ICU Music Study

The Georgetown Lombardi Arts & Humanities Program (AHP) was awarded a grant from the National Endowment for the Arts  (NEA) to study the effect of music on ICU patients’ neurologic and  physiologic responses.

MMI's Executive Director, Andrew Schulman, has been chosen to provide the music for the study. The study  is now underway, as of April 2023, and will conclude in December 2023.

From the Georgetown website:

The award appears to be the first time GUMC has received research  funding from the NEA. The lead investigators on the $64,000 award are Julia Langley, MA (EMBA ’22), project director and faculty director of the AHP, and neuroscientist Jagmeet Kanwal, PhD, principal investigator and associate professor in the department of neurology.

“We’ve seen patients with memory loss and Parkinson’s benefit from  listening to music,” Kanwal says. “For this study, we wanted to explore a  new group of patients. We chose to look at ICU patients because their  physiologic parameters are already being constantly recorded, and these  data can provide new insights on the therapeutic effect of music.”

“All my musicians strongly believe that music is a full body  experience,” Langley says. “We’ve seen patients who are unconscious, or  in a light sleep, start to move their bodies in response to hearing  music. At the same time, we know that music can be extremely calming,  and help sleep-deprived ICU patients get the rest their bodies need.”

Over the course of about six months, the study team plans to recruit  from MedStar Georgetown University Hospital 30 adult male and female ICU  patients. In the ICU, patients will listen to three recorded guitar  music sets performed and arranged specifically for this study by a  professional musician.

Researchers will take several physiologic measures, and document  blood pressure and vital signs before and during the music presentations  in the morning, afternoon, and evening over one to two days. Painless  sensors on the finger and at other locations on the body will evaluate  emotional arousal by music, and researchers will collect saliva samples  to assess specific hormone and neurotransmitter levels before and after  the music is played. In addition, participants will complete a  questionnaire at baseline and before discharge.

We commonly experience the sensation of music in the body when we  attend a loud rock concert. Kanwal hypothesizes that music has a  synergistic effect via pressure receptors in the ear, skin and internal  organs. “In effect, the whole body can function as a sound receiver,” he  explains. “Think of music as a pattern of pressure waves, not just  frequencies.”

Though seemingly imperceptible to us when we listen to soft music,  “the subtle stimulation of pressure receptors under the skin may  energize the brain’s autonomic system,” Kanwal adds. In turn, hormonal  balance as well as respiratory and heart rates may shift. These  physiologic changes could initiate recovery and healing

Langley emphasizes that such powerful responses aren’t evoked by just  anyone playing an instrument. “Professional medical musicians bring a  unique and rare gift to patients, one that has required multiple years  of training to hone,” she says. For this study, Langley had a  uniquely-experienced musician in mind: Andrew Schulman.

Schulman, a professional guitarist for over 40 years in New York  City, was the first musician to be accepted as a professional member of  the Society of Critical Care Medicine. In 2018, he co-founded the  Medical Musician Initiative, which trains professional musicians to  become incorporated into ICU medical teams. He’s now a visiting artist  at Georgetown Lombardi.

Schulman draws much of his inspiration from his own brush with death  and subsequent ICU stay in 2009. In his poignant memoir, “Waking the  Spirit,” he describes how hearing his favorite piece in the world,  Bach’s “St. Matthew Passion,” catalyzed his recovery.

Schulman acknowledges that compiling these sets has been very  challenging and time intensive. “Having a medical musician at the  bedside is the only opportunity, in a sense, for patients to get ‘out’  of the ICU,” he says. “I never know what I’m going to play until I play  it. Then I might see them close their eyes and be transported to  someplace else. But I won’t be there to play in person, so I’m drawing  on my ‘penicillin pieces.’” These are the selections that, in his  experience, tend to resonate with most patients. And they tell a story.  “If the musician is not telling you a story, it’s just notes,” he says.

Kanwal and Langley say that they are in this field for the long haul.  “Patient safety is our number one concern,” Langley says. “We want to  document what happens in the body and mind when we listen to music. We  want to determine how medical music fits into patients’ holistic care.”

Based on the study’s findings, Langley envisions that patients could  be sent home from the hospital with a prescription to continue to listen  to their “healing music.” “What Andrew is doing for this study is  completely unique and could be a game changer in the field,” she says.

Other study collaborators at MedStar Georgetown University Hospital include George Hwang, MD, and Yordanka Kirkova, MD.

Beth N. Peshkin
GUMC Communications