Music and Healing for SMA

Joy, sorrow, tears, lamentation, laughter – to all these music gives voice, but in such a way that we are transported from the world of unrest to a world of peace, and see reality in a new way.
--Dr. Albert Schweitzer

Last year was the 25th anniversary season of the Longwood Symphony which we marked by bringing together multiple organizations with shared visions, and by introducing a new way of communicating our music and healing, a symposium series called Community Conversations. This year, our 26th season, focuses on music and healing for those affected by neurodegenerative disease. Midway through the year, our Community Conversation will be a symposium on the use of the arts as a means of healing.

The care of a family member with a neurodegenerative disease is complex. Beside the multiple doctor’s appointments and variety of therapies there are braces, wheelchairs, and so many other things to attend to. With children, one adds daycare, access, and education. And the list goes on.

Families of Spinal Muscular Atrophy chose to use their concert on Saturday not to raise funds as much as to raise awareness. Jim Gaudreau spoke simply and caringly about the nature of the disease, how it has affected his family, and his seven-year old daughter. Many in the audience said “I learned something tonight, and was moved.”

FSMA honored Dr. Laurie Glader, a special physician whose compassion, understanding, and ability to make things happen has smoothed the road for so many parents and families.

Dr. Glader, a pediatrician in the Complex Care department of Children’s Hospital Boston accepted graciously and spoke eloquently. Dr. Glader’s father, Dr. McCarthy, here in Boston for the American Academy of Pediatrics meeting, looked on proudly.

Creativity, Caring and Community. For me, the moment that is magical at every concert is when I feel and see the orchestra transform. The words, dedication, and passion of Jim Gaudreau as a caring father and that of Dr. Glader as his physician touches the musicians on stage as well as the audience. I see it on the faces of your youngest medical students and most experienced physicians alike. It is the recognition of how our music itself is healing.

Suddenly, even beyond the power of Brahms and pure beauty of the symphony itself, the music is an extension of the work we do day to day.

Perhaps it is captured best by the last person to bid us goodnight at the end of a moving evening. She said “You played the music like it is part of life—I heard and felt all of the emotions. I really got what you were trying to say.”

Music and the mind--a season begins

Creativity, Caring and Community

Tonight we will open our 26th concert season at NEC's Jordan Hall in a concert to benefit the Families of Spinal Muscular Atrophy. This group is particularly special to me because two of the children in my pediatric practice are afflicted with the disease.

The entire season focuses on the way we use Music to Heal. This letter is my opening welcome to the audience.

Dear Friends:

Welcome to the 26th season of Longwood Symphony Orchestra. This season we focus on neurologic diseases and consider Music's role in healing.

Music has had a profound effect on all of LSO's healer-musicians. As music students, we were introduced to the magic of Music and challenged by its complex set of multi-sensory, multi-disciplinary problems. Music required the coordination of all the senses--auditory, visual, and motor--to make the notes on a page come alive. In a symphonic orchestra like the LSO, powerful and profound emotions are expressed, passion is revealed. The whole is greater than the sume of the individual parts, providing musicians and audience with emotional strength, a sense of identity, and a sense of order.

Medicine, like music, is a series of complex multi-sensory, multi-disciplinary challenges. We are inspired and touched by the science and the humanity of every patient, and work together as an ensemble in the classroom, in the laboratory, and on the wards. Medicine requires and provides the same life-sustaining inspiration, clarity, emotional strength, and sense of identity as Music.

Music is best when it is shared, performed, and given voice. Our Healing Art of Music program grew out of our passion for community and passion for music. Our music truly makes a difference and enables medical charities to touch the lives of thousands of patients and families.

I would like to thank all of you for being a part of the Longwood Symphony Orchestra family and sharing in our dual passion for, and mission of, Healing our Community through Music and Medicine. I look forward to seeing you throughout this exciting season.

Lisa M. Wong, M.D.

From Dr. Lisa Wong, LSO President

Dear Friends,

Every once in a while an opportunity comes along that pulls the many threads of a life together. This week, this tour, has done that more frequently, more completely, and to a greater extent than any of us could have anticipated.

While we knew that it would be exciting to combine music and medicine beyond the theoretical to the practical with the delivery of musical performances and medical lectures, the tour has gone beyond all expectations.

In five short days, Longwood Symphony members visited , shared clinical and scientific knowledge or met with people in London from the following institutions:

-St. Bartholomew’s Hospital

-Marie Curie Research Institute (MCRI)

-Eden Hall Marie Curie Hospice

-Royal Marsden Hospital

-Royal National Orthopedic Hospital

-Weatherall Institute for Molecular Medicine, Oxford University

-Arthur Rank Hospice, Cambridge

-British Association of Performing Arts Medicine

-St. Christopher’s Hospice

-National Institute of Health and Clinical Excellence

-Macmillan Cancer Trust

Each day, a different member returned to excitedly report about a new meaningful medical or scientific connection made at these opportunities

-LSO trumpet Dr. Len Zon and cellist Dr. Heidi Greulich discovered the complementary research and therapeutic threads in each other’s work: they plan to develop new collaborations at Harvard Medical School in the near future

-Violinist Jennifer Chang, 7^th year Harvard Medical School M.D. –Ph.D. student found that researchers at the MCRI are doing similar work in genetics as she is doing in her lab and were familiar with the work of her advisor.

-Cellist Nancy Chane, RN, works with Partners HomeCare in Boston, and has been doing intensive research through the week on the similarities and differences between the hospice movement in the UK and US. During the week, Nancy visited Marie Curie Eden Hall Hospice, St. Christopher’s Hospice, and Arthur Rank Hospice, met with people from Macmillan Cancer Support, and will present her findings in Grand Rounds in Boston.

-Dr. Mark Gebhardt, clarinetist and orthopedist, in his lecture, described the treatment options for children with bone cancer. The next day, he met with colleagues at the Royal National Orthopedic Hospital and Stanmore Implants to help design more effective prostheses. This work will continue across the Atlantic.

-Even at a performance: at our Bishopsgate Institute concert, violinist Dr. Anna Legedza, a biostatistician at Vertex Pharmaceuticals, met Dr. Alastair Fletcher, a fellow statistician from the UK’s National Institute of Health and Clinical Excellence during the concert intermission. They had a lively discussion about biostatistics and their research on the global spread of Hepatitis C.

And of course there was the music. Jonathan McPhee’s repertoire truly represented a bridge across the Atlantic, and had a remarkable symmetry in programming. The first half opened with Bach’s Double Violin Concerto, an opportunity to showcase the remarkable talent of our medical students, Sherman Jia and Sandy Mong. The second half opened with Bachianas Brasileiras No. 5 by Heiter Villa-Lobos, that composer’s homage to Bach. The centerpiece was Aaron Copland’s “Appalachian Spring,” in its original scoring for three winds, piano, and strings. Jonathan had brought an intensely personal “Appalachian Spring” to London—this is a work he had performed with Aaron Copland and Martha Graham, and he was delighted to share with London audiences once again. Added to that were the performances of two visually evocative masterworks: Samuel Barber’s “Knoxville Summer of 1915” and Ralph Vaughan Williams “The Lark Ascending” with American Soprano Janna Baty and British violinist David Juritz. In both performances, one could hear not only their fine musicality but deep humanity.

The tour was a demonstration of Music as healing, Music as a means of communication when there are no words left, and Music as a gift. It was also a demonstration of Medicine as healing, Medicine as a means of communication, and Medicine as a gift. Truly a bridging of our two disciplines, across the Atlantic.

Lisa M. Wong, M.D.

From Dr. Mark Gebhardt

About a year ago I met a little girl from Puerto Rico who had a malignant bone tumor of her tibia. She was sent to me to excise her tumor after some extensive preoperative chemotherapy. Because she was only 7 at the time, the removal of the tumor below her knee would leave her with a major inequality of the lengths of her leg. Fortunately, there are internal metal prostheses that can replace certain bones (in this case the tibia) and can be “expanded” or lengthened in small increment as the child grows. The expectation is that by the end of growth the two limbs will be equal length. One of the pioneers in this field of prosthesis manufacture and scientific development is a biomechanics laboratory at the Royal National Orthopaedic Hospital in London. The Centre for Biomedical Engineering has become Stanmore Implants Worldwide Ltd, a company that has a specific interest in making custom prostheses for limb salvage following tumor resections. I had them make one for my little patient and it has so far worked beautifully.

While in London, I visited with the bioengineers and technicians at Stanmore to plan the first lengthening for my little patient. It was a morning well spent. I got to tour the facility and see first hand how they computer model the implants and physically make them. I got a demonstration about how the expansion works and planned a trip for them to come to Boston for the first expansion.

I also got to meet the President of the company, Brian Steer, and discussed a research project with their bioengineer Paul Unwin. Their group has developed a specialized technique involving tissue ingrowth into a metal implant that has to potential to augment the way we currently attach artificial limbs to an amputee. A few centers in the US will participate in a pilot study of these implants and this visit provided an excellent venue for them to present their research to me and begin the collaboration.

This is truly an innovative group that maintains a close tie to the University and they are clearly leaders in the field of tumor prostheses. In addition to enhancing the scientific collaborations, they kindly donated funds to the London tour that sponsored a medical student for the trip.

A Chance to See the Sights

Saturday, June 28, 2008

Saturday provided an opportunity for some sightseeing around the beautiful city of London. Many people took advantage of the beautiful weather and after returning our borrowed celli to Florian Leonhard’s shop, headed to Portobello market in Notting Hill. The market, which comes alive on Saturdays, was packed with bargain hunters, tourists, locals and nearly any item under the sun.

Dr. Lisa Wong and Dr. Denise Lotufo stumbled upon an antique print shop where they found old issues of Philhamonic Post from 1949 and The Strad Magazine, dated 1951! Among the articles were an editorial on the need for government support of the arts that is still current today, and a fascinating comparative survey of which composers were most popular in concerts in four European musical centers (London, Paris, Brussels and Amsterdam).

In the evening, we went back in time attend “The Merry Wives of Windsor” in the Globe Theater, recently restored to reflect the feel and acoustic of Shakespeare’s Day. While there were seats available (and seat cushions that could be rented!), some of us chose to be authentic and stand in the central clearing amongst our fellow peasants.

After the performance, Chris, our Tour Leader and Colin, our amazing bus driver, treated us to a surprise by driving over the London Bridge which was beautifully lit for the mild evening.

Windsor Castle and the Anvil

Friday, June 27, 2008

On Friday morning we headed to visit Windsor Castle. We arrived at the grounds and were immediately impressed by its grandeur and history. There was something for everyone: from armor and armory for those Arthurians among us, to historic documents, to grand ballrooms full of masterworks of art and architecture. We arrived in time to witness the Changing of the Guards. Having already had the surprise opportunity to wave our greetings to the Queen on Tuesday evening, perhaps we should not have been surprised to hear the Royal Guards Fife and Drum Corps playing Copland’s Shaker Melody there on the grounds of Windsor Castle!

We then wandered through St. George’s Chapel and the Castle to admire the luxurious accommodations, and splendid history preserved within in their walls. Some LSO member favorites included Queen Mary’s Doll House (complete with electricity and functional plumbing!), sketches by Leonardo da Vinci, and a marble sculpture in memory of Princess Charlotte, that was so beautifully convincing, that it was as though the subjects in the piece would stand up at any moment.

After grabbing a quick lunch, it was back on the bus for another hour or so to Basingstoke for our afternoon concert and evening performance. We arrived at the Anvil and immediately began rehearsing. The Anvil, built just fifteen years ago, has a wonderful acoustic that brought out the best in our 30-piece ensemble.

In the audience for the evening concert was the Mayor of Basingstoke who opened the concert with warm words of welcome and thanks to the LSO for traveling to London and for performing for such a wonderful cause.

The final piece on the evening’s program was Aaron Copland’s Appalachian Spring. Before beginning the piece, there was a palpable energy on stage and off. As we journeyed through the amazing score, there was a level of connectedness amongst the musicians that had never, until that moment, been experienced. It was as though the entire orchestra was one body—thinking, moving, and breathing as one. The evening was simply amazing. Some, indescribable, intangible magic embraced us all for our final performance of the tour.

We headed back to the hotel, to celebrate with what had become the “usual” post-concert meal --a pint of Guiness and beer-batter Fish and Chips!

Check out the rest of our photos here!

Grand Rounds

Thursday, June 26, 2008

On Thursday morning, Dr. Daniela Krause, Dr. Tom Sheldon, Dr. Steve Wright, Dr. Mark Gebhardt, John Hecker, Dr. Nick Tawa, Dr. Sue Pauker and Jonathan McPhee traveled to Royal Marsden Hospital’s cancer research center in Surrey for Grand Rounds.

Hosted by Royal Marsden Hospital’s Dr. David Cunningham and Dr. Alan Horwich, the morning session featured presentations on cancer surveillance and preventive care by both Royal Marsden physicians and by Longwood Symphony’s Dr. Tom Sheldon (prostate cancer) and Dr. Steve Wright (colorectal cancer).

Dr. Horwich led a lively discussion between UK and US oncologists comparing medical approaches, treatment modalities, and prevention. Afterward, Drs. Sheldon and Wright performed a musical offering of Beethoven duets arranged for oboe and bassoon, and were joined by Dr. Krause, Mr. Hecker, and Dr. Gebhardt for a performance of the Ibert Woodwind Quintet. Following the performance, the musicians asked for any questions from the audience. The only question that was posed was “Is there an encore”? And there was!

At the same time in South London, Dr. Lisa Wong, Nancy Chane RN, Dr. Katherine Hein, Tamara Goldstein OT and M.D.-Ph.D. student Jennifer Chang visited St. Christopher’s Hospice in Sydenham. Forty years ago, Dame Cicely Saunders began her work at St. Christopher’s with mindful care of the dying cancer patient. She is widely recognized as the founder of the current hospice movement.

There we met a remarkable musician who is very much like we are. Mr. Nigel Hartley gave us a brief tour of the grounds and then related his experiences as a concert pianist, psychologist and now music therapist for a wide variety of patients and families who are part of the hospice community. He has demonstrated with his life work the power of music to cross boundaries and to communicate, even with those who have lost the ability to speak. We hope to bring Mr. Hartley here to Boston to share this gift with musicians and caregivers.

After returning the hotel for just long enough to change our clothes, we loaded up the bus again to head to our second full orchestra concert, this time with a different repertoire! In keeping with our “Bridging the Atlantic” theme, the concert, held at Bishopsgate Institute in central London, a featured American soprano Janna Baty (singing Barber), and British violinist David Juritz (playing Vaughan Williams and Villa Lobos).

The concert brought together over 75 people, including Ms. Susan Munroe, Marie Curie Director of Patient Services, Mr. Alastair Fletcher from the British NHS National Institute for Health and Clinical Excellence, Mr. Barrie Walkley of the U.S. Embassy London and other music lovers who were cancer specialists from Marie Curie Cancer Care, St. Bartholomew’s Hospital, Macmillan Cancer Support, and the Marie Curie Research Institute, among others.

Prior to the second half of the concert, Ms. Munroe spoke poignantly about the remarkable work of Marie Curie Cancer Care. As always, the orchestra was as touched by her words as the audience members, and gave an impassioned performance. The concert also raised over #450 in donations for the work of MCCC.