Therese Schroeder-Sheker’s beeper signaled an imminent death. She shouldered her harp and hurried through the corridors of St. Patrick Hospital, praying as she went.
“Please, will You help me be of service?” she prayed.
In the four minutes it took to reach the room of a woman succumbing to cancer, Schroeder-Sheker sought to achieve the calmness and a feeling of vulnerability.
Schroeder-Sheker plays music for people to die by. She describes her bedside work, for which she receives no fee, as “musical-sacramental-midwifery, the reconciliation of art and science for recovering the dignity, reverence and tenderness within the personal experience of death.”
Her work, known as “music thanatology,” is changing how dying patients are cared for in some hospitals and hospices.
“The medical community is reassessing the dying process,” she said. “There is a greater emphasis on caring rather than only curing.”
Schroeder-Sheker, 41, who grew up in Des Plaines, Ill., is the founder and director of the Chalice of Repose Project in Missoula, the only program in the world known to train music thanatologists. She is also a concert and recording artist, lecturer and medieval music scholar.
When Schroeder-Sheker reached the dying woman’s door, she paused, took a deep breath and slipped into the room. She put down her harp and greeted the family grouped at the foot of the bed.
“Hi, I’m Therese. I understand you called for me,” she said. After asking a few questions-about the relationship of those in the room to the patient and their perceptions of her-she checked the medical chart to be certain the woman had a DNR order: Do Not Resuscitate.
Emergency medical intervention would disrupt her attempt “to help the person move toward completion and to unbind her from impediments to a tranquil passage,” she explained.
“If there is physical pain, I play music that specifically addresses the pain,” she said later. “Some music is stimulating, some is calming. It’s my job to do the most calming music. That helps unbind the patient from any kind of nervous stimulus and anxiety.”
She sat on the right side of the bed with her harp as close to the woman’s heart as possible. A student intern of the Chalice of Repose Project entered the room and set her harp on the opposite side of the bed. The two musicians began softly singing an 11th Century melodic chant with Latin words composed by French monks to give solace to the dying. The monks, a reformed group of the Benedictine brotherhood, founded their monastery in Cluny, in southern France in the 10th Century. Their music, rooted in monastic herbal and spiritual medicine, was the first Western European “infirmary music”-music to assist a blessed death-in manuscript form. Monastic medicine had two purposes: to care for the body and cure the soul.It is carefully crafted music without rhythm, pulse or count.
The music Schroeder-Sheker selects is not rhythmic in the usual contemporary sense, she says, because “Everything rhythmic binds us to life because the life process has a rhythm. In music therapy, rhythmic music is used to engage the patient to life. Music thanatology helps free dying patients from what binds them to life.”
Her professional credits include four solo albums on the Windham Hill label, as well as scores and performances for television programs and documentaries.
She founded several chamber ensembles and the Ars Antiqua, a center for medieval musicology in Denver. She lectures frequently in this country and abroad.
Schroeder-Sheker describes herself as “a regular, normal, modern women, a working girl, a contemplative Catholic. I love to work in my herb and flower garden, cook for friends and hike in the mountains and woods near my home. I compose a lot of music.”
She became interested in the connection between music and death while in working parttime as an aide in a nursing home to finance her studies at Loretto Heights College (now Teikyo-Loretto Heights University) in Denver, where she earned a bachelor’s degree in music.
“I had witnessed a number of deaths there that were quiet cold, unprepared, isolated, statistical events, and this was very troubling,” Schroeder-Sheker said. “I realized I could do something. I could care. I could hold their hands, sing to them. I could show up and not leave them alone to die with `I Love Lucy’ blaring on the TV.”
One day she took action. “The (dying) man was struggling, frightened, unable to breathe,” she wrote of the experience in 1991 in Caduceus, a London-based medical magazine. “I climbed into his hospital bed and propped myself behind in midwifery position, my head and heart lined up behind his, my legs folded near his waist, and I held his frail body by the elbows and suspended his weight. … I leaned down and began singing a Gregorian chant into his left ear.
“He immediately nestled in my arms and began to breathe regularly, and we, as a team, breathed together,” she wrote of her impression of their inter-action. “It was as if the way in which sound anointed him made up for the ways in which he had never been touched or returned touch while living.”
The experience changed her life.
Born in Detroit to a musician mother and a scientist/inventor father, she and her family moved to the Chicago area when she was in grade school.
After graduating from college in 1975, she traveled in Germany, France and England, where she performed, taught and researched medieval music for a year before returning to the U.S.
The seed of the Chalice of Repose Project curriculum was planted in 1988 while she was an associate professor of music at Regis College (now University) in Denver. As director of the music program, she included music thanatology in the curriculum.
But she knew her work needed to be within medicineto change the way people die within medical institutions.
In 1989, she was invited to address physicians at the Institute of Medicine and Humanities in Missoula. The president of St. Patrick Hospital, Lawrence L. White, invited her to establish a music thanatology program within the hospital.
In 1992, she incorporated the Chalice of Repose Project to offer a clinical and educational palliative-medical music-thanatology program within St. Patrick Hospital. The first class of 21 student interns will complete the two-year program of academics, musicology, contemplative disciplines and clinical internship in 1994. The students attend medical-related classes taught by hospital staff physicians, plus music classes with Shroeder-Sheker.
The project is supported by seven institutions, including Fetzer Institute, a nonprofit organization in Kalamazoo, Mich., that promotes health care methods based on mind-body principles; the University of Montana and the Institute of Medicine and Humanities in Missoula. Schroeder-Sheker is organizing the Chalice of Repose Thanatology Consortium, an international cooperative educational and clinical alliance to create faculty exchange, collaboration and publication between experts in music thanatology.
“All across the country health-care givers are trying to meet the needs of death and dying by including palliative medicine in the practice of clinical medicine,” Schroeder-Sheker said during a quiet moment in her office.
“Palliative medicine is growing by leaps and bounds in this country,” said Dr. Martha Twaddle, a clinical instructor of medicine at Northwestern University’s medical school and the medical director of the Hospice of the North Shore in Evanston.
“The multidisciplinary approach to caring for a patient-psychology, pain management, spiritual, art and music therapy-is just really starting. Historically, these areas have been considered ‘soft’ disciplines but people have not realized the power behind such intervention.”
Twaddle admires Schroeder-Sheker’s work in providing music and comfort rather than “the beep of machines and sterility” for a dying person. This type of music is something that has to be heard to be appreciated, Twaddle said, and it is particularly meaningful for AIDS patients, who “often have no faith and no family” to provide solace at the end.
At the dying patient’s bedside in St. Patrick’s Hospital, Schroeder-Sheker watched the woman’s face, hands, eyes and breathing. Occasionally she glanced at her own hands, plucking the harp strings.
“I’m terribly aware of the way in which my fingers touch the strings. How I draw the tone from the strings means everything. I strive to pour beauty and reverence into the room. I hope to create a matrix in which it’s safe for the person to let go,” she said later.
Can music actually promote physical changes?
“This is the big question about quantitative versus qualitative research,” answered Schroeder-Sheker. “We’ve just become part of medicine this year, so we’re too new to have put our research models into effect. However, we’re very interested and committed to documenting the physiological responses to music in the bedside vigil and the dying process.”
After about 45 minutes, the dying woman’s breathing became very quiet, slow and shallow. Some family members wept. A nurse came to say goodbye. When Schroeder-Sheker set the harp aside 10 minutes after the woman died, the family hugged her.
In the corridor, she leaned against a wall. “In my life I try to remember to die to something everyday,” she said, reminding herself of the transitory nature of temporal life.
“I must die to things every moment so that I can continually renew, warm again, to life and living.”
