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

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.

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.