Music therapy: Healing with melody

NORFOLK, Va. — When the Johnny Cash melody frustrates James Rodriguez, he chuckles, shakes his head and says, “I don’t know.”

Tracy Bowdish gently pushes him, taking his hand into hers as she leans closer and sings in bell-clear perfect pitch lyrics from “I Walk the Line.” The goal is to get Rodriguez to find the words, still a difficult task since his stroke in summer 2011. But his progress has been remarkable, says Sandra, Rodriguez’s wife of 47 years, who sits within arm’s reach of him, nodding.

They are in a small room inside Fort Norfolk Medical Center — Rodriguez in his wheelchair and Bowdish on a low stool sandwiched between an imposing keyboard and a computer desk. Bowdish is a music therapist with Sentara Music and Medicine Center. In a promotional clip for the program, she mentions that her blindness helps her to engage patients, to “see who they are beyond the stroke.”

As Bowdish holds Rodriguez’s hand, singing lyrics she wants him to repeat, his frustration disappears. Bowdish then pats around for the guitar behind her and strums the chords one more time. Rodriguez joins her on the chorus. His words, though slurred, are clearer, his tone more confident as he sings, “Because you’re mine, I walk the line.”

The Sentara Music and Medicine Center, a part of Sentara Neurosciences Institute, has extended its reach well beyond rehabilitation rooms in which Bowdish and other therapists use rhythmic stimulation and synchronization to create movement and drive speech in patients with neurological damage.

The program also sponsors a lunchtime jazz showcase in the lobby of Sentara Heart Hospital in Norfolk. Gad Brosch, who retired from obstetrics and gynecology 23 years ago, is among the musicians who play in the showcase. He devotes much of his time these days to the jazz he’s loved since his childhood in Israel.

“When I retired, I was thinking about what I wanted to do with the rest of my life,” says Brosch, a pianist who has played the Steinway in the hospital’s airy lobby once a month for the past four years. “There’s life after you retire, and for me there’s the music.”

Stylish in a tie zigzagged with red stripes and piano keys, Brosch says patients were wheeled down in the lobby to listen when he first started playing there. But for logistical reasons, that isn’t done anymore. Still, his straight-ahead takes on the American Songbook soothe outpatients and visitors. The unobtrusive music not only brightens the atmosphere, it also serves a clinical purpose, chiefly to help relieve anxiety. This is a much more accessible, streamlined version of what the Sentara Music and Medicine Center offers its patients.

“The basic physiology of our bodies is rhythmic in nature; therefore it is strongly affected by external rhythms, which are an essential component of music,” says Kamal Chemali, a neurologist who directs the Sentara Music and Medicine Center. “Our brains are hard-wired for music. Therefore, music, more than any other form of art, activates neurons in most of our brain, and by doing so, reactivates areas that were damaged, and creates new connections between nerve cells to bypass the damaged areas. This leads in many cases to dramatic improvement and recovery of function.”

The program is largely beneficial for patients dealing with certain conditions, including multiple sclerosis, gait disorders, Parkinson’s disease, and language and memory disorders. Chemali says that others dealing with anxiety, lethargy, breathing disorders, cognitive problems and chronic pain have also seen improvements with therapy from the Music and Medicine Center.

Other health facilities in the Norfolk area, such as Bon Secours DePaul Medical Center, also have a form of music therapy. Bon Secours DePaul’s Healing Touch program has a harpist on its part-time staff. The Sentara Music and Medicine Center, however, has a more involved approach, targeting neurological disorders specifically.

Data to quantify the success of the program, which started in 2011, is being analyzed, says Chemali, who came to Sentara Music and Medicine from the Cleveland Clinic in 2012.

For Rodriguez, the Sentara Music and Medicine patient recovering from a stroke, the therapy over three years has helped to bring back glimmers of the affable guy he was before — the former insurance salesman who met his wife 50 years ago at the old Peppermint Beach Club in Virginia Beach.

Singing uses more of the brain than speaking, Bowdish explains. After they finish “I Walk the Line,” Rodriguez and Bowdish launch into “I Love You, Lord,” a song Rodriguez used to sing in church. He handles most of the melody, with Bowdish jumping in here and there to help stimulate more speech production.

“Can you say, ‘I love you’?” Bowdish asks Rodriguez.

He nods.

“Tell your wife, ‘I love you.’ ”

Rodriguez turns his head slightly toward Sandra, his words clearer than they’ve been for most of the session, when he says, “I love you.”