Ruth Spargo and Cecily Smith, our Fledgling musicians have completed two residencies on Ward 81, the Burns Unit at Royal Manchester Children’s Hospital. The first was in September last year and the second in January to February this year. They have written about the inspiration for the project, the magical world of music they created and some of the challenges they faced working in such an isolated department. The featured image shows an example of the art work in the Burns Unit created by Lime Art (photos copyright Lime Art):
Ruth Spargo and Cecily Smith took music onto the Burns Unit at the Royal Manchester Children’s Hospital. We used the existing art on the ward as a creative starting point and designed a theme of a magical ship journey. We called the project “Message in a Bottle” After initial meetings with play staff, nursing staff and psychologists we also had creative sessions together to prepare repertoire and plan the sessions.
During the project we went onto the Burns Unit 5 times over the 3 weeks, working in bay areas and isolation rooms, as well as the Outpatients Burns Clinic for one session. We worked with children and parents to make music together, and encouraged children to come up with their own ideas for the music. Feedback from patients and staff was collected with help of the play staff and psychologists.
Creatively speaking, the theme came from the artwork that is in the bathrooms of the Burns Unit, and the treatment rooms of the Burns Outpatient Clinic. The art work is magical and incorporates lots of motifs and ideas: fish, vegetables, Arabic archways, and reminded us of ideas of a magical world. From this we created music that reflected this, thinking about using the theme of a magical boat journey as a basis for encouraging children to engage with the stories and come up with their own ideas. With this theme in mind we came up with the following repertoire for the project:
Byssan Lull – a traditional Swedish lullaby about being on a ship and having a treasure chest.
The lyrics are:
“Byssan lull, koka kittelen full, sjökistan har trenne figurer.
Byssan lull, koka kittelen full,sjökistan har trenne figurer.
Den första är vår tro, den andra är vårt hopp, den tredje är kärleken, den röda”
And this translates roughly to:
“Byssan lull, boil the kettle, the treasure chest has 3 figures,
Byssan lull, boil the kettle, the treasure chest has 3 figures,
The first is trust, the second is hope and the third is love, the red one.”
Skye Boat Song (Trad.) – we modified this to fit the theme, using just the chorus:
“Speed bonnie boat like a bird on the wing, Onward the sailors cry, Carry us on to where we will sing, Travelling through the sky.”
Emer’s Dream (Colm Mac Con Iomaire) – originally an instrumental version for two cellos; we expanded on this and used voices as well:
September In The Rain (Warren & Dubin) – chosen to give a sense of the changing seasons for children who were in isolation and perhaps less aware of the outside world.
“The leaves of brown came tumbling down, Remember, In September, In the rain. The sun went out just like a dying ember, In September, In the rain.”
We couldn’t use the cellos in the isolation rooms, and so focussed on using larger percussion instruments, such as the circle drum or chime tree, as our main instruments, and also had smaller, accessible percussion for anybody to use. We also used our voices extensively during each session, and for two sessions we only used one cello between us when working in the bay area. Twice, we made music in the corridor for the nursing staff and also to encourage interest from patients and families, but getting interest in this way proved difficult as the doors were all kept shut, so the amount of music heard was limited.
This is the link to our Soundcloud page where we have recorded a couple of songs that we used on the ward.
Megan Collis and Polly Virr, our Fledgling musicians have recently completed a residency on Ward 76 and have written about their experiences and one particular magical moment with Baby B:
During the final afternoon of our Fledglings Residency we once again shared some wonderful musical interactions with patients and their families. Being a Friday afternoon, the ward was particularly quiet as the majority of patients and families had been waiting for several hours. After spending 45 minutes or so playing music in each of the bays, Polly and I decided to go into the pre-op waiting area where there were many chairs and tables being occupied by families (several of whom were asleep!). Bearing this in mind, we thought it would be suitable to keep the music rather gentle and soothing.
We approached Baby B who was only a few months old and being held in a relative’s arms. Both her and his mother smiled and nodded as we asked whether they would like to hear some gentle music. I began to play an instrumental version of Twinkle Twinkle Little Star and the relative lifted up Baby B so he could see the cello and violin more clearly. His eyes were transfixed on the instruments and he began to blow bubbles through his mouth, which his relative said he does when he’s calm or happy. Whenever the music would ascend in pitch, his eyebrows would raise and his mouth open slightly and he was so calm when listening to the music.
As we developed the piece, we went into playing the traditional folk song Baloo Baleerie which made him smile. We repeated the verse part of the song two times before going into the chorus. As the harmony changed and the melody went up (the highest we had played) Baby B began to momentarily cry, but not for being sad. He was so invested in every note of the piece, that he expressed each phrase in his facial expressions and pitch of voice. As soon as the harmony resolved and he knew the melody, he smiled and each time it was repeated, his smiled widened. After a short while, he became increasingly sleepy, so we kindly thanked his relatives and slowly left.
It was such a special interaction to be part of and highlights the ever increasing sense of purpose and benefit that live music in hospitals carries. Throughout each session of my residency, I was continuously encouraged and fulfilled; not only as a musician, but in how willing the patients, families and staff members were to share the music.
We had the privilege of playing to many families during one of the most difficult times in their lives and their responses were always of gratitude. We noticed more times than not, a sense of relief and serenity that came from playing music with patients, families and staff and we will be forever grateful for getting to share those experiences with them at the RMCH.
We are so proud that Songbirds, one of our projects working with children at Royal Manchester Children’s Hospital with long-term ventilation needs and ABI (acquired brain injury) is the featured case study for artsandhealth.ie this month. Here is the link:
Music for Health is pleased to announce that our annual Zest Fest at Royal Manchester Children’s Hospital has been selected by the BBC as a feature of BBC Music Day this Friday 3 June. There is an action packed event programme between 10am and 4pm and all the atrium events are open to the public so come along and join in the celebrations with music, laughter, face-painting, balloons and magic. At 12pm there will be a samba parade around the hospital grounds culminating in the atrium with a fantastic sing-a-long samba Happy Birthday to mark the hospital’s 7th birthday. Music for Health has been delivering residencies and training programmes at the hospital since it opened 7 years ago and before that worked at Booth Hall Children’s Hospital. Our work continues to go from strength to strength and the BBC are highlighting the importance of our work bringing high quality music onto the wards for patients, their families and for staff members. We’re very grateful to Youth Music for funding this event and to our event partners Music in Hospitals for providing many of their musicians.
“From this point I can be considered an advocate for the arts in healthcare. The PEP has allowed me to appreciate the value of creative expression not only for those who are ill, but for everybody. I will continue to learn and develop my own creativity to better my personal and professional development”
Ten more third year medical students studied approaches to holistic healthcare with Music for Health and Lime Arts in January 2016. For many this was their first experience of visiting a paediatric hospital, and in seeing first hand the impact of hospitalisation on children and their families. All the students had an interest in either music, or the arts in general – or both – and used their own interests to explore the benefits of music and the arts to young patients who find their lives disrupted by medical treatment.
“I’ve learnt to appreciate the emotional side of a patient’s recovery, and the concept of using music to address this need. And the fact that this is a new form of communication skill.”
The students learnt about how techniques used by musicians on the wards can inform their own communication with patients, and the experience stimulated discussions about their own aspirations for healthcare environments of the future. We were 100% inspired by the dedication, commitment and desire evident in these young professionals right at the start of their careers to make the healthcare environment a better place for patients, and the compassion and conviction shown through their vocation to help people often at the most vulnerable times in their lives.
” I’ve learnt so much about how to engage with children and I will definitely carry these new lessons with me. The way that music changes the ward environment in such a positive way was amazing”
Exploring the clinical environement from a musical perspective provides new insights as to how we train young medical professionals in developing communication skills, and in addressing perceptions of performance and presentation in practice. Often a desire to ‘do things the right way’ can overtake the need to remember to listen.
” The PEP is a great experience that taught me lessons that can be applied in my future career. I learnt how to approach children effectively. I learnt that we should not forget that patients are human too and they need us to treat them like one. We often have our own agenda coming in and forget to really communicate with them.”
In working together we find the best advocates for each other’s practice. It is a privelige to work with such dedicated future medical professionals and to gain an insight as to why they have chosen medicine as a career. In the same way, these clinicians of the future are now able to understand through first hand experience, why arts in healthcare is so important.
” Thank you so much! I have a whole new appreciation for the importance of art and music as a part of health, I will take away so much from the experience. I want to spread the word about what you do. I especially hope that other hospitals will take it up.”
If you want to find out more, an article on our work in training medical students in music and communication at The Royal Manchester Children’s Hospital can be found on P. 6 of Pacemaker Magazine:
LIME Music for Health is recruiting an experienced, part-time freelance project manager for their Youth Music funded programme at Royal Manchester Children’s Hospital – please share the following link with any relevant groups/contacts and thanks in advance. Deadline for applications is 15 February 2016.
Ros Hawley and Mark Fisher will be visting Texas next week as part of their work at LIME Music for Health. A paper on Ros’s case study “I am the Moon”, published by Music Mark in 2013, has been accepted as part of an international panel on music and wellbeing at the Society of Ethnomusicology’s 60th Conference at the Austin Hilton, 3-6th December, Texas.
“I am the Moon” is a case study of Ros’s work as a musician in hospital told through examples of music making with patient Jamie Knott (1998-2012). Both their stories are linked by the music making they experienced together. Jamie took part in music making sessions for 3 years with Ros alongside fellow musician Mark Fisher and placement students from the RNCM, with the support of Jamie’s Play Specialist, Pauline Shaw. The case study and presentation are written with the blessing of Jamie’s mum Tracey.
The abstract for Ros’s conference paper appears in full below:
‘Am I dying Mum?’ is not the question any parent wants to be expected to answer in their lifetime. Through my work as a musician in hospital, working alongside music colleagues and a play specialist, I encountered a family who went through this very experience. I will use this case study as a basis for my paper, examining the processes of observation, performance, engagement and reflection necessary for creating responsive musical dialogue in hospital. The hospital environment presents numerous auditory and sensory challenges that can impact significantly on a patient’s sense of private space. Musical interaction offers a multi-layered experience in which responsive musicality, sensory sensitivity and interaction create a channel for meaningful engagement with patients, family, musical team-mates, medical staff and the environment itself. The therapeutic benefit of music as an aid to relieve anxiety, pain, distress or boredom is common and the effects of increased oxygen saturation or reduced high heart rate are frequent results for patients participating in live musical interaction. Notions of performance and performer are challenged when working at the bedside, demanding that ‘musician- as- music partner’ takes priority over musician-as- presenter. A process of rethinking and reconnection occurs as a musician’s context-aware role is developed. When cultivating space for musical interaction in hospital, the musician has to be receptive, spontaneous and fluid in approach: observing first, listening to what is musically needed, then playing and engaging appropriately in response. A platform for equal communicative exchange through musical dialogue can then be created.
Lime Music for Health (and Ros) would like to say a huge thankyou to mum Tracey and gran Mary for their support in putting this presentation together, and in giving permission for us to share Jamie’s life with others as a way to help tell the world about the value of the work of musicians in hospital settings.
” Nothing stays the same forever. That is the magic of things” (Vathys Libelulla, the dragonfly)
A Songbird’s Tale tells the story of young bird Brambling Rose, who, after being seriously hurt in a collision with a glass windowpane finds his way home to an independent life, helped by a series of kindly creatures encountered on his journey of recovery.
” I can’t see very well. Where am I ?” (Brambling Rose, the songbird)
Written and composed by LIME Music for Health Specialist Mark Fisher, A Songbird’s Tale is inspired by his experiences working on a two year music residency with fellow musician Ros Hawley and the children, families and staff they met on wards 83, 78 and HDU. The project is funded by Youth Music.
Brambling’s story is an imaginative tale, travelling through a series of mini worlds of nature where he meets the animals who help him to find his way back to his nest. At times Brambling finds himself on his own and he has to use his own will and resilience to travel on further. Brambling’s experiences in the story not only help him to get better, they give him the courage to be independent and free.
” You must take the path home. Once there you will be as strong as you ever were” (Madame Caladria, the snowy egret)
Colourful Birds, a dragonfly, a hornet, a terrapin, honeybees and an angel fish are all characters he meets along the way; each has a role in helping Brambling to help himself and find his way back to his nest, in the tree in the garden from where he first flew.
” I’m Perry Starey man, carrier pigeon to the stars…I’ve got a message for you!” (Perry Starey, the pigeon)
Brambling’s journey mirrors the pathway to recovery that many of the children from these wards have experienced, and is a reminder to all of us of the journeys we make and the stages we go through in finding our way in life.
” I know you can, you just have to have faith in yourself” (Vathys Libelulla, the dragonfly)
Mark explains how he created Brambling’s story:
“The idea just came to mind while working on the project. I was reminded of the plight of birds when they hit a solid object, like a window – an obstacle that is invisible to them. Comments made by consultant Dr. Grace Vassalo, in an interview given for our project, made me think about the children and their family’s journey when their world is turned upside down by illness, and they find themselves in hospital. An analogy was created in my mind between the impact on the bird of hitting the pane of glass and the sudden occurrence of illness that can happen to children that we have met. Some birds do get up and recover after a time and this made me think of the story.”
All of the characters are based on living creatures; some of the characters take their names from their real names in nature, other character’s names are inspired by mythological creatures.
LIST OF CHARACTERS (in order of appearance):
Vathys Libelulla – A Dragonfly
Brambling Rose – An Injured Bird
Dr. Bird – A Hummingbird
Hornette Coleman – A Hornet
Dr. Smew – A Duck
Nurse Amelia – An Angelfish *
Terry Pinn – A Terrapin
Morris – A Mynah Bird
Billy McCaw – A Macaw
Soup – A Superb Bird of Paradise
Maggie – A Magnificent Bird of Paradise
Madame Caladria – A Snowy Egret *
Mister B – A Bee
* voiced by Sue Wolmersley, all other characters voiced by Mark Fisher.
As part of our final celebrations of the Songbirds project, all the children and families who have worked with Mark and Ros will receive a recording of A Songbird’s Tale and Songbirds music as part of two special end of project events to be held on Thursday 24th and Friday 25th September at Royal Manchester Children’s Hospital.
The Songbirds CD, as well as featuring Brambling’s story, will feature full versions of music used in the story. The music will be familiar to the children as it has been both inspired by and specially composed for them as part of the project, and used by the musicians on the wards during their weekly sessions.
Click on the link below to listen to A Songbird’s Tale:
The children and families will also receive specially designed Songbird postcards along with percussion instruments similar to those used with Mark and Ros on the wards to take home and use with their families, all of which will be presented in a special bag. A Songbirds logo will be created by LIME artist Kim Thompson, inspired by magical birds created by the children and staff in sessions with Play Specialist John Smith.
Fellow musician Ros says:
“The project has been an incredible experience. We have learnt so much from all the children, families and staff who have welcomed us into their world at the hospital. It has been a privilege to be able to offer music as an element of rehabilitation for these children, and to see how music and musicians can play a part in a child’s progression towards going home.
Although our Songbird’s project will be finishing this autumn, we will be seeking further funding and sponsorship to turn A Songbird’s Tale into a children’s book, audio book and play for children in hospital, with the aim of performing and touring it at children’s hospitals around the UK.
Anyone interested in supporting us in developing our idea can leave a message here for Mark and Ros so we can contact you, or we can be contacted directly through our website http://www.rosfishmusic.com.”
Our second PEP programme with students from The University of Manchester Medical School took place between June and July this year, with a second group of ten students putting into practice their creative skills alongside the LIME Music for Health team.
The PEP continues to expand its creative horizons, with students this time not only exploring music, but also choreography, spoken word and visual art as part of sessions led by PEP tutors under the guidance of Dr. Julia Humphreys. LIME’s role within the module is to give the students a practical experience of the clinical setting from the perspective of using music as an interactive and communicative vehicle for expressive exchange between musicians, patients, families and staff. This is contextualised by additional ‘overview’ sessions that introduce the wider role of the LIME team, and accompanied by a practical exploration of creative techniques used by visual artists who work with patients.
Many of the medical students who take the PEP do so because they have an interest in the arts in some way. But also important here is the fact that students choose this module as it offers a contrast to other elements of their clinical learning, whilst still being crucially centred at the heart of the patient experience. In working with the LIME musicians students are able to gain valuable experience in paediatrics – and in understanding the hospital through the eyes of a child patient and their family. Developing the skills to communicate with children who are hospitalised takes time, and the PEP provides the opportunity to observe, communicate and engage with child patients through use of performance and interactive techniques learnt from observing musicians with specialist training in the field.
As one of the students observed: “I was also exposed to the numerous considerations that a musician has to make when playing on the wards, from body language and position, to being constantly aware of the patient’s reaction and desire for music, to knowing one’s place when on the wards. Despite having the best intentions, musicians must always respect the patient’s wishes and foster their sense of control, especially when they have no say in their illness progression.”
This year student Alison Haigh used her experience to directly inform her clinical learning. Her PEP project focused on the how music can relieve anxiety in hospitalised child patients. She composed a song directly informed by observing and then participating in musical activities on the children’s wards with the musicians. She describes her learning process:
“I realised that children in hospital meet a lot of new people each day from the multi-disciplinary team that cares for them. I wrote “Say Hello” to try and alleviate some of the anxiety around meeting new people in hospital for children, through the medium of music. The lyrics describe meeting and greeting people and encourage the children to wave along and say hello. I presented the lyrics with some cartoons about meeting common members of staff, so children who cannot read could look at the pictures to help them understand what the song is about. When we first played the song on the ward the children waved along and relaxed with the music just as I had envisaged. It was immensely gratifying to see the smiles on their faces and their parents too. The children also added their own percussion to the song as it was played, encouraging interaction with the song and its message.”
The PEP provides a unique opportunity to explore the roles and relationships brought together through the hospital experience and our own perceptions of health and ill-health. It reminds us all that positivity can be created within the smallest of responses and in the shortest of interactions. It reminds us too that the process of healing is multi-faceted.
The reflection of one of our students sums this up: “There has always been such a divide between the arts and science, as if these were two opposing fields that could never integrate. This placement has been incredibly eye-opening in that it changed my perspective and I saw that there was not only an essential link between the two worlds but that they each had unique benefits to offer to the other.”