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Music and Critical Illness
3 Plays1 year ago
This episode, Dr. Sergio Zanotti discusses music and critical illness and explores the topic through the lens of his guest – Andrew Schulman. Andrew is the first musician to be accepted as a professional Society of Critical Care Medicine (SCCM) member. He is a member of the SCCM ICU Liberation Committee, where he met and had the opportunity to work with Dr. Zanotti. Andrew and his wife Wendy, are the subjects of Josh Aronson's documentary film Andrew & Wendy (2015), which has aired multiple times on PBS-TV. He is the author of Waking The Spirit: A Musician’s Journey Healing Body, Mind, and Soul. Since its release in the U.S. in August 2016, Waking the Spirit has been chosen as an Oliver Sacks Foundation Best Book of the Year Selection, Finalist for the Books for a Better Life Award, and a People Magazine Pick in Nonfiction.
Additional Resources:
Andrew Schulman’s Website https://andrewschulmanmusic.com/about
Books and Albums mentioned in this episode:
Waking The Spirit: A Musicians’s Journey Healing Body, Mind and Soul. By Andrew Schulman: https://us.macmillan.com/books/9781250132222
Musicophilia: A Tale of Music and the Brain. By Oliver Sacks: https://bit.ly/4dCTjwv
St. Matthew Passion – Johann Sebastian Bach (Composer), Leonard Bernstein (Conductor): https://amzn.to/4eZmgE5
Lute Sonatas Nos. 30 & 39 & 96: 11 Silvius Leopold Weiss (Composer), Robert Barto (Performer): https://bit.ly/3YfXha2
Recommended
Transcript
Introduction to Podcast and Host
00:00:06
Speaker
Welcome to Critical Matters, a sound podcast covering a broad range of topics related to the practice of intensive care medicine.
00:00:14
Speaker
Sound provides comprehensive critical care programs to hospitals across the country.
00:00:19
Speaker
To learn more about our programs and career opportunities, visit www.soundphysicians.com.
00:00:26
Speaker
And now your host, Dr. Sergio Zanotti.
Impact of Music on Critical Illness
00:00:32
Speaker
In today's episode of Critical Matters, we will discuss music and critical illness.
00:00:36
Speaker
We will explore the topic through the lens of our guest, Andrew Schulman.
00:00:40
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Andrew is the first musician to be accepted as a professional member of the Society of Critical Care Medicine.
00:00:46
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He is a member of the SECM ICU Liberation Committee, where I met him and have had the opportunity to work with him.
00:00:53
Speaker
Andrew and his wife Wendy are the subjects of Josh Aronson's documentary film, Andrew and Wendy, released in 2015, which has been aired multiple times on PBS TV.
00:01:04
Speaker
In addition, Andrew is the author of Waking the Spirit, a musician's journey healing body, mind, and soul.
00:01:12
Speaker
Since its release in the United States in August of 2016, Waking the Spirit has been chosen as an Oliver Sacks Foundation Best Book of the Year selection, has been a finalist for the Books for a Better Life Award, and a People Magazine pick in nonfiction.
Andrew's Near-Death Experience and Recovery
00:01:28
Speaker
As you will find out through our conversation, there is much more to this story.
00:01:33
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Andrew, welcome to Critical Matters.
00:01:35
Speaker
Well, pleasure to be here, Sergio.
00:01:37
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Thank you for asking me to do this.
00:01:40
Speaker
Well, I think that we're going to touch on a very important topic and a fascinating story.
00:01:45
Speaker
And I obviously can't think of anybody better than you to tell this story.
00:01:50
Speaker
But before we get into the story and to your story, Andrew, would you describe to us what you do today?
00:01:56
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How would you tell people?
00:01:57
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How would you answer the question?
00:01:58
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What do you do, Andrew?
00:02:00
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Oh, well, I do a few different things.
00:02:06
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The first is that I'm the executive director of the Medical Musician Initiative, which is based here in New York.
00:02:16
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Actually, it's based here in my apartment.
00:02:20
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And we have a wonderful team.
00:02:24
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Dr. Joseph Schlesinger is the medical advisor, and Javin Bose is our associate director, and our technical advisor is Gregory Silverman of University of Minnesota.
00:02:42
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Joe is at Vanderbilt University Medical Center.
00:02:45
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And our mission is twofold.
00:02:48
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It's to train professional musicians how to become a team member in an ICU.
00:02:58
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And the other mission is research.
00:03:01
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And we're working on, I was hoping...
00:03:04
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I would have the news to share with you today about a new study that we're hoping to do here in New York.
00:03:11
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I'll have to wait on that because the IRB hasn't finished yet.
00:03:17
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But I have finished
00:03:22
Speaker
a study for Georgetown University Medical Center where I provided all the music and we could talk maybe a little later, we'll talk about some detail about that.
00:03:32
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So that's the first thing that I do is medical music.
00:03:39
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I am also a visiting artist,
00:03:43
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as a medical musician at Georgetown University Medical Center.
00:03:47
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And I'm a consultant to the music and the ICU program at Vanderbilt.
00:03:53
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The second thing that I do is I'm a writer.
00:03:57
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And as you have read Waking the Spirit, that was my first book.
00:04:01
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And I have spent the last four years working on a historical novel set in the 18th century that has music at the very heart of it.
00:04:12
Speaker
And it involves a main protagonist who is invented named Andreas Schluter.
00:04:22
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I'm Andrew Shulman, he's Andreas Schluter.
00:04:25
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And in the novel, he's the grandson of a real 18th century Andreas Schluter, who was the most famous architect in Eastern Europe at that time, especially in Berlin.
00:04:37
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And the other two main protagonists are Frederick the Great and Johann Sebastian Bach.
00:04:43
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And I hope to be finished with the novel within a year.
00:04:48
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So that's the second thing that I do.
00:04:54
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And the third thing is I'm still what I call a regular musician.
00:05:00
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And I'm a classical guitarist who plays Bach, but also Gershwin and the Beatles, etc.
00:05:09
Speaker
So I have a pretty full day every day, fortunately.
00:05:13
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I'm 72 years old, and I have never been happier creatively than I am now, and I'm very grateful for that.
00:05:23
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I have the opportunity to also interact with you through the Society of Critical Care Medicine and our ICU Liberation Committee and really appreciate the insight you bring as a patient and advocate for the healing environment in the ICU.
Music's Role During Coma and Recovery
00:05:37
Speaker
So why don't you start by telling us your experience briefly as a patient in the ICU?
00:05:45
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Well,
00:05:48
Speaker
I guess I should probably say a little bit what brought me in there.
00:05:50
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Should I start with that?
00:05:51
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Sure.
00:05:52
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Why I was a patient?
00:05:53
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Yeah.
00:05:54
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Yeah.
00:05:55
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All right.
00:05:55
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It's 15 years ago now, and it was in July 2009.
00:06:03
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I had a diagnosis from several doctors, basically 100% pancreatic cancer.
00:06:12
Speaker
During the surgery, frozen sections were done on the mess and miraculously, it was benign.
00:06:20
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And the results after the surgery continued to show it was benign.
00:06:24
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Very, very lucky.
00:06:25
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However, when the surgery was over,
00:06:30
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I was sewn up and I was put on the gurney.
00:06:35
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And by the time they got to the door of the OR, my blood pressure started plummeting.
00:06:43
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which you continue to do, there was a race to the SICU.
00:06:48
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And in one sense, we didn't make it in time.
00:06:52
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I was dead on arrival.
00:06:54
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But this was Beth Israel Hospital, downtown New York, before it's Mount Sinai takeover.
00:07:01
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So it was Beth Israel then.
00:07:03
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And there was a great...
00:07:05
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a SICU team, they resuscitated me, put me into a medically induced coma.
00:07:11
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But to show you just how sick I was, that was at 9 p.m.
00:07:16
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approximately.
00:07:17
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At 3 in the morning, I coded again.
00:07:20
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And they all had to rush over and bring me back a second time.
00:07:26
Speaker
That was the first day, second day, terrible.
00:07:30
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Third day, Saturday, terrible.
00:07:32
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At the middle of, at noon on the third day, I was really at the cusp.
00:07:42
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I was at the precipice.
00:07:44
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My lactic acid number was 17.
00:07:47
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I hadn't been stable for a second in three days.
00:07:50
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a lot of cardio issues, you know, nobody, not a single doctor or nurse thought I was going to live.
00:07:57
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And I'll hold you there, Andrew, for a second, because also, as I recall from reading the book, you were on multiple vasopressors, which our audience obviously will understand.
00:08:06
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And I can't I can't recall
00:08:09
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talking with somebody who was in shock after a cardiac arrest with a lactic acid of 17.
00:08:15
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Right.
00:08:16
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That's and I'm sure that all the clinicians working on you at that time and caring for you were thinking, like you said, that there's no chance that he will survive.
00:08:25
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However, you did survive and something happened on that third day.
00:08:31
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And I want you to tell us
00:08:34
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Your wife, Wendy, had an intuition.
00:08:37
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Yes.
00:08:37
Speaker
And there's also some serendipity, maybe, based on your iPod.
00:08:42
Speaker
But tell us what happened.
00:08:43
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Yeah.
00:08:44
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So here it is, noon on the third day.
00:08:47
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And as the SICU director, I found out later, it's in the book, actually.
00:08:54
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He actually told his chief PA, he said, this guy is toast.
00:08:58
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Yeah.
00:08:59
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So no one thought anything could happen.
00:09:02
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My wife had been at my bedside for three days, Wendy.
00:09:06
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And she had by the middle of the third day at this moment, she understood that they'd all given up on me and that the standard of care medicine was not saving me, I was dying.
00:09:23
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And she reached into her bed to call my mother, who was in Florida then and not able to come up.
00:09:33
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My mother was not well at that point.
00:09:36
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And when she reached for the phone, she saw my iPod.
00:09:42
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and the balloon bubble went off over her head with the exclamation in it, and she has this epiphany.
00:09:52
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And she turned to the attending, it was Dr. Simon Iriff at that point, who was a really cool doctor, I must say, I really liked Simon a lot.
00:10:03
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And she explained to the situation, what she said was that
00:10:10
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Her words were that my husband loves music more than anything.
00:10:15
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And his heart is beating right now, but his soul is not beating.
00:10:20
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And I believe that the only thing that can give him the will to live is music.
00:10:27
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And I think you can give me a better clue on this than most people.
00:10:33
Speaker
I think maybe a lot of doctors would have, she said I have his iPod, I wanna put it in.
00:10:39
Speaker
I think there are doctors who would have said no, but he said yes.
00:10:43
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He said I'll give you 30 minutes.
00:10:45
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If there's any sign of agitation, remove the earbud.
00:10:50
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And that was it.
00:10:52
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So she did that.
00:10:53
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And she didn't know what to play.
00:10:55
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And somebody said, just hit the first track.
00:10:58
Speaker
And that's the serendipity that you're referring to, because the first track was Bach BWV 244, which is the St.
00:11:09
Speaker
Matthew Passion.
00:11:11
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which is my ultimate favorite piece of music, and especially that recording, which is conducted by Leonard Bernstein with the New York Philharmonic and great singers.
00:11:23
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And so they put it in, and I'll tell you two things.
00:11:29
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of what happened that would be of interest to you and the people listening to this right now.
00:11:34
Speaker
The first was, as it approached 30 minutes, everybody is looking up at the vital signs monitor and people are amazed because blood pressure and heart rate start stabilizing.
00:11:52
Speaker
And you know the experience, doctor or nurse can actually look at the patient or look at the face.
00:11:57
Speaker
People saw a change that was happening.
00:12:00
Speaker
Now, as you know, there is something called coma dreams.
00:12:05
Speaker
which are not regular dreams, they're basically hallucinations caused by the situation the patient is in.
00:12:14
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I had a week's worth of coma dreams, which were fantastic, they really were fantastic.
00:12:21
Speaker
But there was a coma dream that had to have been at that very moment because, and it's worth my telling you how it played out.
00:12:32
Speaker
It was Christmas time.
00:12:34
Speaker
Now this is July 2009, but in the dream it's Christmas.
00:12:39
Speaker
And I'm walking down the street holding my coat tight because it's cold and I'm carrying my guitar.
00:12:46
Speaker
And I noticed that the guitar is so, so heavy.
00:12:50
Speaker
But the reason I'm there is that every year at Christmas time, I played
00:12:58
Speaker
music for the widow.
00:13:02
Speaker
In the dream, that was it.
00:13:04
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It was just the widow.
00:13:06
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And I remember it's an old suburban type street, the kind similar to what I grew up on, but not exactly my street.
00:13:15
Speaker
And I walk up the steps to knock on the door and the door opens and there was a woman there in her 80s.
00:13:26
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But somehow I knew, even it translated later, I didn't know in that moment, but when I remembered the dream, the widow was Wendy.
00:13:37
Speaker
Her blue eyes, her faded red hair, and she didn't say a word.
00:13:42
Speaker
She just said,
00:13:44
Speaker
come in.
00:13:45
Speaker
No, she didn't say a word.
00:13:47
Speaker
She motioned for me to come in to the house.
00:13:50
Speaker
And we went into the living room, which is where I played for her every year.
00:13:56
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And there was a table loaded up high with Christmas treats.
00:14:02
Speaker
And she sat in a chair against the back wall, and there was a chair in the middle of the room for me.
00:14:08
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And I sat down, and I kept noticing to myself how weak I was.
00:14:14
Speaker
And I didn't understand why I was so weak.
00:14:17
Speaker
I bent down to reach for the guitar, and I could barely open the case, and with every effort, I brought the guitar up to my lap.
00:14:27
Speaker
And then something happened.
00:14:30
Speaker
I started to hear beautiful music, astonishingly beautiful music.
00:14:38
Speaker
And I didn't recognize what the piece was because this is actually part of being in a coma dream.
00:14:44
Speaker
Reality is very distorted, but it was beautiful music and I didn't know where it was coming from.
00:14:51
Speaker
And then I looked down at my left hand, which was on the neck of the guitar, and I realized the music was coming from me.
00:15:00
Speaker
I was playing this music and I was bewildered because I said, how can I be playing music that I don't know?
00:15:10
Speaker
It was very, very strange.
00:15:11
Speaker
Now the dream fades from there.
00:15:13
Speaker
But before it starts fading, all of a sudden I go, I feel some strength.
00:15:20
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I feel better.
00:15:22
Speaker
Now, here's why I'm certain that this was the dream at the moment of the music being played.
00:15:31
Speaker
First of all, why did I think it's Christmas?
00:15:34
Speaker
Well, in that ICU, when the last ditch effort is made and there are two or three aluminum stands filled with medicine,
00:15:45
Speaker
and it's that last ditch effort to save the patient.
00:15:48
Speaker
The nurses in that ICU called it a Christmas tree.
00:15:53
Speaker
And they would have been saying that out loud.
00:15:56
Speaker
The other thing is the director of the ICU had an expression.
00:16:04
Speaker
He would tell his nurses that when a patient is right on the verge of death, come and get him so he can make his black bunting speech to the widow.
00:16:18
Speaker
So I had to, and after that, when I came back jumping ahead, I asked those nurses, were you saying, do you remember saying those things?
00:16:30
Speaker
And they said, well, almost certainly we always say that in that situation.
00:16:34
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So that's what I was hearing.
00:16:36
Speaker
Now there's a little message here I have to everybody listening, which is this.
00:16:43
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be very aware of how much a patient in a coma is hearing and registering.
00:16:49
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And it may not register in direct reality, it may be distorted in some way, but when you're in a coma, you hear everything.
00:16:57
Speaker
So be very careful what you say around somebody who's in a coma.
00:17:03
Speaker
Anyway, that was the key story
00:17:09
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My life was saved.
00:17:10
Speaker
The doctors and nurses there all later attested to, and it's in the chart.
00:17:15
Speaker
You can see it in my chart.
00:17:17
Speaker
That was the turning point.
00:17:19
Speaker
The acid is leaching from my tissues.
00:17:22
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I'm stabilizing.
00:17:24
Speaker
The kidney, urine output improves dramatically, and that's the turnaround.
00:17:31
Speaker
And certainly we've all seen things that we can't explain, but it seems that obviously the music and the connection it made in your mind and your brain at that time was a turning point that was very critical.
00:17:45
Speaker
And obviously from there, it wasn't an easy road, but it was moving forward, right?
00:17:50
Speaker
You eventually left the ICU, you eventually left the hospital, eventually you realized you didn't have cancer, which was great news.
00:17:58
Speaker
But there were still a lot of things, I think, worth mentioning that were hard for you, right?
00:18:04
Speaker
One of the things that struck me, Andrew, and I don't know, I mean, you can mention that, and I know it improved over time, is that at one point, you realize that your ability to play from memory was no longer there, right?
00:18:18
Speaker
Yeah.
00:18:19
Speaker
And there's a lot of...
00:18:21
Speaker
cognitive maybe changes or things that happen to patients who survive critical illness that are very important for them that we maybe in the ICU don't appreciate because it usually happens once they're out of the ICU.
00:18:33
Speaker
But the good news is that I think over time you rewired your brain and your neuroplasticity.
00:18:40
Speaker
And I understand that you're back to playing by pieces from memory, which is what you used to do before all this happened, correct?
00:18:48
Speaker
Yeah, well, here's what happened.
00:18:52
Speaker
First of all, one little thing I'll add in terms of my hospital stay is that McMillan, the ICU director, had made a plan on the third day
00:19:08
Speaker
that I would be in the ICU for 30 days, I'd be in step down for two weeks and a regular room for two weeks.
00:19:16
Speaker
And that was the conservative plan.
00:19:19
Speaker
Now, as he made that plan, he said, we don't really need this because he's not gonna live anyway, but we have to make a plan.
00:19:24
Speaker
That was the plan.
00:19:28
Speaker
because when, I'll say it this way, I was not in the SICU for 30 days.
00:19:36
Speaker
I was in for 10 days.
00:19:38
Speaker
They skipped step-down.
00:19:41
Speaker
And I went into a regular room where I was only there for two days.
00:19:45
Speaker
They kept coming in and laughing.
00:19:46
Speaker
Doctors kept coming and looking at my chart and looking at me and said, there's nothing we need to do for you here.
00:19:52
Speaker
You can go home.
00:19:54
Speaker
All right.
00:19:54
Speaker
Now, why was it so fast?
00:19:57
Speaker
There are a variety of reasons, but the most important one, which is pertinent to this podcast right now, is what I had said about...
00:20:10
Speaker
finding out that music had saved my life and deciding that I would come back and dedicating my life to it is I was on a mission.
00:20:18
Speaker
And because I was in a mission, I had a lot of energy.
00:20:21
Speaker
Okay, now on the 12th day, I go home.
00:20:25
Speaker
And the very first thing I did is go to my guitar, pick it up and start to play.
00:20:33
Speaker
And on that first day, only a few minutes, because I could barely play.
00:20:38
Speaker
I was really...
00:20:40
Speaker
so weak from what was going on.
00:20:43
Speaker
The second though, feeling a little stronger, I went to play and I started playing some of my music.
00:20:49
Speaker
Now as a professional musician in New York City at that time, I had about 15 hours of music memorized, classical and popular music.
00:21:03
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And I start trying to play some pieces.
00:21:04
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I remember the first one was Wendy's favorite piece, a Prelude by Villa Lobos.
00:21:10
Speaker
and I could only get a couple of notes and then I couldn't remember.
00:21:14
Speaker
And I start going through my repertoire.
00:21:15
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I can't remember anything.
00:21:17
Speaker
So just jumping ahead on this issue of the brain damage, what I discovered over that first week is there were only six pieces I could play, two Bach, two Spanish, two Beatles.
00:21:35
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And an important clue is that all of those were learned and memorized before the age of 20.
00:21:42
Speaker
Because I was... My situation could be described by Rebo's gradient.
00:21:52
Speaker
And that the damage...
00:21:55
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extended from the age I was in it during the time the damage was done, going back to about the age of 20.
00:22:03
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Everything I learned after the age of 20 was gone.
00:22:06
Speaker
Couldn't play it.
00:22:07
Speaker
Now, this was very upsetting, of course,
00:22:11
Speaker
But I wasn't giving up music, not by a long shot.
00:22:15
Speaker
And it just meant that I have to read, I could read, I could still read music and play.
00:22:21
Speaker
And it just meant that except for those few memorized pieces that left to me, I'd be reading music from then on and I accepted that.
00:22:29
Speaker
Perfect.
00:22:30
Speaker
Well, you talked about your mission and I wanted to move now forward.
Journey as a Medical Musician
00:22:34
Speaker
And obviously you believed at that time and believe now that Wendy's intuition of playing music for you and the fact that it was your favorite piece of music made a real difference in your life.
00:22:48
Speaker
So now you said, I want to give back.
00:22:51
Speaker
Yeah.
00:22:52
Speaker
To the to the surgical ICU or to the ICU that cared for me and the patients who are there.
00:22:57
Speaker
And tell us a little bit about that return and how you found a way at the bedside in the ICU at the hospital there.
00:23:06
Speaker
When I left.
00:23:09
Speaker
the hospital on the 12th day, Wendy arranged it that we would stop by the SICU so I could see Dr. Marvin McMillan, the director, who had been there just for the first two days of my illness.
00:23:25
Speaker
And she had already given him one of my CDs.
00:23:29
Speaker
which he had enjoyed a lot.
00:23:32
Speaker
And the result of that short little meeting I had with him was that after we chatted a couple of minutes, I thanked him.
00:23:40
Speaker
It was a very interesting answer he gave.
00:23:43
Speaker
He said, you don't have to thank me.
00:23:44
Speaker
We just keep you alive long enough so your body can save your life.
00:23:49
Speaker
It was a great answer.
00:23:51
Speaker
And then he said that standard line, we're so happy you're doing well and we never wanna see you again.
00:23:59
Speaker
And I was very fierce and I said, no, I want you to see me again.
00:24:02
Speaker
I want to come back here with my guitar.
00:24:05
Speaker
And he just said, go home, get better and call me.
00:24:08
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Six months later, I called him and I did return.
00:24:11
Speaker
I returned in January, 2010, six months after the surgery.
00:24:17
Speaker
And I thought that I would just go a couple of times as a little thank you.
00:24:23
Speaker
But on the very first day, and it was uproarious when I entered the SICU with my guitar in its case and my winter coat on, because very quickly the nurses realized who it was.
00:24:38
Speaker
Because I was famous in that hospital because of how catastrophic my situation had been.
00:24:43
Speaker
And they were thrilled that they took part in saving my life.
00:24:46
Speaker
After all, it wasn't just the music that saved me.
00:24:48
Speaker
Obviously, it was great medical care that saved me.
00:24:52
Speaker
So I didn't know anything.
00:24:56
Speaker
I have no formal, to this day, I've never had formal training.
00:24:59
Speaker
I'm not a music therapist, and I have never had formal training in this field.
00:25:07
Speaker
And on that first day, all I thought to do was pull up a chair next to the nurses station and just put some beautiful music in the air.
00:25:15
Speaker
So I did that.
00:25:17
Speaker
And at the end of the one hour that I was gonna be there, the two nurses who had been my nurses when I came out of the coma, Madeline and Rozievic, came over and one stood on one side, the other on the other side.
00:25:31
Speaker
And there were three beds nearby where they could see the vital sign monitors.
00:25:36
Speaker
And as I was playing, this is the end of the hour, they looked at the monitors and then looked at each other and did a thumbs up.
00:25:46
Speaker
That was the galvanizing moment.
00:25:48
Speaker
In that moment, I said, I think I just found a new path in my life.
00:25:53
Speaker
And so I kept going.
00:25:56
Speaker
And my background with this is that for six years, I played three days a week at Beth Israel.
00:26:08
Speaker
Then I...
00:26:10
Speaker
I went over to NYU Langone where I was for a year and I played, not just SICU, I was SICU, MICU, neuro, SICU, and cardio, a big hospital.
00:26:26
Speaker
And then I started, I did a residency of once a month at Berkshire Medical Center in Pittsfield, Massachusetts.
00:26:33
Speaker
I would drive up there, I live in Manhattan.
00:26:36
Speaker
And I went out there once a month for a week.
00:26:37
Speaker
I did that for four years.
00:26:39
Speaker
And then the pandemic kicked in.
00:26:41
Speaker
And that ended all of that.
00:26:45
Speaker
And that's also when the pandemic kicked in in 2020 is when I started the visiting artist relationship with Georgetown, which has mainly been research and occasionally teaching Zooms, teaching medical students about medical music.
00:27:03
Speaker
Perfect.
Therapeutic Effects of Music in ICU
00:27:04
Speaker
And I think that as you detail in the book, your experience at the first place where you worked at Mount Sinai was really remarkable in terms that you mentioned a lot of very interesting cases, Andrew.
00:27:22
Speaker
The Russian lady, Alice in blue gown, the jazz musician.
00:27:27
Speaker
I mean, there's a phenomenal, I think, connection that you eventually played for one of the singers of that piece of music that saved your life, right?
00:27:39
Speaker
And when that person was...
00:27:40
Speaker
No, I didn't play for that person.
00:27:42
Speaker
What it was is I had met, I had a lovely gig, steady gig at that time at a bistro, a French bistro up on Broadway.
00:27:55
Speaker
And there was a woman in her 80s who would come in and...
00:28:01
Speaker
Her husband had brain surgery and was very sick and we befriended each other.
00:28:07
Speaker
And she really joined in playing.
00:28:09
Speaker
She was herself a great musician, one of the best Bach players orchestrally in New York.
00:28:16
Speaker
And we had dessert together one night and she said, tell me the story, what happened?
00:28:21
Speaker
And I said, St.
00:28:22
Speaker
Matthew Passion.
00:28:23
Speaker
And then I said, it was the Leonard Bernstein version.
00:28:27
Speaker
And she freezes.
00:28:29
Speaker
And I thought, oh, did I say something wrong?
00:28:32
Speaker
And then she goes, no, it was my husband who was the tenor in that recording.
00:28:38
Speaker
So that was a phenomenal thing.
00:28:41
Speaker
And her name is Barbara Wilson.
00:28:42
Speaker
And to this day, we're very good friends.
00:28:44
Speaker
Which is, I think, obviously, the best part of life is just the connections we make with people.
00:28:50
Speaker
But what I did want to ask you is, as you were developing your skills and trying to figure out, how do I do this?
00:28:59
Speaker
Like you said, I mean, become a medical musician.
00:29:01
Speaker
And you really have made a path for other professional musicians to follow this.
00:29:09
Speaker
Could you share with us some of the things that you noticed, Andrew,
00:29:12
Speaker
I think that repeatedly I sensed that you were able to decrease heart rates and blood pressures likely due to decreasing how people perceived pain.
00:29:26
Speaker
It seemed that you also had a great impact on patients who were having ICU delirium.
00:29:32
Speaker
Could you just tell us a little bit of what you were observing over and over again?
00:29:36
Speaker
Sure.
00:29:37
Speaker
Well, I think the first thing,
00:29:41
Speaker
which is pretty remarkable, is the effect of therapeutic music on blood pressure.
00:29:51
Speaker
And,
00:29:54
Speaker
And I'll give you a little anecdote here about that because it also connects into how do you become a team member in an ICU.
00:30:01
Speaker
When I went up to Berkshire, in New York at Beth Israel, and even at NYU Langone, there were people that I knew, a lot of people that I knew, who accepted me and accepted what I was doing, and it was an easy fit.
00:30:16
Speaker
But up in the Berkshires, they never had music in their ICU.
00:30:20
Speaker
And there was one nurse in particular that was very antagonistic and very skeptical.
00:30:26
Speaker
She was a very, very tough nurse.
00:30:28
Speaker
And for the first couple of months that I was up there, she was not friendly and
00:30:34
Speaker
It was obvious she didn't want me there.
00:30:36
Speaker
It was probably on the third month, I think, when I went up for my week.
00:30:41
Speaker
On the first day, I went to a bedside where there was a patient with blood pressure in the 160s.
00:30:48
Speaker
And 20 minutes later, it was in the 120s.
00:30:52
Speaker
It was her patient.
00:30:53
Speaker
And from the corner of my eye, I could see she still had a scowl on her face.
00:30:59
Speaker
She didn't believe, it wasn't the music that did it.
00:31:01
Speaker
On the second day, this is a true story, and it's the only time in the 10 years I did this where it happened like this three days in a row.
00:31:09
Speaker
The second day, another patient of hers, blood pressure in the 160s, 20 minutes later, it's 120s.
00:31:19
Speaker
And this time I look at her from the corner of my eye and it looked like she's thinking about it now.
00:31:25
Speaker
On the third day, same thing happens, 160s goes down to 120s.
00:31:31
Speaker
And after 20 minutes of playing, she walks over to me and she leans in close and she says, Andrew.
00:31:38
Speaker
could we go to bed too now?
00:31:42
Speaker
That's the moment she accepted me as a team member.
00:31:44
Speaker
She said, yeah, this actually really works.
00:31:47
Speaker
So there's your blood pressure.
00:31:48
Speaker
And of course you do see the heart rate.
00:31:50
Speaker
I'll tell you an interesting thing that you'll appreciate that I learned is there's always a desire for homostasis.
00:32:01
Speaker
But if you put them, if the musician, if I am at that bedside and the patient is not responsive and you play for them,
00:32:16
Speaker
And if you do not see any change in heart rate or blood pressure, that's a sign of just how desperately ill they are.
00:32:25
Speaker
Because when you listen to music, music is an emotional experience after all.
00:32:31
Speaker
When you listen to music, music has phrases and has an arc of rising and releasing tension.
00:32:40
Speaker
and good tension, not bad tension.
00:32:42
Speaker
And so you should see a little bit of movement.
00:32:45
Speaker
And that's one thing that I learned.
00:32:47
Speaker
If I was at the bedside and playing, their eyes are closed and you see nothing, that's a bad sign.
00:32:55
Speaker
Now, ICU delirium, music, in all of these years that I have done this, I have noticed
00:33:07
Speaker
that music can be one of the most effective things for bringing the patient back in.
00:33:14
Speaker
You remember in my book, Waking the Spirit, the chapter's called On the Other Side of the Rainbow.
00:33:21
Speaker
And that was the chapter of a specific woman who was in terrible state of ICU delirium.
00:33:30
Speaker
And it took three days
00:33:33
Speaker
visits over, I went on Monday, Wednesday, and Friday.
00:33:39
Speaker
By the end of Friday, the difference was really tremendous.
00:33:45
Speaker
And the opening story of the prologue in the book is what we call the Russian patient, you mentioned the Russian woman.
00:33:53
Speaker
That was ICU delirium.
00:33:54
Speaker
And there was a Bach prelude
00:33:57
Speaker
that calmed her down literally in 10 seconds, the opening phrase of the piece.
00:34:02
Speaker
However, if I then finished the piece and stopped, she'd go back into ICU delirium state, and I stayed there for 90 minutes.
00:34:15
Speaker
And by the end of the 90 minutes, and by the way, for that patient, I only played Bach.
00:34:22
Speaker
And you, I think, were mentioning this, why do I talk about Bach in the book?
00:34:27
Speaker
And there was actually a study done by Dr. Arthur Harvey, a neuromusicologist, in the early 90s at University of Louisville, Kentucky Medical School.
00:34:40
Speaker
It was a three-year study, and they tried seven different kinds of music, popular and classical.
00:34:47
Speaker
And they found, the quote is something to the effect, I don't remember exactly, but the quote was, we found that the music of Bach balanced the brain better than any other form of music.
00:35:00
Speaker
And then in that chapter in the book, Harvey has a long, there's a long quote for him where he's describing why that is so.
00:35:10
Speaker
And you did mention Bach and obviously we're talking about music as a therapeutic instrument.
00:35:18
Speaker
First, I wanted to ask you about harm, right?
00:35:22
Speaker
Like everything we do in medicine, I think sometimes we forget, but there's potential harm.
00:35:26
Speaker
I think you have a great story of heavy metal, but I don't think we need to go there.
00:35:31
Speaker
But tell me more about
00:35:33
Speaker
how you as a medical musician sometimes might notice that a patient is not receptive or this might not be the right selection for them.
00:35:43
Speaker
Absolutely.
00:35:44
Speaker
So the...
00:35:47
Speaker
Most people like music.
00:35:50
Speaker
I think there's only, there's a term called amusia, which is not liking music, and it's a very, very small number.
00:36:01
Speaker
I think it's about 5% of the population.
00:36:04
Speaker
Once you go above that, you probably have, I'm guessing about 10% of the population
00:36:13
Speaker
uh maybe a little more who i i am in that category where music could actually save your life okay you love music you are so moved by music you do that and everybody else there's a huge middle huge middle where it's just people like music you know it's a positive okay so
00:36:34
Speaker
even with that in consideration.
00:36:37
Speaker
And McMillan actually once said, his guess was, in terms of the interventions at the bedside that I did, he thought I had about an 80% success rate.
00:36:48
Speaker
And he said that was very, very high.
00:36:49
Speaker
That was very good.
00:36:51
Speaker
Now, what happens when you go to the bedside and you start playing?
00:36:57
Speaker
Now, if the patient is awake,
00:37:03
Speaker
you always ask them anyway.
00:37:04
Speaker
And there are people who will say no, they don't wanna hear music.
00:37:08
Speaker
That takes care of that.
00:37:10
Speaker
But if the patient is not awake, not responsive, and you go there,
00:37:19
Speaker
I'll give you a perfect example of what can happen when it's not working.
00:37:23
Speaker
You start playing, and first of all, you always have your eye on the vital signs monitor.
00:37:29
Speaker
And if you see bad things happening there, that's a real warning.
00:37:34
Speaker
Or you see the face grimace,
00:37:36
Speaker
or hands clenching or something.
00:37:39
Speaker
So what I do in these situations is, the very first thing I do is I change what I'm playing immediately.
00:37:48
Speaker
And the thing is, you can't do it in an abrupt way.
00:37:52
Speaker
You have to do it in a smoother way.
00:37:53
Speaker
But you can do a modulation still within two or three seconds where you modulate out.
00:37:59
Speaker
You have to be very aware, very alert.
00:38:02
Speaker
and you wanna do that smoothly.
00:38:04
Speaker
You try the second piece.
00:38:05
Speaker
I think basically I give myself two minutes with three or four different attempts.
00:38:13
Speaker
If it's not working, then you segue out.
00:38:18
Speaker
You stop playing, but not abruptly.
00:38:20
Speaker
You take five seconds.
00:38:22
Speaker
It's almost like fading out with turning the volume down.
00:38:27
Speaker
And you know it's not working for that person.
00:38:30
Speaker
It's as simple as that.
00:38:33
Speaker
And you have those situations going on.
00:38:38
Speaker
And I always say that there's no...
00:38:43
Speaker
better gig in the world than being a medical musician in an ICU for keeping your ego in control.
00:38:51
Speaker
You leave your ego at the door completely.
00:38:55
Speaker
It's not about you at all.
00:38:57
Speaker
It's completely about your three constituencies, the patients, the family, friends,
00:39:04
Speaker
and family and friends and the medical staff.
00:39:08
Speaker
That's who you're there for, has nothing to do with you.
00:39:11
Speaker
And it's a wonderful feeling actually having it set up that way.
00:39:16
Speaker
So, you know, that's it.
00:39:20
Speaker
And I think, Andrew, that obviously you get a lot of immediate feedback.
00:39:24
Speaker
And the idea, when you mentioned 80% success, what we're talking about is having a positive impact in assisting in the healing of a very critical patient, right?
00:39:34
Speaker
It's not like you play a song and everybody gets extubated and wakes up.
00:39:39
Speaker
But like you said, I mean, there are objective signs.
00:39:42
Speaker
but people really turning around.
00:39:44
Speaker
Now, you did mention Bach and you did talk that there's studies that suggest that Bach perhaps because of the way it's constructed, I guess.
00:39:55
Speaker
What I understood is that it really has a very positive effect on both sides of the brain and that might be a balancing act and it might be a good recipe.
00:40:05
Speaker
But you also mentioned, or could you mention,
00:40:08
Speaker
What are other tunes or music that seem to work very well in the ICU?
00:40:14
Speaker
Well, in my repertoire, now here's the thing.
00:40:22
Speaker
We talked about my brain damage before.
00:40:24
Speaker
At the end of the, what was it?
00:40:29
Speaker
It was about a year and a half in, and here's a long story I'll make very short.
00:40:34
Speaker
This is the next to last chapter of my book.
00:40:38
Speaker
My brain did rewire and I wound up having Music Brain 2.0.
00:40:44
Speaker
I had actually better functionality in my Music Brain than I had before.
00:40:50
Speaker
And that's, you know, people who know this stuff know that's not surprising.
00:40:55
Speaker
And the reason it rewired was only because I returned to the ICU and I was doing it three days a week and I was dedicated to it and so on and so forth.
00:41:04
Speaker
Now, the...
00:41:09
Speaker
Fact though, that in the first year, especially, I couldn't play from memory.
00:41:17
Speaker
meant that I brought in a very heavy black bag full of sheet music, because I had to read.
00:41:23
Speaker
And therefore, I had the experience of trying a lot of different music, popular and classical repertoire.
00:41:32
Speaker
And what I noticed, to answer your question about the best medicine, and I call these penicillin pieces, the music that over and over shows the ability to be effective.
00:41:47
Speaker
Uh, I noticed Bach.
00:41:50
Speaker
I noticed Gershwin, I had a lot of Gershwin, I had about 15 Gershwin arrangements, and I noticed the Beatles, and Beatles is, Bach and Beatles is my formative music, so I have a lot of Beatle repertoire, this is arrangements.
00:42:05
Speaker
Now, one of the things that ties them all together, especially the Gershwin and the Beatles, is this is vocal music of which I'm playing instrumental arrangements.
00:42:20
Speaker
And what that does, I believe,
00:42:25
Speaker
is it gets the fact that I'm not singing.
00:42:28
Speaker
Now people, by the way, a lot of people always ask me if I sing, and I always say, I only sing if I want people to leave the room quickly.
00:42:38
Speaker
And I would tell my patients that, and I'd say, you can't leave the room quickly, you have too many lines going into you.
00:42:44
Speaker
But the fact that I'm not singing, but I'm playing melodies that are well known, causes the patient to be
00:42:55
Speaker
to sing in their head, to hear it.
00:42:58
Speaker
Yeah, now, you know, there's a fabulous Dr. Oliver Sacks quote, which I have to memorize, because I never get it exactly right.
00:43:08
Speaker
But what he said was through the effect of,
00:43:12
Speaker
music stimulates more of the brain than anything else.
00:43:17
Speaker
So when music is being played, the whole brain lights up.
00:43:20
Speaker
And when the whole brain lights up, the other thing that happens is that the brain creates more dopamine and serotonin and norepinephrine and whatever else.
00:43:32
Speaker
A lot of chemicals.
00:43:34
Speaker
Dr. Connie Tomeno,
00:43:37
Speaker
who is a music therapist who's in my book, because I knew her in college, long story, but she's towards the end of the book.
00:43:46
Speaker
She has the best layman's description of what happened to me that I've heard.
00:43:53
Speaker
She's, you know, I'll just tell you, the description she said is that Bach St.
00:44:04
Speaker
Matthew Passion played through my iPod,
00:44:08
Speaker
entered through the auditory nerve into the auditory cortex, and then that lit up the rest of my brain and it created chemicals that traveled throughout my body carrying a message.
00:44:21
Speaker
And the message was, it's not time to shut down yet.
00:44:26
Speaker
Now, of course, I listened to this, and I have to tell you something interesting about that opening of the St.
00:44:31
Speaker
Matthew Passion.
00:44:33
Speaker
For about six months after this happened, every time I put it on, I started crying.
00:44:38
Speaker
I could not control, I thought I would never be able to listen to it again without crying.
00:44:45
Speaker
And that did eventually change.
00:44:47
Speaker
So I don't cry.
00:44:48
Speaker
But when I hear it, the degree to which that opening movement moves me, and not just that, the whole piece, it's one of Bach's greatest works, and it's actually one of the greatest musical works ever created.
00:45:01
Speaker
And I have to say, we were talking about this before we were recording that I like music.
00:45:06
Speaker
I listen to a lot more jazz.
00:45:08
Speaker
But as I was reading the book, I was adding all these songs to my playlist and and some of them I had heard and some of them I had not.
00:45:15
Speaker
But that was one that I had not.
00:45:17
Speaker
And and I was very particular about making sure I got the Bernard Birdstein with the New York Philharmonica version.
00:45:25
Speaker
Yeah, I know.
00:45:25
Speaker
It's a great, great, great version.
00:45:30
Speaker
I think you were asking, but I probably didn't answer your question, because what do I recommend to people?
00:45:38
Speaker
And at the back of the book and the resource section, I have a little place where I say, people ask me that, and I always say, I actually really...
00:45:47
Speaker
in one level I can't recommend because it's not, the right music is the right music for you.
00:45:56
Speaker
And what I would tell people, especially anybody who's going in for surgery, I think you should bring a device in
00:46:05
Speaker
where you have your favorite music and medium tempo especially, more in major key, and anything that really moves you.
00:46:15
Speaker
But you did ask me earlier, before we started the podcast, you asked me about what I'd recommend.
00:46:24
Speaker
I've mentioned it now a bunch of times, the St.
00:46:27
Speaker
Matthew Passion.
00:46:27
Speaker
I think the Leonard Bernstein version is something that's a remarkable piece of music.
00:46:33
Speaker
The other thing is Debussy's orchestral work called Nuage, which means clouds.
00:46:42
Speaker
The Debussy is something that I would say to people, I don't think you could go wrong with that.
00:46:47
Speaker
And the third thing I'd recommend is something very off the beaten path,
00:46:53
Speaker
Bach had a contemporary named Silvius Leopold Weiss, as in Weiss, W-E-I-S-S.
00:47:02
Speaker
Weiss was probably the greatest luteinist of all time, lute being the instrument that's a cousin to the guitar, string-plucked instrument.
00:47:12
Speaker
And he wrote a great, great amount of music,
00:47:18
Speaker
I'm gonna give a specific recommendation.
00:47:21
Speaker
There is a luteinist named Robert Bartow, B-A-R-T-O.
00:47:26
Speaker
In my opinion, he is the best lute player there is.
00:47:30
Speaker
He's an extraordinary musician.
00:47:32
Speaker
He's an American who's been living in Sweden, Switzerland for many years.
00:47:38
Speaker
And I...
00:47:40
Speaker
When I was writing Waking the Spirit, and as I write Frederick's tune, the novel that I'm working on, I have my headphones on.
00:47:53
Speaker
I have all 12 CDs of Bartow's Vice music in my computer, and I put it on at a low volume.
00:48:00
Speaker
And I think if you like,
00:48:05
Speaker
even if you don't like, even if you're not a classical music person, that music is very relatable.
00:48:11
Speaker
It's pluck string, it's a lute, it's a guitar.
00:48:15
Speaker
All of them have these similarities.
00:48:18
Speaker
And I recommend that music.
00:48:21
Speaker
It's very, very, very, I think it's very healing music.
Incorporating Music Therapy in ICUs
00:48:28
Speaker
And I think that so we'll definitely put links to all of these in the show notes, Andrew.
00:48:33
Speaker
And I think that also for our audience to realize is that music, musical therapy or music as an adjunct to healing is not new.
00:48:44
Speaker
It might be new for us in the ICU, or you haven't heard it maybe, but there's a rich history of literature and studies that have looked at this, especially true in settings outside of the ICU mostly, but there's a lot of ways that connecting people with music has helped control pain and improve other outcomes.
00:49:05
Speaker
And we'll put some references also in the...
00:49:08
Speaker
in the show notes to that effect.
00:49:11
Speaker
But as we move forward, I wanted to read a quote from your book to get us to the final portion of our conversation.
00:49:20
Speaker
Is that okay?
00:49:22
Speaker
Sure.
00:49:23
Speaker
So this is from the chapter Wild Horses.
00:49:25
Speaker
That's towards the end, Andrew.
00:49:27
Speaker
And you say here that there is no such thing as a panacea in medicine or in medical musics.
00:49:34
Speaker
However, a healing environment that includes music will provide a better chance at the best possible medical outcome.
00:49:42
Speaker
Logic indicates that the more therapeutic music is available in a critical care unit, the greater the chance that seemingly miraculous events will occur more frequently.
00:49:53
Speaker
And I think that that is really what I want to take to our audience, because at the end of the day, education should not be about knowledge, it should be about action.
00:50:03
Speaker
And I know that you are on a mission to call and a call for action.
00:50:07
Speaker
So what would you recommend to ICU doctors and ICU clinicians who are listening today, if they say, I want to bring some music to my ICU, what would be your recommendation?
00:50:19
Speaker
Okay.
00:50:21
Speaker
The field that I'm part of, the big tent is called the field of music and medicine.
00:50:29
Speaker
The core profession in the field of music and medicine is music therapy, which became a profession in 1950.
00:50:41
Speaker
And they're doing wonderful things in music therapy.
00:50:47
Speaker
And there is an organization, the American Music Therapy Association,
00:50:57
Speaker
what is that what it is?
00:50:59
Speaker
I think it's American Music Therapy Association or Google.
00:51:03
Speaker
It'll bring you something like that.
00:51:04
Speaker
It's a very, very, very good website.
00:51:07
Speaker
And I would call that a starting point.
00:51:13
Speaker
Another website to go to is called Music for Transition and Healing.
00:51:18
Speaker
That is another group of therapeutic musicians that go through a program, a rigorous program, and they're called Music Practitioners.
00:51:30
Speaker
So music for transition and healing.
00:51:34
Speaker
The third website is my organization, the Medical Musician Initiative.
00:51:40
Speaker
If you go to Medical Musician Initiative, you'll see a lot of information for critical care because we're the only organization that is specifically critical care.
00:51:53
Speaker
That's all that we do.
00:51:56
Speaker
And you could contact us from the website and we can start a conversation.
00:52:06
Speaker
So I think those are a few.
00:52:11
Speaker
Now, you and I were talking earlier about books.
00:52:17
Speaker
And there's two books that I would recommend.
00:52:21
Speaker
The Musicophilia by Dr. Oliver Sacks.
00:52:26
Speaker
And This Is Your Brain on Music by Daniel Levitin.
00:52:31
Speaker
And the funny thing is, I read both of those books in 2007 and 2008, not knowing that, of course, in 2009, I was gonna have this change happen in my life.
00:52:43
Speaker
But I had read them and...
00:52:45
Speaker
thought it was all fascinating and I'm sure that was a huge factor why when I came out of the coma I decided to dedicate my life to doing this because I already had a lot of information that I had gotten from those books so
00:53:04
Speaker
I think that's a good starting point for anybody.
00:53:07
Speaker
Perfect.
00:53:08
Speaker
And we'll include in the show notes links to the books you mentioned.
00:53:13
Speaker
It's something that we usually ask our guests.
00:53:16
Speaker
We'll also include a link to some of the music that you've mentioned and definitely to all the resources that you've provided.
00:53:23
Speaker
As we close,
00:53:25
Speaker
What I really learned is three important things here, Andrew, that I think are very valuable for us as clinicians and as healers, right?
00:53:35
Speaker
Number one is be aware that your patient who you think is in a coma might be taking inputs from what is said around them.
00:53:46
Speaker
Yeah.
00:53:47
Speaker
And use that in a positive way, right?
00:53:49
Speaker
And there's actually studies that talk about what's called cognitive motor dissociation.
00:53:54
Speaker
where when you do like a quantitative EEGs or functional MRIs to people who are perceived to be in a coma and you give them certain instructions, like imagine you're doing this, it lights up.
00:54:06
Speaker
So they're obviously listening.
00:54:08
Speaker
Number two, be more curious about the people, the person that you're treating.
00:54:14
Speaker
You do mention throughout the book how sometimes learning from a family member or from the patient itself
00:54:22
Speaker
a connection with a special piece of music could be very instrumental in helping them heal.
00:54:27
Speaker
And I really liked the story of the English patient who was a big Rolling Stones fan.
00:54:34
Speaker
That connection, I mean, you probably wouldn't have not made unless somebody shared with you or asked what type of music do they like.
00:54:42
Speaker
I mean, I think knowing that is very important.
00:54:44
Speaker
Do they like music?
00:54:45
Speaker
What type of music do they like?
00:54:47
Speaker
And number three, I think is also something that is always a humbling reminder for me is that we see a lot of patients like yourself underwent a cardiac arrest.
00:54:59
Speaker
We're very nihilistic in terms of their ability to recover from the brain injury.
00:55:05
Speaker
And the truth is we don't know.
00:55:07
Speaker
And there is something described as neuroplasticity that in many people, I mean, comes back and it can help them.
00:55:15
Speaker
So I think that keeping that in the back of our mind, I think is always very important in terms of our patients.
00:55:22
Speaker
So this is a fascinating conversation.
00:55:24
Speaker
Andrew, I really learned a lot from talking with you, but also from reading the book, which I would recommend every critical care practitioner should really take the time to read.
The Call for Music in Healing
00:55:37
Speaker
And as we close, is there one final thought or comment you want to make to our listeners?
00:55:46
Speaker
Well, I have been enjoying this a great deal, Sergio.
00:55:51
Speaker
We know each other, as you said earlier, from the ICU Liberation Committee.
00:55:56
Speaker
And I love that you're doing what you're doing with this podcast and so grateful that you gave me the opportunity to join you for a conversation.
00:56:08
Speaker
And I just really want to impart
00:56:16
Speaker
how valuable music is as medicine.
00:56:20
Speaker
You talked about the history and it's chapter seven in my book is Everything Vibrates.
00:56:25
Speaker
And Dr. Brian Hunter, the official historian of the American Music Therapy Association was my guest in that chapter.
00:56:35
Speaker
And I'll just bring you up to date with that and saying that music was part of medicine
00:56:44
Speaker
in every culture and in Europe and America, by the time you get to the early 19th century, it started getting pushed out because doctors became much more scientific and they said music is not science.
00:57:02
Speaker
The Civil War helped bring music back because in the veterans hospitals, they brought in local musicians and noticed things improved.
00:57:11
Speaker
It went a little bit more in World War I. And World War II is actually where you have a much greater amount of that going on.
00:57:19
Speaker
But we were still, in the background, we were still not considered science.
00:57:28
Speaker
And science is actually what brings us back fully because in the 1980s and 90s, when the FMRIs are being done and they're doing scans of the brains of people who are listening to music, that's where it's learned that music lights up the whole brain.
00:57:48
Speaker
And then there's this awareness that it helps the brain produce all the good chemicals.
00:57:55
Speaker
So we're moving in the right direction.
00:57:58
Speaker
And like I said, I'm 72 years old going on 17 because I'm a guitar player without children.
00:58:06
Speaker
So there was never any reason to really become an adult.
00:58:10
Speaker
And I'm just gonna keep doing this.
00:58:12
Speaker
My mother, God bless her, is 99 years old.
00:58:15
Speaker
and I take after her.
00:58:16
Speaker
So I may be doing this for a while longer, and I'm just going to keep at it.
00:58:21
Speaker
You have a medical musician in your ICU, and it will make a difference, a positive difference.
00:58:29
Speaker
Beautiful.
00:58:31
Speaker
Andrew, could we end with some Bach?
Conclusion with Bach Performance
00:58:36
Speaker
From me?
00:58:36
Speaker
Yes.
00:58:41
Speaker
Well...
00:58:43
Speaker
I'm gonna not play a whole piece.
00:58:46
Speaker
I'm gonna play the opening of a Bach Sarabin.
00:59:09
Speaker
Thank you for listening to Critical Matters, a sound podcast.
00:59:13
Speaker
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00:59:19
Speaker
Sound's transforming the way critical care is provided in hospitals across the country.
00:59:23
Speaker
To learn more, visit www.soundphysicians.com.