American hospitals and health care providers are beginning to pay more attention to the process of dying, a study known as thanatology. Two Catholic hospitals in Oregon are among the first in the United States to hire full-time harpists who play for dying patients. Their job is part of a larger effort to improve care for people who are at the end of their life. While some families say the harpists provide a more peaceful transition to death, the program may not be for everyone.
Laura Moya has attended more than 450 bedside vigils. As a music thanatologist, her job is to play the harp and sometimes sing while people die.
Reporters aren't allowed to attend such vigils, but Ms. Moya recently demonstrated her skills by playing the harp for 92 year-old Margaret Brandt, who suffers from heart disease and is expected to leave the hospital for home in a few days. The harpist tries to match the music to the patient's experience and that includes her or his vital signs, what drugs they're on and how the patient or family members are handling the situation. For example in this case, Ms. Moya plays a relaxing, slow-paced tune that mirrors the rhythm of Miz Brandt's breathing.
After about ten minutes, Margaret Brandt says the music has mellowed her. When asked what she was thinking about, she starts to tear up. "Let me get a hold of myself now," she said. "I was thinking of my mother and my husband."
That reaction does not surprise Ms. Moya. She says her music affects people physically. She said, "We've seen, a lot of times, where a person's actual oxygen saturation will go up, their blood pressure will stabilize because, physically, they're relaxing more and they're able to take in more air."
Laura Moya works for Providence St. Vincent Medical Center in Portland. Across town, another music thanatologist works at the Providence Portland Medical Center. Both hospitals are affiliated with the Catholic Church. As part of the religion's opposition to assisted suicide which is legal in Oregon Catholic hospitals in recent years have redoubled their efforts to improve the death experience through better pain management and unique services like music thanatologists.
Monica Anderson is the director of Pastoral Services at St. Vincent and says she wasn't sure how nurses and doctors would react to having a harpist in the hospital room. She said, "We expected some tongue in cheek, 'Yeah, right!' But so far the physicians and nursing staff have embraced Laura."
Ms. Anderson says nurses often feel like they're too busy to spend the time they'd like to with a dying patient… and are grateful that the musician in there. "When they know Laura's in there providing her form of ministry," she said, "not only do they just enjoy the music themselves, because it's beautiful, but it also gives them a sense of peace that their patients are being cared for. Medical ethicist Susan Tolle says music thanatology programs signal a much larger trend in American health care one that rejects the idea of people dying in antiseptic hospital rooms, their bodies connected to machines. Doctor Tolle says more people are asking questions about what the process of dying should be like. "Should it be so technical," she asks? "So sterile? So isolated? So away from community? And like dads in the delivery room we have begun to see the pendulum swing back."
Back to a time when almost everyone died in their home, surrounded by family and friends. But Dr. Tolle says the emerging trend updates those traditions with modern pain medication and healthcare practices.
Still, Dr. Tolle says music thanatology is not for everyone. She said, "This will be very well received by some and seen as a wonderful, supportive, peaceful transition. For others it will be seen as a not very comfortable, too spiritual, too stranger-oriented - in their personal space. We need to figure out who's who to make this just the right thing for the right people."
Susan Tolle says there are as many ways to mark the end of a life as there are people and each person needs to do it in his or her own way.. Music thanatologist Laura Moya agrees. She tries to learn as much as she can about a patient before she attends a bedside vigil. "It's not like a cookie cutter," she said, "'Alright for this... He's 82. His name is Joe, okay, so I'm gonna play this music.'" Laura Moya calls her music prescriptive, designed for the person, their family and the situation in which they find themselves at the end of life.