Alabama Symphony Orchestra Musicians Perform Virtual Concerts

Music has the power to transport listeners, even when heard through computer speakers, protective equipment and hospital walls.

During the COVID-19 pandemic, the sickest patients at the University of Alabama at Birmingham Hospital have had their troubles eased, however briefly, thanks to an innovative musical project.

Helping those patients recover — and keeping their spirits up amid the isolation the virus requires — is the motivation for the project, an effort between UAB health care staff and the Alabama Symphony Orchestra.

Since June, six ASO musicians playing instruments including flute, clarinet, violin, cello and double bass have performed as many as 68 live, private, solo, and virtual recitals for patients with respiratory failure due to COVID-19, in the Medical Intensive Care Unit at UAB Hospital. Staff use the secure UAB eMedicine platform and telehealth carts — the same secure UAB eMedicine platform used for family meetings for ICU patients — for the virtual concerts.

Anand Iyer, M.D., MSPH, a pulmonologist, intensivist and assistant professor in the UAB Division of Pulmonary, Allergy and Critical Care Medicine, and Maria Wilson, educational initiatives manager for the ASO, were classmates at The Donoho School in Anniston, Alabama. They reconnected on a mission to brainstorm sustainable ways ASO musicians could boost patient morale at UAB during the pandemic and were inspired by a moving video in The New York Times. In that video, a classmate of theirs, Rachel Easterwood, M.D., a physician who was a clarinetist at Donoho, described her experience treating gravely ill patients with COVID-19 in New York City. Easterwood knew of one thing with the power to give patients comfort without risking lives or precious protective equipment: music. She called on her musical friends across the country to bring live performances via FaceTime into the patients’ rooms.

ASO cellist Hellen Weberpal also saw the video and was similarly moved. The ASO Orchestra Committee broached the idea to Wilson, and the wheels were set in motion. Symphony musicians have felt a huge loss at not being able to play concerts for the Birmingham community, Wilson says.

Both classically trained pianists themselves, Iyer and Wilson collaborated with Valerie Labbe’, manager of UAB Acute Care Therapy, and Wesley Hyde, MT-BC, and Hannah Oakes, MT-BC, the primary therapists coordinating with musicians to facilitate the recitals.

“We know from research that music can positively impact the well-being of critically ill patients in the ICU, improving their anxiety, delirium and sedation medication needs,” Iyer said. “Beyond the potential palliative benefits for patients, the project has also had immense benefit for symphony musicians, who have an opportunity to perform again and touch lives in the ICU affected by COVID-19.”

ICU patients in the project have acute respiratory failure due to COVID-19 and are either sedated on the ventilator or awake and receiving high-flow nasal cannula oxygenation. The virus has challenged how health care teams care for patients who become seriously ill and require the ICU, Iyer says — specifically how to manage the disease’s impact on the brain. Elevated anxiety symptoms and very high sedation needs for patients on the ventilator, plus prolonged ICU stays without family, contribute to significant delirium and the development of post-traumatic stress.

“It’s taking a major toll on patients, families and staff,” Iyer said. MICU patients and staff have expressed appreciation of the recitals, and most report feeling more relaxed or calmer after the music listening sessions.

Each experience is a half-hour long and done remotely through live video. The patients can see and hear the performers on screen; but because of HIPAA regulations, the performers do not hear or see the patients. The performances feature “everything from Bach to Beatles,” said ASO principal flutist Lisa Wienhold, who is also adjunct flute faculty in the College of Arts and Sciences’ Department of Music. She usually plays her alto flute, since it has a lower and softer sound.

“Music is a small respite for them,” Wienhold said. “The therapist has communicated with me about the patients’ reactions. One patient had been upset and angry all day. He said, when I played, the patient relaxed, listened and smiled. That is what music is all about — communicating with others through music and bringing some sense of comfort in these very difficult times.”

This has been a labor of love for volunteer musicians. They have spent a great deal of time sorting through their repertoire for pieces that fit the guidelines and worked with the music therapists to make small adjustments, so each experience is meaningful for the listener.

“Each has expressed such a joy and desire to provide these performances at a time when their own creative and professional outlet has been dimmed by COVID-19, and how they hope their performance brings healing and comfort to the patients,” Wilson said. “The generosity of both their time and talent is incredibly admirable.”

The first-day Weberpal played for COVID-19 patients, she was surprised how it hit home, “when I knew there was someone a couple of miles away from me at UAB listening to me in real-time. I didn’t know I could play my heart out through an iPhone.”

She has played for many patients in hospitals even before COVID-19, she says because she remembers being in a hospital bed when she was younger, uncomfortable, and in pain.

“When I would close my eyes, I’d hear a Brahms melody flood my mind, and it was so beautiful it would be distracting from the pain, at least for a moment,” she said. “Ever since then, I have thought partnering professional musicians with music therapists is a fantastic way to get beautiful sound to people who need it, to inspire them to be well.”

As an undergraduate at UAB, Iyer studied piano performance under Van Cliburn silver medalist and University Professor of Piano Yakov Kasman, DMA, in the Department of Music. His first experience at UAB Hospital was in 2006, as an undergraduate student volunteering to play music for patients, with an electronic keyboard or on an out-of-tune piano.

“One particular case taught me the art of medicine and what music can do for the human spirit. It still stands out as a top 10 highlight of my career: a woman with Alzheimer’s dementia stood and danced when I played ‘Fly Me to the Moon.’ It unlocked her past for a moment,” Iyer said.

Playing for the patients “honestly gives me back more than I give,” Wienhold said. “I miss performing so much and have been so grateful for this opportunity to play for people. I hope this program is one that can continue beyond this COVID-19 pandemic.”