Q I specialise in music therapy because...
A Medical music therapists apply music in both scientific and artistic ways to achieve health, rehabilitation and well-being goals. These goals are targeted towards the patients' mobility, brain function, communication needs, physical rehabilitation and emotional well-being.
I am there for patients in difficult moments as well as positive ones. For example, I act as a pillar of support and comfort for them as well as their loved ones when patients take their last breath.
Q Music can heal because…
A Studies have shown that the effects of music can impact our DNA on a cellular level.
In music therapy, the patient's preferred music is usually performed live. And the music therapist is attentive to whether the patient needs to focus on the music instead of the pain, or whether a certain rhythmic pattern could motivate him to continue with the exercises that he needs to do, for instance.
There is a therapeutic reason for choosing a particular song that is played with a specific key and tempo, using certain instruments.
For example, therapeutic singing interventions are used to help patients with brain injuries regain their speech.
And, live lullabies, when used with various gentle stimulation such as the soothing sounds of ocean waves, can help premature infants maintain a calm state.
Lyric discussions or song-writing techniques are also used to address the emotional needs of patients with chronic illnesses.
I also use music to conjure up a positive memory for a patient to encourage him on the road ahead.
Q If I were to give an analogy for what I do, I would...
A Be a musical buoy that can be anchored or made to drift with the waves. I help patients harness their inner strength and musicality to ride the rapids or sail through the calm waters of their medical journey.
It is up to patients to decide when and how they want to access and use the buoy - as a flotation device, as a resting or reference point, or as a resource for problem-solving or decision making.
Q I have come across cases including...
A Teenagers and children who are diagnosed with cancer, premature babies, survivors of road traffic accidents, and children with conditions ranging from short gut syndrome to skin disorders to pneumonia. Some of them require frequent hospitalisation or may have medical needs requiring extended hospital stays.
Q A typical day...
A Starts at 9am with the planning and reviewing of cases. Before I head to the wards, I often prepare newly requested songs or materials by typing out lyrics, editing recordings or making CDs as keepsakes.
I may work with up to eight patients a day. The length of each session is variable. It may take 15 minutes for a fretful infant to calm down after a needle prick. Or it may take 45 minutes to support an adolescent who is undergoing neuro-rehabilitation to improve his upper limb coordination as well as his communication skills.
Many sessions are held at the patient's bedside with the curtains drawn. I sometimes work with other allied health professionals, such as a physiotherapist or occupational therapist at the rehabilitation gym, the ward play area, or the music therapy room.
Q One little-known fact about the rhythm in music is...
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BioBox
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MELANIE KWAN
AGE: 45
OCCUPATION: Senior music therapist in Champs (child life, art and music therapy programmes) at the rehabilitation centre in KK Women's and Children's Hospital (KKH).
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When Ms Kwan was 15, she learnt about alternative careers in music from a book on music therapy for children with disabilities.
She went on to get a degree in music education as well as one in English literature from Andrews University in the United States. As an undergraduate there, Ms Kwan observed music therapists at a special school and a mental health facility, and saw how music therapy was used to heal people.
She also has a master's degree in music therapy.
She recalled: "What blew me away was that music brought out motivation and engagement from individuals with a range of learning and movement difficulties, along with plenty of laughter and smiles."
She said it can also work to relieve pain or discomfort, achieve rehabilitation goals and instil hope in patients.
She has been a board-certified music therapist since 2000 and is one of two music therapists at KKH.
Patients are not required to have prior experience or training in music.
She said: "We tailor the music to meet them where they are at - whether they are heavily sedated, non-communicative, restless, agitated or in pain."
A Rhythm is processed not just in the brain, but also by numerous motor receptors in the body.
From the regular beating of our heart to our speech, to even picking up and drinking from a cup, these biological processes and movements are intrinsically rhythmical but may be disrupted as the result of a brain injury.
Music can be used to retrain and re-educate the injured brain.
Q Patients who may not be suitable for music therapy include...
A Those who are uninterested in music. But an important part of our work is to show patients that engaging with music is safe and useful.
Q Those who are deaf or hearing-impaired can still do music therapy because...
A Sound waves are actual vibrations that can be felt.
A child with hearing impairments can go right up against a piano, a guitar or wooden xylophone to feel the vibrations against his back.
Q It breaks my heart when...
A I hear phrases starting with "don't", such as "don't be scared", "don't cry", and "don't be sad".
Doing so tells young patients that something is wrong when they feel the way they do, or that they are not brave. It is important, instead, that their feelings be acknowledged and expressed so that we can work through them rather than suppress them.
For example, when we support children undergoing medical procedures, we let them model after us by singing, "I am so brave. I am not alone and (name of KK Women's and Children's Hospital staff) is here with me. I am safe and KKH staff care for me".
Q My best tip is to...
A Give yourself the freedom to be musical, expressive, creative and motivated, and spend time musically with your friends, such as by singing karaoke or strumming the ukulele together.
