The musical program of a hospital need not necessarily be conducted by a musician, but a trained person is most desirable. There are people with an intense love for music and so comprehensive a grasp of its many fields that they might be capable of conducting a hospital program although unable to play an instrument. At some institutions music has been guided by volunteers with great satisfaction to staff and patients, but this is an age of specialization and a paid, trained musician will usually be worth the salary in efficiency, dependability, and control.
Director
Music for patients differs from music for the well. The average musician is not qualified to decide which patients should or should not have music. There are too many well meaning musicians who have had one or two personal experiences or heard of others in which the efforts of the musician were rewarded by apparent miracles of mental reaction. Musicians are not capable of evaluating such changes nor do they bother to recount what the condition of the patient was an hour or a day after this personal exposure. Musicians must have medical direction. The medical director of music does not have to be a trained musician but he should be acquainted in a general way with most musical forms which appeal to a majority of patients. His most important qualification will be the ability to rise above personal prejudices of musical taste. He must recognize that musical tastes can be as diverse as individual appetites for different foods, and feel free to order music as he would food for patients. It will be his duty to prescribe quantity, quality, duration, and intervals of music; to contraindicate music for the irritable, certain post-operative patients, the acutely ill, and any others for whom he thinks music is wrong. It will be necessary for him to protect the patients from the possible musical whims, hobbies, convictions or over-enthusiasm of the musical aide.
The director should be selected from volunteers on the staff. For the physician director of music to be chosen in any other way is to hamper the musical program. He must be a physician who has the time or can make the time to carry out his part adequately. At the outset the director should have daily conferences with the senior musical aide in which he should not only outline the procedures desired but should observe the musician at work with patients.
Music Aide
There is considerable disagreement concerning the title most desirable for the person conducting music in the hospital. The term “musical therapist” implies a training not only in music but in treatment. The occupational therapist has had a training not only in crafts, but in basic medical subjects, psychology, and some clinical subjects. Until musicians can take similar courses at accredited schools a different title seems wiser. At some hospitals the workers are called recreational aides, but such people also conduct other recreational activities. It seems picayune to argue over terminology, but the hospital music worker must be called something and it is hard to conceive that anyone would find fault with the appellation “music aide” for those people who bring music to the patient.
A music aide may be of either sex and of any age. The choice will depend not only upon what is available locally but on such considerations as the personalities involved and personal recommendations. If intelligence is not exercised, the program will fail because the senior music aide is the keystone of the entire structure. For a children’s hospital, a woman who has raised children would seem most suitable. The aide for children should be able to sing and play the piano. She should also be able to play musical games with children.
For a hospital of young adults, such as the average hospital for the tuberculous, a young woman between thirty and forty will have the energy, drive and spirit to match the requirements and contemporary tastes of the patients under her care. The aide for this type of work should also be able to lead group and mass singing and be able to play an instrument. Ability to play a second instrument, or to teach it is a valuable asset.
For the mental hospital an aide should be mature, patient, well informed and have the urge, but not the preformed opinions, for handling the mental patient. For the hospital treating the aged or other chronic patients, an older man or woman is desirable.
It is preferable for any aide to have had some formal musical instruction. Most desirable is a graduate of a musical conservatory or of a college which offers a major in music. The music aide should play at least one instrument, and preferably the piano. If the hospital budget permits additional music aides each successive one should know another instrument. The aide should be able to play music at sight and sing with an acceptable voice. The chief qualification should be the absence of “artistic temperament.” Patients are admitted to a hospital for medical care, not musical knowledge. The aide should not consider them as music students. Music should be given to them with patience and without undue emotion. If music evokes a marked mental response it may be beneficial, but it should be the music and not the musician which elicits such reactions. Previous experience in teaching music is a valuable asset to the music aide.