Specific interventions, ongoing workshops, concerts, shows, resident artists, cultural outings – that’s right, the word “hospital” today is not necessarily a synonym of silence and sadness. However, this has not always been so clear and obvious. Because, theoretically, there is nothing further from the hospital world than music, which is by nature festive and loud.
By the end of the 70s, the word “humanization” started to be used. Nowadays, the phrases used are improvement of hospitalization conditions or improvement of healthcare for children and their families. This is, without a doubt, politically correct.
This is not to say that the healthcare institution and particularly the medical and healthcare staff are not humanitarian, rather that the practice has been highlighted over the “human” component of the hospital.
The keys of the hospital musician are improving the quality of life of a child, their family and the healthcare staff through the integration of music in pediatric services, and allowing access to live art to each of them.
When working with newborns who have complications or with hospitalized young children and their families, it is all about culture and weaving: knitting relationships, creating bonds among parents and healthcare staff and strengthening links outside the hospital, with the neighborhood. Giving space to live music is a way of prevention, as it will reduce the negative consequences of hospitalization. Why should a child be deprived of their favorite song just because of an illness or a hospitalization?
The Art of Participating
During the last 20 years, things have evolved very quickly because the musicians who intervene in hospitals proved their professional capacities in the workplace and maintained an intense reflection and communication work.
Music, the art of participation by definition, gathers and breaks down the barriers of age, language and culture. The child who starts to lose autonomy and is weakened by the hospitalization can talk, share, build and exchange ideas based on shared experiences and the poetic component of music. The song learnt in the room will stick with the affected even in the operating room. The percussion instrument given to the child will be the sounding “teddy”, the object to discover and explore. The musician, for example, will stay in the pediatrics’ hall to play and sing with some children and their parents. In neonatology, the mother will regain contact with her baby through a lullaby from her own childhood.
Music contributes to daily improvement and fires up the meaning of being alive. Parents, children and experts gather around the musical object. They explore, improvise and flow with the rhythm of their room partner.
The approach to Music and Health resembles that of an actor in the neighborhood, in everyday life. From the beginning of the partnership, we prioritize actions aimed at babies, since we consider that music must be present in the cultural awakening of young children: language, movement, relationships with others, discovering sounds…
The multiple ways in which the intervention can take place shows that, at the hospital, music can be very diverse. The patient may be the audience, but also the actor (doing for and with). It could be a one-time intervention or a regular activity. Music can be a distraction, an emotion, a surprise, a discovery, a creation and so many other things. The places where it intervenes can also be diverse: at the bed of the patient, in a game room, hall, staircase, operating room, anesthesia room -any place can be used to this end. Therefore, if the waiting room becomes a music room, it is thanks to the good predisposition and cooperation of the healthcare and medical staff, but also of the abilities of the musician.
Music at the hospital is the clash of two opposing worlds. For the artist who ventures into hospital territory, the clash can sometimes be brutal. This encounter usually transforms the musician as much as they are going to transform the others. They will have to show the capacity to be open, attentive and to share the fundamental values of respect and tolerance. Knowledge, abilities and social skills are key to communicating pleasure, passion, curiosity and desire. For the musician, an ongoing professional activity outside the hospital is the best way for bringing “the outside.”
Communication and Cooperation
Music and Health have also chosen to focus their work on training educational teams and healthcare staff. Understanding music as a way to exchange thoughts, communicate and improve wellbeing, as well as the space it occupies in caring for others; developing quality care and enabling the relationships between healthcare staff teams, patients and parents; making music enter the lives of the healthcare staff. Training healthcare staff is communicating our passion, our social skills, but also our theoretical and practical tools for them to take over our work on a daily basis.
Assessment and Search
Assessment has always guided our work. Apart from the concrete evaluation of the action field, we need to find the means to validate our presence in the area of healthcare.
Therefore, the task is complex, since the assessment must not only be based on quantitative criteria but also on qualitative.
For example, we have worked on issues such as the participation of parents, the change in hospital staff and the staff’s absence rate, the fact that they sing along with the musician and that they come to greet him or her, the organization to have exchanges with an outside cultural institution, among others.
We also think about issues that contribute to children: from the passive to the active child, the improvement of their self-trust, music as an encounter point, the development of expressing feelings, the improvement of interactions among children, parents and healthcare staff, the musician as a spokesperson of the children’s emotions, among others.
The task presents a great challenge, and the musician by him or herself cannot pretend to transform the spaces of medical attention.
The Professional Musician
The hospital, a highly technical place, expects the highest professional level from everyone who works in it. The musician intervenes in favor of the needs of children during their hospitalization: a caring and steady presence who, without being part of the healthcare staff that takes care of children, does not intimidate them. The musical message is therefore a rich form of communication, which many times replaces well-intended but often meaningless words in the mind of the child. This presence ensures a referent among a crowd of busy caretakers that approach the child. The hospital is no longer the quiet place but rather the expressive hospital, where the patient reclaims words. Through the ethical and humanitarian process that is art and culture, the patient will find their place and gain meaning.
Philippe Bouteloup is a musician and educator, director of Music and Health since its creation in 1998. He intervenes in diverse situations with children, teenagers and adults: in kindergartens and preschools, music conservatories, pediatrics and neonatology services, child psychiatry, day care centers and training medical institutions.
He currently teaches at the National Conservatory of Music and Dance in Paris, in the Paris Philharmonic and in the CFMI (the intervening musicians training center) at the Aix-Marseille University.
He trains musicians in orchestras who wish to intervene in the healthcare area (the French National Orchestra, Ensemble Accentus, the Paris chamber music center, the Region de Loire National Orchestra, the l’Ile de France National Orchestra, and the Lyon National Orchestra).
His work – « Des musiciens et des bébés » (Musicians and Babies) and « La musique et l’enfant à l’hôpital » (Music and the Child at the Hospital) – is published in Erès Editions.
His last album for children called “Ti-Train” received the Coup de Coeur award of the Charles Cros Academy, which granted him a presentation on a show and a tour around France.
He was bestowed the Knight of Arts and Letters order by the Culture and Communication minister, Catherina Tasca.
 Jean Lombard, Bernard Vandewalle, Philosophie de l’hôpital, L’Harmattan, 2007, p.7.
 Ibid., p. 110.
 At the international level, see the work by Constanza Preti: Music in hospitals: Defining an emerging activity, The Second International Conference on Music Communication Science, 3-4 December 2009, Sydney, Australia, p. 79-82
 Caroline Simonds, Bernie Warren. Le Rire Médecin, Journal du Docteur Girafe, Albin Michel, 2001, p. 150.