Allegro

‘How very much alive I am’

Stroke survivors and their caregivers share the joy of music

Volume 115, No. 4April, 2015

Joanne Loewy, DA, LCAT, MT-BC
Singing Together Measure by Measure is a choir and a forum for community health and wellness. It's for stroke survivors and caregivers, and it's free and open to the public.

Singing Together Measure by Measure is a choir and a forum for community health and wellness. It’s for stroke survivors and caregivers, and it’s free and open to the public.

What is it about singing that enhances speech and our willingness to communicate? The research team at Mount Sinai Beth Israel’s Louis Armstrong Center for Music and Medicine is eager to learn about the impact of singing on health and how the elements of music and speech may stimulate conversation. Music and singing can improve language, elevate mood and foster community connections, which becomes particularly important for survivors of stroke and their caregivers.

The medical literature is full of accounts where the ability of stroke survivors to speak is recovered when singing familiar songs. Olaf Dalin was the first to report this, centuries ago. Dr. Dalin, a Swedish physician, observed in 1736 that a man with brain damage astonished his community of churchgoers one day by spontaneously singing hymns. A more recent example is former Representative Gabrille Giffords, who was critically injured in 2011 when a gunshot wounded her brain. During her early recovery, she was shown singing along to Tom Petty’s “Free Fallin’” and Cyndi Lauper’s “Girls Just Want to Have Fun” even when she was struggling to speak. The songs came out easier for her than everyday speech.

In research published last year in the journal NeuroRehabilitation, one of my colleagues – Jeanette Tamplin, a music therapist from Australia – led a team who followed 13 patients with aphasia who participated in a weekly choir. (Aphasia refers to language trouble caused by brain damage.) Their study showed that before joining the choir, participants had greater negative mood symptoms and poorer subjective sense of belonging compared to general population samples. But results suggested a trend towards reduction of psychological distress after participating in the choir. Quality of life and community participation increased.

Much medical research in the past several decades has focused on brain function. Neural pathways, we now understand, have a restorative capacity. The phenomenon includes an observable effect called “music memory.” The brain often remains seemingly intact in places where singing, melody and rhythm had been connected and fused, even when the meaning of words and the ability to use language might seem otherwise impaired. Research and clinical practice involving singing and aphasia are growing globally.

Joanne Loewy, director of the Louis Armstrong Center for Music and Medicine

Joanne Loewy, director of the Louis Armstrong Center for Music and Medicine

I lead a weekly singing group made up of stroke survivors and their caregivers. It’s called Singing Together Measure by Measure, and it’s free and open to the public. One of the group’s members, Andy Polon, has been a Local 802 member since 1973. His stroke occurred in late 2003. I recently sat down with Andy to chat about his involvement in the stroke choir. (Also see Andy’s web site and blog at www.andypolon.com.)

Andy Polon: I had been a professional guitarist and guitar teacher since the early 1970s. I was already a good guitarist as a teenager and after I left college in the late 1960s, I got serious about playing guitar as a professional. I started teaching guitar as an adjunct at Turtle Bay Music School and the Hebrew Arts School. I also found it easy to get private students, since I performed at local coffeehouses and my chops were fairly respected. Since I also sang (and since I came of age in the 1960s), I had a strong repertoire of songs that were in demand by wedding and club date bands. I was able to start picking up these type of gigs as a “rock specialist,” a term which I found amusing, since I considered myself mainly a folk guitar player who also played some electric, classical and Fender bass. After my stroke, I became a fish out of water…I still am. My right hand and arm are useless, and my strong muscle tone interferes with many normal activities.

Dr. Joanne Loewy: Andy’s relationship with music is strong. He is able to recover lyrics unusually fast, and this seems to assist in his conversational readiness outside of music. I can see the transfer. It takes some time for most people to be ready to go public and make a commitment to joining a community after their stroke. This is a shame, because there is speculation that brain plasticity is at its height immediately following a trauma. We believe that including family caregivers in our choir is a key aspect of incentive for singing. We also thought it was also critical to include professional caregivers as well, because they represent the true “community” for most survivors of stroke, and singing affords the opportunity for the medical team to be involved in natural and healthful ways.

Local 802 member Andy Polon.

Local 802 member Andy Polon.

Andy Polon: Right after my stroke, it was too emotionally painful for me to see live guitar players, since I was too full of envy. But a terrific speech therapist named Mona Greenfield encouraged me to at least try to get back to singing. However I was not ready to face the emotions. Last summer my Mount Sinai Beth Israel stroke counselor Amy Walker told me about Dr. Loewy’s stroke choir, and that’s how I joined.

Recently, I got together with a musical buddy of mine from my club date days, Michael Palmieri, a pianist and piano teacher in northern New Jersey. He had found me through my web site and e-mailed me to tell me that another musician had told him I was dead! I was able to reassure him that this wasn’t true, and we had a lovely day together with his wife Susan. In fact, singing each week with fellow stroke survivors, medical staff and friends reminds me how very much alive I am.

The choir for stroke survivors and their caregivers, Singing Together Measure by Measure, meets on Monday nights from 5 p.m. to 6 p.m. at Mount Sinai Beth Israel’s Phillips Ambulatory Care Center, 10 Union Square East. For more information, call the Louis Armstrong Center for Music and Medicine at (212) 420-2704 or see www.MusicAndMedicine.org. Joanne Loewy, DA, LCAT, MT-BC is the director of the Louis Armstrong Center for Music and Medicine, and an Associate Professor at Icahn School of Medicine at Mount Sinai.

The Louis Armstrong Center is hosting a full-day conference on May 5 entitled: “Implicit Being: A Colloquium on Music & the Brain,” which will feature experts presenting on music neuroscience and its role in therapeutic recovery. To register, call (212) 420-2704 or visit www.chpnet.org/cme.