Upon entering Chelsea and Westminster Hospital for the first time you would be forgiven for thinking it was a modern art gallery. The cavernous central atrium is adorned with huge paintings, frescoes and sculptures at every turn, and in ever surprising places. A climb up an innocuous looking flight of steps reveals more artwork, hidden on the top of protruding lower-level rooms so they can only be seen from above. Natural light pours in through the vast glass ceiling, and the echoing bustle of staff and visitors gives the space the feel of a busy shopping centre.
This was the space into which I was invited to create new music as ‘Musician in Residence’ for CW+, the charity for the hospital, with a specific focus on the older people wards. The potential for interesting work within this enormous building is tantalising, with so many varied environments and vast numbers of people moving through them on a daily basis. Conversations with the CW+ staff stoked my interest further: ‘why don’t you do something in our cinema?’, ‘have you seen our work in the new A&E?’, ‘you should go and see the piece Brian Eno has done for us in the surgical admissions lounge’. The buzz is extraordinary, the possibilities seemingly endless. My first task, then, is to narrow the options down, to find some workable strategies that will be practical in this busy environment.
My first visits to the wards were to view a bedside project called ‘Playlist for Life’, in which patients are encouraged to choose some of their favourite pieces or songs to be streamed from Spotify to a small Bluetooth speaker. The brilliance of this idea is its pure simplicity and mobility: take an iPad and a speaker, sit down next to a patient and ask if they’d like to listen to something – but, as I would find out, the most interesting results come not from the listening but from the talking.
The first patients we saw illustrated to me how unpredictable it can be to work with potentially confused older people. One lady we visited asserted that she was far too busy to listen to music, although she admitted it was a nice idea. She insisted she had ‘work to do’; further lines of conversation were equally resisted, so we moved on. Another lady similarly told us she had no time as she had to get to London and wanted to pack her things – she was a pianist and again seemed to appreciate the idea of listening, but refused to do so.
By contrast, our third attempt was a relaxed and very coherent man who was into rock, having himself been a guitarist in bands. Once started he didn’t want to stop chatting about his favourites: mourning the loss of Lemmy and Bowie, amused at the surprising longevity of Ozzy Osbourne and Pink Floyd, the latter of which was his first listening choice after prompting from a visitor to the bed next door. I asked about his guitar playing and his favourite gig (Thin Lizzy at the Hammersmith Odeon), but soon the conversation was moving onto a varied range of topics – where he lived, his family, even his thoughts on the internet and its effect on music consumption. Particularly fascinating were his perspectives on how people felt when they listened to music: he described it as like entering into a ‘layer of a book’, or a personal ‘tunnel’, an internal process perhaps similar to daydreaming.
The interaction with this man showed me just how integral the communicative aspect of this project would be, as an essential counterpart to the music and at least as important. The music serves not only as a distraction from the potentially disorientating environment of the ward, but also as a window into the patient’s personality, allowing them to assert their identity through song choices and associated reminiscences.
The following week I attended a live version of a similar project, in which singers from Opera Holland Park visited bays on several different wards to sing song requests made in previous weeks. These were a mixture of classic arias (The Flower Duet, the Habanera from Carmen) and show tunes (A Nightingale Sang in Berkeley Square, Edelweiss), each accompanied on a wheeled clavinova piano that could be easily moved from one bay to the next. The impact on the patients was seismic, and vastly different in scale to that of the iPad listening: heads were quickly raised to the spectacle that was taking place by their bedsides, and faces lit up in recognition of the music. What was immediately obvious was how the presence of performers, both singers and the pianist, created an extraordinary atmosphere, a sensational musical encounter that was much more about spectacle than simple reminiscence; a brief window out to another resplendent operatic world. One patient was heard to exclaim “who turned the lights out?!” when the performance ended – to her, the sound was so potent that her confused mind mistook it for light.
I left the session inspired but also troubled: throughout my compositional training and career I’d always been searching for ways to find and present the unfamiliar or unexpected, in terms of musical sound or ways of creating it. ‘New’ music is expected to be just that – surprising, unpredictable – but for some older patients in a hospital the environment they find themselves in is already ‘new’ enough, with the potential to be confusing or even frightening. Part of the effectiveness of both the recorded and live ‘Playlist’ projects I had observed is that they help to remind patients of life outside this environment, reasserting their cultural and musical identities in a space where the physical is necessarily prioritised. What use, then, would be my music, which might appear to be completely unfamiliar?
Reanimating my dormant PhD instincts, I undertook some research on the subject to try and get a clearer idea of the issue; I was encouraged to find that alongside the considerations of reminiscence and memory, practitioners gave equal weight to the assertion of individual identity through creative musical activities, including singing or even instrumental playing. Manchester Camerata’s ‘Music in Mind’ project is an example of a project where improvisation with simple percussion instruments enabled dementia sufferers to create new music under the guidance of professional musicians, allowing that person to express their identity through an instrument and process they may not be familiar with. As my recent PhD work has investigated, such an engagement can lead to a creative ‘displacement’: the discovery of a new way of being musical, which can refocus a performer’s attention away from their habits and towards an exploration of novel creative practices. This manner of intervention might also address concerns such as those mentioned in Harmer and Orrell (2008, p.553) that some elderly care home residents ‘think about the past more than the present’.
Even with professional musicians, however, such an approach needs to be treated with caution: if the level of unfamiliarity is too great the performer may simply reject the task they are presented with. In my PhD work I drew on the writings of Gilles Deleuze in this regard, in particular his idea of ‘deterritorialisation’, the process resulting from an exploration beyond the limits of one’s prior experience, and ‘reterritorialisation’, in which a person’s identity is reconstituted to include that which has been newly discovered; the danger lies in where deterritorialisation is so severe that no connection back to one’s original understanding can be made, and therefore the new appears incomprehensible.
Perhaps it could be said that the ‘Playlist for Life’ sessions, in both iPad-based and live formats, demonstrate the power of reminiscence and memory to ‘reterritorialise’ a person’s musical identity, in the midst of changes which might appear overwhelmingly destabilising. Clearly for me to wade in with music or music-making which appears overly strange would be inappropriate, but equally it is clear from other examples in this area that, for some patients, novel forms of engagement might stimulate a further affirmation of their creative identity.
Just as such a balancing act was on my mind during my PhD research, so will it be as I approach the work to be done at Chelsea and Westminster Hospital through CW+: how to create new musical activities and pieces in such an environment, which tread that fine line of creative discovery and accessibility. This is itself a research project, one which is, to my knowledge at least, unparalleled in its creative scope and potential, and one which I couldn’t be more excited to be part of.