Music-thanatology: The soundtrack to life’s final moments

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    Jennifer Hollis tunes her harp before playing for palliative care patients. (Paige Pfleger/WHYY)

    Jennifer Hollis tunes her harp before playing for palliative care patients. (Paige Pfleger/WHYY)

    Jennifer Hollis is perched on a black stool, her harp cradled between her legs. Her fingers move along the multicolored strings, plucking out a melody that drifts around the hospital room.

    An oxygen tank is humming in the corner. A clear tube leads to Susan Steinbauer — she’s laying in the bed with her eyes closed, her hands folded over a blue crocheted blanket. She’s 64 years old, and has terminal cancer.

    As she listens to the harp music, she cries a few tears, but doesn’t move to wipe them away. When Hollis stops playing, Steinbauer opens her eyes.

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    Susan Steinbauer closes her eyes and listens to Jennifer Hollis play the harp and sing. (Paige Pfleger/WHYY)

    “That was wonderful,” Steinbauer says softly. “It actually brought me back to a certain place in my childhood, that you know when you’re little you run so free. And that’s what it was — it was like the freedom feeling.”

    Hollis nods her head. She’s heard similar reviews before — she’s no ordinary harpist. She’s what’s called a music-thanatologist. She plays the harp and sings for dying patients.

    If life was a movie, Hollis plays the music during the closing credits.

    How it began

    If you’ve never heard of music-thanatology, that’s probably because it’s a really rare profession. Hollis is the only music thanatologist in the north eastern U.S. and there are less than 100 of them worldwide.

    Hollis hadn’t heard of it either, until one fateful day in 1995 when she came across a magazine article about it. At that point, she had been playing music since she was a kid, and knew she wanted to do some sort of service related job.

    She was about to graduate from college, and her plan was to become a teacher and play music on the weekend. But this music-thanatology thing, whatever it was, sounded right up her alley — the perfect combination of all of her interests.

    “It sounded very strange to people, that someone who was about to graduate from college was going to go off and move from the Boston area, and the only training program at that time in the world was in Missoula, Montana. So my plan was to graduate from college and move to Missoula, which is exactly what I did,” Hollis says, laughing. “To me, that sounded like a great adventure.”

    She saved up some money, bought a car, and drove to Montana with no job and no apartment.

    “I do think it was an unusual choice,” she says, “but it was a really good fit for me.”

    At the time, the school was called the Chalice of Repose project and was housed within Saint Patrick Hospital in Missoula, Montana. Hollis took classes in anatomy and physiology, anthropology, music theory, and of course, harp and voice lessons. And by 1999, she was a certified music-thanatologist.

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    Jennifer Hollis plays the harp in the hospital rooms of dying patients. (Paige Pfleger/WHYY)

    The defining characteristic of music-thanatology is called the prescriptive process. Hollis explains that music-thanatologists think of the raw elements of music like melody, harmony, rhythm and tonality, and then they use those things to respond to the different moods of hospital rooms.

    The mood of the room can differ based on a myriad of things — from the person’s diagnosis, their current state, their symptoms, to how their day is going so far. It’s case by case, and always changing.

    “So if a patient has restlessness, agitation, I would start thinking prescriptively about what are the qualities of music that might be able to address that in some way,” Hollis says.

    Hollis has been going to Lahey Hospital outside of Boston, Massachusetts for the last 10 years to play for dying patients.

    Sometimes, the patient’s response is physical: they might breathe more deeply or their facial expression might relax.

    More often than not, Hollis will play a room full of people straight to sleep. She’s not insulted by that, though.

    “It’s such a compliment!” she says with a smile. “It means that people are relaxed, they feel safe and they feel comfortable.”

    Other times, the response to the music is really emotional, and not just for the patient. Hollis says that families might use the time that she’s in the room to tell stories about their loved one, to pray, or to say goodbye.

    “The interesting thing about music-thanatology, I think, is that, in some ways, it’s medicine you can give both to the patient and to their family.”

    How it ends

    Usually Hollis isn’t actually in the room when people pass away — she’s not the angel of death, although that’s a misconception people have about her career.

    “People think I see one patient, and then they die, and I see another patient and then they die, and then I go home and have dinner,” she says. “That’s not the case.”

    It still takes a toll emotionally, as far as careers go. A lot of music-thanatologists say that it was hard at first to be surrounded by dying people, but it got easier over time. But not for Hollis. As she’s gotten older, gotten married, and had a son, she’s realized how interwoven her connections are to her loved ones. And that death, as a part of life, means she will lose people and other people will lose her.

    “I haven’t had to wait to tune into my own mortality,” Hollis says, “It’s just been there all along.”

    Despite the impact that Hollis has seen with the patients she plays for, there’s no research backing up the benefits of music-thanatology.

    Beth Collins is the medical director of Lahey’s palliative care program. She says that at first, when she heard about Jennifer Hollis and her work, she was worried that her unit would be seen as “soft” or “touchy-feely” by other doctors — that is, until she saw Hollis in action. Then, she didn’t really care about the lack of science.

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    Beth Collins, the medical direct of Lahey Hospital’s palliative care program. (Paige Pfleger/WHYY)

    “I don’t think things have to be proven, I think they just have to work,” Collins says. “To me, this is a heck of a lot better than giving somebody some medication that’s going to change things going on in their body. If her work is able to help a heart rate slow down, and someone not breathe as hard and be more comfortable, that’s better than anything I think.”

    In the time that Hollis has been visiting the hospital, Collins says there has only been one complaint about her service: families have said “Oh my god, no, if my father ever opened his eyes and saw somebody with a harp near his bed he would think he’d already died,” Collins says.

    And who can blame them? There’s a quintessential idea of death, regardless of what religion you are, which usually includes a bright light, angels perhaps, and of course, the sound of the harp.

    “There’s no denying that those associations are there, and that the harp can be very evocative for people,” Hollis says. “For some people, it’s evocative in a very positive way. They love the idea that their loved one, especially if they’re not conscious and speaking any more, might hear the music and feel like they were in heaven.”

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    Jennifer Hollis plays for Susan Steinbauer and her friend. (Paige Pfleger/WHYY)

    Susan Steinbauer passed away after this piece was reported. Jennifer Hollis has written a book about being a music-thanatologist — it’s called “Music at the End of Life, Easing the Pain and Preparing the Passage.” 

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