Teaching and Learning Moments
It was clear the woman in 402 was dying. You didn’t need the details of her chart to know it. The high-flow nasal cannula never left her nose; now it could not be weaned. Morning or afternoon, you could see her small shape in the same place nestled beneath the hospital blankets. From the hallway, you could perceive her frailty, the effort each breath required. The words pulmonary fibrosis were spoken often in the hallway with worried looks. You turned your head sharply when her family members moved in and out because your knowing gaze might meet their knowing gaze. Most of all, you knew the patient’s time was short because you saw the white coats labeled Palliative Care crossing her threshold.
On one of those visits, a curious thing happened. The white coats—just a few at first, then more—came in accompanied by a person carrying a guitar case. From the case, a guitar emerged, and with a hum, a song began. An iPad propped at a delicate angle in the blankets showed the tab sheets of a Beatles song. Slowly, the song rose. The not-yet rock star playing the guitar began to sway in stylish rhythm as the song picked up steam. The timid latecomers held small maracas, scratching out a soft rhythm. The stately attending took the hand of the dying woman, not in gentle comfort but in bouncing syncopation with the music. Bells rang in her hand. The psychologist who was known to love goth rock made an exception and eagerly joined the song. You could hear the melody seep into the hall, and the repeated call to hold your hand rang across the floor.
Just as formality had slipped from the singers, frailty had slid from the bed as a beaming smile stretched across the woman’s mahogany skin and her soft gray curls swayed with melody. A stray tear formed at the edge of the fellow’s eye. It was clear that the woman in 402 was living.
As that tearful fellow, I was humbled. The oxygen, the medication, the careful respiratory therapy, none of these could transform our patient the way music did. Rather than seeing an impossible problem to fix, our team saw a person to celebrate. I was reminded that our patients are always our best teachers, and I will forever remember that bringing life into a patient’s room can be about more than medical intervention. The look on the woman’s face, the skill of the music therapist, and the foresight of the attending created the only treatment for an incurable illness. It’s as close to magic as we can expect in a hospital. I will remember that singing imperfect songs might be better medicine than reciting a perfect care plan.