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Posted by Dr. Sushrut Jangi May 17, 2013 12:00 PM
Chuck isn't averse to contemporary music, but he can be critical: "Have you heard Mumford and Sons?" he asks me. "They lack all nuance and dynamics," he says. Instead, he's partial to British pop: "the English make pounds and pounds of melody," he says, naming the band Swing Out Sister, whose music he describes as uplifting and positive.
Positivity is crucial, Chuck says, as though reminding himself. Soon after he began to bleed again, he drove to the hospital. A gastroenterologist offered a colonoscopy. Chuck agreed, preparing for the worst. Although the symptoms of inflammatory bowel disease had been quiet over the past decade, Chuck had lost insurance and hadn't had a colonscopy since 2001. The gastroenterologist returned with dismal news. "You have a really large cancer," the doctor told him, and it had already begun to spread from his colon to his liver. A few months later, it would be in his lungs.
Although it is a controversial idea, many specialists believe Crohn's disease increases risk for developing colon cancer; some gastroenterologists will routinely survey the intestine to ensure this process has not begun. Chuck's other symptoms were more certainly side effects from steroids he was taking for Crohn's: prednisone had damaged his teeth, caused a cataract on his left eye, and destroyed his hips, a condition called avascular necrosis, that made walking hard.
Aside from surgery, Chuck needed chemotherapy. "Depending on the drugs," he tells me, "I used to get really sick and uncomfortable from the chemo treatments." It was during one of these infusions that Chuck had a fortuitous meeting. "I met her through happenstance," he says, referring to Lorrie Kubicek, music therapist and director of the HOPES program at Mass. General. Lorrie, who uses harp, guitars, ukeleles, xylophones, and singing to help patients through cancer and other illnesses, suggested that music might help Chuck better tolerate the chemo. "Prior to his infusion sessions, Chuck would go home and search through his collection and would bring in a list of songs and we'd burn a playlist onto CD for him."
"The music washed over me," Chuck says. "I don't take any anti-nausea medicines anymore. Certain tones were like a balm. The music took my nausea away and put me into a dream-like state," he says, almost like he is describing an anesthesia. Chuck mentions several studies that examine music's vibrational properties, and the role of melodic structure in healing. But Chuck doesn't think music works the same way for everyone. "There is no perfect melody," he says, as though he has learned from his obsessive searches and hunts through the record shops in Boston.
For Chuck, music is an intensely personal, spiritual, and familial experience that ties him to his cancer, to his chemotherapy, to his own childhood when he listened to the phonograph with his mother, and even to his grandfather who played alongside his grandmother in Portugal two generations earlier. "Music has lifted me above my physical and psychological problems -- it has been an abiding anchor for me throughout my life."
Through music, Chuck has even lightened the prospect of his own death. "When it happens," Chuck laughs, "I want to have a recessional to a song called Partners in Crime by Jim Brickman. Have you heard it?" I shake my head. "There's two things going on melodically in the song. One is a great nostalgic sadness. The other is a gospel-like hopefulness," he says, the two threads of emotion inseparable. "That's how I want to go out."
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About the authorSushrut Jangi is an internist at Beth Israel Deaconess Medical Center and an editorial fellow at The New England Journal of Medicine. More »
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