music is frequently the only form of entertainment. Music can be
used at the bedside, in the ward, the assembly hall, or when
weather permits, outdoors. In hospitals equipped with public address
systems the problem is decreased by the simultaneous performance
of mechanically reproduced music throughout the wards and rooms of
the hospital. Where public address systems have not been installed,
entertainment will depend largely on radios, record reproducers, and
personal appearances of musicians.
“Live” musicians are the most welcome source of entertainment. If the
hospital has a music aide, this aim is partially fulfilled by his
activities. If there is no full time musician, hospitals may be able to
secure the part-time services of a musician or recreational aide. Some
one person should have control of arranging programs, and an interested
person will usually be found on the hospital staff. It may be an
occupational therapist, a nurse, or even one of the physicians. The
person selected to direct music will have little difficulty in finding
in the community some musicians or groups of amateur entertainers who
will be willing to assist in this work. Groups from schools of music,
high schools, fraternal or benevolent organizations, women’s clubs,
music clubs and veteran’s societies constitute an incomplete list of
sources. Most communities have soloists or small groups which will be
willing to perform. Direct solicitation by the hospital director, the
ladies auxiliary, or members of the staff should be made personally or
through the press.
A schedule of performances arranged for at least one month in advance
is most important. There should be a regularity to performances even
if they occur only once a month. It will give patients something to
which they may look forward with the pleasure of anticipation. Whenever
possible, musical programs should be prepared for the same weekday or
night. These appearances should be announced or posted to increase the
interest.
In hospitals for the chronically ill there is usually an assembly
hall or recreational building, where entertainment may be given for
ambulatory patients. The appearance of famous musicians on its stage
will be rare or impossible, especially in hospitals not located near
large cities. This is not as unfortunate as might be believed, because
although some patients are impressed with names of national reputation,
maximum enjoyment will result for the majority from listening to their
fellow patients performing. Patient participation is always more
desirable for the ambulatory than passive entertainment. Patient music
may take one of three forms--formal, amateur, or spontaneous.
Formal presentations require much work on the part of the musical
aide and the patients. Orchestras of variable size may be formed,
depending upon the number and variety of talented patients. Inasmuch
as quality of performance is the prime consideration, the repertoire
of such groups will not be great. At the outset it will take almost a
month to develop a one hour variety program. With the progress of time
and increased work and co-operation it should be possible to rehearse
enough new numbers each week to produce a weekly program with too few
repetitions to arouse complaints on the part of the patients. The
program should contain all types of music so that during the course of
a performance almost everyone in the audience will have heard something
to his taste. Vocal numbers are welcome and audience participation at
one or two points will sustain interest. It is advisable for some one
to act as master of ceremonies to announce selections and to evoke
maximum response from the non-participating patients. There is usually
one patient with a desire to be a master of ceremonies and, if he
executes his work well, this will be a valuable asset to the project. A
master of ceremonies is important and if necessary an outsider should
be secured for this purpose.
Amateur programs have been present on the American scene for a long
time but the efforts of Major Bowes have made them an American
institution. People of almost all ages will attend them joyfully,
but the performers will usually be in the second and third quarters
of life’s span. There was a time when amateur performances were
unrehearsed or sounded so. Major Bowes has changed that, too.
The amateur show will now be found to demand rehearsals, expert
accompaniment, and a certain amount of theatrical display. These
factors should be encouraged and the music aide will do well to humor
patients along, because success depends upon the seriousness, energy,
and efforts of the performer. Care should be expended in careful
programming. The best performers should be well spaced and appear in
the second half of the program. Instrumentalists should be separated
by vocalists. The procedure should follow the set pattern of regular
amateur shows, including the award of prizes to the winner and second
best. Where patient turn-over is slow, it is likely that the same
performer may be first too often. Some limit should be set on the
frequency or total number of times the same patient may receive an
award to prevent participation from diminishing.
Spontaneous shows in the recreation hall will consist of community
singing, humming, whistling, and occasional rhythmic hand-clapping.
It is not difficult to get a group to sing but maximum response will
call for ingenuity on the part of the leader. The series of motion
picture shorts called “The Bouncing Ball”, “Community Sing”, and
others of a similar nature are excellent because they are complete
packages of music, words, direction, humor, and tricks. The song leader
should adopt as many of the novelties included in these films as the
facilities will allow. Next best to the motion picture is the lantern
slide. There are a few available with humorous illustrations, but they
may be difficult to obtain. Lantern slides may be made rapidly and
inexpensively by the music aide. The makings of simple slides may be
had in any large commercial photography supply shop. “Radio Mats” are
slide-sized pieces of clear cellophane enclosed in a folded piece of
carbon paper and surrounded by a black mask. The “Mat” is placed in a
typewriter and the words of the song are typed on it. The carbonized
paper is discarded, as is the back of the mask, and the cellophane with
words imprinted is easily mounted between the two glass cover-slips
joined by “Scotch Tape”. By this method a permanent slide may be
produced for about eight cents. If a projector is not available, the
words may be mimeographed, printed in the occupational therapy shop,
or obtained commercially printed in pamphlet form. The salient need is
that all may be permitted to read the words.
Community sings should not last too long. The music aide will soon
learn to sense the capacity of the audience. To extend the period,
patient participation may be interrupted by instrumental music or some
other form of interlude.
CHOIR
Listening to a combination of trained voices is pleasurable to most
people. Where the patient population is relatively static, the music
aide will be well repaid by time spent on training quartettes or larger
groups of singers. Such groups can be of value not only in any of the
musical programs for the assembly hall but may be used on the wards,
for religious services and on holiday occasions. If, as is usual, both
sexes are represented among the patients, the range of selections will
be limited only by the musicianship of the leader and the participants.
The range of repertoire should be suited to all occasions and tastes
from “barbershop” quartets to serious music.
All possible arrangements of voices should be exploited with a view
to competitive singing between sexes and among wards. The range of
usefulness of this activity will of course depend to a large extent on
the size of the hospital and the predominant age group.
DIVERSION
Music may also be used to help time pass less noticeably. Listening is
enjoyable but does not focus or sustain attention in any way comparable
to playing. There will always be patients interested in learning to
play music. The instrument of choice will depend upon individual taste,
which of course is conditioned by background, education, nationality,
age, and many other factors. The instruments which will be most
acceptable are those which are not too difficult to play and which emit
a pleasant sound with ease for a long period.
The piano is the instrument which best meets the qualifications of the
ideal instrument for hospital use. When reduced to pure physics, the
sound produced by striking a single note on the same keyboard will
be of approximately the same quality whether made by a child or a
virtuoso. This is not true of any other instruments, except to a degree
in certain other percussion instruments, that produce less pleasant
or interesting sounds. Piano fingering is more easily mastered than
that of stringed instruments, and offers greater latitude in precision
placement. The piano may be played in the restful sitting position
and requires little effort to play. More people know how to play the
piano than any other instrument. Patients may be interested in any of
the other instruments, but with the exception of the plectrum type,
may become too readily discouraged at the amount of practice required
to elicit pleasant tones. If a patient is interested in learning an
instrument for diversion, the piano should be the first offered. If
the problem of replacing musicians in or completing a patient band
arises, the missing instrument should be offered. But in order to
get the maximum co-operation and application, the patient should be
made to feel that the choice is his. The free choice might be vocal
instruction. It may even be a disappointment to the musician when
it turns out to be so-called instruments like the ocarina, but if
the aim is diversion a maximum will be reached earliest by initial
gratification. Perhaps at a later date the music aide may be able to
inculcate enough sophistication to lead to the choice of a more musical
instrument.
The scope of music as an educational diversion will expand in
proportion to the training, patience and energy of the music aide.
It will be limited by the number of patients who demonstrate an
interest and also upon their intelligence and perseverance. For the
major instruments, instruction is usually individual and much time is
consumed in the diversion of a single patient. In a large hospital
this will not be very practical unless there is a large staff, and
there are many activities available to patients. Group diversion can
be happily attained by some form of instruction in music appreciation.
The nature of this instruction should be tailored to the intelligence
and taste of the majority and the music aide must exercise common
sense and free himself of prejudice. If the patients are young and
uninterested in the classics he must devise a program around popular
music and discuss current personalities and popular forms. A driving
wedge into the classics may be constructed on the classic themes of
Tschaikowsky, Chopin and others which are currently popular. If the
group is very young, music appreciation demonstrations such as those
conducted by Walter Damrosch should be followed. Whenever possible, the
musician should illustrate with “live” music, but recordings will be
well received. As with all other features of a musical program in the
hospital, sessions should be regular and governed to some extent by the
will of the majority.
_CHAPTER NINE_
PUBLIC ADDRESS SYSTEM
Many hospitals now have public address systems. Before long most
hospitals of one hundred or more beds will have public address systems,
if for no other reason than emergency calls and to lessen the load on
the intramural telephone network.
The public address system originally installed as an emergency call
device may be used for music reproduction at relatively little
increase in expense. The same operator may be used for both forms of
transmission. Ideally, the system should include a loud speaker in
every ward and a “phone-jack” at every bedside. The central switchboard
should have a good radio and an automatic record player which may
transmit music to the patients by means of the public address systems.
The addition of a set of switches which can cut wards in or out at
will can prove most useful. If there are halls or buildings from
which programs of general interest emanate frequently, they should
be equipped with microphones which are connected with the central
switchboard so that musical programs from the assembly hall or the
church services from the chapel may be broadcast to the non-ambulatory
patients.
The central switchboard should be housed in a relatively sound proof
room or booth. Additional equipment for it should include shelves for
recordings and a telephone for which the usual bell signal is replaced
by a light signal. An instantaneous record-cutter which permits the
operator to record programs from the radio or microphone will be found
of great value, but the expense involved may be too great for most
hospitals of fewer than 500 beds.
It is most advisable that a full-time operator for the system be
employed. The operator should have a pleasant voice, but even more
important, a highly intelligible one. He will require some basic
training in the operation of the switchboard and its accessories and
this should be the obligation of the organization which installs the
equipment. The operator should be required to keep a written record
of everything that emanates from the studio. He should be responsible
for the routine care of the apparatus and know enough about its parts
to recognize defects early and to correct some of the simpler ones. He
must be prepared to live a lone life. There is always a temptation to
invite or permit guests in the studio, and the resultant diversion or
conversation might adversely affect the broadcast.
If an instantaneous record cutter is available he should read “_How
to Make Good Recordings_” (Audak Co. of New York) which is not only
valuable for the recording of music but gives some excellent advice
concerning the use of the proper needle for music reproduction and the
use of the microphone.
PROGRAM
_Music._ The public address system should be operated on a rigid
schedule in imitation of a commercial radio studio. This is necessary
because the patients will come to expect certain features at specified
times of the day and fluctuations may result in disappointment and
reduced morale. The program policy should be the direct concern of the
hospital superintendent and any service chiefs who are interested.
The hours of use will vary considerably with the individual hospital
from a few hours to a very full program. Because of the great number
of possible variations, some general applications will be considered
first and then a model program will be suggested.
The hour of awakening for patients may vary from about six to seven.
At some time during that hour, a program of exhilarating music is
indicated to start the day off right and perhaps get better cooperation
between the patients and the nursing personnel in morning care. To this
end, military or other marches are suggested as well as gay melodies,
because as Seashore[73] has shown, “pronounced rhythm brings on a
feeling of elation,” and martial music is traditionally stirring. This
program should last from fifteen to thirty minutes, and should be
followed by silence for at least fifteen minutes before breakfast is
served. It is unwise to begin eating while too stimulated.
During the breakfast, luncheon and supper periods, mealtime music
should be broadcast for the entire duration of the dining period.
The nature of mealtime music may be the same for all meals. This is
discussed in Chapter VII.
The period between eight and ten in the morning is frequently reserved
for routine dressings or medical rounds and a period of silence should
be observed in the wards during the hours of maximum professional
services. Obviously, music should not be broadcast at any time during
the day when rounds are held. The operator should be supplied with a
schedule of ward rounds and cut out those wards which are concerned.
The duration of rounds will vary from very brief periods on the
surgical wards to prolonged ones on the medical wards. Soon after
rounds the operator should broadcast to wards on which no regular
activity is taking place. A half hour program of request music in the
morning between ten and eleven is suggested. This should be followed by
the pre-meal period of silence.
Where desired, luncheon music should be followed by restful or very
soft music. If the blinds are drawn and silence among patients is
maintained maximum benefit will result. Those patients who can fall
asleep readily at this time will do so. Those who find it impossible to
nap in the afternoon will be grateful for the diversion of music which
will permit greater relaxation. It is more difficult for some people to
rest in absolute quiet than with soft background music.
Another request program of music lasting one hour may be begun between
two and three o’clock. It is advisable to mention specific names of
patients who request music to stimulate patient interest in communal
participation and listening. During the evening hours following supper,
it is suggested that the most popular radio programs be transmitted
over the system. These should be chosen on the bases of Hooper or
Crossley ratings so that the greatest number of patients will be
satisfied. When more than one channel is available, the second program
selected should be of a different nature from the first.
_Announcements._ Announcements should be kept to a minimum. Routine
announcements should be made at specified hours daily, such as after
breakfast, before lunch, and after supper. Emergency calls should
be limited to genuine emergencies or they will not be regarded as
compelling, as they should be.
Newscasts are a much appreciated and desirable feature for patients
who, until their admission to the hospital, may have read or listened
to the news daily and will want to keep up with it. The newscast should
be given in an unsensational manner and news which is too depressing or
exciting should be deleted or reworded, for psychiatric patients.
_Special Programs._ There should be a weekly religious program sent
out over the system for those in bed. The minister affiliated with the
hospital should be able to fit the hospital into his Sunday morning
schedule. If no minister is available, a regular radio program should
be rebroadcast, but a Sunday service of local origin will be more
personal, and therefore will be more appreciated. There are many
suitable religious recordings available for incidental service music,
particularly the series of albums pressed by Bibletone.
Holidays should be observed by the reproduction of appropriate music or
radio rebroadcasts.
For the small hospital with limited personnel a two-channel system
continuously tuned to the two most popular networks locally available,
should be used.
_CHAPTER TEN_
EQUIPMENT AND LIBRARY
A hospital which wishes to use music as an adjunct to medical practice
must be willing to offer the space required for its activities. The
extent to which music will be needed will depend upon the nature of the
illnesses treated and the average stay of the patients. For mental and
tuberculosis hospitals, music is a “must.” The chronic hospital usually
has an assembly or recreation hall for musical performance. This hall
will generally be adequate for band rehearsals, and may also be used at
other hours of the day for instrumental practice. Where funds and space
can be spared, additional rehearsal rooms should be built so that more
patients will be able to participate. Space can be saved by building
small cubicles sound-proofed with any of the sound absorbing fabricated
wall boards such as _Celotex_ or _Transite_. Cubicles should be built
with much glazing so that the patient will not feel the smallness of
the room. If there is only one music aide, there will be an advantage
in centralizing all music activities, but if more help is available,
music rehearsal rooms should be available in the different pavilions or
wings of the hospital so that newly convalescent patients will not have
to walk too far.
If the age range of the patients runs the full gamut, seating and
instrumental provisions will have to include provisions for all. This
means adjustable piano benches, music stands, etc. Chairs should be
provided not only for musicians but spectators. Patients should be
encouraged to attend band and other group rehearsals as a method of
stimulating their interest in music and for the diversion which it will
afford. Music stands for the bands should be dressed up to resemble
those used by popular bands. These stands are colorful, collapsible,
and hence transportable for any outside performances which the patient
band may contract.
INSTRUMENTS
_Participation._ The number and nature of instruments which a hospital
should have will depend only upon budget limitations and the interest
of the community. There is no limit except storage space to the number
and variety of instruments which a hospital should accept as gifts.
Ideally there should be at least one of each of the major instruments.
Each instrument should have its own case, and it is wise to engrave the
hospital name on each instrument to minimize loss. The initials of the
hospital may be cut into an inconspicuous part of the instrument such
as the inside of the brass bell or the under side of the wood body. All
the instruments should be locked in cabinets when not in use.
In addition to regular band instruments, small instruments which can be
played in bed should be acquired. These can be divided into those of
normal construction such as the ukulele, mandolin, and autoharp and the
toneless instruments which can be made by removing the resonating body.
A toneless violin can be constructed from a donated violin in poor
condition by mounting the tailpiece, bridge, and fingering element on a
narrow strip of wood or plastic. A piece of rubber “kneeling” pad makes
a good practice drum head.
For children toy instruments such as the Typatune, the toy-xylophone,
trumpet, maracas, etc. should be available.
_Listening._ A room should be designated as a “Music Listening Room.”
For economy of use this may be a multi-purpose room. It may be a
combination of the music aide’s office and musical library used at
selected hours of the day for both practice and listening. It should
contain an instrument for playing recordings. The choice of record
player should depend upon the sound produced by the instrument rather
than its name. The record player for the listening room should have an
automatic changer and wide tone control if possible. Because of the
excellence of many musical broadcasts a combination radio-record player
is most desirable.
Portable record players are also desirable for the bedside listening
of those who request it. In hospitals not equipped with public address
systems, the portable record player can act as an excellent substitute
for it. If the player is mounted on a cart fitted with shelves for
records and albums, it can be wheeled from one ward to another for
daily musical periods. If the hospital has small-sized lantern slides
with words to songs imprinted (such as those supplied Service groups
during the war by the USO), a small slide projector should be added to
the music cart to be used on the darkened ward for ward songs.
THE MUSIC LIBRARY
The hospital music library may vary from a few recordings to a
composite collection of all forms of musical literature available.
General hospitals which treat all diseases and age groups will
require the most extensive and catholic varieties of all kinds of
music. Specialty hospitals can operate on a library tailored to their
individual needs. A hospital for the aged will not require too much
of contemporary popular music. For purposes of inclusiveness, the
ideal will be discussed in the hope that some hospitals will be able
to afford it and that others will be able to select those items which
become possible for them.
_Recordings._ The choice of recordings will be determined by the usual
hospital population. In building up the record library the music aide
should submit check lists to every patient in the hospital on any
one day. The list should include ten specific titles in each of six
categories: symphony, opera, operetta, folk-songs, old-time favorites,
and the currently popular songs. These should be carefully tabulated
and should be used to form the nucleus of the permanent collection. A
space should be left for patients to write in other pieces than those
named. Records should be purchased in the order of their numerically
recorded popularity. A collection should begin with one record per
hospital bed. This method of starting a library is very tedious but
well worth the effort, because only by determining the musical tastes
of patients can you give the majority the music they want. The musical
tastes of the patients will not vary significantly after a complete
turn-over in patient census, since most hospitals derive their patient
population from the same geographic area, and the tabulation of musical
desires arrived at in this manner will correspond satisfactorily with
the tastes of the same age group in the community. If the budget will
not permit an original collection of this size, it might be reduced to
half of that recommended, but that is a minimum.
The collection should be built up at a rate of approximately one record
for every ten new patient admissions. The choice of additional records
should be on a request basis, but the proportion of the six categories
as originally determined should remain relatively constant to keep the
collection balanced.
Whenever there is a choice of two or more recordings of the same piece,
the discs to choose are those which are played softly or sweetly so
that they are adaptable for the additional purpose of mealtime or
restful music.
In the library of recordings there should be included albums of
records for special occasions and holidays. Patients look forward to
hearing Irish songs on St. Patrick’s Day and appropriate songs on
other holidays. To accompany religious services the albums prepared by
Bibletone are valuable. A glance through any standard record catalogue
will readily permit the music aide to assemble a suitable collection.
The following is a list of records suggested for Easter Sunday and St.
Patrick’s Day.
Easter Recordings:
I Want a Bunny for Easter Decca 18654 A
Easter Sunday With You Decca 18591 B
Easter Parade Decca 18425 B
Easter Sunday on the Prairie Decca 18654 B
Chorale for Easter Cantata Victor 15631 B
Requiem, by Gabriel Faure Victor 18301, 2, 3, and 4
St. Patrick’s Day:
Molly Brannigan Columbia 35496
That’s How I Spell Ireland Columbia 35496
Come Back to Erin Victor 27770 B
Mother Machree Victor 27772 A
Eileen Columbia 36585
A Little Bit of Heaven Sonora 1069 B
You’re Irish and You’re Beautiful Sonora 1068 A
Irish Lullaby Decca 18621 A
Same Old Shellalagh Columbia 354986
Macushla Victor 27770 A
I’ll Take You Home Again Kathleen Sonora 1067 B
Little Town in Old County Down Sonora 1070 B
All recordings should be kept in their albums or jackets. Because
jackets have a way of getting lost or torn, there should be a stock of
unused jackets on hand. Each jacket should be labelled according to its
contents. In addition a cross-index catalogue file should be maintained
by the music aide for all records in the hospital collection. Three
cards should be filled out for each face of each record: one card for
composer, one for title, and one for performer. This seems like a lot
of work but is worth the effort because it is only in this manner that
a program can be rapidly assembled from the record library. Any filing
system will suffice, but if the collection is large, an elaborate
system will be found worth the effort. Cards of three different colors
may be used to separate classical, popular and miscellaneous. Tabs may
be placed on those cards which list music for occasions. Tabs in one
corner may refer to meal-time music and tabs in another holiday music,
etc.
It is well to have the entire record collection in one room, and
shelves for holding records should be built of very heavy lumber
because recordings when closely packed are very heavy. It is best
to add records to shelves with continuous accession numbers in each
category and to rely on the file for alphabetic listing. If there
are duplicates, they can form the nucleus for a second or lending
library. Broken, cracked, or defective discs should be placed in a
separate section of the shelves for replacement when budget permits and
popularity demands.
_Instantaneous Recordings._ A few hospitals will have the good fortune
to acquire a record-cutter for hospital recording of radio music.
When this is possible, the record collection can be augmented most
satisfactorily. The music aide should study all radio programs to
determine the hours during which the best performances of desired
music are played. By listening to several carefully selected programs
each week he will soon discover which programs use music employed in a
manner most desirable for hospital reproduction. The orchestrations of
Kostelanetz and Lombardo are especially suitable for easy listening in
the field of popular music. The broadcasts of the Metropolitan Opera
Association include passages not commercially recorded or at least not
recorded with the most popular singers. There are many other radio
features which are worth recording for the hospital record library.
It is relatively easy to operate a record-cutter, but there are many
minor details which must be known for maximum efficiency. An excellent
book for beginners is that published by the Audak Company of New York,
_How to Make Good Recordings_.
_Sheet Music._ A library of sheet music will once more depend upon
the local needs. It may include orchestral, instrumental, vocal, and
band music. In the hospital for the chronically ill, a large number of
varieties will be needed. Inasmuch as the simplest group performance
will be vocal, music for group singing should head the list. The music
should include old-time favorites, hymns, spirituals and any other
items which the aide can determine from the intellectual and musical
qualifications and desires of the patients. This type of music can be
purchased individually and increased according to the interest shown.
If there is a patient band, the musical scores should include a few
marches which may be used at the beginning and end of its concerts.
The perennial favorites most desirable for community singing should
constitute a major portion of the orchestral literature. The readily
available medleys of Victor Herbert melodies and similar stand-bys can
complete the initial group.
Sheet music should be catalogued and filed in cabinets. A simple system
of shelving consists of grouping music according to use: one shelf
for group playing, one for solo and beginners instrumental books, and
another for vocal selections. The numbers most commonly and currently
used by the band can be placed in folders according to the accepted
usage among bands, and if there are daily rehearsals they can remain on
the band stands at all times.
The library should also contain books, printed forms, or mimeographed
collections of songs for distribution to patients during community
singing.
_Books About Music._ The average hospital library will have relatively
few books about musical appreciation or history. This will depend
first on the budget and second on the demand. The addition of a music
aide to a hospital staff will usually increase the demand. The music
aide should be consulted concerning the books he thinks will appeal to
patients. Books on music should also be available to help the music
aide in preparing commentaries on the music he plays for the patients.
The following are some books suggested for inclusion in the hospital
patient library:
Copland, Aaron--_What to Listen for in Music_, 1939.
Goss, Madeline--_Unfinished Symphony_, 1941.
Elson, Arthur--_Music Club Programs From All Nations_.
Erskine, John--_What Is Music_, 1944.
Ewen, David--_Tales From The Vienna Woods_, 1944.
Ewen, David--_Gershwin’s Life_, 1944.
Ewen, David--_Men of Popular Music_, 1944.
Gronowicz, Antoni--_Chopin_, 1943.
O’Connell, Charles--_Victor Book of Opera_, 1936.
Taylor, Deems--_Of Men and Music_, 1945.
Taylor, Deems--_The Well Tempered Listener_, 1944.
Siegmeister, Elie--_Music Lover’s Handbook_, 1943.
Spaeth, Sigmund--_At Home With Music_, 1945.
For young patients there are the new series of colorfully illustrated
lives of composers from Bach to Gershwin by Waldo Mayo, as well as a
great number of old and good titles.
_CHAPTER ELEVEN_
DIRECTION
The introduction of music into the hospital will depend not so much
upon its proven value as an aid to medical practice as upon the
interest of someone on the staff who loves music or recognizes its
importance in the mental hygiene of the patients. There are many
reasons for the absence of music in some hospitals which may seem
difficult for the musician to comprehend. The acceptance of a music
program in a hospital calls for increased budget and space. These are
two items which constantly beset the hospital director and they are
sometimes matters of improbable solution. For the chronic type of
hospital the problem must be solved. Other drawbacks are found in the
contemplated interference of medical and nursing procedures. Hospitals
are traditionally havens of quiet and the uninformed hospital director
or his staff may envisage a conversion to a three-ringed circus of
sound. The progress of music in hospitals will depend largely upon the
ingenuity and intelligence of existing organizations and the examples
they can set for prospective hospitals.
The musical program of a hospital need not necessarily be conducted
by a musician, but a trained person is most desirable. There are
people with an intense love for music and so comprehensive a grasp of
its many fields that they might be capable of conducting a hospital
program although unable to play an instrument. At some institutions
music has been guided by volunteers with great satisfaction to staff
and patients, but this is an age of specialization and a paid, trained
musician will usually be worth the salary in efficiency, dependability,
and control.
DIRECTOR
Music for patients differs from music for the well. The average
musician is not qualified to decide which patients should or should not
have music. There are too many well meaning musicians who have had one
or two personal experiences or heard of others in which the efforts of
the musician were rewarded by apparent miracles of mental reaction.
Musicians are not capable of evaluating such changes nor do they bother
to recount what the condition of the patient was an hour or a day after
this personal exposure. Musicians must have medical direction. The
medical director of music does not have to be a trained musician but
he should be acquainted in a general way with most musical forms which
appeal to a majority of patients. His most important qualification will
be the ability to rise above personal prejudices of musical taste. He
must recognize that musical tastes can be as diverse as individual
appetites for different foods, and feel free to order music as he
would food for patients. It will be his duty to prescribe quantity,
quality, duration, and intervals of music; to contraindicate music for
the irritable, certain post-operative patients, the acutely ill, and
any others for whom he thinks music is wrong. It will be necessary for
him to protect the patients from the possible musical whims, hobbies,
convictions or over-enthusiasm of the musical aide.
The director should be selected from volunteers on the staff. For the
physician director of music to be chosen in any other way is to hamper
the musical program. He must be a physician who has the time or can
make the time to carry out his part adequately. At the outset the
director should have daily conferences with the senior musical aide in
which he should not only outline the procedures desired but should
observe the musician at work with patients.
MUSIC AIDE
There is considerable disagreement concerning the title most desirable
for the person conducting music in the hospital. The term “musical
therapist” implies a training not only in music but in treatment. The
occupational therapist has had a training not only in crafts, but
in basic medical subjects, psychology, and some clinical subjects.
Until musicians can take similar courses at accredited schools a
different title seems wiser. At some hospitals the workers are called
recreational aides, but such people also conduct other recreational
activities. It seems picayune to argue over terminology, but the
hospital music worker must be called something and it is hard to
conceive that anyone would find fault with the appellation “music aide”
for those people who bring music to the patient.
A music aide may be of either sex and of any age. The choice
will depend not only upon what is available locally but on
such considerations as the personalities involved and personal
recommendations. If intelligence is not exercised, the program will
fail because the senior music aide is the keystone of the entire
structure. For a children’s hospital, a woman who has raised children
would seem most suitable. The aide for children should be able to sing
and play the piano. She should also be able to play musical games with
children.
For a hospital of young adults, such as the average hospital for the
tuberculous, a young woman between thirty and forty will have the
energy, drive and spirit to match the requirements and contemporary
tastes of the patients under her care. The aide for this type of work
should also be able to lead group and mass singing and be able to play
an instrument. Ability to play a second instrument, or to teach it is a
valuable asset.
For the mental hospital an aide should be mature, patient, well
informed and have the urge, but not the preformed opinions, for
handling the mental patient. For the hospital treating the aged or
other chronic patients, an older man or woman is desirable.
It is preferable for any aide to have had some formal musical
instruction. Most desirable is a graduate of a musical conservatory
or of a college which offers a major in music. The music aide should
play at least one instrument, and preferably the piano. If the hospital
budget permits additional music aides each successive one should know
another instrument. The aide should be able to play music at sight and
sing with an acceptable voice. The chief qualification should be the
absence of “artistic temperament.” Patients are admitted to a hospital
for medical care, not musical knowledge. The aide should not consider
them as music students. Music should be given to them with patience and
without undue emotion. If music evokes a marked mental response it may
be beneficial, but it should be the music and not the musician which
elicits such reactions. Previous experience in teaching music is a
valuable asset to the music aide.
The duties of the music aide will vary with the number and type of
patients. In hospitals with a large number of ambulatory patients
emphasis will be placed on group activities; in hospitals where
children predominate music will be used largely as diversion, in
games, dancing and other bodily activities called “rhythms” which is a
development of Eurhythmics.
Under the supervision of the medical director, the music aide should
outline a definite schedule of musical activities and adhere to it.
This will require much preparation and the best hours for preparatory
work will be those during which patients are resting, sleeping, or
receiving active medical and nursing care. The preparation will include
maintenance and cataloguing of instruments and the medical library;
tabulation of patient requests for instruction, books and recordings;
programming for concerts, ward songs and the public address system;
correspondence with musicians and musical groups in the community;
ordering of equipment and music; and scheduling.
The schedule should be patterned to fit into the hospital routine. The
first hour of the day should be reserved for preparatory activities.
Individual instruction in music may be given from nine until ten. At
ten the music cart may be taken to the wards until mealtime. Following
the meal hour, the aide can prepare for the afternoon ward visits.
Recreation Hall activities or the listening room may be scheduled for
the period of two to three. Three to four-thirty may be used for ward
entertainment, either with the music cart or with portable instruments.
On one or two nights a weeks, an hour or more may be set aside for the
hospital concert or a music appreciation hour.
TRAINING
At present, no accredited school of music or medicine offers a compete
course of instruction leading to a degree in music in medical practice,
or a major in that subject. It is believed that eventually the demand
may bring about the establishment of such a course in a musical
college, where it belongs. It will be necessary for the school of music
to secure liaison with a medical college or school of occupational
therapy and this will limit instruction to those cities where grade
A institutions of both kinds are to be found. There are at least ten
cities scattered throughout the United States in which this happy
combination may be found, but there is hardly need for more than six.
Applicants should be interviewed by a representative of both the
medical and music schools. A projected curriculum is suggested as
follows:
_First Year_
Piano 8 Credits
Solfège 5 Credits
Counterpoint 2 Credits
Harmony 2 Credits
English 6 Credits
History of Medicine 1 Credit
_Second Year_
Piano 4 Credits
Solfège 2 Credits
Harmony 2 Credits
Counterpoint 2 Credits
History of Music 4 Credits
Nursing anatomy 6 Credits
_Third Year_
Violin 4 Credits
Harmony 4 Credits
Musical Form 4 Credits
Physics 6 Credits
Physiology 2 Credits
Kinesiology 2 Credits
Psychology 4 Credits
Conducting 2 Credits
Piano Sight Playing 4 Credits
Ensemble 2 Credits
_Fourth Year_
Violin 4 Credits
Choral Class 0 Credits
Conducting 2 Credits
Contemporary Music 4 Credits
Occupational Therapy 4 Credits
Music in Medicine 6 Credits
Abnormal Psychology 6 Credits
Orchestra Reading 2 Credits
A brief explanation of courses not normally found at music schools and
which should be given at medical or professional schools follows.
_Anatomy for Nurses._ This should consist of a brief survey of the
anatomy of the human body with especial reference to the muscles,
nerves, brain, and a casual introduction to the internal organs.
_History of Medicine._ This would be an orientation course on the
development of medicine and hospitals.
_Physiology._ Especial attention should be drawn to the physiology of
the nervous system and the muscles.
_Psychology._ Normal psychology, including laboratory experimentation
in the psychology of music, would be the basis of this course.
_Kinesiology._ The standard course as taught in schools of physical and
occupational therapy, and physical education, would be sufficient.
_Occupational Therapy._ An introduction into craft analysis and
psychiatric occupational therapy is necessary.
_Abnormal Psychology._ An introduction to psychiatry is sufficient.
_Music in Medicine._ A course of lectures, including the subjects
discussed in this volume, should be offered.
In the summer between the third and fourth years, the student should
be affiliated with a hospital with a music program to work under the
hospital staff.
These are suggestions only, and each school in consultation with an
approved medical college will want to work out its own schedule. It is
hoped that the above outline will be of definite assistance.
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INDEX
Aesclepiades, 6
Aide, duties of, xvii, 121
Aide, qualifications of, xvi, 120
Albrecht, Wilhelm, 11
Alcoholic psychosis, 63
Altschuler, I., 60, 66, 68, 69
Amateur shows, 101
Amphion, 2
Analysis, instrumental, 57
Anesthesia, use with, 75
Ankle exercise, 54
Appetite, musical, 42
Apollo, xi
Aquinas, St. Thomas, 42
Areteus, 8
Aristotle, xi
Armstrong, John, 1
Arteriosclerotic psychosis, 64
Atheneus, 6
Aurelianus, 6
Avicenna, 74
Background music, 73
Bacon, 8
Band, patient, 70
Beacham, H., 9
Beaunis, B., 17
Beckett, W., 79
Bedside instruction, 95
Beethoven, L., 29
Bites, treatment of animal, 7
Boerhaave, H., 8
Books about music, 117
Brocklesby, R., 12
Bücher, K., 19
Butler, Nicholas M., xii
Calisthenics, music for, 76
Capella, M., 6
Carle, F., 86
Cart, music, 94, 112
Catatonic schizophrenia, 66
Cato, 5
Cavallero, C., 86
Celsus, A. C., xii, 8
Champlain, S., 11
Chateaubriand, 2
Children, music for, 90
Chiron, 5
Chomet, Hector, xix, 12
Chopin, F. F., 30
Chronically ill, music for, 98
Color in sound, 28
Community sing, 69, 101
Confucius, 5
Counter-irritation, 74
Criteria of therapy, xiii, 61
Crosby, Bing, 18, 91
Curriculum for aides, 123
Dalcroze, J., 76
Damon, K. F., 28
Dancing as exercise, 78
David’s Harp, xi, 5
De Marian, 28
Democritus, 11
Densmore, F., 3
Dentistry, music in, 75
Desault, P., 7
Direction of hospital music, 118
Diserens, C. M., 42
Dorian mode, xi
Duchin, E., 84, 86
Duration, effect of, 18
Dunlap, K., 19
Easter music recordings, 114
Eby, Julia, 67
Egyptian use of music, 4
Emotional response to music, 32
Enjoyment of music, 32, 39
Epilepsy, music in, 8, 11
Eurhythmics, 77
Exercise, effect of music on, 75
Exercise through music, 50
Expectation, role of, 27
Factory, use of music in, 79
Faith, Percy, 86
Farinelli and Philip V, 10
Fatigue, effect on, 76
Flute, the magic, 11
Functional Occupational Therapy, 45
Galen, 7
Gaston, E., 59
Gatewood, E., 79
Gehring, A., 28
Gellius, A., 6
General paresis, 63
Gilman, B., 30
Goldman, Edwin Franko, 31
Good music, 38
Grosseteste, R., 8
Group singing, 69, 101
Gundlach, R., 18, 26, 34
Gurney, E., 21, 25, 31
Hanson, Howard, 26, 27
Harrington, A., 69
Hauptmann, M., 20
Head-phones vs. loud-speakers, 93
Hebrew use of music, xi, 5
Heinlein, C. P., 17, 22
Helmholtz, H. L. F., 20
Hevner, K., 22
Homer, 5
Hulbert, H., 77
Hydrotherapy, music and, 66
Hysteria, 68
Imaginal response to music, 37
Indian, American, 2, 34
Industrial music, 79
Instantaneous recordings, 106
Instrumental analysis, 57
Instrumental instruction, 103
Iriquois practice, 3
Intensity, effect of, 17, 22
Jacobson, E., 19
Jaw fracture, music in, 58
Jerrold, D., 86
Johnson, M., 77
Karwarski, T., 28
Key, effect of, 23
Kostelanetz, A., 86
Kraines, S., 69
Lacedemonian music, 5
Lantern slide preparation, 102
Levine, M., 69
Library of music, 116
Listening to music, 36
Live music, 34, 96, 99
_Loca dolentia decantare_, 6
Lombardo, Guy, 86
Lower extremity exercises, 53
Luther, Martin, 3
Lydian mode, xi
Manic-depressive psychosis, 64
Mealtime music, 82
Medical direction, 119
Medicine man, 3, 4
Melancholy, involutional, 64
Melody, effect of, 19
Mendelssohn, F., 30
Mental deficiency, 71
Mental disease, 9
Mental disease classification, 62
Mode, effect of, 20
Mood effects, 17, 22, 32, 40
Morale, effect on, 7
Mozart, W., 11
Mursell, James, 18
Music aide, training for, 123
Musical therapy, ix, xviii, 57, 61
National Music Council, xiv
Nearchus, 6
Newton, Isaac, 28
Noyes, A. P., 61
Occupational Therapy, 44
_Orenda_, 3
Orpheus, 2
Ortmann, Otto, 17
Operating room, music in, 75
Opponens action, 52
Paget, V., 36
Painful level of sound, 41
Palmer House Ensemble, 86
Paresis, general, 63
Parlor organ as foot exercise, 54
Patient band, 70
Pediatric ward, music in, 90
Percussion instruments, 55
Persian use of music, 5
Philip V of Spain, 10
Photoism in music, 28
Phrygian mode, xi, 6
Physical therapy, 45
Physiologic effects of music, 34
Piano; analysis of motions, 52
Piano playing for exercise, 50
Pianola, value of, 52
Pierce, A., 70
Pinel, P., 11, 44
Pitch, effect of, 17
Plato, 5, 76
Plectrum instruments, 53
Plutarch, 6
Pocket instruments, 54
Porta, J. B., 11
Primitive people, music among, xi, 2
Production, effects of music on, 80
Program distribution system, 93
Program notes, effect of, 33
Psychiatry, value in, 72
Psychologic effects of music, 36
Psychosis, alcoholic, 63
Psychosis, arteriosclerotic, 64
Psychosis, manic-depressive, 64
Public address system, 93
Pythagoras, xi
Quarin, 8
Quintillian, 76
Radio, bedside, 91
Rameau, J. P., 18, 20
Reade, W., 19
Record library, 115
Remedial exercise, 78
Renaissance of art forms, xii
Response to music, 36
Rhythm, effect of, 18
Room, listening, 111
Rose, D., 86
Rubinstein, A., 30
Sauvages, G., 12
St. Chrysostome, 9
St. Patrick’s Day music, 114
St. Thomas Aquinas, 42
Schizophrenia, 65
Schoen, M., 32, 37
Schönberg, A., 41
Schumann, R., 30
Scorpion bites, music for, 7
Seashore, C., 107
Secret remedies, xiii
Selinsky String Ensemble, 86
Shakespeare, W., 9, 13, 59
Shaw, G. B., 84
Shopwork, music in, 79
Sickert, W., 42
Sioux Indian practice, 3
Slumber music, 90
Sonorous fluid, 12
Stravinsky, Igor, 42
Surgery, music in, 75
Tarantula bites, music in, 7
Tarchanoff, I., 76
Taste, musical, 38
Templeton, Alec, 91
Tempo, effect of, 25
Thalamus, role of, 68
Thaletas, 6
Timbre, effect of, 18
Toneless instruments, 95
Tuberculosis ward, music in, 92
Ulysses’ wound, 5
Upper extremity exercise, 51
Valentine, C., 21
Vernon, P. E., 36
Vescelius, Eva, xix, 12
Vibration, effect of, 7
Victor Salon Orchestra, 86
Violin as exercise, 52
Viper bite, music in, 7
Vocal music, 32, 35
Voice, human, 35
Voltaire, 82
Volume, effect of, 80
Volunteers, hospital, 97, 99
Wallaschek, R., 4
Wallawalla practice, 4
Waltzes, effects of, 81
War, music in, 7
War songs, 7
Ward sings, 96
Wasambara practice, 4
Weber, Marek, 86
Willis, T., 10
Words, effect of, 35
Working songs, 79
Transcriber’s Notes
In a few cases, obvious errors or omissions in punctuation have been
fixed.
Page ii: “nervous insistance,” changed to “nervous insistence,”
Table of Contents and Index: “Eurthymics” changed to “Eurhythmics”
Page xvi: “of human ature” changed to “of human nature”
Page xix: “forget his preconcieved” changed to “forget his preconceived”
Page 8: “delerium, melancholy and mania” changed to “delirium,
melancholy and mania”
Page 12: “she admitted after after having” changed to “she admitted
after having”
Page 25: “in every singly key” changed to “in every single key”
Page 31: “Largo al Factotem” changed to “Largo al Factotum”
Page 41: “Most people have been conditioned” changed to “Most people
who have been conditioned”
Page 44: “sooner those who remained” changed to “sooner than those who
remained”
Page 53: “are readily adpatable” changed to “are readily adaptable”
Page 60: “which has lead some musicians” changed to “which has led some
musicians”
Page 65: “may appear quiet normal” changed to “may appear quite normal”
Page 68: “more powerful subconcious” changed to “more powerful
subconscious”
Page 69: “for heterogenious groups” changed to “for heterogeneous
groups”
Page 77: “preferable the piano” changed to “preferably the piano”
Page 78: “places of assemble” changed to “places of assembly”
Page 84: “barbershop and other public” changed to “barbershops and
other public”
Page 92: “alloting certain periods” changed to “allotting certain
periods”
Page 94: “musical programs and hospital announcement,” changed to
“musical programs and hospital announcements,”
Page 110: “age range of the patient” changed to “age range of the
patients”
Page 115: “with continuous acession” changed to “with continuous
accession”
Page 120: “the appelation “music aide”” changed to “the appellation
“music aide””
Page 122: “programing for concerts” changed to “programming for
concerts”
In the bibliography, “Electrophsiology of Mental Activities” was
changed to “Electrophysiology of Mental Activities”; there is no
anchor for reference [6] Barker. L., in the text.
In the index, “Mental disease classication” changed to “Mental disease
classification” and “Cavotte from Mignon” changed to “Gavotte from
Mignon”
The original index had T located after W. This has been fixed.
There are numerous probable mistakes in the French and German
references in the footnotes; these have been intentionally left as per
the original.
The spellings of “Philippe Pinel” and “Richard Wallaschek” have been
corrected.