Nov. 6, 2000 -- It was the day of her surgery, and Kate Richards was face to face with her phobia -- the surgery itself. Her diagnosis: a large ovarian cyst, which caused episodes of tremendous pain. She needed surgery soon, her doctor advised her.
"I was terrified," Richards tells WebMD. "My mother had multiple surgeries when I was very young -- years ago -- and she had a lot of pain with them. I knew my fear was related to what she had gone through. I knew that things are different in hospitals now ... but still there was this whole imprint of that experience." Richards just couldn't get past her anxieties.
Richards -- a trained vocalist and songwriter -- turned to music to soothe her fears. Wearing headphones and listening to her own singing on tape, she was ushered into surgery. When she woke up in recovery, a real-life guitarist was strumming her favorite lullabies. "The woman in the bed next to me was smiling," Richards remembers. "It wasn't the usual recovery room experience ... loud, abrasive, harsh ... I somehow felt my nerves were being massaged."
Her experience is not unique. In a sprinkling of hospitals, music is increasingly being used as therapy.
"Selection of music is very personalized," says Joanne V. Loewy, PhD, director of the music therapy program at New York's Beth Israel Medical Center. "For some, classical music might work best, for others it might be jazz. It depends very much on the person."
"Music therapy is about being in the moment and adapting music to fit the patient's needs," Loewy tells WebMD. "There are no distinct recipes."
As in Richards' case, music can ease anxiety and even reduce the perception of pain. It can even decrease the need for medications that help patients deal with fear and pain, says Loewy, who consults internationally with hospitals starting music therapy programs.
"We see it in patients admitted for any kind of surgery," she tells WebMD. "For some, it's fear of surgery ... for others, even having blood drawn can produce a lot of anxiety." At Beth Israel, if that fear of pain is preventing you from facing the procedure, musicians can be at your side -- perhaps playing an improvisational piece -- helping take your focus away from your fears, away from the pain.
"I still felt the pain but could tolerate it. ... I guess the music helped me relax, so it softened the pain. I needed less pain medicine because of it," she says.
Loewy says, "There's a belief that music and pain are processed along the same [nerve] pathways. So if we have a patient playing or focusing with the music, they won't feel the pain."
Even asthmatics are benefiting from music therapy -- learning to breathe and gaining better breath control by blowing a horn or other wind instrument, Loewy says. "They're working lung muscles, but they're also creating something." That's somehow fitting, since Beth Israel's music therapy program is funded by the estate of legendary jazz musician Louis Armstrong, she says. "He would love it that we use winds to build lung volume capacity through breath control."
With asthmatics, music therapy does not replace medications -- it is used in conjunction with them. Research shows that asthma medications actually work better when the patient is relaxed, Loewy says.
Music also helps newborns thrive in Beth Israel's Neonatal Intensive Care Unit. Just one hour of music every day helps babies "eat more, sleep more, gain more weight. These babies are very compromised. They're on machines. The environment is typically very loud and noisy. Music softens the environment and soothes them," she says.
And for dying patients, music can help provide a "transition from life to death," Loewy says. "It might be during the weeks before death. It could be during the last few hours."
Mood disorders -- often seen in hospitalized patients -- can be eased through live music sessions in the hospital room, says Paul Nolan, director of music therapy education at MCP Hahnemann University Hospital in Philadelphia.
"Being in the hospital is anxiety-producing in itself," Nolan tells WebMD. "Facing a catastrophic illness also affects emotional well-being. Some patients are reluctant to work with a psychiatrist because of the stigma, but they're not resistant to working with a music therapist."
Through music, the therapist works to "attract that which is healthy in the person," Nolan says. "The music therapist isn't so concerned with the direct medical illness. They're working to change mood ... creating a feeling of support for the patient." The music connects them with memories, associations, thoughts, and helps them relax and feel nurtured, he says.
If those memories are not positive, Nolan says, "that's fine, because the patient needs a way to talk about them. If those feelings are repressed, they continue to create tension. If we release them, we have more control over them, and we realize that the thoughts can't hurt us. And we release the tension."
And music can bring elderly patients with dementia into the present -- unlike anything else, Nolan says. "Sometimes, they will refuse to see anybody and won't cooperate with doctors. They can't converse with people ... they won't recognize a spouse of 60 years, but they will recognize the song 'Amazing Grace'. Even if just for a few moments, the music provides an orienting response to time and place and person.
"It's not like you're playing at them, like in a concert," he tells WebMD. "You're hearing their rhythms, their sounds, and even looking at their body and breathing. You're adjusting your music, your tempo, how much tension is in the music, based upon what the patient's response is. We're not just getting a musical response from the patient; we're basing it on what the response is."
Patients who have experienced heart failure -- and are awaiting a heart transplant -- benefit greatly from this nurturing relationship, says Cheryl Dileo, PhD, music therapy professor at Temple University.
"These patients do not leave the hospital," she tells WebMD. "In some cases, they're here more than a year. Research shows that patients like this ... are under a great deal of stress. We've found that music therapy improves their heart rate, blood pressure, sleep -- the demands placed on the heart."
According to Dileo, the music opens many doors. "[Patients] feel more like talking after the sessions," she says. "Music brings people together ... helps them feel less isolated. It spontaneously stimulates discussion, memories, feelings. This is an opportunity for patients to express their feelings in a safe environment."
The music also can bring patients in touch with something bigger than themselves. "We sing many spiritual hymns," Dileo says. "People in this situation have a heightened sense of spirituality."