“Where Words Fail, Music Speaks”

Fabled creator of fairy tales Hans Christian Andersen observed that “where words fail, music speaks.”

MSK music therapy guitar player

And it is perhaps never truer than when a person is struggling with a serious illness. Music can connect one individual to another, giving “voice” without speaking a word.

Memorial Sloan Kettering is committed to helping people negotiate all the challenges of cancer and its treatment, offering a myriad of programs that provide support in dealing with the disease both physically and emotionally. And board-certified music therapist Karen Popkin, manager of MSK’s Music Therapy Program since 2006, is intimately familiar with music’s power to heal and facilitate communication during difficult times.

Karen is responsible for overseeing music therapy services for both MSK’s adult and pediatric patients. “I feel that there are more similarities than differences between the services we offer for adults and children,” she says. “In both cases, our main objective is to use music in a healing way and to build therapeutic relationships with patients and families.” A key component of MSK’s Integrative Medicine Service, the program was established in 2000 and has maintained an active presence since, fulfilling MSK’s mission in all three areas: patient care, research, and education. The program is academically affiliated with prestigious training programs at New York University and Molloy College.

In addition to Karen, the program has two other board-certified licensed music therapists, two graduate interns, and one pre-internship graduate student. Together, they offer bedside individual and family-based music therapy sessions; group-based music therapy in the Pediatric Day Hospital Recreation Center and the adult Patient Recreation Pavilion; and environmental music therapy (EMT) in different areas of the hospital, such as the Surgical Day Hospital and the Post-Anesthesia Care Unit. In these settings, music offers a means by which patients can better cope with the stress of surgery and recovery.

In addition to board certification, MSK music therapists are licensed by the state of New York to work with patients at the bedside and in small groups, customizing therapeutic interventions designed to address the needs of each patient.

Therapists are required to have skills on harmonic instruments (guitar and piano) and be able to produce a pleasing vocal sound, in addition to having a working knowledge of a variety of other instruments, as well as formal training in psychology. Karen uses guitar, voice, and various handheld percussion instruments in her work at MSK.

Music, Music Everywhere!

MSK music therapy extends even further afield than Memorial Hospital. “Our wonderful interns also provide outreach groups twice a month at Hope Lodge, the American Cancer Center home away from home,” says Karen. “And a new extension of our program called Rising Voices is the first North American chapter of Something to Sing About, a global consortium of choral groups for people with cancer. It’s led by a fantastic choral director, Sue Ribaudo, who also volunteers as the leader of the Threshold Choir at MSK and Bellevue Hospital.”

In addition, the music therapy program works with Musicians on Call (MOC), an independent organization that places volunteer musicians in healthcare settings nationwide. MSK was among the first hospitals to coordinate with MOC, which brings live and recorded music to patients’ bedsides.

Helping Marty and Vinny

Karen points to several stories as emblematic of the way in which music can make a profound difference in the lives of patients and their loved ones.

One of these patients is Marty*. He was referred by his nurse practitioner to the music therapy program for support in coping with anxiety. “When I met this young man, who was coming to grips with his diagnosis of testicular cancer, it was immediately apparent that he was overwhelmed, frightened, and very tense,” recalls Karen. “His mother was there and she was also experiencing difficulty with all the complexities a new diagnosis presents.”

Karen spoke with Marty, explaining some of the ways in which music therapy could be beneficial. “Together, we decided to use a music-assisted relaxation technique whereby he engaged in active listening while I provided live, gentle guitar music coupled with verbal cues for breath awareness,” she explains. In this technique, the pace, rhythm, and tonal progression of the music supports the meditation instruction.

“Marty was able to quickly make a shift from an over-aroused state to a calm and controlled state,” Karen continues. “When I completed the first phase of instruction, he said, ‘This is helping, can we do more?’ We continued with the technique for another ten minutes. Afterward, I learned he was going to be discharged, so I gave him information about our mind/body and music meditation podcasts so he could continue to explore this type of technique on his own.”

Another music therapist, Holly Mentzer, shares her experience with Vinny,* a 67-year-old gentleman who was undergoing a bone marrow transplant for leukemia. “He experienced a myriad of complications, which impaired his normally focused thinking,” she says. Episodes of delirium, paranoia, and depression made him appear at the outset to be angry and cantankerous. What she quickly discovered was that he had a warm and humorous side that was very much still present.

“By actively engaging in music therapy, Vinny was able to recall significant events and happy memories. He not only relived them through familiar songs but also allowed himself to join me in the music-making process,” Holly says. “I observed him singing and playing ‘California Dreaming.’ It was a transformative experience in which Vinny was playful, interactive, and able to enjoy life in the present.”

Everyone’s Voice Has Meaning

When Karen looks for music therapists to join the MSK program, she says, she wants men and women “with compassion and a sense of calling to work with people who have cancer.” Beyond being good communicators with an understanding of group dynamics, a repertoire of songs they can play, and improvisational skills, “it’s vital for them to have the ability to be fully present and able to listen deeply and empathically.”

She adds that it’s difficult to remember a time in her life when she was not singing or playing an instrument. “Finding ways to express my emotions and connect with others through music has always been a part of me,” she says. “When I learned about the profession of music therapy, I felt incredibly fortunate because I saw a way to bring my dual interests in health and music together. For me, this field elevates the art form beyond the realm of performance to a place in which every person’s authentic voice has meaning.”

*Name changed to protect privacy.

Memorial Sloan Kettering's Music Therapy Program is generously supported by Gabrielle's Angel Foundation for Cancer Research.