you can get the strum going - basically it's just a whole lot of fun. The patient's daughter got right up close to her mom and we both sang to her. Full volume, truly "rocking out".

By the end of the song the patient had opened her eyes, her brow unfurrowed, she looked much more comfortable and at ease, and her daughter reported that she had squeezed her hand. We decided to end on a positive note... AND the nurse came in pretty directly after (likely wondering what the hell was going on). I can only imagine what anyone walking by thought! I felt like a crazy person real music therapist. This was what it was all about! Making the patient and their family the experts in their own care and meeting them where they are.As we said goodbye, the daughters (through their tears) could not say enough...

"This is the most relaxed she's been!"

"I know she heard that!"

"That was amazing, she hasn't been awake at all today."

"I hope you can come back"

"Thank you"

After I returned to my car, I shot of a few texts of disbelief to my Mom and Dad.

"I didn't know you knew how to play that song" they texted back.

"Neither did I"

When I woke up this morning I knew which songs I could play for clients. I knew the generalizations we make about people's preferred music and I could go from there. I knew we would enter people's lives and share with them our talent. I knew I would be doing something I loved and hoped would change someone's situation.

I NEVER would have guessed that the songs I knew and the generalizations I made would be thrown out the window and yet I could still do my job successfully.

Cheer's Big and Rich - you're music is truly enjoyed by all generations.

Good things for the day...

A great quote for today... no matter WHAT you do for a living

"do all the good you can, in all the ways you can, by all the means you can, to all of those you can…” 

- John Wesley

18th century reformer of the Church of England

A fantastic book to read (I just finished it last night)

Still Alice is a compelling debut novel about a 50-year-old woman's sudden descent into early onset Alzheimer's disease, written by first-time author Lisa Genova, who holds a Ph. D in neuroscience from Harvard University. Alice Howland, happily married with three grown children and a house on the Cape, is a celebrated Harvard professor at the height of her career when she notices a forgetfulness creeping into her life. As confusion starts to cloud her thinking and her memory begins to fail her, she receives a devastating diagnosis: early onset Alzheimer's disease. Fiercely independent, Alice struggles to maintain her lifestyle and live in the moment, even as her sense of self is being stripped away. In turns heartbreaking, inspiring and terrifying, Still Alice captures in remarkable detail what's it's like to literally lose your mind...        

(taken from Google product review)

Other great reading material - a new blog from one of my classmates and friends, Morgan. Morgan not only just got married but also just started her internship at West Music in Iowa. She is a wonderful up and coming therapist, she often set the (high) standard for our classes and I loved hearing her ideas. I have truly enjoyed getting to know her and cannot wait to read more about her adventures out in the field. Morgan's post "What the hell am I doing here " is one of my favorites. Check her out!

On my own...

Let's take moment to sing...

ok, just had to get my diva on for a moment. :)


Today was my first official day on my own <<fighting the urge to sing again...>>, though I ended up doing one visit on Friday unattended (I shadowed the team chaplain and while she had an urgent phone call I was up to bat. I sat with a patient's wife on Friday and used active listening, live music, proximity, reinforcement and prompts to help validate her, her husband, and their life together. After being with her for an hour and  half, playing some good old songs "none of that jive music" as she put it, and having her teach me the secret to a 65 year marriage I left that assisted living facility on cloud nine.

Today was just as wonderful. Since, the visits are "transition visits" my supervisor is attending them with me, but I have to do it all myself. And.I.Love.It!! From the patient who cracks me up continually to the sweet heart who sings along. From Irish tunes to American standards, introductions to documentation, I felt like I was doing exactly what I was supposed to be doing. Sure! There are lots of things that I need to work on... realizing part way into a song that the meter is 4/4 as opposed to the 3/4 I am playing or having the gumption to just take the lead in a situation and "go for it". But as I continue on my journey I am continually faced with the question, "Isn't it hard to work in Hospice?"

Two months ago that was a real fear of mine. That it would be too hard. I'm a fairly emotional person. I cry at sad/happy/sappy/scary movies. I cry at weddings. I empathize with others to a fault. I had a very serious fear that this position would prove to be to much. To much death. To much sadness. Now, my honest feelings are not of fear or sadness. Rather they are of pride in the work that every one of the staff members on the hospice team does. The feeling of making a difference in the world. Ok... making a difference in the life of one person. I love the results I see...

• the tears of a wife as I sing Ave Maria
• the slow steady breaths of a patient with Pancreatic Cancer as I improvise at his bedside
• the recognition of a song for a patient with an Alzheimer's diagnosis as they sing along
• the comfort a patient diagnosed with dementia feels (and the much less agitated/more cooperative attitude they display) when being played music as they are given a shower
• the smooth transition from labored breathing while being assisted with a BiPAP to breathing on their own
• the memory made for a family member or an entire family as they spend musical (non-medical) time with their loved one

The work of a music therapist is profound and awesome. I do not feel sad working in hospice. Yes, today I held back a few tears seeing the major decline a patient had taken since the last time I had been to visit, but I am so grateful that I was able to do something for them to make that day, that hour of their life, a little better. I am privileged. I am blessed to be able to share my talent in a way that might help someone. I am so thankful that I have an opportunity to use my gifts this way. The founder of Seasons Hospice, Marcia Norman, MS, RN explains:

When we touch a single piano key, we hear not a single string, but the rich sound of many strings vibrating in harmony. When we touch a single life, the harmony that spreads enriches the lives of many. 

I'm not saying that I am any big deal. By no means. I am not out changing the world. But I just feel lucky to know that maybe I made a difference to someone somewhere along the way.

A man was walking along a deserted beach at sunset. As he walked he could see a young boy in the distance, as he drew nearer he noticed that the boy kept bending down, picking something up and throwing it into the water. Time and again he kept hurling things into the ocean. As the man approached even closer, he was able to see that the boy was picking up starfish that had been washed up on the beach and, one at a time he was throwing them back into the water. The man asked the boy what he was doing, the boy replied,"I am throwing these washed up starfish back into the ocean, or else they will die through lack of oxygen. "But", said the man, "You can't possibly save them all, there are thousands on this beach, and this must be happening on hundreds of beaches along the coast. You can't possibly make a difference." The boy smiled, bent down and picked up another starfish, and as he threw it back into the sea, he replied. "I made a difference to that one." 

The good... and the bad

I have two stories for you today...

The good:

I went to a facility the other day and met with a woman. She had a diagnosis of Dementia, she loved Irish tunes. She laid sprawled in a geri-chair, seemed very agitated, and all alone. At first my supervisor tried playing the guitar by her side but the patient was so agitated and uncomfortable. She kept trying to pull herself up and into a different position. My supervisor wanted me to jump in while she went to find a nurse to help move the patient to a more comfortable position. I got down on my knees, scooted right up next to the patient, reached out to hold her hand, and just sang every Irish tune I knew. (Thank goodness we always celebrated St. Patrick's day in Practicum - and that many residents in Iowa tend to have a strong German/Irish heritage). The patient turned to look at me and in a slurred, toothless, loud voice - she started singing right along with me... Oh Danny Boy, My Wild Irish Rose, I'm Looking Over a Four Leaf Clover, even My Bonnie Lies Over the Ocean... she looked at me, sang every word, and held my hand the entire time. When I ran out of Irish type tunes, I sang Scottish ones. I could have stayed with her forever. This Patient is exactly why I am so in love (already) with this work.

The bad:

There was another storm in Chicagoland earlier this week and as a result caused the worst power outages since 1998 (if I am not mistaken). Facilities were still running on generators and are getting HOT. When it gets hot, windows are opened. When windows are opened, flies get in. When you sing and there are flies in the room you run the risk of having a fly get sucked into your mouth. These are the risks music therapists face every day.

That's all I have to say about that.

Month One in Review

I am officially one month into my internship. How did that happen?! About 4 weeks ago I asked another intern if they felt that their internship time flew by. Their answer was no. So why does it feel like mine is?!

Today, the day after the 4th of July and a long weekend, I know many were dragging themselves out of bed and off to work. And while I admit that I love my bed, enjoy sleeping, and generally procrastinate getting up in the morning, I have to admit that I am amazed at my enthusiasm to be right where I am. One month in and I am honestly loving it. The patients, my supervisor, the other MTs, everything. I feel like I did on my first day of school at the University of Iowa - as if I was right where I was supposed to be. And that's a great feeling.

And so now, in honor of my past TA and the reflections I shared on my first day, I present you again with a positive/negative/ridiculous Month One Review.

Positive

1. I have been able to shadow so many different professional and have learned so much. Especially from the MTs here... they are all just simply amazing.
2. I have started having the opportunities to sing, play, and interact with patients and have had some fantastic results/experiences. I am confident that this area is exactly where I am supposed to be. Also, the data collection, documentation, and charting process is not as daunting as I was afraid it would be.
3. I know I am being pushed to be a better musician. I am being challenged and have already grown/learned so much. It's really nice and very exciting.

Negative

1. I am still trying to get comfortable with unresponsive patients. I can understand when the patient is sleeping and I'm ok if they are so progressed in their disease that they are no longer alert. BUT I am still very uncomfortable/awkward when the clients are unable to respond and you're not quite sure what is going on cognitively (for example: a patient diagnosed with Parkinson's and unable to speak but keeps eye contact).

Ridiculous

1. I was sitting observing a MT spending time with a patient who was sleeping. The MT utilized improvisational music to comfort the patient (easing the labored breathing and pain management), mask the sounds of the facility, and generally create a peaceful environment. The room was dark and the chair I sat in was sooo cozy. Let me tell you that THAT music therapy intervention was very successful the patients breaths became more even and deeper, their face and jaw relaxed, they showed no signs or symptoms of pain, they slept peacefully, and I had to fight to NOT sleep peacefully as well. :)

July is Music Therapy Month!

The awesome Dr. Russell Hilliard sent us an email today for Music Therapy Month with the following message:

Top 10 Reasons Seasons Hospice Loves our Music Therapists:

10.  They calm our patients and families.

9. They help our HCCs get a foot in the door.

8. They lighten and inspire our teams with their talents.

7. Their creativity stands above and beyond.

6. They make Seasons unique in our field.

5. They mentor interns into the profession.

4. They can answer any music trivia question.

3. They make our memorial services more meaningful.

2. They brighten the days of our loneliest patients.

1. They always have a song in their heart.

Why do you love music therapy or a music therapist?

Giving through grief

The first time I ever went to visit my husband's family was for a meeting that was being held at the church where he grew up. It was about an hour and a half away from our little college, across the unfamiliar gravel roads of his childhood. Between giving directions he laughed at his city girlfriend white knuckling through the back roads of southeastern Iowa.

After the meeting we went over to his grandparents house to visit for a little while to visit. Upon entering I was bombarded with offers by his grandfather. Would I like any one of the following:
1. Cheese sandwich (something my husband considers a delicacy and I really just do not understand)
2. Oreos
3.Ice cream
4. Homemade chocolate chip cookies
5. Doritos
6. Ice Cream and Oreos
7. Water
8. Milk
9. Mountain Dew
... the list could continue.

Forget the fact that it was about 10pm, but also in an effort to be as low maintenance and an unobtrusive "easy" guest, I turned down most of what was offered. Opting for a water and a few Oreos (I mean who can say no to Oreos?).

After we left and headed back to Monmouth, I remember looking at my new boyfriend (and now husband) and asking, "Do you think they liked me?" He answered, "I'm sure they loved you... but you could have eaten more." :)

___________________________

Just a few days ago my supervisor and I were out seeing patients when we got a call to see someone actively dying. We headed right over for what would be one of my more memorable visits so far. We were greeted by the patient's daughter who showed us to her room. Upon entering we met the most distraught young boy. He showed us his iPod, instructing us on what music she likes, and requested in the most grown up way a preteen boy can, "Make her happy. Just make her happy." My heart broke for him. He told us stories of how he is the favorite grandchild. The special nicknames his Grandma had for him and the music they listened to together. Looking around the room it was clear he was a cherished child as his pictures graced a majority of the frames, were slid into the sides of mirrors, and covered the side table.

Her priest came and gave the anointing of the sick. Her daughters crowded into the room to take turns caring, holding her hand, and whispering their love between kisses to the cheek.

After about an hour and a half of providing music for pain management and to "provide a peaceful holding environment" (one of my favorite documentation phrases often used here)... my supervisor and I made our way out of the family's house. Before we could get to the door though, we were stopped.

"Do you want something to eat? Come here! We have more than enough food... please, eat!"

___________________

A few days later and a visit to a different patient, with a family I could easily have just fallen in love with... ok let's be honest, I DID fall in love with... upon our arrival we were met with offers for food or a drink (which included a list of various beverages probably 15 varieties long).

___________________

A separate visit to another family with a 1 year old on hospice care I sat with the social worker, the chaplain, and the sweet girl's family. As we were walking out the door I was presented with a Minnie Mouse invitation to the child's birthday party a few weeks away. The family who hardly knew me more than an hour wanted to share with me the awesome joy and accomplishment of celebrating a 2nd birthday with a child who was not expected to live past the first 24 hours of life.

___________________

It has been these encounters of pure gratitude and the need to give back that have caught me off guard. I always seem to walk away from patients wishing I could do more... or even still having that feeling of "what am I doing here?" as if I am an impostor.  These people let us into their home and see them at their most vulnerable. We enter their lives only for a short while and yet they are so grateful. My first inclination is to deny their efforts... they don't need to serve me. I never want to ask for anything or require any attention. However, it may be the therapeutic! It's very different for me, but it's also very nice of them to do.

Be prepared!!

The past few days I have been out an about visiting patients with MTs, interns, and CNAs. Tomorrow I will go out with another intern, Next week I will go out with a social worker, two more MTs and a RN. All in all, it is FANTASTIC. Not only am I learning a ton by watching them but I am really getting a feel for the population I will be serving. It has been shocking at times. There have been moments where I was glad that I was just there observing and moments where I wished I could jump in with a song I knew. There have been families I wanted to stay and get to know more.

One big lesson I want to highlight with two stories:

BUILD YOUR REPERTOIRE!

1. Monday I went out with a MT intern who is just about to wrap up her time with Seasons. July 1 will be her last day and I wish her all the best. She is a great MT. Monday we met downtown and visited a few patients. Then she got a phone call and we needed to head over to Rush to be with an actively dying patient and their family. The patient was Hispanic. "How's your Spanish?" She asked me, "Do you know any Spanish songs?" **GULP** The only song I could think of was a song about "La Llorona" or the Weeping Woman, a sad and kind of scary tale about a ghost searching for children (and possibly killing them). It's from a play I was in. It's probably not the best choice to sing to a person dying OR their family. I kept my thought to myself and instead watched her mind race as we drove to the hospital. A

After parking and walking and going up elevators and signing in and getting lost and walking/wandering some more we arrived at the patient's hospital room. She talked a bit with the family, talked with the patient (who was not responsive), and started playing. A few spiritual songs, a little instrumental here and there, and three songs in Spanish. How awesome was that!? Right there on the spot she pulled out a few songs and was singing beautiful Spanish.

2. Today I went out with my supervisor to see a bunch of people. Our first stop was at a facility where we saw three patients. Two of the patients who had diagnosis of ADRD were uninterested in having music therapy for the day either sleeping or wanted to be left alone, but the third (with a diagnosis of COPD) we found up, alert, and ready for music. After the first song, for some reason, the client mentioned that he had recently been to Iowa to hear a music program. Of course my supervisor asks, "What town was it?" After a while of thinking he finally managed to say "Iowa City". And thus began my first real interaction with a client.
"I went to the University of Iowa in Iowa City," I said.
"I was born in Iowa," He said.
"So are you a Hawkeye fan or a Cyclone fan?" I asked.
"Hawkeyes!" He answered breathlessly.
"Is there a Hawkeye fight song you could sing?" piped up my supervisor.
Oh dear I thought, "Yes...If I remember all the words." There had been a competition each semester to see who knew all the words. Last semester I even used the fight song in one of my practicum sessions. But I had only been a Hawkeye for 2 years and I have YET to go to a game...

But, I sung it. And in the middle of a quiet facility in a small suburb of Chicago about 4 hours away from Iowa City, two Hawkeyes bonded. It ended up being a great session for life review and reminiscence. When we were about finished with our visit it was such a blessing to hear this man who had played Iowa basketball, who had loved the ladies in high school, and who had served his country say, "It was some life. I could live that life over and over and over..."

I guess there are actually two lessons here:
1. Be prepared. Learn and remember songs. A variety of songs. You never know when you'll need them. Whether you need to know a song in a foreign language, country music, Frank Sinatra, the Red Hot Chile Peppers, or heavy metal (all of which I have seen since I've been here) - you can never be TOO prepared.

and...

2. Live a life that in old age you can look back and say, "That was some life."

I am certain that my rendition was not nearly as cute.

Wow

Here at Seasons Hospice it is a part of orientation that every discipline or division of care shadow all the other care providers.

Today I shadowed an Certified Nurse Assistant... an absolutely AMAZING woman. She was so much fun and worked so hard. She cared so much about each and every one of her patients and in the end was so generous. She has probably the hardest job - dealing with some of the hardest (grossest??) stuff. She didn't take anything too seriously or get upset. But! At the same time the care and love that she give in everything she does was 100% serious. You could see how much she meant to the people she cared for. It was inspiring and I was humbled knowing that I could never do what she does every day. Wow. Amazing.

Also... CNAs do not make nearly enough money.

What is music therapy?

So, we took a little personality test in orientation. The test was written in response to the Meyers-Briggs test and is a little more fun as well as much less time consuming. I'm an otter. Adorable, yes? I know I am.

Anyway! Here's why I am an "otter":

Otters

Common traits
            they are:
                 - our entertainers
                 - a party waiting to happen
                 - visionaries
                 - eternal optimists
                 - motivational (people believe them)
                 - the fun bringers
                 - they tend to be: fast paced (easily bored)
                 - networkers
                 - people oriented
                 - quick starts but slow finishes
                 - bored by details
                 - good communicators
                 - people pleasers

Communication:
                 - surround an otter with positive feelings - don't harp

If you are an OTTER, caution:
                 - finish what you start - details DO matter

Why do we need otters?
                 - to make the world a fun place
                 - to have great ideas and visionaries
                 - so that we don't take ourselves too seriously

All that excitement is exhausting!!

Even though this was just a fun little thing to do... it is amazing how accurate this describes me. I am always coming up with (what I think are) great ideas... birthday parties, TV shows, trips, songs, etc. I often have to be reigned in as to what is actually possible to happen as opposed to the big huge ideas that formulate. I am someone who has a million bubbles popping up, ideas floating around all over, and I need someone who can come by and tie down all my crazy ideas and help me follow through with them. I can't work as a "sales person" probably because I feel like I would lose my mind AND paperwork is NOT my friend. However, I am exceptionally loyal and very good at selling the things that I believe in. In ever conversation I am a moment away from saying "Oh! Did you know the music therapy would be perfect for that?" or "Hey! My husband, sister, best friend is just the perfect person for that _____ (job/project/idea)." I always have been great at getting pumped up about an idea, wanting everyone to get excited too. Case in point? This past weekend I invited 20+ people on vacation to a home that really only comfortably sleeps 11. But I love big parties, lots of fun, and tons of activity. I invited people from all areas of my life... friends from college, high school, and work... everyone is welcome. And when friends wanted to back out of the weekend because they didn't know anyone, or didn't like so and so, or didn't want to sleep in a certain room... whatever, I will admit I am let down. I just want everyone to be happy, excited, and all together. So! I have to work on understanding that not everyone is an otter. There are those that are beavers (schedulers/detail oriented) or people that are lions (aggressive/task oriented) and that's ok.

______________________________________________

We are still trudging through orientation... but we had a highlight!! The music therapy orientation session! One whole half hour of "What is music therapy?" How do you condensce the awesomeness that is MUSIC THERAPY into just 30 minutes!? My orientation room was filled with CNAs, social workers, and administrators new to Seasons. I could see the skepticism on their faces. What a hard task!

Here's some brainstorming I did on what I would share, because I very well may be teaching about the therapy to someone at any point in time. I would cover a range of goal areas in hospice such as:

• Grief and bereavement
• quality of life
• life review
• social interaction - family and friend relationships
• weight loss
• anxiety, stress, and mental health issues
• pain management

• and more

All of which are proven to be effectively addressed by music therapy. Also, concerns of safety such as moving a client or staff support can be aided by music therapy. RAS (rhythmic auditory stimulation) may assist a client needing to walk from one place to another and decrease the risk of a fall. I would think that if another professional explained how their services could assist me and my services, I might be more open to their profession. Maybe?

Even though Seasons takes music therapy more seriously than I think many other institutions, the presenters (non-music therapists) have not really gone into dept on the music therapy profession. They have of course made sure to mention that music therapy is a tool to be used but I think that since the presenters are not music therapists it's not necessarily the first thing that pops up for them. The music therapist only had 30 minutes to teach the room about MT. That seems like such a limited time to shared all the possibilities of music therapy intervention!!  I would have wanted to show videos or statistics. I would want to handed out fact sheets like those on

• Alzheimer
• Pain management

provided by the AMTA would be fantastic. Or made my own! It's an opportunity to educate and market the profession. I want my colleagues in the room to fall in love with music therapy. To really know why I changed my whole life to go into this profession. I would want to share my passion... pass it on. But I'm sure I could have rambled forever. How do you effectively share information on music therapy in a timely and engaging manner?

I'm wondering... if you were given 30 minutes to teach a room full of various professionals about music therapy what would you say? What would you feel is important to share when teaching about our profession? Comments are requested please! I am sure in the future I will in fact have to do this. My otter personality wants to make sure everyone is thrilled about the possibilities with music therapy. What aspects need to be reigned in? What areas do you think are mandatory for a presentation?

Let me hear your thoughts!

First Day

Yesterday (May 31st) was really my "first day". I went into Season's to meet with Lindsey (my supervisor) and Shelby (supervisor of the other intern, Gina). Basically we just did some preliminary information, signed some papers, copied my licence/car insurance and went out for a GREAT lunch! Oh la la...

Today the real fun started. Orientation. Orientation that is going to last for 2 weeks. For 7 hours a day. Wow. I can't really complain though. I think I am still on cloud nine just being there. The greatest thing is that the Executive Director came to talk with us about the philosophy of hospice. We learned about the history of hospice care and the goals of Season's Hospice care. This may sound corny but it sounded like the descriptions and vision were describing me. We talked about hospice in general... my orientation including nurses, administrators, and social work... but I kept feeling like "I can do this. I can really do this well." It really just fired me up to get started.

I'm not going to lie though, going through all the OSHA and HIPAA guidelines, the payroll and insurance information (which don't even apply to me), and the more tedious details are... well... tedious.

So today in honor of my awesome TA and practicum supervisor Sarah, I am going to share some positives and negatives from today. In practicum she limited it to 3 positives and 1 negative but I think I need to add in my own flair and provide some insight to the ridiculousness (it always seems to happen to me)...

Positive

1. I successfully navigated commuter traffic, bought an I-Pass, and made it to work on time.
2. I loved some of the readings from today and want to (will) share them with you in the future.
3. The information shared was not as boring as I was afraid it would be.

Negative

1. I had to have a TB test. I have a diabetic husband, watched a friend give birth, and visited enough hospitals. Needles don't bother me. Unless they are penetrating my skin. Ugh... dislike

Ridiculous

1. I locked myself in the bathroom stall. No joke. I wish I was lying. I was panicking for about 30 seconds until I just slammed my fist on the door and busted out. Yeesh
2. I believe that Orientation is also synonymous with some sort of torture. The air conditioning would kick on and freeze me to death, then the room would warm up, then the air would come on again, etc. About ever 20 minutes. Tomorrow I will dress in layers. It's only 90degrees outside, a cardigan seems appropriate.

1 day of orientation down, 7 (at least) more to go.

Prelude

prel·ude

  –noun

1.

a preliminary to an action, event, condition, or work ofbroader scope and higher importance.

2.

any action, event, comment, etc. that precedes somethingelse.

3.

Music 

a.

a relatively short, independent instrumental composition,free in form and resembling an improvisation.

b.

a piece that precedes a more important movement.

c.

the overture to an opera.

d.

an independent piece, of moderate length, sometimesused as an introduction to a fugue.

e.

music opening a church service; an introductory voluntary.

A new beginning.

Two years ago, on an exceptionally rainy day I drove the hour treck through cornfield to the University of Iowa. Having lived in the Quad Cities for three years I was ready for something new… and I was about to start that adventure. On that rainy day I met a fantastic woman, Dr. Mary Adamek. Former president of the American Music Therapy Association, Director of the University of Iowa Music Therapy Program, and a wonderful mentor. She immediately put me on the right track to completing the music therapy equivalency program (I had previously majored in Music:Vocal Performance at Monmouth College – graduating in 2006). That fall I started classes at the University and within days knew that this was exactly where I was supposed to be.

Fast forward to last November, just after attending the National Convention in Cleveland, OH I set out on my first internship interview. Before convention I talked with supervisors and teaching assistants. I set up mock interviews and rehearsed answers to ensure controlling my impulse to get flustered. While at convention I talked with every professional in Hospice that I could and went to session after session on Hospice care. Friends of mine had interviews scheduled during conference and I picked their brains. My dear friend Lindsay practiced my interview piano piece with me and in my spare time went back to the hotel room to practice my guitar.

So, after conference I returned to Chicago and headed out on my first interview. Things went well… well, except for getting a little lost going there. And the sight singing. And the one exceptionally intimidating interviewer. I felt great about the interview (statements like “Oh! We didn’t expect you to have your pieces memorized” were a boost to my confidence that I had impressed) and at the same time I cried in the parking lot before even driving away. I flip flopped, cried, and prayed for most of the drive home. I wanted this so bad…

“On behalf of all of the music therapists at Seasons Hospice & Palliative Care of Illinois, I would like to offer you a position to intern here starting in June 2011.  Please let me know if you have decided to accept the position.  It was a pleasure meeting you today, and I look forward to hearing from you.”

~ time stamped four hours after my interview

Of course my generally paranoid attitude took this as a “great they don’t have anyone else and have to settle for me”… but in my heart I know I did a great job interviewing and I knew this was where I was supposed to be.

A few months, multiple trips with my car packed to the gills, sweat, tears, worried, and excitement later… I started my internship at Seasons Hospice in Chicago, IL.

This blog is my story… so that if anyone cares to read it might find hope, direction, lessons (on what not to do) or guidance. Or maybe they’ll read about my (mis)adventures and think “thank God that didn’t happen to me” or “that girl is crazy”. But also so that in 20 years when I’m a cranky old MT, cynical and worn down, I can go back and read about this exhilarating time. Just like the beginning of the opera, or the musical… when the lights dim, the audience falls silent in anticipation, and the conductor takes the stand. This time in my life when the prelude begins and the story starts to unfold. While my eyes are still twinkling and my heart is ready to burst with excitement.