The Arts & Health

 

[Here are two reports from PBS NewsHour on the confluence of the performing arts and matters of health.  The first report concerns the beneficial effect of music on the health, particularly mental health, of people who aren’t musicians.  It’s proof that, indeed, “Music has charms to soothe a savage breast” (William Congreve [1670-1729], The Mourning Bride [1697]). 

[The second report examines the relationship between the Houston healthcare community and that city’s performing artists and performing arts institutions.  Performers, including actors and musicians but especially singers and dancers, are susceptible to many career-endangering health issues that “civilians” (as one of my teachers called artistic muggles) don’t face.  Houston’s hospitals and health-care facilities have developed a community of care for Houston’s performing artists that the professionals of both societal groups claim is unique.] 

“OPERA LEGEND RENÉE FLEMING TEAMS UP WITH
DR. FRANCIS COLLINS TO STUDY HOW MUSIC CAN IMPROVE HEALTH”
by Jeffrey Brown and Anne Azzi Davenport 

[The following story, about opera singer Renée Fleming and former NIH head Francis Collins working in tandem on the application of music therapy to a range of mental and emotional stresses, was reported on PBS NewsHour on 22 February 2024.  The transcript and video of the segment is at Opera legend Renee Fleming teams up with Dr. Francis Collins to study how music can improve health | PBS NewsHour.

[Note: The NewsHour transcript of its segments is annotated with the warning, “Transcripts are machine and human generated and lightly edited for accuracy. They may contain errors.”  In light of that statement, I have edited or corrected mistranscrIptions directly from the video, sometimes without marking them below.  I’ve also added annotations in brackets to clarify some remarks.]

Giants in their fields of music and science are merging their knowledge to propel advancements in body and mind. A recent international gathering of researchers, therapists and artists took stock of what is known and what is yet to be discovered. Jeffrey Brown reports for our ongoing arts and health coverage on CANVAS.

Amna Nawaz, “NewsHour” Co-Anchor: Two giants of music and science are merging their knowledge to propel advancements in body and mind.

Researchers, therapists, and artists from around the world gathered to explore what is known and what is yet to be discovered.

Jeffrey Brown takes a look and a listen for our ongoing arts and health coverage on Canvas.

Jeffrey Brown: [Renée Fleming singing in concert.] She is a singer, one of the world’s most beloved sopranos. But at times in her remarkable career, Renée Fleming has experienced terrible bouts of somatic pain [relating to or characteristic of the body as opposed to the mind or spirit], the body’s way of distracting her from the mental anxiety brought from performance.

Renée Fleming, Singer: I was never a natural performer. And so I just kept reading and reading about the mind-body connection, trying to understand more about what was causing this, et cetera. And I discovered that the medical profession and neuroscientists were studying music. And I asked him [indicating Dr. Francis Collins, sitting next to her] why one day.

Jeffrey Brown: He is the renowned physician-geneticist best known for his landmark discoveries of disease genes and leadership of the Human Genome Project.

Dr. Francis Collins, Former Director, National Institutes of Health: [26 June 2000, in the East Room of the White House, at the presidential conference, Decoding the Book of Life: A Milestone for Humanity] Today, we celebrate the revelation of the first draft of the human book of life.

Jeffrey Brown: Francis Collins headed the National Institutes of Health, the world’s largest supporter of biomedical research, for 12 years until 2021.

Dr. Francis Collins: I’m a doctor. I want to find every possible way to help people who are suffering from illnesses or other kinds of life experiences that are limiting their ability to flourish. I want to make everybody flourish, and music is such a powerful source of that kind of influence.

Jeffrey Brown: Together, they are leading proponents of a marriage of arts and health, advocates for research, understanding, and practice in the nexus of music and the brain.

We talked recently on the NIH campus [Bethesda, Md.] about their music and health initiative, now in its seventh year.

Renée Fleming: I believe the arts should be embedded in health care across the boards.

Jeffrey Brown: Embedded meaning?

Renée Fleming: Meaning, we already have it in many, many places. Many hospitals have discovered just how beneficial it is to have creative arts therapists on staff. Children’s hospitals should have a creative arts studio, I think, available to parents and their children and families. So, I just think it should be everywhere in health care.

Jeffrey Brown: It’s a growing movement, one we have been reporting on around the country, including neuroscientists at Johns Hopkins studying music’s impact on dementia patients, a hospital at the University of Florida incorporating arts into its care, individuals who’ve suffered traumatic brain injuries, like former Congresswoman Gabby Giffords, playing the French horn to help rewire her brain and rebuild her ability to speak.

[Gabrielle Giffords (b. 1970) is a retired member of the United States House of Representatives from Maricopa County, Arizona, from January 2007 until January 2012. She suffered severe brain injury during an assassination attempt on 8 January 2011, when she was shot in the head.  Giffords resigned from Congress on 25 January 2012 to focus on her recovery and, as of 2016, has recovered much of her ability to walk, speak, read, and write, though she continues to struggle with language and had lost fifty percent of her vision in both eyes.]

Our understanding of the brain’s connections and responses is still in early stages, Francis Collins says, with projects like the NIH-funded BRAIN Initiative [Brain Research through Advancing Innovative Neurotechnologies] helping show how individual circuits connect and respond. We do know some basics, however.

Dr. Francis Collins: I think you can say the acoustic cortex, which is where your brain processes incoming sound, and particularly musical sound, does have some pretty interesting circuits. It’s also plastic [easily shaped or molded]. It responds to training.

If you look at the brain of somebody who had intense musical training before age 7, you can actually see that part of the cortex is a little larger than in somebody who did not have that. So, our brains are responding to the environment very clearly in that way.

And then you can say, OK, if you have a musical experience that affects you, you can see how that signal that starts out in the acoustic cortex spreads to many other parts of the brain.

Jeffrey Brown: Maybe you have had an MRI? Renée Fleming got in and sang for two hours.

(Singing [in the MRI machine])

Renée Fleming: When I show this video to people, I always say, well, no Grammys for this performance.

(Laughter)

Jeffrey Brown: One interesting finding [was], that for an experienced singer like Fleming, her brain circuits were more active while she thought about or imagined singing than when she actually sang.

Did that surprise you?

Renée Fleming: It surprised me a great deal. It’s also — I think what’s even more surprising to me is that music actually is in every known mapped part of the brain. So it’s extraordinarily diverse and throughout the entire brain, as we know, as we currently understand it.

Jeffrey Brown: The research so far has a wide range of implications for child development, Alzheimer’s, and other forms of dementia, Parkinson’s, and other conditions and interventions.

Some research goes on in labs, some in the world, as in a study in which individuals were offered singing lessons. One group was given individual training, the other as part of a chorus.

Dr. Francis Collins: For 12 weeks, and to just see what happens as far as their health, the people that had individual singing, they did OK. The people in the choir, by all kinds of measures, were actually affected in a very positive way.

Many of them had chronic pain. Their chronic pain was noticeably reduced. They had various measures of personal attitudes. Their attitude toward generosity went straight up, and their oxytocin levels went up too, as another sort of hormonal measure of good will, good sense of health.

[Oxytocin is a hormone released by the pituitary gland. It plays roles in behavior that include social bonding, sexual activity, reproduction, childbirth, and the period after childbirth.]

Renée Fleming: My favorite is, postpartum depression is tremendously benefited by singing in a choir. I would never have — I wouldn’t have guessed that.

Narrator: Having even one risk factor . . . .

Jeffrey Brown: In fact, you know those advertisements for drugs we’re all bombarded with?

Narrator: [Clip from a television commercial] Ask your doctor or pharmacist if Paxlovid is right for you.

Jeffrey Brown: Renée Fleming has one she’d like to see.

Renée Fleming: Ask your doctor if music therapy is right for you.

(Laughter)

Jeffrey Brown: As a kind of prescription.

Renée Fleming: Exactly. Exactly.

(Crosstalk)

Dr. Francis Collins: The prescription. Why not?

Jeffrey Brown: Yes, but you have to — you’re saying it still has to be shown exactly in a scientific method . . .

Dr. Francis Collins: Yes.

Jeffrey Brown: . . . for a doctor to be willing to prescribe it.

Dr. Francis Collins: Sure. That’s our system, and I’m totally behind it. You need evidence that this actually isn’t just a nice thing; it actually improves outcomes.

I’m pretty convinced from the data we have that’s the case for various places, but let’s tighten that up. Let’s make it absolutely incontrovertible. And then you will have a better chance with the insurance companies saying OK, because that may save them money in the long run.

Man: [Instructor of a music therapy demonstration in a conference] Let’s listen to this melody line as it floats all the way up.

Jeffrey Brown: At this recent gathering and others, Fleming and Collins are advancing new findings through a variety of collaborations, including NIH Music and Health with 20 NIH institutes, the Kennedy Center’s Sound Health partnership, and the Renée Fleming Foundation.

Everything you’re talking about requires a kind of buy-in from your communities, the arts world and the science world. But is there still pushback?

Dr. Francis Collins: There’s a bit, but I think were getting some real momentum going. It doesn’t hurt that scientists are also musicians. At least, many of them are.

This workshop, we invited multiple leadership at NIH to come and take part, and they all said pretty much yes, and they went away saying, that was even more interesting than I thought.

Jeffrey Brown: A young person now goes to the music conservatory, you want them to study therapy, science, health?

Renée Fleming: Well, these would be divisions within a conservatory or university.

But there’s definite buy-in now. But when I started, people were saying exactly what you’re saying, is, well, we have too much to do already with what we’re doing, in terms of presenting, and we’re strapped, and the funding is difficult, et cetera, et cetera.

But I think pretty much everyone is on board now, because we’re community service providers. So, I think people who run performing arts organizations and conservatories are starting to see the benefit of it.

Jeffrey Brown: And these two don’t just talk about bringing their disciplines together. They have been known to give it literal form, as amateur musician Francis Collins accompanies science-fascinated Renée Fleming.

For the “PBS NewsHour,” I’m Jeffrey Brown at the National Institutes of Health in Bethesda, Maryland.

(Music [Fleming on stage singing with Collins accompanying on guitar and signing])

(Applause)

Amna Nawaz: And Fleming has edited a collection of essays from scientists, artists, and therapists called “Music and Mind: Harnessing the Arts for Health and Wellness” [Penguin Publishing Group; publication date: 9 April 2024]. That’s due out this spring.

[I want to connect this NewsHour report on the benefits of music to anguished souls to some past posts on Rick On Theater that touch on the same or similar topics.  The first is “Theater: A Healing Art,” published on 3 September 2023, in which I examine the function of theater as a healing event for those who witness it and those who perform it.

[One example I gave of this phenomenon was a play, The Last Cyclist, written by a concentration camp inmate for his fellow prisoners.  In my report, posted on 2 and 5 September 2022, on the play which was reconstructed and staged and then filmed, I observed that it was, first, a healing force for the incarcerated Jews 80 years ago by reducing their dire circumstances to their farcical foundations.  Then it was a healing phenomenon for both the modern actors, mostly non-Jews, who performed the reconstruction and the modern audiences who saw it in the present day.

[A more contemporary play that was conceived as a healing event for the participants and the spectators was Last Out: Elegy of a Green Beret, a play about combat service in Afghanistan and its effects on the GI’s and their families on which I reported on 10 July 2023.

[On 28 August 2020, I ran “Yo-Yo Ma on the Artist’s Role in the Time of Covid-19,” a collection of articles on the famous cellist’s call for musicians and other artists “to take up a role in the struggle against the pandemic and its consequences.  He especially focused on the issues of raising the spirits of Americans who were struggling under the health threat and the psychological burdens of being confined to their homes.”  This lines up precisely with the work of Dr. Francis Collins with Renée Fleming, reported above.

[In his moe than 30-year career with PBS NewsHour, Brown’s served as co-anchor, studio moderator, and field reporter on a wide range of national and international issues, with work taking him around the country and to many parts of the globe. As arts correspondent, he’s profiled many of the world's leading writers, musicians, actors and other artists. Among his signature works at the NewsHour: a multi-year series, “Culture at Risk,” about threatened cultural heritage in the United States and abroad; the creation of the NewsHour’s online “Art Beat”; and hosting the monthly book club, “Now Read This,” a collaboration with the New York Times.

[As Senior Coordinating Producer of “Canvas,” Anne Davenport is the primary field producer of arts and culture pieces and oversees all coverage. She’s been leading “Canvas” since its beginning, collaborating with Chief Arts Correspondent Jeffrey Brown for most of her 21 years at PBS NewsHour as well as with others.] 

*  *  *  *
“HOW A HOUSTON MEDICAL CENTER IS
HARMONIZING HEALTH AND PERFORMING ARTS”
by Jeffrey Brown and Alison Thoet 

[Before the report on the use of music to reduce stress and distress, correspondent Jeffrey Brown covered the Houston collaboration between the health-care facilities and the performing arts institutions of the city.  The segment aired on PBS NewsHour on 2 October 2023 and is online at How a Houston medical center is harmonizing health and performing arts | PBS NewsHour.]

The Center For Performing Arts Medicine is an unusual partnership of a world-class hospital and world-class performing arts organizations. It was founded in 1992 with a focus on singers, but then something unexpected happened. Jeffrey Brown reports from Houston for our arts and culture series, CANVAS.

Amna Nawaz, “NewsHour” Co-Anchor: It’s an unusual partnership, a world-class hospital and world-class performing arts organizations, a model in the growing field that brings together health and the arts.

Jeffrey Brown reports from Houston for our ongoing series, Canvas.

Woman [Dr. Yin Yiu]: We’re just going to get a look at your throat and your vocal cords. Breathe in.

Jeffrey Brown: We’re up close and personal with 25-year-old opera singer Emily Treigle and her vocal cords. This is her instrument, requiring constant care and attention.

Emily Treigle, Houston Grand Opera: It’s not like I’m playing the Trumpet or piano, like, if something goes wrong, you can see it. You know, it’s all in here. So, you need the professional to be able to go in and make sure that everything is going well.

Jeffrey Brown: In July, after multiple tonsil infections, Treigle, a mezzo-soprano, had a tonsillectomy. All went well, and, this day, she was getting a checkup ahead of the Houston Grand Opera’s new season.

For someone in your position, what’s the problem? I mean, what’s the thing you have to deal with or worry about most with your voice?

Emily Treigle: The short answer is everything. The long answer is, it’s incredibly challenging to be in a career that there are so many variables attached to it.

And so our task as singers is to have such a good, solid technical foundation that we can defy whatever odds are thrown at us and just continue to be able to produce a really beautiful sound. And when it’s something that’s outside of our control, our technical realm, that’s when we end up back here and say, something is not working. Can we do a checkup and make sure that everything is where it’s supposed to be?

Dr. Yin Yiu, Houston Methodist Hospital: We really encourage our singers as vocal athletes.

Jeffrey Brown: Working with Treigle, Dr. Yin Yiu, a laryngologist at the Texas Voice Center at the Houston Methodist Hospital. As she puts it, she’s the T in the ENT [ear, nose, and throat].

She doesn’t sing herself, though some of her colleagues do, but she loves the challenge of caring for singers.

Dr. Yin Yiu: We think about athletes, right, and they have like this whole team of people that take care of them. And we don’t really think about performers.

So, singers, actors, people who do, like, use their voice in that capacity, we don’t think about them in that same way. But they can also have injuries, right? So, they can be performing and have different things happening. The vocal cords can get swollen. They can have vocal cord hemorrhage or bleed whenever. They’re singing. These are all things that can happen. And we get to be that team for them.

[The “swollen” vocal cords Dr. Yiu mentions may refer to laryngeal polyps or nodules, which can appear as swelling and can cause symptoms including hoarseness or breathiness, “rough” or “scratchy” voice, decreased pitch range, and vocal and bodily fatigue.  It was the condition with which singer-actress Julie Andrews was diagnosed in 1997—although she disputes the diagnosis—and as a result of the surgical treatment for which, she lost her magnificent singing voice.  

[Dr. Yiu has omitted from her list of vulnerable performers arguably the most susceptible to physical injury—though not usually to the throat: dancers.  These artists are brought up later in the report.]

Jeffrey Brown: The Texas Voice Center is part of the hospital’s highly unusual program, the Center for Performing Arts Medicine. Founded by Dr. Richard Stasney in 1992, it all began with a focus on singers, but then something unexpected happened.

Todd Frazier has led the center since 2012.

Todd Frazier, System Director, Center for Performing Arts Medicine: We started to get preachers, newscasters, classroom teachers, anyone that would associate their voice to what they do professionally.

[I would add to the list of potential professional subjects, lawyers, specifically litigators.  When I was an acting student and then a teacher of acting, along with the occasional priest or teacher, I saw a number of lawyers taking acting classes.]

And that’s when the hospital realized that, yes, there really is something special and unique here, and that’s unique to Houston as well.

Jeffrey Brown: The center then grew to support performing artists of all kinds from Houston’s thriving arts community, as well as from all over the country. Crucially, it also developed official relationships with several of Houston’s leading performance art groups.

Todd Frazier: There are a lot of unique health issues that show up in the arts community that deserve a home and deserve a place to be cared for.

Jeffrey Brown: Are you surprised that this is a thing now between the hospital and arts organizations?

Todd Frazier: I’m not surprised that its successful, because I am from the arts community [he’s a composer, trained at the Eastman School of Music in Rochester, New York, and the Juilliard School in New York City], and I really knew that the artists were yearning for a home and a sympathetic place that they would be understood.

But I am — have to be surprised that a major hospital would sort of take this on in a way that’s sort of unprecedented. They felt it fit with their values to be supporting the arts and culture within the community of Houston, which all the hospitals are in Houston. And the physicians really enjoyed being able to help these talented people making their lives and homes here in Houston.

Jeffrey Brown: One major partner, the Houston Ballet, which now has an on-site clinic, giving dancers like Kellen Hornbuckle daily access to athletic trainers and physical therapists.

[Readers may remember some years ago, professional and college athletes, football players in particular, were discovered taking dance classes to help them tone and coordinate their bodies.  I wonder if it’s still common.]

Dr. Kevin Varner, Houston Methodist Hospital: The types of injuries that ballet dancers get are very unique. It’s a very unique population. And while they are performing artists, they are incredible athletes.

Jeffrey Brown: Kevin Varner is the chairman of orthopedic surgery at Houston Methodist Orthopedic Sports Medicine.

Dr. Kevin Varner: It’s interesting to look at how things evolved over the last 15 or 20 years in terms of dancer health. And, remember, it’s a big team approach, right? So, you really need a hospital that wants to be a partner, because you need not just orthopedic surgery.

You need nutrition. You need cardiology. You need primary care sports medicine, so people that take care of the dancer as a whole [and] when you do that, it really does improve dancer health.

Jeffrey Brown: In this session, Hornbuckle received dry needling, cupping, massaging, and other treatments to alleviate pain in her legs and prevent serious injury.

[Dry needling is a treatment for pain and movement issues in which thin needles are inserted into or near trigger points to stimulate the muscles, causing them to contract or twitch. This helps relieve pain and improve the range of motion. Cupping is a traditional therapeutic treatment in which heated cupping glasses are applied to the skin, supposedly to draw blood towards the surface for relieving internal congestion or loosening and stimulating the muscles.]

The big idea, according to Houston Ballet executive director James Nelson, change from reactive to proactive care.

James Nelson, Executive Director, Houston Ballet: So, when I was dancing, we never had any on-site care. It was always, wait until you’re broken, then go to the doctor, then get it fixed.

At the end of the day, it’s a very short career. And so to be able to give an artist a year, two years, five years more of this precious time is such a gift. And I attribute a lot of that to this partnership with Methodist. You won’t find this kind of relationship in most ballet companies.

Jeffrey Brown: Back at the hospital, Frazier sees this kind of focus on the performing arts only growing in the future.

Todd Frazier: Many universities are starting arts and health certificates, music therapy degrees.

And even medical schools are looking at internships in artists health or how artists might be cared for to develop those skills. And it is growing.

Jeffrey Brown: Meanwhile, singer Emily Treigle is ready to go.

Your throat looks great. I mean, I saw it.

(Laughter)

Emily Treigle: Thank you. Who knew my tonsils were so big? I had no idea. But now that I don’t have them, I certainly notice their absence.

I’m very excited about this coming season and seeing how things change now that I don’t have this obstacle.

Jeffrey Brown: Treigle performs [as Meg Page] with the Houston Grand Opera later this month in Giuseppe Verdi’s “Falstaff” [27 October-10 November 2023].

For the “PBS NewsHour,” I’m Jeffrey Brown in Houston, Texas.

[Jeffrey Brown’s bio and credits are reported above. Alison Thoet is a writer and a “Canvas” associate producer and national affairs associate producer at PBS NewsHour.]