What I learn from people caring for music (by Wolfgang Schmid)
Heavy clouds, drizzle, called yr in Norwegian, and strong winds herald the beginning of spring in Bergen. One of my colleagues at the hospice once explained to me “we have two seasons in Bergen: White winter and green winter. And such weather indicates the green one”. Nevertheless, I am on my way to Grieghallen, Bergen´s big concert venue in the middle of the city, named after one of her famous sons, the musician and composer Edvard Hagerup Grieg.
Inside the Grieghallen, in the foyer on the first level, about 300 people have come together. A friendly, warming atmosphere with the humming sounds of people´s chatting, laughter, and pleasant anticipation fills the hall. On a stage, 60 people from the Bergen Røde Kors kor (Bergen Red Cross choir) have taken their seats. In a semicircle in front of the stage, about 250 people have gathered, most of them sitting around coffee tables with cake and coffee served. I see two TV teams positioning their cameras, and several journalists walking around taking photos. On the lefthand side of the stage, seven musicians from the Bergen Philharmonic Orchestra warm up: Two violin players, a third one with a traditional Hardangerfidel, a trumpetist, a pianist, a percussionist, and a double bass player. The choir are about 35 people living at the Bergen Red Cross home for the elderly, presenting with varied stages of dementia, and around 25 volunteers. Since 2013, the choir has its annual concert at the Grieghallen related to the project “Musikk for minnet” (Music for memory) where people with dementia and volunteers from the Bergen Red Cross sing, play and dance in concert with professional musicians from the Bergen Philharmonic Orchestra and music therapy students and tutors from the Grieg Academy.
Later, I read on the “Musikk for minnet”-website about the project’s intention and philosophy highlighting that “people with dementia are often referred to as a uniform group. Through the project, we hope to be able to contribute to seeing the individual behind the disease.” The melody of the folktune «Å var jeg en sangfugl” (Oh were I a songbird) played on the Hardangerfidel mixes with the people´s chatting. Eventually, the choir joins and sings the tune in unison. Our colleague Fraser and the choir at the Mountbatten hospice on the Isle of Wight comes into my mind. A community of around 70-80 people with both staff, patients, and relatives. Fraser describes in his blog on these pages (“Why do we sing?”) their weekly meetings on Wednesday evening, also throughout the lockdown on zoom. There, choir members emphasize their enjoyment with singing together, lifting each other up, and jointly create an animated atmosphere of pleasure and recreation, that I also sense on this afternoon in the Grieghallen.
One song follows the other. Next one is the waltz “No kjem ein vals, den vil eg ha med deg” (Now comes a waltz, I want to dance it with you). The people on the stage sing, clap, and dance. We, the people around them, sing, clap and dance. We move and are moved by the music and each other´s commitment and enjoyment. I notice others’ emotion. They notice mine. We confirm each other´s sense of this occasion, which is contained and carried on from moment to moment by and in the music.
No kjem ein vals
Den vil eg ha med deg
Kom lat oss dansa til trekkspelmusikken
Til sola går ned
Now comes a waltz
I want to dance it with you
Come let’s dance to the accordion music
Until the sun goes down
I see people filming with their mobile phones. I see people smiling and with tears in their eyes. I see a younger woman approaching an older choir singer right in front of the stage. Is it his daughter or niece? After a sniff, he recognizes her and kisses her on the check. And then they waltz together. I have tears in my eyes and wonder, who is including whom here? What people might care for when they care for music? Questions that we in the C4M-team have discussed throughout the project. Now at the end of the project, as we sum up, these questions come up again. So, not new issues, but on this afternoon in Grieghallen, I understand that this concert tells me something simple but important related to these questions: I do not just listen to a choir performance, but also witness how people living with dementia share and invite me into their lives. Their care for music is a materialization of both agency and community. Their care for music dissolves established roles of caregiver and care recipient, of person with dementia and person without dementia. The people on the stage let us into their world, take care for all of us and make us feel welcome and included. We see, listen, are curious, learn from, and are affected by each other. We embody this in our care for music.
The philosopher Hans-Georg Gadamer suggests a person´s health and their caring for it as an active and rewarding engagement, and an original manifestation of human existence. How this can take place, be perceived and embodied, is discussed by several authors on musicking and health. For example, David Aldridge (2005) suggests that we perform our health through and in dialogue with others within a social and cultural context. We improvise our lives from moment to moment. With living as jazz, he proposes a musical metaphor for understanding human live. Like a piece of jazz, we are constantly improvising our lives to meet internal and external demands of our daily lives. Living as jazz highlights how we are and remain active, dynamic beings throughout our lives. This can continue even when we experience loss of memory, sense of orientation, or the ability to communicate with language. Also, when we are terminally ill and dying.
The word exist originates from the Latin word existō and means to come and stand forth, be who one is, have a perception of oneself, be seen by others and interact with them, inhabit a place in the world, where one experiences meaning with their unfolding lives. On this afternoon in Grieghallen, I witness how people, how I myself, perform and perceive myself in the presence and together with hundreds of other people. We have just met each other. Now, some minutes later, we dance and sing with each other. We share some time of our lives. Freely. Intimately. Joyfully. If once only. To me, this invitation to dance is a deeply devoted and enriching engagement. An acknowledgement and celebration of the experience of being and belonging. Experiences that the philosopher Ola Sigurdson suggests, are core aspects of a person´s existential health. We are healthy, in an existential sense, when we experience that the life we live is ours. Existential health also comprises the experience and awareness for our vulnerability and the way we relate to suffering. It equips us with intentional and reflexive qualities to relate to both our ailment and health.
In my music therapy work at the hospice, people with advanced stages of terminal illness show me photos, share stories and songs from their lives, are curious, humorous, sad, tired, in existential pain. Though they often have limited time, some share their imagination and thoughts, their hope, their despair. Some their struggles and strategies to cope and live their lives at the end of life. I understand this as an enactment of their existential health, a care for their own lives, including both its ailment and health.
Espen, one of the participants in the care for music-project taught me his favorite songs. He was referred to the hospice with advanced stage stomach cancer that had spread throughout his body making it difficult for him to swallow and speak. Espen spends most of the time lying in bed. He loves to sing. In our first encounter, he tells me, with a hoarse voice and many pauses, about his lifelong passion for singing in choirs. As a boy, he had seen a film version of an Italian opera with Enrico Caruso and Kirsten Flagstad at the Bergen cinema. He was thrilled by their voices and the performance. During the interval – the film roles needed to be changed at that time – he run home to his mother to share his excitement. But only to hear from her that the film had not been over yet, and that he had missed the second half. He remembers that this was the time when he decided to sing himself, when he joined a children´s choir. Now, some decades later in the hospice room, he still cares for music and asks me to play the song “Jeg er havren” (I am the oats). I find the text and melody on the internet and take up my accordion. First, he tries to sing himself, but it is difficult, and he lets me know. It makes him sad. I gently continue playing the song in a more improvised manner and at some point, Espen starts to conduct me with his left hand. After some time, I realize that he does not only show me the tempo and dynamic of the music, but its melody with its articulation and rhythm. Lying on his back in the hospice bed, the position that gives him least pain, he draws the words of the song with his left forefinger in the air above him. He sings the song with his hand. He conducts me as precisely as any skilled conductor. His repertoire of caring for music has expanded. He improvises and adapts it according to his very condition and the context. He acknowledges his vulnerability and limitations and at the same time reveals his enormous capacity and will for creativity and ownership. And by teaching me his song in this way, he includes me in his care for music, like the choir singers in Grieghallen did. Espen shares something important from his life with me. And he shows me not only how we can care for music together, care for each other and ourselves, but how care can be done in a broader sense. Based on a theory of selfhood consisting of multiple parts, psychologist Philip Bromberg suggests that health is the ability to stand in the spaces between realities without losing any of them. One can relate to different parts of self while being a whole person at the same time. I understand, that with his care for music, Espen still relates to himself as a singer, without ignoring the limitations set by a terminal illness. I understand that he stands in the space between these realities, performs and improvises his life, his existential health. His care for music might even help him to inhabit this space, keep it open and invite me into it. In our third session he does not want to make music himself nor listen to it. He has become much weaker and even more tired. He says: “What a pity that we do not have more time together. I could have taught you so many songs”. Instead, he asks his wife to bring all his songbooks with her from home and give them to me. This is, in my understanding, how he continues to care for music.
What I learn from encounters with Espen, many other participants, and from the choir singers on the afternoon in Grieghallen is that care for music comes in various forms and variations. It can be done in various places. In a hospice bed and in the foyer of the Grieghallen. Thus, not everybody wants to care for music. Music might not be equally important for all people, but many still care for music at the end of their life, seek and find opportunities to do so, and thus also nurture the experience of existential health, of living and owning their lives with its limitations and possibilities. People´s care for music provides me with some guidance for how I can support them in doing this: How to stand in the spaces between several, sometimes contradictory realities of living and dying. How to value these spaces, keep them alive and open, care for continuity and coherence that can come from them. How to care for and perform existential health. How to continue to write our own life stories.
The “Music for memory” concert is over. I pass the bronze statue of Edvard H. Grieg outside the Grieghallen and wonder, if and how he might have cared for music at the end of his life. Later I read in one of the biographies about him, that from 1903 he had increasing respiratory problems, and during the spring of 1907 his health deteriorated considerably. After an unusually wet summer in Western Norway, his condition became critical, and he died on 4th of September 1907 at Bergen Municipal Hospital. During the autopsy, a pulmonary emphysema was diagnosed as the cause of death. It is not recorded if Grieg had music at the hospital. If somebody has sung or played for him. His wife Nina Grieg later wrote in a letter: “Things went badly for him all summer, ever more badly. He was always freezing and had less and less breath. Energetic as he was up to the end, he practiced the piano and studied his scores in spite of increasing weakness.”
Aldridge, D. (1998). Life as jazz: Hope, meaning, and music therapy in the treatment of life-threatening illness. Advances in Mind-Body Medicine, 14(4), 271–282.
Aldridge, D. (Ed). (2005). Music Therapy and Neurological Rehabilitation: Performing Health. London: Jessica Kingsley.
Bromberg, P. M. (1996). Standing in the spaces: the multiplicity of self and the psychoanalytic relationship. Contemp. Psychoanal. 32, 509–535. doi: 10.1080/ 00107530.1996.10746334
Sigurdson, O. (2016). Existential Health. Philosophical and historical perspectives. LIR J. 6, 8–26.
Sigurdson, O. (2019). “Only vulnerable creatures suffer: on suffering, embodiment and existential health”, in Phenomenology of the Broken Body, eds E. Dahl, C.