Diversion
Music may also be used to help time pass less noticeably. Listening is enjoyable but does not focus or sustain attention in any way comparable to playing. There will always be patients interested in learning to play music. The instrument of choice will depend upon individual taste, which of course is conditioned by background, education, nationality, age, and many other factors. The instruments which will be most acceptable are those which are not too difficult to play and which emit a pleasant sound with ease for a long period.
The piano is the instrument which best meets the qualifications of the ideal instrument for hospital use. When reduced to pure physics, the sound produced by striking a single note on the same keyboard will be of approximately the same quality whether made by a child or a virtuoso. This is not true of any other instruments, except to a degree in certain other percussion instruments, that produce less pleasant or interesting sounds. Piano fingering is more easily mastered than that of stringed instruments, and offers greater latitude in precision placement. The piano may be played in the restful sitting position and requires little effort to play. More people know how to play the piano than any other instrument. Patients may be interested in any of the other instruments, but with the exception of the plectrum type, may become too readily discouraged at the amount of practice required to elicit pleasant tones. If a patient is interested in learning an instrument for diversion, the piano should be the first offered. If the problem of replacing musicians in or completing a patient band arises, the missing instrument should be offered. But in order to get the maximum co-operation and application, the patient should be made to feel that the choice is his. The free choice might be vocal instruction. It may even be a disappointment to the musician when it turns out to be so-called instruments like the ocarina, but if the aim is diversion a maximum will be reached earliest by initial gratification. Perhaps at a later date the music aide may be able to inculcate enough sophistication to lead to the choice of a more musical instrument.
The scope of music as an educational diversion will expand in proportion to the training, patience and energy of the music aide. It will be limited by the number of patients who demonstrate an interest and also upon their intelligence and perseverance. For the major instruments, instruction is usually individual and much time is consumed in the diversion of a single patient. In a large hospital this will not be very practical unless there is a large staff, and there are many activities available to patients. Group diversion can be happily attained by some form of instruction in music appreciation. The nature of this instruction should be tailored to the intelligence and taste of the majority and the music aide must exercise common sense and free himself of prejudice. If the patients are young and uninterested in the classics he must devise a program around popular music and discuss current personalities and popular forms. A driving wedge into the classics may be constructed on the classic themes of Tschaikowsky, Chopin and others which are currently popular. If the group is very young, music appreciation demonstrations such as those conducted by Walter Damrosch should be followed. Whenever possible, the musician should illustrate with “live” music, but recordings will be well received. As with all other features of a musical program in the hospital, sessions should be regular and governed to some extent by the will of the majority.
CHAPTER NINE
PUBLIC ADDRESS SYSTEM
Many hospitals now have public address systems. Before long most hospitals of one hundred or more beds will have public address systems, if for no other reason than emergency calls and to lessen the load on the intramural telephone network.
The public address system originally installed as an emergency call device may be used for music reproduction at relatively little increase in expense. The same operator may be used for both forms of transmission. Ideally, the system should include a loud speaker in every ward and a “phone-jack” at every bedside. The central switchboard should have a good radio and an automatic record player which may transmit music to the patients by means of the public address systems. The addition of a set of switches which can cut wards in or out at will can prove most useful. If there are halls or buildings from which programs of general interest emanate frequently, they should be equipped with microphones which are connected with the central switchboard so that musical programs from the assembly hall or the church services from the chapel may be broadcast to the non-ambulatory patients.
The central switchboard should be housed in a relatively sound proof room or booth. Additional equipment for it should include shelves for recordings and a telephone for which the usual bell signal is replaced by a light signal. An instantaneous record-cutter which permits the operator to record programs from the radio or microphone will be found of great value, but the expense involved may be too great for most hospitals of fewer than 500 beds.
It is most advisable that a full-time operator for the system be employed. The operator should have a pleasant voice, but even more important, a highly intelligible one. He will require some basic training in the operation of the switchboard and its accessories and this should be the obligation of the organization which installs the equipment. The operator should be required to keep a written record of everything that emanates from the studio. He should be responsible for the routine care of the apparatus and know enough about its parts to recognize defects early and to correct some of the simpler ones. He must be prepared to live a lone life. There is always a temptation to invite or permit guests in the studio, and the resultant diversion or conversation might adversely affect the broadcast.
If an instantaneous record cutter is available he should read “How to Make Good Recordings” (Audak Co. of New York) which is not only valuable for the recording of music but gives some excellent advice concerning the use of the proper needle for music reproduction and the use of the microphone.