When one works in palliative care, one is faced with death every day.
I work at the Palliative Care Unit in the Department of Medical Oncology at Centre Fòrum, a hospital in Barcelona, Spain. People often ask, “Why would anyone want to work in palliative care? Isn’t it depressing and sad?” One might think so, but paradoxically that’s often not the case. When we know the end is near, we are often more determined that ever to squeeze life out of our remaining days and be positive – and it often has an inspiring effect on the hospital’s staff.
It’s a challenge to bring forth positive, healing, and life-affirming experiences when we are sick, in emotional or physical pain. And if we are stuck in a hospital bed in a sterile white room, knowing our lives are likely nearing an end, that’s even more challenging. But that’s why music therapy is such a powerful intervention in palliative care and hospice. The end of one’s life is an obvious time for reflection, and music therapy contains multiple mechanisms that can provide physical, psychological, emotional, expressive, existential/spiritual and social support at this stage:
Often we do a “life review”. Patients enjoy reliving fond memories of their past. Also, they may struggle with unresolved conflicts, estranged relationships, spiritual distress, worrying about how they will be remembered, and music therapy can help them process these feelings as they come up in sessions.
I could describe a lot of profound and magical moments I’ve witnessed with patients and their families in my time as a music therapist, but one of my favorite experiences was with Esther, a lovely woman fighting breast cancer that passed away August 2018. Esther demonstrated more than anyone else I met the power of music therapy in this setting. Her spirit and resilience as she fought breast cancer was inspiring.
Songwriting is an especially powerful music therapy intervention for people near the end of life to express themselves, as well as leave legacy gifts of music for their loved ones to remember them by…
Watch this video of Esther’s song “Jo Decideixo / (I Decide)” (shared with her permission) in 2017 in her hospital room. Lyrics in Catalan, with English translations, are below the video.
Esther is in the big chair. Co-writer (and head music therapist at Centre Fòrum) Jordi Mercadé is playing guitar, I’m playing bongos and tambourine, and other hospital staff (nurses, doctors, and a psychologist) are singing with us.
RIP Esther, you are amazing! ♥
JO DECIDEIXO / (I Decide) – written by Esther Vollmer and Jordi Mercadé
Hi ha vegades que la ràbia t’envaeix / (There are times when rage overtakes you)
I no sempre és la malaltia que no l’entens / (And it’s not always the illness that you don’t understand)
T’ha canviat la vida i això et fa mal / (Your life has changed and it hurts you)
Però ho intentes superar / (But you try to overcome it)
Vas aprenent a conviure amb el que tens / (You learn to live with what you have)
I t’agrada que t’entenguin i et vegin tal com ets: / (And you like that the others understand and see you as you are:)
Una persona amb ganes de viure, / (A person who wants to live,)
Una persona amb ganes de riure, / (A person who wants to laugh,)
Una persona que vol ser com sempre feliç / (A person who wants to be as always happy)
Jo decideixo el que puc fer / (I decide what I can do)
Jo em coneixo / (I know myself)
Jo sé fins on puc arribar / (I know where I can get)
Jo em coneixo / (I know myself)
No decideixis per mi / (Don’t decide for me)
No pensis el que és millor / (Don’t you think what is better)
Jo ja ho sé, en sóc conscient / (I already know, I am aware)
Jo decideixo! / (I decide!)
Agraeixo als que volen que tingui el millor / (I’m grateful to those who want me to have the best)
Però tingues en compte la meva opinió / (But keep in mind my opinion)
Jo sé el que vull, jo sé el que puc, jo em conec / (I know what I want, I know what I can, I know myself)
Jo em conec més que tu / (I know myself more than you)
El meu cos em parla, de vegades fent-me mal / (My body talks to me, sometimes hurting me)
De vegades limitant-me la mobilitat / (Sometimes limiting my mobility)
Llavors paro: jo sóc mortal / (Then I stop: I am mortal)
Però quan milloro espero suport, / (But when I improve I expect support,)
companyia i decisió. / (company and decision.)
REPEAT CHORUS (2x)