Music Therapy Interventions: Helping Patients As A Physician And Classical Musician

Tara Rajendran talks about Music Therapy Interventions: As a toddler, I was intrigued by how a couple of musical notes coming out of the massive red stereo tape recorder brought great relief to my bed-ridden grandmother's back pain and anxiety while she was ailing with acute lymphoblastic leukemia. She passed away in 1998, and my parent's gratitude and adulation towards music lead them to put me into Carnatic vocal lessons.

Two years later, at age seven, I started taking the Saraswati Veena classes. On the first day, my teacher asked me, would you like me to play one of your favourite pieces for you? I asked for 'Mahaganapatim,' the composition that reminded me of my grandmother.

I started giving public performances at age seven, and my maiden Veena recital was at 11. Most of my recitals were for an erudite audience. I took a sabbatical from public performances when I joined medical school; however, I did my bachelor's and master's in 'Veena' during this while. My interest in oncology piqued during this time, and I spent several hours in cancer wards. My fascination with oncology further bolstered during my oncology rotations as a visiting international medical student at Harvard, Stanford, and Cornell. Witnessing the stress and anxiety faced by the cancer patients under our care made me uncomfortable. I was in a predicament where I could fathom the patient's plight with bouts of pain and anxiety, yet I did not know a cost-effective solution with limited side effects. I discovered my purpose during a hectic labor-theatre night in obstetrics while I was in my final medical school year. I encountered an awful physician burnout and felt depersonalised and disconnected. We ran between caesarian sections and vaginal deliveries, the entire night, unpaused. Drained, vulnerable, and lost. When I returned home, I played Veena for 15 minutes. It was cathartic! This was a revelation. My mentor, the advisory dean of Harvard Medical School, presciently connected me with a leading music therapist and researcher. She said this that left an indelible mark on my mind. "Tara, don't underestimate your ability as a physician and classical musician to provide music and help your patients."

The empirical basis for music-therapeutic approaches for the treatment of pathologic anxiety maybe because music modulates the activity of the amygdala-the brain structure whose dysfunction is related to anxiety. There is a sharp distinction between music and music therapy interventions. According to the American Music Therapy Association (AMTA), music therapy is the clinical and evidence-based use of music interventions to accomplish individualised goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. Last year, the United States celebrated 60 years of incorporating music therapy into its academic curriculum. India has two indigenous and ancient classical music traditions, Hindustani and Carnatic. Yet sadly, Indian academic medicine has underutilised music's potential in healing. Neither do we have large randomised controlled trials in music to support the evidence of the impact of music tailored to the Indian population and nor we have a national medical council (NMC) accredited academic music therapy training programs. This makes it challenging to incorporate music into the healthcare infrastructure instantly. Medical students, oncologists, and palliative care physicians must apprehend these deficiencies and work towards remitting them. That is the target of 'Oncology and Strings,' my self-initiative lecture-concert series. Until NMC designs an academic training curriculum for music therapy, medical students, with the help of oncologists, could perform "randomised" controlled trials, and palliative care physicians could play music passively (therapeutic music therapy) in their inpatients' floors and outpatients waiting for areas. I am hopeful that slowly and steadily, we move towards a day where patients could have access to a music therapist's expertise as part of the treatment course.

The empirical basis for music-therapeutic approaches for the treatment of pathologic anxiety maybe because music modulates the activity of the amygdala-the brain structure whose dysfunction is related to anxiety

The launch of 'Oncology & Strings' was in March 2019, at the Stanford University campus. Subsequently, I was invited to Manipal University, Tata Memorial Hospital, 27th International Conference of Indian Association of Palliative Care,"> TEDx AIIMS Bhubaneswar, Asian Medical Students Association-India, among others. I am also providing free MP3 'Veena' recitals to palliative centers. I am assured that sooner or later, there will be a day in India where a patient will wait in the hospital listening to passive live music, and they receive a music therapist's service from day one along with their standard treatment.

Additionally, healthcare professionals' burnout is a significant mental health issue, particularly in an extra-ordinarily grim and unprecedented phase like this. Frontline healthcare workers, grappling with SARS-CoV-2 to stem its spread against an exponentially increasing workload, are going through extreme burnout, leading to depression and even suicides. I find, medical students and physicians put their artistic skills on the back burner to focus on medicine and now have lost sight of it. Maybe we must embrace our creative outlets, as they make us so resilient and tenacious.

Dr Tara Rajendran is a physician-musician. The views expressed are the author's own.