Given that medical science is enamored of diagnostic machinery, new drugs and specialization, alternative therapies are not readily accepted. But there is a place for music therapy, especially in intensive care (IC) wards, which is now in use at the Onassis Cardiac Surgery Center. The suggestion came from cardiologist-composer Thanassis Dritsas, and was accepted by Professor Costas Stefanis, psychiatrist, academician and director of the hospital. A voluntary listening system has been installed in three IC wards. Each bed has earphones offering patients a variety of music according to taste. The objective is to combat stress and assist smooth, speedy recovery, whether patients have had a heart attack or bypass surgery. «The relaxation that comes from listening to music can slow down the heart beat and breathing and reduce diastolic and systolic pressure,» Dritsas told Kathimerini. «It has also been shown to lower the level of neurohormones in patients’ blood.» Does this mean that music can replace drugs? Authoritative medical journals have published results that might convince even the most skeptical observers. One thing that music therapy achieves is to restore the human face of medicine. Losing sight of the wood for the trees, conventional medicine has started to treat patients as objects or guinea pigs that are stuck in the intensive care ward, sprouting catheters. Dritsas, a pioneer of intensive care music therapy in Greece, talked to Kathimerini about this alternative treatment. How much stress does a patient in intensive care suffer? A great deal. Think about it. Someone knows he’s had a heart attack and is in an intensive care ward. Apart from the stress the body undergoes from the disease itself, there is also the subjective feeling, the fear of sudden death, which drastically raises adrenaline levels. I felt that music could act first of all as a stimulant that would distract the patient from anxiety-provoking dialogues among his doctors: «What’s he doing now? What can you see on the cardiogram? What’s his pulse?» Patients listen to all of that very intently. As we know, mental stress can have very severe consequences, since one bad thought can speed up a patient’s pulse as much as running a race. And the higher the adrenaline levels at this stage, the greater the danger of a sudden attack. A distraction Does music combat stress effectively? Someone listening to music is more relaxed and daydreams more easily. Music is like a fairy tale, taking us away from reality and curing us. In the ward, it distracts the patient from the emergency and also from the sounds of the monitor tracking his pulse at 100-120 a minute. Does cardiac disease have special features which make music therapy more beneficial? When you’ve had a heart attack, adrenaline rises. It’s a normal reaction. But it rises even further because of fear and panic, so it is important to subdue these feelings. People who suffer great panic and stress don’t do as well in surgery as those who are calm because they are informed about their illness and can beat pre-surgery nerves. Is music the drug? There are two drugs that anaesthetists can administer when preparing patients for surgery, and music can replace both of them. Studies show the exact amounts of each drug which can be substituted by music therapy. What we are studying now is the effect of music on patients after surgery and before they come round. International studies concur that in the early post-operative phase, music reduces the amount of drugs needed, lessens pain, subdues excitable patients better and leads to better sleep. This last point is vital. Some people remain sleepless for a long time in IC wards because of all the general stimulation. Has recent research led to the adoption of music’s new uses? Music as a drug, no. We are international pioneers. Very few clinics in the world have completely adopted the new way of thinking and implemented these methods. But the inclusion of music in medicine on an objective basis is very recent. In the past decade, there have been many studies (at the Onassis Center as well) using questionnaires and objective measurements. By using positron magnetic tomography, we can monitor what happens when patients are listening to music. We see which areas of the brain are involved in the reaction, whether some areas linked to pain are deactivated, how music affects the parts of the brain such as the amygdala which is linked to all types of addiction, the feelings of pleasure, enjoyment and distaste. Are these fields unknown to medicine? This study of music allows us to enter a new field which is called the medicine of emotions. Until now, we were unaware of its importance. We used to say: «Oh, it’s good that you have less pain, feel better, feel more joy,» but we didn’t know objectively what caused it. Now we can measure it (feeling) and say that in essence, it is the birth of an entirely new way of thinking in medicine which shows that feelings are important, that they have physical projections and translate into bodily reactions. The holistic spirit This confirms the holistic spirit in medicine. We cannot look at each problem separately from the whole person. Does this confirm the value of the human approach to the patient and of a proper nursing environment? We now know that this human approach, to engender optimism and cheerfulness in somebody who is recovering in hospital, to convey a positive outlook, to take him out of him or herself with music is an objective fact; it is not something that is simply registered subjectively. Is there a particular kind of music used in the wards? The choice of music for therapeutic use is influenced by the culture in which each person has been brought up. Western music incorporates styles such as light, serious, folk, religious, pop and Afro-American. It is very difficult to cater for such complexity. That’s why each patient can choose the type of music he prefers, and of course, listening to it is voluntary. We often play music composed of natural sounds – the sound of the sea or dolphins. An image, a video wall on the ceiling might be even more effective. The patient could feel as if he was traveling in water. This might sound strange. But I think that a hospital can become more and more like our normal environment, like home.