While neuroscience research continues to uncover the mechanisms of how the brain responds to music, clinicians and patients are experiencing the benefits of creative new applications for music and healing.
By Patti North
A decade ago, Joseph Myers, MD, noticed something disturbing in his clinical practice.
“I realized that opioids were causing a lot of problems in the operating room—blood pressure would drop, and we’d be resuscitating some very sick patients because they couldn’t tolerate them,” says the associate professor of anesthesiology, who delivers care at MedStar Georgetown University Hospital. “So instead, we started using a local anesthesia along with a variety of non-opioid analgesics. And patients were waking up without pain—and without the predisposition to addiction that unnecessary opioids can cause. The truth is, almost any surgery can be done without opioids—especially before and during the anesthesia.”
That was the start of a protocol he developed called the Comfort Safe Pyramid, which is a checklist of methods and modalities of non-opioid analgesics the patient can choose from that includes music. “They can pick what kind of music they would like. We suggest classical or smooth jazz, but some of them will pick Springsteen,” he adds.
Myers finds that music has a powerful effect on everyone—not just the patient. “Staff are typically rushed and driven by the clock. With music their voices get lower, slower and more hushed. The family sees their loved ones going into surgery with Joshua Bell being played and they think, Oh my gosh, he’s in good hands. You gain trust and confidence from the patient when they sense you are doing it the way they want. You’re listening to them, and they have a little bit of control restored to them.”
The opioid crisis in the U.S. increases the urgency for deploying safer alternatives. Myer’s team was recently recognized by the American Society of Anesthesiologists, and awarded first place for its “Comfort Safe Program: A Safe Path for Patients in Recovery From Opioid Addiction,” as part of Anesthesiology 2017—the annual international convention that attracts 20,000 attendees.
Myers has started to see the program take root and grow. “Anesthesiologists have the ability—not only to help prevent addiction—but to avoid relapse in recovering addicts who need surgery.”
Melodic Processing and Language Rehabilitation
When a stroke occurs in the left hemisphere of the brain, a patient can experience loss of language, though comprehension is sometimes preserved. When the right side is undamaged, melodic processing is preserved, says Peter Turkeltaub, MD, PhD, assistant professor of neurology.
“Those preserved abilities provide a scaffolding to help whatever is left of the left hemisphere recover some core language abilities like grammar and vocabulary,” he adds.
As the medical director of the Center for Aphasia Research and Rehabilitation, and director of the Aphasia Clinic at MedStar National Rehabilitation Network, Turkeltaub’s research investigates the brain’s organization for language and other cognitive faculties. He studies developmental or acquired communication disorders like aphasia, and how to enhance recovery. The brain’s functional scaffolding allows speech therapists to utilize music in helping stroke victims recover some of their lost language ability.
One treatment for severe, nonfluent aphasia is Melodic Intonation Therapy (MIT), which uses the musical elements of speech (melody and rhythm) to improve expressive language.
Chris Baron uses the principles of MIT in her clinical work as director of the Inpatient Speech Language Pathology Service at MedStar National Rehabilitation Hospital. “For someone I can’t get a correct syllable or sound out of, suddenly they’re singing five out of six words. For the people it works well in, it’s really like magic.”
Researchers hope to uncover the potential of music and rhythm in addressing any number of neurological and motor disorders, including dementia, Parkinson’s, Alzheimer’s, and even blindness.