Local Santa Cruz: What are some of the biggest challenges of playing music for hospital patients?
David Pavlovich: Hospitals and hospices are increasingly diverse places. Especially with Obamacare, you have people of all ages from all walks of life and all different cultures. I can play one hour for a one-year-old in pediatrics who is in the process of recovery, and the next hour, I can be playing for a 90-year-old in the ICU who’s breathing his last breath. And then there are people from all different countries, all different musical backgrounds. I’m not going to play classical music, necessarily, for somebody who was a campesino in South America. You need to know how to play classical, folk, African, Asian… all kinds of music. So that requires a musician to be knowledgeable, skillful and versatile. You’ve got to be a good musician—not just play soft, peaceful music. Maybe that’s not what the situation calls for; maybe you want to elevate somebody’s heartbeat and not slow it down. Okay, then you not only need to know how to do that, but you have to have the skill on the instrument to do it. But you can’t just be a good musician without having a good bedside manner, because that wouldn’t work, either.
In your book Music in Hospitals, you describe situations where therapeutic music is inseparable from the environment in which it is being played. Can you talk about how that applies to the hospital setting?Unfortunately, there’s a hard and fast rule that exists in many music therapy schools today. The thought is that when you play music for people, there is just you and the patient, and you’re not to be thinking about doctors, nurses or family members. I’m pretty sure the reason why that thought was developed—the good reason for it—was to keep it from turning into a performance. Unfortunately, you can’t do that! Music doesn’t travel along a linear plane; it radiates outward, and it affects a whole environment. So why not use that? Just keep in mind not to turn it into a performance, but the music you play can affect both the patient directly and doctors, nurses, staff members and family members indirectly. Then they are in a better mindset to bring their skills and talents to the patient, so you affect the patient indirectly.
I’ve seen nurses waltzing down the hall with each other as I’m playing. If I can help them do that, then why not? Or, one time I was playing for a little skeleton of a woman—70 pounds. I wasn’t able to talk to her or ask her what she liked, but her family was there. Why not talk to them? It turned out she was an organ player in her church for 50 years. Well, okay, what’s the denomination? I know music from that denomination, because I try to be a diverse musician. So I start playing music from her background, and as I’m playing, her right and left foot start [moving]. I recognized immediately that she was working the pedals of her [imaginary] organ. So it was as if we were playing duets! She died later that afternoon. Her family was very moved.
What are some of the things you’ve learned from doing this work?
When you’re playing into somebody’s physical situation, harmony tends to affect circulatory systems. Meter is going to affect metabolism: fast meter, faster heartbeat; slower [meter] tends to [reduce the heartrate]. And we know that melody affects neurological pathways. However, I’ve played for thousands of people who were in the process of dying or in the process of getting better, and I can honestly say that no situation has been the same. I’ve learned that this is not so much a science as it is an art, and that I don’t really have control over any of this. There isn’t some formula that can be universally used all the time.
I don’t call myself a healer—I never use the H word—and there are two reasons for that. One is that in an allopathic setting, it is the doctors, nurses, physical therapists, etc. who are defined as the healers. I am there, at best, just to provide comfort to those who are suffering. But secondly, music doesn’t have an agenda. Not to sound cold, but it doesn’t really care about healing or not healing. It plays equally for heartbroken and newlyweds, for sick and not sick, for living and dying. It goes out with equanimity; it goes out without preference to all of those situations.
When you’re in the hospital, everybody has a very legitimate agenda for you: the get-well agenda. The doctors, nurses and physical therapists have it; you have it; your family has it. Your world becomes increasingly defined as, “I must get better.” When I enter a room and I actually give something that has no agenda, it is a relief to that very intense agenda that people are involved with. [Patients] are reminded that there’s a world that exists outside of their own physical pain, outside of the hospital walls.