In the Trenches

When will the healthcare we offer be as warm, as human, as authentic as the people to whom we offer it?

Seriously. I'm asking.

I work with and for real, living, loving, breathing, hurting, healing, and dying human beings, each a complex universe of human experience unto him or herself.

One of the reasons I was so drawn to hospice work is because the hospice philosophy of care is acutely aware of this reality, and every policy in place reflects this reality for providing individualized patient care.

But earlier this week, my therapist heart got slammed up against a wall because of someone I wasn't working with. In short, it hurt and it made me intensely frustrated with the big, overall umbrella of providing healthcare to older adults in this country.

I pulled up to outside of an assisted living and skilled nursing facility where one of my patients resides. I was there on my employer's time to see someone on my hospice caseload. This means I don't have the luxury of interacting with every resident in the facility.

That's why my heart sank as I wound my way past the nurse's station, guitar on my back -- I heard a gentleman call out from behind me, "Miss? Miss! Is that a guitar? Are you going to share some good, old music with me today?"

I turned back long enough to wave at him, to give him the warmest, most compassionate smile I could, and said, "I'm so sorry, but I am here to see someone specific."

I tried to ignore the pangs in my heart as his face fell and I kept moving.

After a beautiful, delightful routine visit to my patient, I passed back by this gentleman and several other ladies, all parked in wheelchairs, dozing or making hushed small talk in front of the nursing station.

This time, the gentleman leaned forward and asked me what kind of guitar I owned. I told him, and his eyes lit up. He exclaimed, "That's a great guitar! I used to have one, but with 12 strings. I had to get rid of most of my guitars when I moved here though...not enough room." The lady next to him joined our conversation, asking me if I knew the entertainer that was scheduled to appear later that afternoon. They invited me to join them sometime and said they wished I had been there to see them.

I lingered just a few moments with these people. I had other patients to see that day and paperwork to finish after that. By way of parting, I started singing the old standard, "Show Me the Way to Go Home."

A woman had been sitting silently this entire time, with her head bent way down over her lap and her eyes closed. I started singing this song and she immediately sprang to life. Her posture changed. She made eye contact, and her eyes began to sparkle with the smile that was now illuminating her entire face. She opened her mouth and sang the entire little song in beautiful harmony to my melody. In an instant, she was transformed into a former, vibrant version of herself.

The facility staff that observed this brief interaction remarked that she had a cousin who was a famous singer and that she had occasionally sung duets with him.

This woman said nothing, but continued to smile at me expectantly, as though waiting for her next cue to sing.

That's when my heart slammed into the wall.

I was not there for her. I cannot bill for time spent interacting with her. No one has asked me to assess her needs, limitations, strengths, abilities, and responses for clinical music therapy.

I wanted nothing more than to advocate for her access to a certified music therapist. To speak with the facility staff about the real and significant changes in her when a live person interacted with her using her preferred music. To demonstrate the ways in which I could meet her care plan needs and improve her quality of life.

I wanted to see what other songs she remembered and took joy from. I wanted to provide human touch as I supported her in playing small rhythm instruments with me, if she was willing.

In short, I wanted to serve as music therapist to her -- to use music to bring her out of the world in which she spends her days drooped silently over her knees in a wheelchair.

The gentleman who had to give up his guitar collection, this woman, and every other resident there were warm, human, authentic.

But I had to rush along. That's what it's like to work in the trenches of healthcare in this country.

The trenches are where I meet my fellow human beings and offer them help and therapy through the medium of music.

So the trenches are where I want to stay. I want to change the culture of healthcare from the inside.

And today I am asking...when will he healthcare we offer be as warm, as human, as authentic as the people to whom we offer it?