Music lives on: fine tuning the memory
2017; Elsevier BV; Volume: 17; Issue: 3 Linguagem: Inglês
10.1016/s1474-4422(17)30399-x
ISSN1474-4465
Autores Tópico(s)Empathy and Medical Education
Resumo“Music is part of being human.”Oliver Sacks “Music, at its essence, is what gives us memories. And the longer a song has existed in our lives, the more memories we have of it”. So sais iconic artist-musician Stevie Wonder. Music is associative, emotive, and communicative; it transports to a place, a time, a moment—a memory. It can connect us to each other and it connects to something within us that is almost instinctive, like a heartbeat. Waxing lyrical about music and its magical properties seems effortless but what about the science? The Wellcome Collection, a museum in London, UK, which “invites you to explore what it means to be human”, tries to connect medicine to life to art in a unique fashion; a weekend of events, concerts, and discussions to explore the universality of music was no exception. Bustling with people and bursting with sounds, the event was partnered with BBC Radio 3, broadcasting live from a number of platforms to showcase their proclivity for live concerts and conversations around classical and jazz genres. Why Music? The key to memory ran over three days, offering an intriguing programme of free sessions created around this topic of music and memory. Music cannot exist without memory because sound needs to be identified and processed as rhythm and structure, timbres and notes, an association that depends on memory. But it does not need to be understood in a semantic way because it is felt—to use the truism; music is pure emotion beyond words. Perhaps this is the reason why, for people with dementia, music can provoke an emotional response when no other stimuli can. The concept of unlocking or opening doors is a proverbial metaphor for remembering. So, does music hold a special key, and if so, what can it do? Memory is not a single process. The art of memory is the art of association, Ed Cooke (the author known as Grand Master of Memory) convinces us: building a picture or a narrative help us to remember things. Not surprisingly, the book by late author and neurologist Oliver Sacks, Musicophilia: Tales of Music and the Brain was referenced at the event: it is considered an invaluable text for the musically curious mind. “Music, uniquely among the arts, is both completely abstract and profoundly emotional. It has no power to represent anything particular or external, but it has a unique power to express inner states or feelings. Music can pierce the heart directly; it needs no mediation”, Sacks writes, suggesting “a past that is not recoverable in any other way [in those with Alzheimer's disease], seems to be sort of ‘embedded in amber’, if you will, in music”. Being responsive to music seems an intrinsic quality to being human. Is this the case with any form of music? To start with, let's talk about jazz. It flows like a conversation and often sounds like an expressive and emotional interaction. A session hosted by Julian Joseph, Jazz Line-up: Improvising Memory, explored the relationship that a jazz musician has with memory, imagination, and creation. One of his guests, pianist Kit Downes, performed a piece inspired by Sacks, called Oliver's thoughts, with lyrics lifted directly from Sack's writing: “Every act of perception is to some degree an act of creation and every act of memory is to some degree an act of imagination”. Live jazz performances from accomplished musicians (Nikki Yeoh, Tori Handsley, Nick Smart, Martin France, Tom Herbert, and Kit Downes) and students from the Royal Academy of Music (London, UK) were punctuated with pre-recorded snippets from neuroscientist and musician Charles Lim (University of California, San Francisco, CA, USA). Lim provided scientific context as he explained how a “complex interplay between multiple areas in the brain” is occurring as the musician performs. Lim briefly described some of his observations: compared to other more structured music that might also be played from memory, the act of improvisation causes the brain to “turn off conscious self-monitoring areas in order to have unimpeded flow of new ideas” and suggests that a deactivation in prefrontal cortex activity might be an important signature of neural creativity. This session fed into the overarching question that united the events over the weekend: how and why can musical memory survive when other parts of our memory are irrevocably damaged? Memory is what makes us human—without it, a sense of identity also disappears. How can science and the creative arts step in, and step up together, in an increasingly alienating world for people living with dementia? The Hub Award is a 2-year residency granted by Wellcome Collection to interdisciplinary groups who collaborate on projects that explore the cultural and social contexts of health. Current residents Created Out of Mind—set up to examine and challenge perceptions of dementia through scientific and creative experimentation—contributed to a variety of programmes over the weekend. Project director Sebastian Crutch (University College London Dementia Research Centre, London, UK) and team collaborators Paul Camic (Canterbury Christ Church University, Canterbury, UK) and Julian West (Royal Academy of Music, London, UK) joined BBC Radio 3 host Sarah Walker for Beyond Memory: Music in the Moment. Walker's guests also included cognitive neuroscientist Catherine Loveday; Clare, who has amnesia; Clare's daughter, Georgia; and musician Anna Tilbrook. Clare is incapable of making new memories; although she has knowledge of her past, she has no memory of it. “I was introduced to Clare because her experience with music was unusual”, Loveday explains. This prompts a reference to Clive Wearing—who had an extreme case of anterograde and retrograde amnesia, but never lost his ability to play music. Clare was not a musician like Clive, but new music (since her amnesia) seems familiar to her. “I've seen Claire sing along to songs I know she has never heard. This could be a ‘pre-memory’, similar to a déjà vu, where something in the music or the environment is setting off a feeling of remembering”, says Loveday. So began a quasi-experiment. Clare was played different styles of music and asked if she knew them, and what she felt. The Bee Gees song Tragedy—”disco fabulousness, a first for Radio 3” quipped Walker—brought smiles and chair dancing, but the high-pitched simulation of laughter in Mozart's magic flute distressed Claire (and it felt uncomfortable watching her distress). She said “I don't…want to remember it. It makes me shaky, unsettled”. So is it just a matter of taste or are Clare's responses related to her amnesia? Loveday said that Clare's sensitivity to music has become heightened, and she will quite often say that it sounds “wrong”. There is something authentic about Clare's reactions as we watch her, unimpeded by social peer pressure, with no requirement to conceal displeasure or even pleasure. However, at the same time, it felt voyeuristic, although the audience was assured that Clare fully consented to the experiment. After Claire left, there was a lingering frustration that not enough was unearthed, with yet more questions raised than answers given. This absence reflects on the poor understanding of the causes of dementia. With no cure and no treatment to slow down progression, the quality of life for people living with dementia must then be a priority. This is why initiatives like Created Out of Mind might help. “The project is important because it lends further support to making a national commitment to provide more accessible creative social activities to those with a dementia”, Camic says. Crutch adds that the project emerged “largely from hundreds of conversations with people living with dementia, in which they shared experiences, questions, and uncertainties”, providing “rich inspiration for scientific and artistic exploration, not just into the dementias but also our sense of selves and understanding of the healthy and ageing brain”. “There is an expectation we are trying to make people happy or better”, Crutch says, “but we are really asking questions, such as how do we use music? Are we recalling a feeling or a memory? And also looking at the different ways we connect through music”. Connection is important because it counters isolation and exclusion. Pianist Anna Tilbrook performs for people with dementia across the UK for the charity Lost Chord. “There is no fixed programme but, excuse the pun, we play it by ear. For example, if we are presented with stillness, we try to get people to sing along, to create energy. The most powerful song is Moon River, by Henry Mancini”, Tilbrook says before playing a rousing rendition of the song, which does indeed strike a chord of nostalgia and emotion with the audience. The urge to “make people better”, as Crutch says, might result in missing a trick. That is why Created Out of Mind is “exploring new territory and new ways of understanding how the arts can impact dementia care”, Camic says. Coming to the event with an expectation that music has been proven to unlock mysteries, to restore or to find lost memories, might have caused disappointment for some. The conclusion is that researchers need to be “creative and collaborative in their definition of evidence”. Then, different questions could be asked: “should the burden of proof be the same for pharmacological treatments and musical interventions?, or can artistic works be the outcome of research?”. Embracing a truly diverse and heterogeneous world, Camic concludes: “we seek to capture and communicate the complexity of different responses to different art forms in different contexts, experienced by different people with different brains affected by different dementias.” Why Music: the key to memory October 13–15, 2017 Wellcome Collection, London, UKOliver Sacks. Musicophilia: Tales of Music and the Brain, Knopf, 2007 ISBN 9780330523592 Why Music: the key to memory October 13–15, 2017 Wellcome Collection, London, UK Oliver Sacks. Musicophilia: Tales of Music and the Brain, Knopf, 2007 ISBN 9780330523592
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