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Musing in Oncology: When Oncology Meets Music Something Special Happens

2013; AlphaMed Press; Volume: 18; Issue: 1 Linguagem: Inglês

10.1634/theoncologist.2012-0140

1549-490X

Alessandro Toccafondi, Andrea Bonacchi, Andrea Mambrini, Maurizio Cantore,

Empathy and Medical Education

On June 24, 2007, the greatest Italian producer of classical music, Gian Andrea Lodovici, entered our oncology department for gastric cancer treatment. He came to his first examination with his belt undone, staring into the void, totally disinterested in what we were saying. He had lost complete interest in the world and had become detached from the significant things in his life, including music. Everything he would have expected, other than “the music,” was waiting for him there in the oncology department. In fact, we had always tried to establish a link between oncology and music in our department. A piano has been located in the ward since 2003 and local artists have performed regularly for the inpatients. Gian Andrea could not resist what had driven his life before cancer and he was seduced by music even during that dramatic period. Thus, he began to take part in the music events organized in the ward. In the meantime, given the difficulty in capturing his attention regarding therapeutic proposals, we adopted a different strategy of communication. Instead of talking just about chemotherapy, we began to talk about music. We asked him to help us produce a concert season of high-quality performances for cancer inpatients. We aimed to use his infinite love of music to stimulate his willingness to participate in his treatment and to improve therapeutic compliance. Gian Andrea's psychological state quickly changed upon being involved in a musical project for inpatients. His relationship with oncology staff also improved; he began listening to our therapeutic proposals and discussed them with us. At long last, we were fighting the disease together. In this project, he found a reason to fight and a dream to be realized. He was reconnected to the world and to life. Gian Andrea's experience is reminiscent of the recent film “A Wayfarer's Journey: Listening to Mahler” (2007) by Ruth Yorkin Drazen. It describes the healing effect that music had on the pianist and conductor Christoph Eschenbach and on the Austrian composer Gustav Mahler. In fact, music helped both of them to recover from traumatic periods that had occurred in their lives. Until his death in January 2008, Gian Andrea was totally engaged in organizing classical concerts in our department (Fig. 1). In the first 6 months, he organized “the first season of extraordinary concerts” with performances by six established musicians. Through this work, he was able to create a tangible link between the world of oncology and the world of music. In 2008, under the artistic supervision of pianist Roberto Prosseda, our oncology department hosted one of the most important concert seasons in Italy, with 26 concerts from March to December. This initiative spread quickly, and we were contacted by many musicians who offered to perform for cancer inpatients. At the same time, other oncology departments expressed the desire to participate in the project. The Donatori di Musica (Music Givers) network was born. Figure 1. “In the hope that great music can become an increasingly important means of aid for medical treatment in every department of oncology.”–Gian Andrea Lodovici. Officially created in 2009, Donatori di Musica is a network of musicians, doctors, nurses, volunteers, patients, and families of patients whose aim is to organize a regular series of free concerts in oncology departments throughout Italy. More than 200 musicians have performed 160 concerts for 6,000 inpatients in several oncology departments from the north to the south of Italy. The Donatori di Musica project features regular performances, not occasional events. It is a nonprofit project: The artists do not charge for their performances, and the concerts are free for patients, families of patients, and hospital staff. Only professional musicians with an established career are invited to perform. They display a friendly and open attitude during these concerts by dressing informally and introducing the music to the public before the beginning of the concert. At the end of the performances, patients and health care professionals enjoy a free buffet, where they can meet the musicians and talk with them if they wish. These features, especially the regularity of these events, make Donatori di Musica concerts one of a kind. Sharing the emotion of a concert inside the oncology ward creates an atmosphere favorable to improving the relationships between all those involved: patients, their relatives, and health care professionals. In this context, the relationship acquires a different meaning and the frequently observed doctor-patient barrier is minimized. Meeting patients in a nonclinical context also influences how clinicians relate to them in the days after the concerts, enabling us to communicate more confidently regarding their disease, treatments, and prognosis. In this sense, Donatori di Musica positively shifts our perspective from an emphasis on the disease to the overall person, from the treatment to the care. Finally, we believe that Donatori di Musica creates a more positive perception of the hospital setting in patients and their families. The Oncology Department is no longer considered only as a place of suffering, pain, and death, but also of music and joy (Fig. 2). Figure 2. Gian Andrea Lodovici's music hall in our oncology department. The value of Donatori di Musica is the blending of several different gifts: the talent and hard work of the musicians; the commitment and time of the volunteers; the doctors' willingness to get personally involved, not just professionally; and the patients' ability to express their feelings to others in a new way. This circularity of interactions between all involved creates unexpected moments, in which the disease is present but not seen, felt but not heard, giving to each person a gift of hope. We have always believed that integrating music into our work benefits both patients and health care professionals. Meeting Gian Andrea Lodovici turned this belief into a project. Throughout these years, Donatori di Musica has been an emotional force, forever changing the way we relate to patients and our work as oncologists. We hope that this initiative spreads outside Italy to create an international network that strengthens the link between music and oncology. Gian Andrea Lodovici's discography as producer and recording supervisor can been found at http://www.discogs.com/artist/Gian+Andrea+Lodovici. News, past concerts, and Donatori di Musica musicians are available at http://www.donatoridimusica.it (in Italian).