When I play for patients in the oncology clinics and hospital rooms of DHMC, I choose from a wide variety of music depending on the situation. I might ask the patient or family member what kind of music they like, or sometimes they make requests. My choice of tempo, the meter (3/4, 4/4), the key, and the musical mode (major or minor) all affect the interaction.

If a person is resting or in discomfort, I choose music that is quiet, probably in 3/4 or a slow 4/4, and I often start with unfamiliar or improvised music so as not to arouse more physical or mental activity. This type of music is good for deep relaxation and distraction from pain.

If I encounter a person who is anxious or breathing rapidly, I focus on the speed and rhythm of the music and match my playing with their rate of breathing. Gradually I slow down my playing as the patient's breathing synchronizes with the music. This process is called entrainment, and it refers to the body's natural tendency to synchronize with external rhythms that are heard or felt.

Another technique is to use music to touch emotions and change moods. This is a very powerful tool and needs to be used with sensitivity. For instance, I tend not to play pieces like "Amazing Grace" and "Danny Boy" when I am in the waiting rooms because

they can evoke strong emotions and not everyone wants to respond emotionally in public. However, in a one-to-one situation, such songs are often requested and I use them when I feel it is appropriate.

Most patients experience challenges on many levels, and they need to feel safe to cry and express emotions. If I see that the music is touching a tender part of the soul, I respect that time, but before I leave I try to lift the mood a notch by playing music in a different style, tempo, or key.

Probably the most common use of harp music in the infusion suite is for distraction and relaxation. People seem to respond very quickly to the resonance of the harp strings. One woman found it very helpful to listen to the harp while undergoing a painful procedure. She said she didn't feel any pain that day.

For the patients who spend long hours receiving treatment, I frequently see their eyes close and they tell me how relaxed the music makes them feel. I tell them that if they go to sleep while I am playing, I will feel that I am doing a good job.

A few weeks ago, after I had played in the oncology waiting room, a woman said to me, "You could just feel the atmosphere change and see everyone relax as you played."