Wired for Sound
Humans are uniquely able to produce and enjoy music—very few other animals can do so. But not only is music one of the fundamental ways we bond with each other, it literally shapes our brains. Perhaps this is so because musical activity involves many parts of the brain (emotional, motor, and cognitive areas), even more than we use for our other great human achievement, language. This is why it can be such an effective way to remember or to learn. It is no accident that we teach our youngest children with rhymes and songs. As anyone who can't get an advertising jingle or a popular song out of their head knows, music burrows its way deep into the nervous system, so deep, in fact, that even when people suffer devastating neurological disease or injury, music is usually the last thing they lose.
I have seen this over and over again in my practice as a neurologist. The right sort of music can literally unlock someone frozen by Parkinson's disease, so that they may be able to dance or sing, even though, in the absence of music, they may be unable to take a step or say a word. For many people with aphasia, a loss of the use of language most commonly caused by stroke, songs can be the key to retrieving words they cannot otherwise utter. People with Tourette's syndrome, who may be distracted by physical and sometimes verbal tics, often find that music allows them to bypass those tics. I have seen people with extreme forms of amnesia who are unable to remember what happened to them a few minutes ago but are nonetheless able to sing or play long, complicated pieces of music, or even to conduct an orchestra or choir.
Perhaps most remarkably, people with Alzheimer's disease and other dementias can respond to music when nothing else reaches them. Alzheimer's can totally destroy the ability to remember family members or events from one's own life—but musical memory somehow survives the ravages of disease, and even in people with advanced dementia, music can often reawaken personal memories and associations that are otherwise lost.
Recently, I met Mary Ellen Geist, a former WCBS radio anchor who has written a book, Measure of the Heart. She contacted me about her father, Woody, who began to show signs of Alzheimer's 15 years ago, at the age of 67. Now, she said, "he can't remember much of anything about his life. He has no idea what he did for a living, where he is living now, or what he did 10 minutes ago. Almost every memory is gone. Except for the music." Mary Ellen brought her father and her mother to New York to meet me. Mr. Geist walked into my office carrying a neatly furled newspaper—though he did not seem to know what a newspaper was. He was well-groomed and nattily dressed, though this, his daughter later told me, had required supervision, for left alone, he might put on his pants backward, not recognize his shoes, shave with toothpaste, and so on. Yet there was a deep civility and courtesy in Woody (as he immediately introduced himself).
Despite the manifest ravages of Alzheimer's—his loss of event memory and of general knowledge, his disorientation, his cognitive problems—Woody's gentle and polite disposition, it seemed, was ingrained at a much deeper level, and he chatted with me amiably. Soon, however, he tired of my questions, which he was unable to answer—simple ones such as "Can you read this?" or "Where were you born?" So I asked him to sing.
Mary Ellen had told me how, ever since she could remember, the whole family—Woody, Rosemary, and their three daughters—had sung together, and how singing had always been a central part of family life. I asked Woody to sing "Somewhere over the Rainbow," and Rosemary and Mary Ellen soon joined in. The three of them sang beautifully, each harmonizing in different ways, and Woody showed all the expressions, emotions, and postures appropriate to the song, and to singing in a group (turning to the others, awaiting their cues, and so on). This was so with all the songs they sang—whether exuberant, jazzy, lyrical and romantic, funny, or sad. The songs seemed to engage him totally.
Woody's musicality, like his civility and equanimity, was completely intact. Indeed, he seemed so whole, so "normal" when singing that his disorientation, his confusion, when he was not singing came as something of a shock.
For Woody, who can no longer even dress himself, the act of singing is immensely important. Remembering (each time, in some sense, anew) that he can sing is profoundly reassuring to him. It is a skill he has not lost, and it can stimulate his feelings, his imagination, his humor, and his sense of identity as nothing else can. It can enliven him, calm him, focus and engage him. It can give him back himself, and not least, it can charm others, arouse their amazement and admiration—reactions increasingly necessary to someone who, in his lucid moments, is painfully aware of his tragic disease and sometimes says that he feels "broken inside."
Such effects—improvements of mood, behavior, even cognitive function—once set off by music can sometimes persist for hours or even days in people with dementia. Researchers are only beginning to study the secrets of why and how this happens; for now, we simply know, from patients like Woody, that music is a powerful therapy for those with nearly any kind of neurological problem. Music is much more than a beautiful luxury: It is a fundamental way of expressing our humanity—and it is often our best medicine.
So this holiday season, I will surround myself with as much music as possible. I will remember and sing the Hanukkah songs I grew up with, I will listen to Bach's Christmas Oratorio, and I will go with friends to Carnegie Hall to hear Handel's Messiah sung by the heavenly St. Cecilia Chorus. And I will spend plenty of time practicing the piano, because, after a gap of 60 years, I have just started taking lessons again.