It's Official!

I received word from the Music for Healing & Transition Program that I have officially graduated. I am now a Certified Music Practitioner! They sent me a diploma and a even a handy dandy nametag.


WHEW. Being part of a program like this in which everything is done on a long-distance and online basis is difficult. I'm a face-to-face, read your expression kind of girl. Phone calls and emails just don't cut it for the most part. However, if it's a choice between that or traveling all over, I'll take the online stuff.

I felt as though I was completely punting with my final CD recording that had to be sent in. It was basically an audio homework assignment to prove that I am proficient in all the styles of music we learned to play and apply. There was a sense in which I fully expected my advisor, Mona, to notify me that I had to re-record it. But the first thing she said in her email after receiving it was "I love your CD!" There's simply no way for me to convey to you just how ultimately relieved I was in reading that. It had taken me no less than 15 minutes to actually open that email from her.

The best compliment I received in the whole deal is that Mona (who is president of MHTP) asked me to consider being an advisor.

As flattering as that is, I'm going to wait. After all, if you were a new intern, would you want your advisor to be a green-horn CMP who was just starting out in her practice?

Nope ... neither would I. So I'll get a few miles under my belt with this work and then look into doing it.

I would like to stop and thank all of you who have been part of and shared in this life event with me. Your generosity and support are priceless gifts. I am GRATEFUL!!

Waiting Game ...

As of last week, I turned in the last of my paperwork pertaining to this certification. I got my CD recorded and turned in ... sure hope it's what they are looking for. (I simply had to demonstrate proficiency in the four main styles of music that are played for individual patients.)

Now I wait to hear back from MHTP to see if they are actually going to grant me this certification as a Music Practitioner.

I am also in job negotiations with a couple of facilities. This means more waiting. I have no idea when things may or may not materialize. I'm weighing carefully just how often to check in or hold off on following up with the key players. You know the dance one has to do ... appear to be interested enough but not show so much interest that one becomes a pest.

This is a place of disorientation for me ... I'm done with the internship, trying to get work, wondering how in the world this is ever going to get off the ground, and if it does, what will it look like? I don't enjoy not having things laid out nicely and neatly. So, I'm doing my best to live in and around the tension, and still be aware enough to pay attention to the messages God has for me ... probably tucked in the most unexpected places, right?

You are not obligated to win. You're obligated to keep trying to do the best you can every day. Don't assume a door is closed; push on it. Don't assume if it was closed yesterday that it will be closed today. It doesn't matter how many times you fall down, it just matters how many times you get up. - Marian Wright Edelman

So ... I'll keep carefully "pushing on doors."

Let's Get Down To Business

I got a nervous pit in my stomach when I typed the title to this post. At the same time, I'm really excited about it.

As of today, I am 38 hours into my required 45-hour internship! Things are moving along nicely. My hope is that, sometime during the month of April 2008, I will become a bona fide Certified Music Practitioner (CMP). I still have a few hoops to jump through ... recording a sample of my music for MHTP, submitting a list of all the music I use, etc. It's all subject to their approval.

My internship hours have been pro bono. My one big goal as a CMP is to now find some paying gigs! Just because I'm interning somewhere in no way guarantees that they will decide to start paying me. (This subject could take up an entire blog post.) Suffice it to say that I'm working to not be the least bit pushy with these organizations in which I currently practice. My hope is that the work will speak for itself and that the decision to hire me as an independent contractor will be one that makes sense for them. (Let's just say that a marketer I am NOT.) Naturally, I'm dropping the obvious hints that my internship is almost fulfilled and will be having face-to-face meetings with certain people in the near future. Please pray that I present myself in the best possible light for these folks.

Anyhoooo ... I am getting down to the business of creating my professional/business image. The problem with so many small businesses and independent contractors is that our brochures, business cards can look slightly unprofessional. Gaining real graphics experience or having the cash on hand to PAY a graphic artist is a real problem for those of us without some kind of corporate umbrella.

So where does one go for cheap, quasi-professional looking graphics? Well, Avery, of course!

I lucked out and found a graphic that fits me to a "T." Not only is it colorful, it is representative of the seasons. Seasons and life cycles are an integral part of my everyday thinking. And the clients I meet and with whom I work beautifully embody this cycle of life. This is an image that I would be happy to have people associate with my work.

Then there's the issue of a name. Hmmmmmm ... a "name" for the business. Yeah ... no ... I think not. This is something that is built on ME, so me name is what will be on the shingle.

Cindy L. Purifoy
CERTIFIED MUSIC PRACTITIONER

Has a great ring, huh? (SHEEPISH GRIN)

Can y'all believe this??? I have almost reached this goal of mine -- and you were all there to be part of it with me! It was just one year ago that I began classes with the Music for Healing & Transition Program. Just ONE year ago!! And look at all that has happened.

God is ah-MAY-zing. You have all been incredibly supportive and generous. I've felt your prayers and seen things come to fruition for me and in me that I never could have imagined would have occurred.

I must remind you of this life-changing quote I heard in January 2007, just before all this took place:

Concerning all acts of initiative and creation: There is one elementary truth, the ignorance of which kills countless ideas and splendid plans - that the moment one definitely commits oneself, then Providence moves, too. A whole stream of events issues from the decision, raising in one’s favor all manor of unforeseen incidents, meetings and material assistance, which no man could have dreamt would come his way. - W.H. Murray

And so we move upward and onward. It's just the beginning!

Internship

So, I made it through the holiday season and managed to get my internship sites set up. In order to become certified, I am required to play for 45 hours, one-on-one at the bedside for ill and/or dying patients. This will take a little time to complete -- but it will be a phenomenal learning experience!

I am currently playing at the KC Hospice House (see Module 5 post), the NICU at Overland Park Regional Medical Center, and at Lakeview Village's Care Center.

These were the three places at which I really wanted to focus my attention, and all three have graciously opened their doors to me! I'm learning so much from each of the patients and, of course, from the phenomenal staff at each location. I've become acutely aware throughout this educational process of the large number of hurting and sick people out there ... at the same time, there are large numbers of individuals working very hard to assist these hurting souls. What an amazing group with which to be associated. They are teaching me so much.

When I play/sing for an individual at their bedside, I must fill out a patient log with general info about each person's condition, what type of music I used in that given situation, and how the patient responded to the music. I then send batches of patient logs to my adviser out in New York, and she in turn provides me with feedback.

I'm not sure how I got so lucky, but my adviser is none other than the President of MHTP. Mona is a fantastic person with incredible talent. She is also in the process of taking a 2-year course for her certification with the Chalice of Repose Project. (This is an organization that focuses on Music Thanatology (thanatology = study of death and dying). You must be a harp player to be part of this group. These are people specially trained in, well ... hopefully this isn't too indelicate: playing people out. Mona has told me about the various death bed vigils she's been called to play for. It's quite a specialized skill -- one that is intimate, and strives to bring peace and dignity to the dying process.

There's just no greater privilege than when a family invites me into the room with their dying loved one to play what is hopefully peaceful and healing music for not only the patient, but the family members themselves. I strive to be as much a background element as possible. Witnessing the love and caring present within these various families is such a gift.

The biggest thing I've come away with so far in my internship is just how much I have to learn. It can be overwhelming at times -- but the important thing for me to do is take things one day and one patient at a time. This is, after all, the only way to gain the experience and seasoning that I so hope to achieve.

Module 5 Practicum

DISCLAIMER: This is a very long post ... read when you've got an entire weekend.

[GRIN]

Sunday, November 11, was Practicum Day. My class of six made their way to Kansas City Hospice House early to play at the bedside for the first time.

KC Hospice House is a new facility on 120th & Wornall in South KC … and it's beautiful. It was a bit like walking into a 4-star hotel, only the warmest and most welcoming hotel you've ever been to. The peace in the air was palpable. It immediately calmed my nerves.

Our teacher had arrived before us to check in with the nurses as to which patients would be the best candidates. She then spoke to each patient and/or family member to obtain permission for us to come and play therapeutic music in their respective rooms.

Each of us was assigned two patients – typically Module 5 students play for just one in the Practicum. We were fortunate. AND, each of us had the opportunity to play for someone who was actively dying.

Actively Dying refers to someone who is very close to death (within hours or a few days). At some point, there is a definitive shift in the person's behavior, demeanor, physical condition that will point to impending death. And this process of death is as varied in people as the process of labor & delivery.

One of the things we discussed at great length in class is that it's hard for the body to die. By design, it wants to keep functioning, keep working. One book described it as shutting down a large factory with multiple machines that need to be turned off one or two at a time. This process, as I said, is hard for the body – but it doesn't necessarily mean that the patient is in great pain. (Sometimes they are – but with the pain management options available in hospice settings, it can be minimized greatly.) This leads to one of the big reasons I pursued this course of study … death is as much a part of life here on earth as living. And death, in my opinion, should be handled with as much care as birth.

It is possible for many people to experience a dignified and peaceful death. Sometimes the disease that inflicts a body works against this – but not always. If a patient has resolved his/her relationships and is "current" with friends and loved ones, this can greatly enhance one's ability to let go when it’s time.

My goal is to offer some assistance in those moments of an actively dying person's life – by helping to create an atmosphere of relaxation and comfort. This is achieved by playing something called "arrhythmic music."

The term arrhythmic music can sound rather harsh or experimental. Really, it's neither. It means to play with no set rhythm, no beat, and no recognizable melody. Maybe the word "ethereal" would be a better description. As a person dies, they are separating from the things and people around them. It has been said that some people, during the dying process, hover between spiritual planes of existence – this life and that of the next. As an outsider in the patient's room, the last thing I want to do is to unintentionally "pull" that person back from wherever they are. Whether we realize it or not, when we listen to music, our brains are looking for and anticipating patterns, trying to make sense of the music's structure. Arrhythmic music provides soothing sounds and moments of silence that allow the patient to relax and let the music truly be a background element rather than sounds to which they are actively engaged in listening.

Lots of verbiage here … but I thought it important to help y'all understand how this works.

So, back to the patient assignments …

After our teacher gave us the pertinent info on who we would be playing for, she said, "Now, go play for your actively dying patients first so they don't pass away before you get a chance to play for them."

GULP.

(Inner Monologue) "She means it about this actively dying thing. This is REAL."

I played for an 80-year-old woman who was in the final stages of Alzheimer's. She was unresponsive, and her breathing was very fast and labored. She had been like that for several hours.

I introduced myself to her two sons and a daughter-in-law and then introduced myself to the patient. (Although a patient may be unresponsive or even comatose, we treat them as though they can hear every word – because hearing is said to be the last thing to go.)

Several minutes into playing for this woman, her breathing made a dramatic shift. She started to breathe much slower and in a more relaxed way. Shortly after that, her breathing stopped altogether …

(Inner Monologue) "Oh my gosh – is this woman going to actually DIE while I'm here?”

The daughter-in-law got up to say goodbye to the patient.

(More Inner Monologue) “Is this a good thing, a bad thing? How do I handle this???"

… and after about 30 seconds, the patient began to breathe again, still slow and relaxed.

I played for about 25 minutes and decided it was time to gently wrap things up. (Honestly, I completely lost track of the time and thought it had only been 10 minutes or so. It wasn’t until after the fact that I realized how much time had gone by.) I sat quietly for a moment after I finished, and the patient's breathing became labored again. I made the call to listen to my gut and resumed playing … and her breathing returned to the calmer state. After about 5 minutes, I wrapped up again, thanked the family members, said my goodbyes to the patient, and quietly left the room.

My mind was spinning at such a rate, I was SURE everyone could hear it.

The surprising thing to me (aside from the overwhelming nature of the whole experience) was that her two sons sat as still as posts while I played. I honestly thought they may get bored and walk around or maybe even leave the room – which was absolutely their right. After all, they were waiting for the football game to start. (Not that they weren’t fully engaged in what was going on with their mother … I think it was going to be a welcome distraction for them for a short while.) When I left the room, these two men had tears rolling down their cheeks. It was very moving.

I forgot to mention earlier that our teacher had paired us up with one of the other students. So while I played, my partner observed me, and vice versa. The woman I was paired up with used to be a hospice chaplain. This was a very familiar environment for her. As we stood in the hallway outside my patient's room (with me, looking like a deer in headlights), she said this:

"I don't think you realize what happened in there. You gave that woman her breath back."

I almost lost mine ...

(GRAND, VERY PREGNANT PAUSE HERE)

My second patient was a gentleman in his early 70s, dying of pancreatic and liver cancer. He was awake and alert, sitting up in his bed. A very educated and cultured man, he became the quintessential host when I entered his room. He was very concerned that I was comfortable. His wife, who had died several years before, was an opera singer; he enjoyed listening to my songs and comparing the sound of her voice with mine and how unique each was. He became very reflective and was able to relax back into his pillow and rest. We had a lovely conversation before I left. Meeting him was a rich experience.

My classmates and I stayed at the hospice all day and finished up our remaining classwork that afternoon in one of the conference rooms. We got done around 3:30pm. On my way out, I ran into one of the sons and the daughter-in-law of the first woman I had played for that morning. He pulled me aside and said, "You wouldn't believe the change in my mother today! It's amazing. She's awake and alert, and we've been talking to her." Then he added, tongue-in-cheek, "They keep trying to put her down, but she's just not ready to go." He thanked me over and over again for playing for her. And then they left.

Wow. (CHOKE BACK TEARS ...)

While I don't truly know what happened with that patient and why she became more alert (because, let's face it, there are so many factors involved), it was incredibly meaningful to get feedback like that from a family member.

Let's just say I had a good day. Incredibly emotional and intense, but oh so positive.

(Inner Monologue) "I really want to do this. I'm in the right place."

And boy, is that a good feeling.

MHTP Training Module #5

On November 9-11, I attended the final training module for my training as a music practitioner. This class was three days instead of the usual two -- primarily because the final day was all about our Practicum -- each student's individual maiden voyage of playing at the bedside.

Our instructor this time was Carol Joy Loeb. Carol is an RN from Baltimore who has left allopathic (traditional) medicine to work as a Certified Music Practitioner. Lovely lady. Probably one of the most consistently present people I've ever met.

It was so good to see my classmates again as we gathered at the UMKC School of Nursing. They have become dear friends. Much of that day was spent dealing with the topics of death and dying. We watched an incredible video called Living Your Dying. The video follows the last months of three individuals who are facing terminal illnesses. It is intense, moving, real, light-hearted, and gut-wrenching. Our teacher was very careful to leave plenty of debrief and discussion time after we watched this excellent presentation. Two of my favorite lines from the video are "... he lived happily enough, but not ever after," and "Let God enter your life and enlarge it."

On Saturday we studied the major diseases we will encounter in our work as CMPs. Lots of medical terminology, diagrams, anatomy, etc. We also discussed possible patient scenarios and what specific music styles we would use in those settings.

Then came Sunday. The day I've been looking forward to for almost a year now ... playing at the bedside of patients.

We all felt very kicked out of the nest, so to speak. And the experience was amazing. I'll write about it in my next post ...

The Needs of the Dying

In preparation for Module 5, I read a wonderful book: The Needs of the Dying by David Kessler. This book served, for me at least, as a primer on the subject of death. I am a typical American who has rarely encountered this final phase of life on earth. And - quite honestly - I have struggled more with the idea of my loved ones' deaths rather than my own. How does one share that experience?

The author writes about walking to the gate:

The concept of "walking to the gate" has much to offer with respect to life and death. Today's newborn is "met at the gate" by his father in the delivery room. The father hands him to the mother and may then cut the umbilical cord. Dad is no longer confined to or content to sit in the waiting room. Just as greeting the newborn at the "gate" is beneficial, we should do the same for the dying.

… We walk our loved ones to the gate when we bring them home to die. We walk our loved ones to the gate when we spend the night in the hospital room rather than waiting in the waiting room for them to die. We walk them to the gate when we let them know that no matter what happens, we will be with them. We finish our unfinished business when we say what needs to be said, we cry with them and for them, and we hold their hands as we walk them to the gate.

So in the line of work I'm pursuing, bringing therapeutic music to the bedside of an actively dying patient is an opportunity to be part of walking that individual to their gate. Kessler has helped me put words to this desire in my heart ... something I wasn't able to articulate prior to reading his book.

Death is as primitive as birth. Often loud and messy, it is always deeply authentic. We can find peace and dignity in this authenticity.

At some point in all of our lives, we will be faced with the loss of a friend, loved one, or even our own life. Let me just say that, this book is the one for you. It's an incredible resource.