Music to mitigate pain

The silence is palpable as the young violinist tunes the instrument in front of a full house waiting with bated breath. It is not an auditorium or an ampitheatre but the the palliative ward of the All India Institute of Medical Science’s oncology department in New Delhi. The rasikas are patients who look visibly tired battling day in and day out against the dreaded cancer. Once Radha R plays Hamsadhwani varnam followed by Raghuvamsasudha in Kadanakuthuhalam raga the atmosphere changes. With many tapping their feet while others keeping beats with their fingers, Radha realised she is in the midst of an appreciative audience. That is the effect of music. Along with Kanika on sitar, the opening piece of the film Piku and the theme song of Roja too were played much to the delight of the audience. “At the end the patients were deeply moved by the music. Thanking us they insisted on repeat visit. Hope we are able to do this regularly,” says Radha.

A musician in performance at an oncology ward.

Music down the ages has proved to be an effective source to calm agitated minds and frayed nerves. One has heard of legends and stories of how a ferocious animal or a savage was rendered harmless by the notes of a melody.

Even though in India the use of music therapy is still at nascent stage, internationally several studies have been conducted highlighting the benefits of music on mental and physical health. One such is the meta-analysis of 400 studies done by Daniel J. Levitin, who studied the neuroscience of music at McGill University in Montreal and his postgraduate research fellow Mona Lisa Chanda, Ph.D. that found music improves the body’s immune system function and reduces stress.

Now efforts are being made by the Ashwin Maharaj Foundation (AMF) to bring music therapy to limelight. It has been conducting such sessions twice a week at the Adyar Cancer Institute since January this year for pediatric and adult wards and has already done more than 100 sessions. This week it has been started at Kidwai Memorial Institute of Oncology, Bengaluru. AMF was started in memory of Ashwin Maharaj, who passed away last October at the age of 22 fighting leukaemia by his family and friends. Law student in Jindal Global University, Ashwin was fond of musicm debate, dramatics and elocution.

Terming music therapy as a definitive support therapy Ashwin’s father, Dr. Ramasubramanian, an anaesthetist for the last 30 years, says it impacts at psychological as well as physiological levels. “The disease and its treatment-the medicines and chemotherapy — sap out the patients, making them prone to depression. Music mitigates pain. It makes them feel tranquil and better. Many of them start clapping and dancing while some join in singing too.” On the physical side, the doctor says that it is hospitals who can study it adding that there have been several studies that prove that music therapy leads to hormonal changes leading to lessening of vomiting and pain.

Ashwin’s mother, Manonmani Ramasubramanian who has attended many of these sessions finds a definite change in the patients. “Most of them at end of the sessions feel relieved, blessing the artists for making them forget their pain and bringing a ray of hope and joy in their otherwise struggling life. There is a change in the energy level as I have witnessed many old patients making an effort to dance in step with the tunes being played.” The level of involvement can be gauged by the fact that every time an artist performs, there are request numbers from the patients. Music makes a world of difference for the care givers and the family members too. “In Delhi the oncology doctors felt that such sessions relieved them from their job stress. Such is the effect of this art.”

As parents, Ramasubramanians know first hand how singing by Aida Sanchez greatly relieved Ashwin when he was undergoing treatment in San Diego Scripps Green Hospital. “He used to feel happy and would sleep much better than other days. In fact, he went on teach her a number of A. R. Rahman ,” recalls Manonmani . In fact, so deeply impressed was Ashwin by this method that he wanted to introduce it in India on his return. “That is the reason we started this with the intent of taking it to as many cancer hospitals as possible.” After ensuring that their initiatives takes firm footing in the Capital and Bengaluru they will move to Mumbai and Ahmedabad.

Be it semi-classical or popular numbers from films, only soft and soothing music isplayed. Keeping in mind how infection prone the patients are, there are one or two vocalists or instrumentalists. The three sessions conducted in Delhi so far featured a violinist, a sitar player and two vocalists, one being Ashwin’s class mate. Completely voluntary in nature, the idea is to make this movement participatory in nature. Says Manonmani, “We want it to be a people’s initiative. The participants must want to do something for the society and feel good about it. Artists, generally amateurs and college bands and sometimes professionals get tremendous satisfaction after these performances. We appeal to the entire fraternity of artists to help us in this endeavour.” In Chennai, performers who participated included Saindhavi Prakash, a classical and playback singer, A. V. Pooja who sang in Raanjhanaa. On preferring live session to playing recorded music, Dr. Ramasubramanian feels the former brings more joy. “There is direct connect and a touch of human interaction which is essential for the therapeutic effect.”

Among other methods tried in the medical world to help patients cope with their illness and the after-effects of treatment is use of clowns to entertain especially the children. “Laughter too provides a great relief. We explored this avenue but in this artists need to be paid. Once the funds come through we may explore this too. Till such time we will try to spread relief through music as far and wide as possible,” comments Dr. Ramasubramanian.

The foundation also works in the field of spreading awareness about stem cell donation and giving supplementary nutrition for patients undergoing chemotherapy and intends to work for legal awareness among rural and illiterate people. Remarkably, AMF runs its initiative in Government-run hospitals. “The reason is obvious because that is where the most needy go for relief,” says Dr. Ramasubramanian.

Stress busters

Years ago when Patch Adams starring Robin Williams – based on the life story of Dr. Hunter Patch Adams – depicted how patients can be treated by humour and compassion many wondered if it could be true. It does as shown by clown doctors who use magic, music, storytelling and other clowning skills to help patients deal with fear, anxiety, loneliness and boredom. The healing power of laughter helps reduce pain and fight stress while promoting a healthy outlook to life. Not widely practised in the world, it is far less known in India.

Last year, The Hope Doctors, a PSBT documentary made by Diya Banerjee explored this phenomenon. Revolving around Pondicherry-based Fif Fernandes and her husband Hamish Boyd who work at Aravind Eye Hospital and Ashwath Bhatt, a trained clown and theatre artist who visits the patients at paediatric cancer ward of AIIMS, Diya’s film brings to fore on how clowning can be therapeutic. Thus the antics of the clowns have children giggling and grinning while patients and the family members too feel relieved.

A former journalist, Diya feels that there is a possibility of using clowns as hospital staff where along with their nursing they can put their skills to help spread cheer. This according to her will greatly help people to be at ease with treatment and the medical procedures. She has weaved stories of patients from lower income families to emphasise on the need to adopt this method to help them have a spot of cheer in life full of trials and tribulations. Clowning has a great potential to be effective especially in public hospitals where the patient turnout is huge and the doctors few leading to stress