Music in Medicine

A hospital which wishes to use music as an adjunct to medical practice must be willing to offer the space required for its activities. The extent to which music will be needed will depend upon the nature of the illnesses treated and the average stay of the patients. For mental and tuberculosis hospitals, music is a “must.” The chronic hospital usually has an assembly or recreation hall for musical performance. This hall will generally be adequate for band rehearsals, and may also be used at other hours of the day for instrumental practice. Where funds and space can be spared, additional rehearsal rooms should be built so that more patients will be able to participate. Space can be saved by building small cubicles sound-proofed with any of the sound absorbing fabricated wall boards such as Celotex or Transite. Cubicles should be built with much glazing so that the patient will not feel the smallness of the room. If there is only one music aide, there will be an advantage in centralizing all music activities, but if more help is available, music rehearsal rooms should be available in the different pavilions or wings of the hospital so that newly convalescent patients will not have to walk too far.

If the age range of the patients runs the full gamut, seating and instrumental provisions will have to include provisions for all. This means adjustable piano benches, music stands, etc. Chairs should be provided not only for musicians but spectators. Patients should be encouraged to attend band and other group rehearsals as a method of stimulating their interest in music and for the diversion which it will afford. Music stands for the bands should be dressed up to resemble those used by popular bands. These stands are colorful, collapsible, and hence transportable for any outside performances which the patient band may contract.

Instruments

Participation. The number and nature of instruments which a hospital should have will depend only upon budget limitations and the interest of the community. There is no limit except storage space to the number and variety of instruments which a hospital should accept as gifts. Ideally there should be at least one of each of the major instruments. Each instrument should have its own case, and it is wise to engrave the hospital name on each instrument to minimize loss. The initials of the hospital may be cut into an inconspicuous part of the instrument such as the inside of the brass bell or the under side of the wood body. All the instruments should be locked in cabinets when not in use.

In addition to regular band instruments, small instruments which can be played in bed should be acquired. These can be divided into those of normal construction such as the ukulele, mandolin, and autoharp and the toneless instruments which can be made by removing the resonating body. A toneless violin can be constructed from a donated violin in poor condition by mounting the tailpiece, bridge, and fingering element on a narrow strip of wood or plastic. A piece of rubber “kneeling” pad makes a good practice drum head.

For children toy instruments such as the Typatune, the toy-xylophone, trumpet, maracas, etc. should be available.

Listening. A room should be designated as a “Music Listening Room.” For economy of use this may be a multi-purpose room. It may be a combination of the music aide’s office and musical library used at selected hours of the day for both practice and listening. It should contain an instrument for playing recordings. The choice of record player should depend upon the sound produced by the instrument rather than its name. The record player for the listening room should have an automatic changer and wide tone control if possible. Because of the excellence of many musical broadcasts a combination radio-record player is most desirable.

Portable record players are also desirable for the bedside listening of those who request it. In hospitals not equipped with public address systems, the portable record player can act as an excellent substitute for it. If the player is mounted on a cart fitted with shelves for records and albums, it can be wheeled from one ward to another for daily musical periods. If the hospital has small-sized lantern slides with words to songs imprinted (such as those supplied Service groups during the war by the USO), a small slide projector should be added to the music cart to be used on the darkened ward for ward songs.

The Music Library

The hospital music library may vary from a few recordings to a composite collection of all forms of musical literature available. General hospitals which treat all diseases and age groups will require the most extensive and catholic varieties of all kinds of music. Specialty hospitals can operate on a library tailored to their individual needs. A hospital for the aged will not require too much of contemporary popular music. For purposes of inclusiveness, the ideal will be discussed in the hope that some hospitals will be able to afford it and that others will be able to select those items which become possible for them.

Recordings. The choice of recordings will be determined by the usual hospital population. In building up the record library the music aide should submit check lists to every patient in the hospital on any one day. The list should include ten specific titles in each of six categories: symphony, opera, operetta, folk-songs, old-time favorites, and the currently popular songs. These should be carefully tabulated and should be used to form the nucleus of the permanent collection. A space should be left for patients to write in other pieces than those named. Records should be purchased in the order of their numerically recorded popularity. A collection should begin with one record per hospital bed. This method of starting a library is very tedious but well worth the effort, because only by determining the musical tastes of patients can you give the majority the music they want. The musical tastes of the patients will not vary significantly after a complete turn-over in patient census, since most hospitals derive their patient population from the same geographic area, and the tabulation of musical desires arrived at in this manner will correspond satisfactorily with the tastes of the same age group in the community. If the budget will not permit an original collection of this size, it might be reduced to half of that recommended, but that is a minimum.

The collection should be built up at a rate of approximately one record for every ten new patient admissions. The choice of additional records should be on a request basis, but the proportion of the six categories as originally determined should remain relatively constant to keep the collection balanced.

Whenever there is a choice of two or more recordings of the same piece, the discs to choose are those which are played softly or sweetly so that they are adaptable for the additional purpose of mealtime or restful music.

In the library of recordings there should be included albums of records for special occasions and holidays. Patients look forward to hearing Irish songs on St. Patrick’s Day and appropriate songs on other holidays. To accompany religious services the albums prepared by Bibletone are valuable. A glance through any standard record catalogue will readily permit the music aide to assemble a suitable collection.

The following is a list of records suggested for Easter Sunday and St. Patrick’s Day.

All recordings should be kept in their albums or jackets. Because jackets have a way of getting lost or torn, there should be a stock of unused jackets on hand. Each jacket should be labelled according to its contents. In addition a cross-index catalogue file should be maintained by the music aide for all records in the hospital collection. Three cards should be filled out for each face of each record: one card for composer, one for title, and one for performer. This seems like a lot of work but is worth the effort because it is only in this manner that a program can be rapidly assembled from the record library. Any filing system will suffice, but if the collection is large, an elaborate system will be found worth the effort. Cards of three different colors may be used to separate classical, popular and miscellaneous. Tabs may be placed on those cards which list music for occasions. Tabs in one corner may refer to meal-time music and tabs in another holiday music, etc.

It is well to have the entire record collection in one room, and shelves for holding records should be built of very heavy lumber because recordings when closely packed are very heavy. It is best to add records to shelves with continuous accession numbers in each category and to rely on the file for alphabetic listing. If there are duplicates, they can form the nucleus for a second or lending library. Broken, cracked, or defective discs should be placed in a separate section of the shelves for replacement when budget permits and popularity demands.

Instantaneous Recordings. A few hospitals will have the good fortune to acquire a record-cutter for hospital recording of radio music. When this is possible, the record collection can be augmented most satisfactorily. The music aide should study all radio programs to determine the hours during which the best performances of desired music are played. By listening to several carefully selected programs each week he will soon discover which programs use music employed in a manner most desirable for hospital reproduction. The orchestrations of Kostelanetz and Lombardo are especially suitable for easy listening in the field of popular music. The broadcasts of the Metropolitan Opera Association include passages not commercially recorded or at least not recorded with the most popular singers. There are many other radio features which are worth recording for the hospital record library.

It is relatively easy to operate a record-cutter, but there are many minor details which must be known for maximum efficiency. An excellent book for beginners is that published by the Audak Company of New York, How to Make Good Recordings.

Sheet Music. A library of sheet music will once more depend upon the local needs. It may include orchestral, instrumental, vocal, and band music. In the hospital for the chronically ill, a large number of varieties will be needed. Inasmuch as the simplest group performance will be vocal, music for group singing should head the list. The music should include old-time favorites, hymns, spirituals and any other items which the aide can determine from the intellectual and musical qualifications and desires of the patients. This type of music can be purchased individually and increased according to the interest shown.

If there is a patient band, the musical scores should include a few marches which may be used at the beginning and end of its concerts. The perennial favorites most desirable for community singing should constitute a major portion of the orchestral literature. The readily available medleys of Victor Herbert melodies and similar stand-bys can complete the initial group.

Sheet music should be catalogued and filed in cabinets. A simple system of shelving consists of grouping music according to use: one shelf for group playing, one for solo and beginners instrumental books, and another for vocal selections. The numbers most commonly and currently used by the band can be placed in folders according to the accepted usage among bands, and if there are daily rehearsals they can remain on the band stands at all times.

The library should also contain books, printed forms, or mimeographed collections of songs for distribution to patients during community singing.

Books About Music. The average hospital library will have relatively few books about musical appreciation or history. This will depend first on the budget and second on the demand. The addition of a music aide to a hospital staff will usually increase the demand. The music aide should be consulted concerning the books he thinks will appeal to patients. Books on music should also be available to help the music aide in preparing commentaries on the music he plays for the patients.

The following are some books suggested for inclusion in the hospital patient library:

• Copland, Aaron—What to Listen for in Music, 1939.
• Goss, Madeline—Unfinished Symphony, 1941.
• Elson, Arthur—Music Club Programs From All Nations.
• Erskine, John—What Is Music, 1944.
• Ewen, David—Tales From The Vienna Woods, 1944.
• Ewen, David—Gershwin’s Life, 1944.
• Ewen, David—Men of Popular Music, 1944.
• Gronowicz, Antoni—Chopin, 1943.
• O’Connell, Charles—Victor Book of Opera, 1936.
• Taylor, Deems—Of Men and Music, 1945.
• Taylor, Deems—The Well Tempered Listener, 1944.
• Siegmeister, Elie—Music Lover’s Handbook, 1943.
• Spaeth, Sigmund—At Home With Music, 1945.

For young patients there are the new series of colorfully illustrated lives of composers from Bach to Gershwin by Waldo Mayo, as well as a great number of old and good titles.