Milwaukee VA Medical Center
Sound of music helps Veterans heal, find peace
Christine Wiggin sings a song from the 1940s with World War II Veteran John Bosch.
John Bosch taps his toes and sways his head as Christine Wiggin strums a guitar at his bedside and sings:
“All I want, is loving you, and music, music, music.”
Before long, Bosch, a 94-year-old World War II veteran, is singing along to the 1949 hit song, “Music! Music! Music!” with Wiggin, a music therapist with the Milwaukee VA Medical Center.
“The nicest part, of any melody, is when you’re dancing, close to me,” they sing together.
As the song concludes, a smile beams from Bosch’s face.
“That’s a song I sang with my mother,” he says. “It makes me feel like I’m back home. I can see my kids, my wife, my family; we would sit down in our rec room and enjoy the music on Saturdays.”
“How do you feel?” Wiggin asks.
“I feel comfortable and relaxed,” Bosch says. “That music is as soft as can be. How could you not enjoy that?”
The two join voices on two other classics -- “By the Light of the Silvery Moon” and “Smile.” In between, Bosch talks about the memories the songs evoke and the wonderful feelings that flood over him.
“It’s all good,” he says.
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“That’s a song I sang with my mother. It makes me feel like I'm back home. I can see my kids, my wife, my family.” World War II Veteran John Bosch
Sessions like the above are just one facet of music therapy at the Milwaukee VA.
The hospital’s three music therapists work with Veterans in a variety of settings, including the Mental Health unit, Palliative Care, Hospice and Transitional Care. And before the COVID-19 pandemic closed all outpatient services, a therapist worked with Veterans in Adult Day Health Care as well.
In use since World War II -- the VA pioneered the use of music to aid shell-shocked Veterans returning from the war -- music therapy is another tool health care workers use to aid patients.
“It’s a tool to help people with their goals,” said Sandi McCormick, 57, who has been working in music therapy for nearly 34 years. “It’s a tool to get people to work hard at their goals.”
Makenzie Kojis, 32, who rounds out the team at the Milwaukee VA, agreed.
“I use music to achieve non-musical goals,” she said. “Music is the vehicle, not the goal. I’m working on goals that align with the rest of the treatment team.
“If they get to the (desired) outcome, the therapy worked -- no matter if it’s music therapy, physical therapy, pharmacotherapy, whatever it is.”
The therapists agreed that there is often a misconception about music therapy. That misconception extends from laymen and other health professionals to patients.
“A lot of people think we just do sing-alongs and teach instruments,” McCormick said. “When we do that, there are other goals besides just fun or filling time. We’re working on other goals. I think of it more as cognitive therapy; you’re really working on the psyche.”
Wiggin, 37, who has been a music therapist for 13 years, noted that she and her colleagues are board certified and highly trained professionals. The difference is music therapy works in a different way than other forms of therapy.
“Oftentimes the experience is pleasing; we hope that it is pleasing,” Wiggin said. “However, there is so much more going on in a session other than fun. There are individualized treatment goals being targeted; there are intense emotions involved.
“Music therapists are nurturing and guiding patients through some of their most stressful, traumatic times in life -- i.e., a patient who is looking at passing on, or a patient that has experienced a stroke and has to relearn how to live.”
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Makenzie Kojis, a music therapist, uses her skills in the Milwaukee VA's closed Mental Health unit.
In a recent group session in the hospital’s Mental Health unit, Kojis worked with a handful of patients as well as doctors.
In a song-writing exercise, Kojis went around the room and asked each person to add a word to the lyrics. In the end, the lyrics formed a song that touched on recovery, tragedy, excitement and hope.
“We did this together,” she told the group. “What was that like?”
“It makes you feel like you’re helping,” one group member said.
“It makes you feel like you’re part of something,” another chimed in.
Then Kojis set the words to music -- first in slow, plaintive chords that conveyed a sad or dark tone.
But she then used the same lyrics in an upbeat style and quicker tempo that gave the song an entirely different vibe.
“Have you ever felt one way on the inside and another on the outside?” she said. “That’s called being incongruent. Two opposites can be true at the same time. Even though your mood might change from day to day, you can keep that mantra of moving forward.”
Psychiatrist Dr. Nathaniel Ray, who took part in the group, said music therapy is a key component of the work taking place in the unit.
“I really love it,” he said. “It allows for the patients to connect with themselves, their feelings and thoughts, and where they are in life. And it allows people to connect with one another.”
Reflecting on the group session with Kojis, Ray pointed to the patient who said he felt like he was part of something.
“That’s priceless,” he said. “It can be a really powerful, emotional experience for the patients to be with each other, listen to each other and support each other. It also helps you get in tune with yourself.”
Ray said such interactions are important because many patients in the unit are isolated, highly stressed and sometimes in crisis.
“They can get constricted within themselves -- avoiding feelings and shutting down. They lose the ability to connect.”
But music therapy -- almost like a spiritual revival, Ray said -- can get the patients to engage.
“They share an experience,” he said. “It’s a powerful way for them to drop their fears and inhibitions and connect.”
Kojis agreed.
“A lot of the folks in that group were working on being able to express themselves, coping skills, mindfulness,” she said. “To be able to reach those goals … I do believe music is a really powerful tool to do that.”
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“For a lot of those guys, it’s scary. They are confused and don’t know. I play some music from their era and kind of nudge them there. It starts the memory going.” Sandi McCormick, on how music helps Veterans with dementia
While the music therapists may sing, play guitar or use percussion instruments when working with patients, recorded music is also a big part of their arsenal.
They will assemble individualized playlists for iPods or iPads that Veterans can dial up at any time. And those playlists are culled from working with the Veterans and finding the right music for the right situation.
Many are struggling with post-traumatic stress syndrome. Others may grapple with substance abuse or dementia.
“The music is an easy way to connect with them,” McCormick said.
Veterans coping with PTSD may use music to soothe and calm them, McCormick said. Or they may have certain tunes that help them express or cope with their feelings.
She noted one patient who conquered his substance abuse and is now employed by the Milwaukee VA.
“To see him go from rock bottom to this is just incredible,” she said. “And when I see him, he says, ‘That music helped me.’ I always knew music was a powerful tool, but when I saw it in play -- wow.”
For those experiencing dementia, music therapy can help build bridges in the brain that reconnect memories.
“For a lot of those guys, it’s scary. They are confused and don’t know. I play some music from their era and kind of nudge them there,” McCormick said.
“It starts the memory going. They remember they liked this music and they used to dance. It’s a way to have a moment.”
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Milwaukee VA music therapists (from left to right): Christine Wiggin, Sandi McCormick and Makenzie Kojis.
Wiggin concentrates her work in hospice and palliative care, with Veterans nearing the end of their lives.
She also is often charged with soothing and calming patients at a very stressful time.
“Music therapy is one of the very few evidence-based, non-pharmacological interventions used with Veterans until they take their last breath,” she said.
“It’s not uncommon for veterans to pass within hours of music therapy or during the treatment itself.”
She recalled instances when nurses have called her for “an extra layer of support” for a patient on the verge of dying.
“Oftentimes music can work beautifully with medication. They can complement each other to create as pain-free of an experience as we can.”
She recalled one Veteran who was a guitarist on Milwaukee’s jazz scene and had fond memories of performing with B.B. King. So Wiggin crafted a playlist of King’s music for the man’s iPod.
“After he passed, the nurses let me know that not only was he listening to his playlist, but they were letting him know he … would be playing again in heaven with B.B. King.”
“A lot of the folks in that group were working on being able to express themselves. To be able to reach those goals … I do believe music is a really powerful tool to do that.” Makenzie Kojis, on the therapeutic value of music
For another patient, Wiggin learned one of his fondest memories was being with his family at a YMCA dance filled with James Brown music.
“Knowing that a lot of patients are anxious on passing, it’s a challenge to find James Brown music that is not chaotic,” she said. “It took awhile to find music that would be conducive to his memory but also keep him in a stable place emotionally.”
But Wiggin was successful.
“He passed as he was listening to the playlist, with this memory in his mind,” she said.
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The therapists emphasized there is science behind what they do.
“There is research behind it,” Wiggin said. “It (music) enters the brain differently than other types of treatment. And because of that, music therapists often get different results.”
She noted a patient with terminal brain cancer who was a drummer in his younger days but hadn’t played in 25 years.
The therapist arranged for him to get behind a drum set again.
“He used the word ‘joy’ to describe the experience,” Wiggin said.
“There is science behind it: Active participation in music causes the brain to release endorphins, which help with stress relief and enhanced pleasure.”
McCormick agreed.
“There’s a lot of great research on the neuro-science of it all,” she said. “It hits so many parts of the brain.”
Despite that, the music therapists said they still battle misperceptions.
“You have to constantly be educating and sharing and rationalizing what you do,” McCormick said. “That’s the most exhausting part.”
“We’re trained musicians. We’re trained therapists. We’re trained clinicians,” Kojis said. “There is a lot that goes into our training.
“There is a uniqueness to music therapy. Someone who may not succeed in other therapies but can succeed in music therapy --- that’s awesome when that happens.”
