I first met my patient, a man in his late 80s, in 2012, when he had been living with myelodysplastic syndromes, a form of bone marrow cancer, for five years — longer than the average survival for those diagnosed with the condition. He was a former high school math teacher who was unerringly precise about his laboratory values. He also had a spark to him that no cancer could extinguish.
Over the years, we had tried a variety of therapies to treat him, some of which worked for a while, some not at all. After our most recent failed attempt to solve the complicated equation of his disease, he had said enough was enough, and asked to be placed on hospice at the nursing facility where he now resided. Fortunately for him, it was one of the few hospice programs that allowed him to continue seeing me to receive the regular blood transfusions that corrected the anemia brought on by his cancer, which eased his fatigue and made him feel more like himself.
When I entered the examination room, he was wearing an outfit typical of what he sported to many of our visits: a red and yellow tattersall shirt; chinos with a broken button, held closed with a black belt; red Ohio State socks; and tan moccasins. His face was framed by square, dark brown glasses that gave him an air of being more serious than he frequently was. His son sat by his side.
“I’m honored to be in the presence of such musical greatness!” I joked with my patient. “I should have brought a Sharpie marker with me to get your autograph.”
He smiled and his son started to chuckle. My patient had just sung in a concert at the hospital near his nursing facility, showcasing performances by him and six other patients. He had been participating in a music therapy program for over a year.
I am a firm believer in the ability of music to help people express their emotions, hopes and fears, making their medical conditions more tolerable. In one study, patients undergoing a bone-marrow transplant were randomized to participate in a music therapy program or receive standard medical care. Those who received music therapy needed fewer narcotic pain medications than those receiving the usual care.
“Were you able to see a video of the show?” his son asked as he brought out his phone. I shook my head, and he scrolled through his files until he found the one he was looking for and pressed play.
On the screen, my patient sat tall in a black wheelchair with a high back, wearing a blue dress shirt and bow tie. A microphone hovered in front of him, and a music therapist strummed a guitar softly by his side.
He started in on “Sentimental Journey,” the song originally sung by Doris Day with Les Brown and His Band of Renown in the mid-1940s, when my patient was entering his teenage years.
Gonna take a sentimental journey
Gonna set my heart at ease
Gonna make a sentimental journey
To renew old memories …
His voice started out a bit tremulous and unsure, but gathered strength as the song progressed, with some vibrato and huskiness adding depth to the words, as if he were living them in real time.
“You sound incredible,” I told him. His eyes danced with delight. “You must have done this before.”
“Only in a church choir,” he said. “And in a men’s quartet for a bit when I was younger. But never on my own for an audience.”
“Did your family attend the show?”
“Oh, they all came. My wife, children and my granddaughter. One son drove all the way from Illinois, he couldn’t believe his dad was actually going to do this.”
“How long did it take you to practice?” I asked.
“About two months,” his son answered.
“The music therapist joined me while I was getting transfusions,” my patient added. I considered the many hours he spent regularly in an infusion chair as the blood slowly dripped in, time now well spent.
Never thought my heart could be so yearny
Why did I decide to roam?
Gotta take that sentimental journey
Sentimental journey home.
The three of us sat in silence when the song ended, thinking about the end of his journey, his journey home.
“All of the care you’ve given me came out in that solo,” he said, his eyes now glistening.
“Today, you’re the one who’s cared for me,” I said, shaking my head, as I considered how this man I’ve known for years had just sung his goodbye to all of us.
Dr. Mikkael Sekeres (@MikkaelSekeres) is director of the leukemia program at the Cleveland Clinic.