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My sister's experience with her music therapist surprised me, and not because of how much the music helped her manage her cancer pain. Witnessing the therapist's work up-close, I discovered how little I knew as a physician about the variety of ways these professionals can help patients throughout survivorship, whatever the prognosis. The biggest surprise was how my sister's music therapist helped me. Here's our story.

Music Therapy. Music... - Click to enlarge in new windowMusic Therapy. Music Therapy

A few years ago, a cardinal perched on a bare branch, announcing the imminent arrival of winter. My 65-year-old sister opened the door to welcome a music-therapy intern into her spacious bedroom, warm and bright from the morning sun. The youthful Danielle set down her guitar and introduced herself while scanning the room, with its two acoustic guitars, three djembes (tall, goblet-shaped drums played with bare hands), and stacks of sheet music. She assessed my sister's movements with a clinical eye, making a mental list of potential interventions, and asked, "How are you feeling today?"


Debra's answer informed Danielle that low-dose narcotics were controlling the physical pain but not the surreality and sadness of settling into hospice-something she sensed Debra didn't want to talk about. All my sister wanted was to learn drumming patterns for songs from her childhood. For the rest of the hour, Danielle taught her "music student." They sang traditional Jewish melodies in unison, accompanied by drumbeats and chords. The only talk was of notes or rhythms. Not pain or cancer. Each song ended with a coda of smiles and Debra's eager, "Okay, what's next?"


Unlike the passivity of receiving radiation and chemotherapy, Debra ran the show for this therapy, deciding where they sat and what they played. If a song felt too challenging or stirred sadness, she simply stopped mid-phrase and turned the page. When time was up, before saying their first goodbye and opening the door to the cold, Debra assured Danielle she'd practice.


At least once a day throughout the subsequent week, between nurses' visits and managing all her pills and trying to eat or sleep, Debra took out her djembes. The music transported her like a magic carpet to joyful spaces where she escaped her pain and grief.


In anticipation of Danielle's second visit, Debra readied the chairs and music stand. She couldn't wait to show off her progress and learn new techniques and harmonies. Again, Danielle first asked "How are you feeling?" to gauge the best therapies for the day. For the rest of the hour the bedroom vibrated with music and laughter-celebrations of life.


Visit after visit, the two women became increasingly in sync. Danielle rejoiced in Debra's expanding musical repertoire and improving technique while noting Debra's weakening muscles and increasing abdominal distension. Conversation remained limited to notes and rhythms. Danielle knew to wait until Debra was ready to let her in.


The end of winter brought the end of their musical give-and-take. Leaving her drums untouched in the corner, Debra asked if she could lie down and just listen. Danielle played familiar melodies she knew would help. Once the creases in Debra's forehead relaxed, Danielle used guided visualization to serenade Debra on a moonlit boat ride a world away from the army of pill bottles on the nightstand.


Outside, a few daffodils defied the chill, heralding the hope of new beginnings. Inside, hope waned. The usual "How are you?" prompted Debra to start talking about what was happening to her...and to her family. Danielle asked, "Would you like to leave them a song?" Without hesitation, Debra welcomed the chance to preserve her voice, answering, "Let's do it!" Danielle scribed, catching all she could as Debra poured herself into a jumble of verses that sent a message: "I want my family to keep love in their hearts regardless of the hardships they face."


By their next session, Debra's somnolence made talking difficult. Danielle performed music that enabled her patient to escape the pain. Suddenly, with tears streaming, Debra turned to Danielle, took her hand, and said clear as day: "Thank you for the amazing work we've done...for bringing music, laughter, positivity and joy to these months." Her last words to Danielle.


A few weeks later, Debra's family, two nurses, and I surrounded Debra's bed. Danielle quietly entered the room with her guitar. By now, Debra was non-verbal but obviously still aware of her surroundings. We propped her up with pillows. Her daughters kept stroking her back and Danielle kept strumming two chords over and over as we waited for Debra's pain to quiet down enough for her to hear her musical debut.


For three sacred minutes, Debra's Song filled the room with the love of my sister's heart.


Danielle quietly packed up her guitar and leaned over her patient to whisper a final goodbye. She then made the rounds, giving each of us a hug and a promise to email an mp3 version of the song. With a wave, Danielle was gone. Before sundown the next day, Debra was gone, too.


After the funeral, the promised email arrived. I plugged in my earbuds and adjusted the media settings to auto replay. When my fingers froze, my grief counselors' wise words echoed in my head: "You have to feel it to heal." Taking a deep breath, I pressed "play."


Danielle's sweet rendition of Debra's Song ushered me through the painful transition to life without my sister. That first month, the song helped me accept my loss as real... and forever. A few months later, I played Debra's Song for my new granddaughter while holding a photo of my sister in front of her face. Delighted cooing assuaged my pain of knowing they'd never meet on earth. For the rest of my life, I can play Debra's Song whenever I miss my sister or want to feel inspired by her message, such as right now.


In today's world of high-tech medicine, let's remember the ancient healing art of music therapy. From baroque to Broadway hits to bawdy rap, music therapists use rhythms and tunes to help patients through tough times. Minimally, music may offer patients respite-a few bars of cheer or a memory-filled return to happier times and places. At best, music helps them live fully in the moment. If conversation fails, music may give voice to patients' thoughts and feelings that desperately need sharing. If illness threatens all happiness, music may offer patients a way to regain a sense of control, obtain pain relief, calm anxiety, or find hope. And if patients die, their loved ones' memories of music-therapy sessions may make it easier to let go of painful memories and remember their loved one with joy. Music can be like a medicine for patients and for their loved ones.


WENDY S. HARPHAM, MD, FACP, is an internist, cancer survivor, and author. Her books include Healing Hope-Through and Beyond Cancer, as well as Diagnosis Cancer, After Cancer, When a Parent Has Cancer, and Only 10 Seconds to Care: Help and Hope for Busy Clinicians. She lectures on "Healthy Survivorship" and "Healing Hope." As she notes on her website ( and her blog (, her mission is to help others through the synergy of science and caring.

Wendy S. Harpham, MD... - Click to enlarge in new windowWendy S. Harpham, MD, FACP. Wendy S. Harpham, MD, FACP