During the past three years, Susan LeMessurier Quinn has sat at the bedside of many children at the Janeway Children’s Health and Rehabilitation Centre in St. John’s.
There’s no stethoscope draped around her neck.
Instead she holds a flute, a guitar or a percussion instrument. As a music therapist she uses these as tools to enhance the healing process.
While music therapy might have a long history in the kitchens of Newfoundlanders, its use in hospitals has been limited.
“There have been a couple of music therapists in the province for a few years,” LeMessurier Quinn says, “but awareness seems to be spreading more quickly recently.”
The therapist spends two days each week working with patients at the Janeway. The program is offered to inpatients on the surgery, medicine and psychiatry units, and to outpatients in rehabilitation and psychiatry. Patients range in age from birth to young adults.
She uses various musical instruments, including her voice, to help patients on their road to recovery. For instance, music can provide a distraction during uncomfortable procedures like blood tests.
The therapist’s goal is to help manage pain, reduce anxiety, reduce heart rate, and aid in emotional expression, growth and development, speech and language.
The therapist doesn’t just play and sing to the kids. She brings along instruments for them to use.
“Music therapists are trained in improvisation,” LeMessurier Quinn says. “If a patient needs to express an emotion, however they play it, the music therapist has to be able to match what they’re playing.” Essentially, she and her patient are developing it into an original piece of music.
She says that helps patients feel a sense of control.
“A patient expresses so many emotions in hospital. I will play along with them and match what they’re playing, improvising to help them express freely. It provides a good release of energy and emotions and is helpful in their treatment.”
LeMessurier Quinn will choose whatever technique is best for that patient in that particular moment. Obviously, recorded music could not have the same effect.
Slowing the beat
One of her patients, Keegan, had surgery about three months ago.
“I first met Keegan as an inpatient on the surgery unit. During the initial session we focussed on relaxation. After surgery it can be hard to find a comfortable position in which to rest,” she explains.
When some patients experience pain their heart rate increases.
“There were periods when Keegan would feel discomfort and you could see his heart rate go up by looking at the monitor.”
Using live music and improvisation — on an instrument or vocally — the therapist is able to lower heart rate by playing or singing to match the patient’s breathing and heartbeat, gradually decreasing the beat and tempo of the music.
“And hopefully it relaxes their bodies and slows their heartbeat. You can notice they are more relaxed and sometimes they close their eyes and rest.”
LeMessurier Quinn has been meeting with 11-year-old Keegan for a half-hour session once a week for about three months.
While his first few sessions were focussed on relaxation techniques to help him recover from surgery, the second stage focussed on movement, working on Keegan’s ability to bring his hands and arms towards instruments.
“I would hold his hands on the drum so he could feel the vibrations of the instrument, for sensory stimulation.”
Getting his hands stretching and moving was good for his motor movement.
The next step was towards rehabilitation. When Keegan was able to get into his chair, the therapist began bringing him to another room for the session, still working one-to-one.
“It’s important once a patient is able to get out of bed that they leave the room, which can enhance their energy and motivation,” she says.
Playing music also enhances co-ordination. “Holding and playing a variety of different instruments — textures, weights, whether the instrument has a handle — helped in the development of fine and gross motor skills and in improving his grasp.”
Surgery can weaken a person’s ability to take big, full breaths, so singing and using wind instruments are effective interventions.
“Singing was the next step, rhythmic breathing, blowing into wind instruments.”
Keegan used a recorder to practise long breaths and short breaths, then progressed to singing different sounds, “open vowels, the consonants — and now he’s singing full songs with lyrics.”
Because he’s made such progress in the past couple of months, the music therapist currently sees Keegan on an outpatient basis through the rehabilitation unit. They will continue to work together for as long as he is an outpatient.
“He still spends the days in hospital for his (regular) treatment program, and goes home at night.”
Before the surgery, Keegan was involved in music both at school and privately. His mother, Kelly, says he will likely stick with the music after he’s discharged.
“I’m enjoying it a lot,” Keegan agrees, adding “I played guitar for a couple of years before and I gave it up.”
So it seems the therapy has also rekindled his interest.
Kelly sits in on the music therapy sessions with her son.
“I get to observe Keegan’s progress — and I enjoy the music. Susan has adapted the program to his needs,” she points out. “In surgery the program was quite different, so it’s very flexible. When he was on the fourth floor (surgery) and in a different state of health, the music relaxed him and me — and not only him and me. A hush would fall over the entire floor when Susan started playing. The whole floor would become relaxed and calm. It was very neat to see. The session would come to an end and we’d all have to snap out of it.”
Kelly says Keegan is given a lot of creative control, autonomy and expression in the program, “which is good for his mental state. He chooses what he wants to play and it complements the other therapies he’s involved in at the Janeway.”
When she finished up a Music degree at Memorial University, LeMessurier Quinn went on to pursue a bachelor of music therapy, and five years later a master’s degree at Wilfred Laurier University in Ontario.
She spent 12 years in Ontario, working as a music therapist, some of that time in private practice, some as an instructor at Wilfred Laurier University.
But she always knew she would return to Newfoundland.
During her days as a music student at Memorial University, she did some volunteer work on a musical program at the Janeway. The experience stuck with her.
“My volunteer experience was so amazing there. It gave me the opportunity to see how important music is for patients and their families. When I began exploring music therapy I learned about the therapeutic benefits and the goals that can be achieved and realized that’s what I wanted to do.
“I always had it in the back of my mind to come back and do a program at the Janeway, but I wanted to get as much training as I could first.”
She returned in 2008 and through a six-month grant implemented a pilot program at the Janeway.
That program has been able to continue through support from the Janeway Auxiliary.
“They found out about the benefits and have funded the program since. They are an amazing group. They’ve been funding the program for two years and have approved funding for next year.”
That news is music to Kelly’s ears.
“It’s been a very positive experience, not only for Keegan, but for me,” she says. “I’m constantly seeing big improvements in his progress every week. It’s contributed a lot to his well-being from Day 1.”