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by Tessa Forsythe
Harriss not only plays for dying patients, but also for cancer patients.
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Music Thanatologist Eases Patients' Deaths
Sile Harriss tunes the smaller of her two harps. -- Tessa Forsythe, photo
Sile Harriss confronts death every time she grasps the pale, cold hand of a patient whose breathing is raspy and staggered. She plays her harp for that patient and perhaps is there when he takes his final, painful breath.
Harriss said witnessing a person's death is awesome in the best sense. "You see in awe the beauty of the human life and the relationship with death," she said. "I often feel some sadness, and I often feel some joy. I often just sit speechless because [death] is that big of an event...it is very sacred, it is very holy."
Harriss' job is to play her harp for terminally ill patients at Providence Medical Center. Harriss uses her knowledge of the human body and education in music theory to play vigils designed specifically for the patient's physical, spiritual and emotional needs.
The process is called music thanatology. Music thanatology is offered to dying patients after medical intervention no longer works. "When we can do no more for them physically, there is always the gift of music," Harriss said.
Paula Gunness, senior public relations coordinator at Providence, said Providence Health System is one of the few hospitals nationwide to offer music thanatology, which is a free service for the patients.
Music thanatology is rooted in the ancient use of music in medicine, as well as in scientifically proven physiological affects of music. Professor David Jongeward, professor of psychology at Multnomah Bible College and Seminary, said music affects heart rate, blood pressure, brain waves and perspiration. Music helps people relax.
Harriss said music thanatologists work deliberately with rhythm, melody and harmony to affect physical pain, anxiety, breathing, heart rate and muscle relaxation.
"We know that rhythm and the metabolic systems in our body are related," Harriss said. "And we know that our nervous systems and the melodic content are related. We know that heart processes and lung processes, including the emotional and spiritual heart processes, are connected intimately with harmony."
Science can prove that music affects the body; however, much of the how remains unknown.
Harriss said, "On one level I can talk to you about how we think music works, but on another level there is so much that we don't know. It is part of the larger mystery."
Music thanatology has been developed over the last 30 years by a harpist named Therese Shroeder-Sheker and the Chalice of Repose Project, according to the Music Thanatology Association International's website (www.music-thanatolgyassociation.com).
The Chalice of Repose Project offers the only graduate program for music thanatology in the United States. Harriss said the two-year program includes harp and voice lessons, medical and musical studies, studies on world religions and their views of death, anthropology and an internship.
Harriss said, "I just reached a point in the middle of my life, like many of us do, when I needed to make some major changes."
A friend, who is also a harpist, told Harriss about the school. She graduated from the program in 1994 and taught at the Chalice Project for six years before working at Providence.
Harriss not only plays for dying patients, but also for cancer patients and others who have serious diagnoses, Gunness said.
One day, Harriss played for a man who had no family. "He was very sick. He wasn't dying right then, right there, but he knew that this was in his not-too-far distant future," Harriss said.
"And as I played for him, watching his breathing in particular, his eyes just filled up, and he spent a lot of time just looking at me. His statements later were he had never had an experience like that, or love delivered in that kind of way."
Harriss plays all different types of rhythms and melodies. Each vigil is different because she gauges her music according to the emotional and physical state of the patient.
The first thing Harriss does is to gather information on the patient's background by reading the patient's chart and, when possible, talking with the family.
"Sometimes I need to work specially with families," she said. "If they are terrifically distressed or scattered or in denial about an impending death, then I need to pay attention to them first."
She uses the information she gathers to give her an idea of how she will compose her music for the patient and his family.
"You may start with an idea about what music would be applicable and how to use it, and that might just change in an instant when you walk into a room and see what is going on right now," she said. "The music needs to be flexible enough so that you can tear it apart and put it back together again."
When she enters the patient's room, she greets him with warmth and tenderness. She takes his hand into hers while she introduces herself. One hand she places gently around the patient's wrist and the other holds the patient's hand.
While setting the patient at ease, she subtly makes observations that are crucial for the vigil she is about to perform. She holds his wrist to check his pulse and, while talking to him, she counts the heartbeats in her head.
Harriss watches the patient's breathing, noticing how often and how deep his breath is. She can tell if the patient is tense or frightened and if the patient has difficulty breathing. Harriss gauges the blood flow of the patient by the warmth of his hand. The whole process happens within minutes and is unknown to the patient.
As a person enters death, his heartbeat and breathing slow down and become irregular. "I use a lot of unmetered music, music that doesn't have a beat, doesn't have a rhythm because at the end of life, the physiological processes become very irregular," Harriss said.
"If you were looking at it on a monitor, the terrible term is 'flat lining.' Unmetered music lets me follow those processes much more carefully and support people," she said.
Harriss sometimes supports the breathing of a dying patient with her music if the patient isn't quite ready to die. "People really need to be gathering up their strength to let go," she said. "It takes an effort to die. It is not always easy work."
Harriss said about 80 percent of the patients she visits fall asleep. When that happens, Harriss finishes her piece, tiptoes out of the room and heads for the hospital's prayer chapel. Alone with her thoughts, Harriss spends several minutes thinking about the patient. "Some people view [death] as the biggest event of their lives," she said. "And it seems like we are just learning in this culture to pay attention to it again with the attention it deserves."
Music thanatologists use the harp because of its universality and rich, soothing tones. "Every culture that we know of has made some sort of harp," Harris said. "Along with percussion, harps are the most common instrument cross-culturally." She can pluck just one at a time, or several strings, which gives the music a rich texture.
Most of the music Harriss plays the average American wouldn't recognize. Harriss said some songs she plays go back as far as 1,000 years. "I use a lot of lullabies," she said.
Not every patient responds positively to Harriss and her harp. Harriss said that some people find the harp offensive because of the connotations with angels and death. Often, those are the people who are not ready to accept they are dying.
She also sees patients who just don't like the harp. "Some people go out playing '20s jazz music, and that's fine," she said.
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