By Genesis Barbosa-Padilla, Music Therapy Intern
Edited by Theresa Kwong, Communications Consultant

Death is a scary word. It’s a subject many people, like myself, seem to avoid due to its nature. While people have differing interpretations of what happens following death, what we generally find consensus on is that death brings grief. Just like a ripple, it spreads — affecting everyone close and reshaping their present reality. One of the first experiences I knew I would face when I began my internship was confronting death in the medical setting. Really, I could not comprehend the reality of how close I would actually come to those who are near death.

Within my first experiences in the medical setting, I was introduced to the interdisciplinary team (the palliative team), who deal with a variety of patients with chronic or progressive illnesses, including those who are dying. It immediately became clear that this group faces the realities of death every day. Not only do they face it, but they also act as a grounded presence for the families that the ripple effect touches. They bring truth, emotional support, clarification on medical decisions, and so much more to these families. And they do it all with a strong balance of empathy and realism.

One of the first things I noticed was the way this team discussed patients who were close to death. Always with the utmost respect, but unafraid to face the reality that death was inevitable for some. Within my first few meetings, I found myself struggling to keep the professional wall up. When you evade the subject of death for so long, it’s not an easy transition to make it part of conversation. Sitting in meetings and discussing these patients, their children, their parents, or even those who had no loved ones at their side, I instantly began to wonder: Can I do this? Can I provide services to dying patients and their families, and not make it about my own emotions?

I grappled with these questions for the first one to two weeks of my internship. At times, it felt as though I had to choke down the realities surrounding these patients while I was in meetings. Taking note of this, I decided to have an open conversation with my supervisor about how she developed her ability to discuss themes of death with patients, and how she processed this subject matter personally.

She shared that the ability to compartmentalize is a skill. It takes work, exposure, and a strong mental capacity to enter a room and professionally separate your emotions from what is happening. I had heard the term “compartmentalize” before, but I had never viewed it as a skill to develop. I realized that the ability to compartmentalize would not only benefit me, but also the patients I serve.

Another point she emphasized was this: “Remember you are also human, and it is okay to have an emotional reaction — in the proper place and time.” There it was, the reminder I needed to say to myself: Hey, you are going to have a reaction to this, and that’s okay. The emotion is not the issue; it is what you do with it.

Emotions will come out, regardless of how far we push them down, and that’s where the skill lies. The skill is being able to remove your personal emotions when necessary and to bring them back up to process them at an appropriate time. From then on, I knew I needed to build my compartmentalization skill, find my processing skill, and create an ebb and flow of containing emotion within the work setting and releasing it when I was able, on my own time.

The time had finally come for me to visit my first patient who had been referred by palliative care for comfort/end-of-life support. The team shared that this patient was nearing the end of her journey and that we would provide support as she had been alone for some time. I had no idea what to expect, but my supervisor prepared me before we entered the room. She said to be ready, as people near the end of life may say or do unexpected things within the session — they may be in pain, verbalize, vocalize, move in a way that shows it, or be unresponsive for a great deal of the time.

When we entered, the room was dark, and the patient was lying down. She did not move much and did not say much, but she verbally agreed to have us in the room to support her with music therapy. My supervisor chose the song “Cruisin’” by Smokey Robinson. We sat together and played through the song softly, slowly, and just loud enough for her to hear.

During the song, the patient began to make statements about being “ready to go home” and called out the name of her son. Immediately, tears began to well, and I closed my eyes, trying to compose myself. My supervisor asked questions: “Where is home for you?” — all while still playing guitar. The patient responded, “With my son.” My supervisor provided statements of affirmation that the patient was “free” and could do what she needed to feel safe and comfortable enough to “let go,” if that was her choice.

Almost out of nowhere, the patient opened her eyes, looked at both of us, and said, “When you ladies come home, make sure you come by and say hi to me.” How I kept my composure, I will never know.

When we left that session, my supervisor immediately asked how it went. “Overwhelming” was the only word I could mutter. She shared that one way she processed heavy sessions or patient loss was by listening to songs that reminded her of the patient, on her own time, and allowing herself to feel whatever needed to come up in that moment.

She also gave me a book called “Nothing to Fear: Demystifying Death to Live More Fully” by Julie McFadden, which reflects on being near death while working in hospice settings. From these readings, discussions, and patient sessions, I learned that death is an inevitable and intimate part of life.

As a soon-to-be professional with the opportunity to work with patients and their families at this critical point, I began to realize the privilege it is to be allowed into such an intimate time. In these moments, you can come face-to-face with pain and sadness, but within that sadness is the joy of seeing who this person was — you see it in the presence of their families or in the words and stories they share.

You also notice when a person has made peace with death. Patients who accept death as a part of life experience a much smoother transition, physically and emotionally.

A quote from Julie’s book says:

“Imagine you are on a beach with the ocean in front of you. The ocean is death. Will you get pulled into the ocean via the undertow, against your will, kicking and screaming? Or do you cross the ocean in a boat you made, with your friends and family beside you, shoving the boat off and sailing on your own accord?”

When I left that first session, my supervisor said, “What an honor it is to be with someone at the end of their life.” As soon as she said it, I knew that’s exactly how I felt. I felt honored to be in the presence of someone during such an intimate time, supporting them through music as they prepared for their transition away from this world.

I went home that day and listened to “Cruisin’” by Smokey Robinson the entire way. Death is a big word; it can have many adjectives before it, but it doesn’t have to be scary.

At life’s most tender moments, music and presence can hold space for love, memory, and peace. If you or someone you love is navigating the end-of-life journey, the hospice team at MusicWorx is here to walk alongside you with compassionate music therapy and care. Contact us to learn more.