Kate Munger first discovered the power of music nearly 20 years ago when she saw the profound difference it made for people in the end stages of life, even for those who were comatose. It was 1990, and she was visiting a friend who was comatose and dying of HIV/AIDS.
"I sat down by his bed and wondered what to do next," she recalls. "And instinctively I began to sing. And he had been restless, and as I sang, he calmed and so did I. At the end of that experience, I felt I that I had done something that was a special gift that only I could give at this moment to that person. And it was very penetrating as an experience for me."
Every waking moment devoted to music
After years of leading informal singing groups, Munger started her first Threshold Choir with 15 women in the San Francisco Bay Area. The idea of singing to ease the pain of passing away caught on, and Munger was soon busy adding new choirs around the Bay area, leading rehearsals and scheduling bedside visits.
At that point, Munger says, the Threshold Choir had turned into a full-time job.
"Every single minute of my waking time is devoted to this work," she says, pointing out that she has a degree in psychology; had been a music teacher for 10 years, and had a private practice in deep-tissue massage. "Everything I've done has led me to do this. There is a satisfaction that I've never felt the likes of before, of knowing that you're doing what you're supposed to be doing with your life. I had no idea that this would be as big as it is. So it's exceeded by far my original intention."
When Munger started her choir in 2000, singing to the terminally ill was a relatively new concept. This was at a time when medical students were not required to study palliative care and ministering to the needs of dying patients was not considered a high priority.
"I think we've gone back to a more traditional, more tribal way of thinking about death and about caring for our elders," she observes. "This choir has been so well received. It's a sign that there's a graciousness about attending respectfully to people who are dying."
Singing for others, and each other
It's rehearsal time for members of the Threshold Choir. Munger meets with choir members around the Bay area twice a month to practice the songs they will sing at bedsides. At today's rehearsal, Munger has the women sing over her cell phone to Shirley, a choir member with terminal cancer.
The all-women's choir performs for free, usually in groups of two or three, in hospitals, nursing homes, hospices, private residences and for their own members facing death. Munger calls the songs they sing "lullabies for the end of life."
"There's generally two or three of us at a time, no more," she explains. "We're singing songs that are simple and that are repetitive. And we sing very, very close to the person's ear. We like to recreate the distance between a mother's mouth and a baby's ear. So we sing very, very softly."
An exclamation point at the end of life
As patients lay dying, bearing witness to their struggles can be difficult. But for Susan, who has been a choir member for three years, singing for the terminally ill has been deeply rewarding and satisfying.
"Recently, I sang for a member of our choir who was dying. And she had the most beatific smile on her face when we were singing for her."
Susan says she comes away from these experiences feeling more enriched and less aware of her own problems.
"I think I'm giving something more than I'm getting. Death doesn't have to be a painful experience or a fearful one. That we can go into it with song and with joy and come away from it, feeling that there's an exclamation point at the end of our lives, not just a period."
Kate Munger's tireless efforts have eased the passing of many patients and touched the lives of many more - their families and friends. And the tradition she revived is spreading. There are now Threshold Choirs in more than 70 U.S. cities and around the world, including Iceland and Australia, far from the San Francisco Bay-area bedside where the idea began.