CONCORD -- A recent treatment breakthrough at John Muir Medical Center's Concord and Walnut Creek hospitals isn't pharmacological, surgical, or even strictly "medicine." It is music.

The one-and-a-half-year-old in-house Horizons Choir brings sweet relief to palliative care patients and their families. Palliative care bypasses medicine's pursuit of a cure and aims to relieve symptoms of stress and pain for seriously ill patients, regardless of their prognosis. John Muir Health Staff Chaplain and Horizons Choir director Erika Macs says her small band of singers seeks to be comforting and peaceful.

"This is singing for care, not for performance," the classically-trained pianist and onetime baritone sax player says. "Peace, light, and love are the themes we chose."

After a visit to John Muir's Walnut Creek campus from the Bay Area's Threshold Choir, an organization that now has approximately 100 chapters worldwide and sings for "those at the thresholds of life," Macs thought, "Why don't we do that here?"

Through word-of-mouth and an internal newsletter, advertising for the troupe has resulted in eight members, including chaplain residents and nursing administrators. The choir is currently all women, but Macs reports one man has expressed interest, and she hopes to attract more participants.

"We invite anyone who can carry a tune," she says. "We seek to create a mood, an atmosphere, not a performance."


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The choir rehearses weekly, with one rehearsal period each month devoted to singing for patients. The repertoire includes popular songs, hymns, and even original compositions. Macs and the choir look for songs with inclusive language and adapt their selections to suit the patient's background or interests.

"We like to close with a Brahms lullaby. We hum when we sing it for adults, because the lyrics are right for children, but infantilizing for older patients," Macs says.

Spiritual Care Chaplain Birte Beuck says caring for the whole person is crucial.

"Offering music is part of that. John Muir (the preservationist) said we need both bread and beauty. Music is beyond the physical medicine and contributes comfort."

Macs says she sees an energy shift when Horizons sings, similar to the phenomenon she has observed at memorial services. Emotions held in check find their release and flow within what she says is "music's safe space."

Beuck agrees, recalling one family's tension and divisiveness.

"When we sang to them, it was a moment when they could come together," she remembers. "And for the family to see there are choir members giving attention to their dying loved one--it was comforting and moving."

Brenda Lippincott, a buyer in the John Muir Health Concord purchasing department since 2009, felt an urge to find a creative outlet and joined Horizons.

"I've always been musical," the Walnut Creek resident says, "I dropped it for years, then decided to pick it up."

She's discovered that patients aren't the only people who benefit from sharing the gift of music.

"A hospital isn't a great place to be, and if we can get somebody to be in a peaceful place, even for three minutes, it's a great gift. For them and for us. You can see a smile on their face, they relax. As a buyer, I don't have patient contact, so that's the benefit: seeing comfort in their eyes."

Macs says Horizons is not only singing for end-of-life patents -- resident chaplains on every unit of the hospital are finding patients eager to receive the choir. As the group grows and jells, they are increasingly able to respond to patient or family requests. "Amazing Grace" is the most commonly asked-for song, but one recent patient came from the Buddhist tradition and Macs found herself donning her compositional hat.

"I wrote a piece called 'Metta,' a reference to loving kindness meditation about being free from suffering and dwelling in the light," Macs says. "I changed a few words about healing that might have been too much to unpack for a seriously ill hospital patient. We don't perform stress; we aspire to peace."

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