“After silence, that which comes nearest to expressing the inexpressible, is music.” —Aldous Huxley
The inebriated voice slurred loudly from the back of the ambulance while I navigated traffic through the downtown bar district. My snickering partner poked her head into the cab from the captain’s chair to play interpreter, “Our detox bound guest requests you turn the radio up.”
As my partner withdrew back into her spirit-fragranced chalet, I imagined her rolling her eyes upward as she realized what was coming next. Sure enough, I pulled out my collection of CDs. I readily asked our BA patient of .25 in a twanged manner, “You like country western, cowboy?”
“Shhhure! Azzz long azzz you crank it up,” he returned. And with that, the lyrical sonnet by country crooner Garth Brooks,
“Friends in Low Places,” began to resonate through our mobile cabin, “Blame it all on my roots. I showed up in boots and ruined your black tie affair.”
By the time we reached our journey’s end, all three of us were singing at the top of our lungs in perfect tone-deaf harmony,
“’Cause I’ve got friends in low places, where the whiskey drowns and the beer chases my blues away.”
Call it what you will—a distraction, an antidote for maintaining social order, a bonding tool or a pleasant alternative to counteract a normally depressing patient transport. I call it music therapy.
Now some may say music has no place in the field of prehospital care. Not that I would know who those “some” are because my iPod usually drowns out such opinions. But seriously, if music therapists are found in nearly every area of medical professions, why not EMS?
Not only has music therapy proven to decrease a patient’s anxiety and pain while helping to relax and increase healing time, but it has also proven to be a powerful motivating tool for the medical community. When I had knee surgery a few years back, my orthopedic doc told me just prior to paralyzing my reticular activating system that he always listened to Blue Oyster Cult to help keep him focused during this type of tedious surgery—the same band, mind you, who wrote, “(Don’t Fear) The Reaper.” Very nice.
As long as my partner keeps their dancing moves to a minimum and doesn’t sing along, I can listen to almost any kind of music. And during those long stretches of no calls, my partner and I often amp up the volume to keep the endorphins flowing. Then again, maybe there are calls being relayed to us and we just don’t hear them being dispatched.
But let us also not forget those private moments when we may need a minstrel infusion of song by someone who can better articulate through music what we are feeling in our achy breaky hearts—specifically those calls so emotionally taxing that they can leave us speechless.
I’ve always found music to be the great equalizer in its magnificence and harmony along a unifying force bringing people together regardless of background, age, gender or social order. As they sang in the ’60s, “I’d like to teach the world to sing, in perfect harmony. I’d like to buy the world a Coke, and keep it company. That’s the real thing.”
The key lies in finding the right melody at the appropriate time and place with those (patient or co-worker) to help motivate, inspire, relax, improve concentration or even process emotions.
Whether it be classical, country, pop, rock, heavy metal, gangsta-rap, acoustic, new age or hip-hop, it comes down to finding the right combination of tempo, pitch, volume and rhythm when it comes to creating an atmosphere for physical well-being. For example, do I really want to set the heart rate for the external heart pacer of my monitor on a patient while listening to a song with the tempo (pace rate) of “Whip it,” by Devo?
One must, of course, also consider the wording of a song in the presence of their patients. We don’t want to cause disharmony in our patient’s circadian rhythms—specifically their regulated autonomic system for respiration, heart rate and peristalsis, and renal flow. Care must be taken in choosing the right song to fit the situation. Because the list of individual music preferences is so vast in number, I’ve found it easier to simply list those songs I don’t recommend playing during your patient care. Below is a small, twisted sampling:
Do not resuscitate
Hygienically challenged patients
Organ procurement team
Rapid sequence intubation
Driving code 3 during rush hour
Driving under the influence
Pelvic inflammatory disease
Until next time, remember, music can serve us in health and illness, in happiness and in sorrow… and in the unemployment line after you (accidently) keyed your mike while playing Johnny Paycheck’s, “Take this Job and Shove It.”