Palliative and Supportive Care
cambridge.org/pax
Essay/Personal Reflection
Cite this article: Rajendran T (2024). One
question. Palliative and Supportive Care.
https://doi.org/10.1017/S1478951523002043
Received: 26 November 2023
Accepted: 05 December 2023
Email: tara.mankara@gmail.com
© The Author(s), 2024. Published by
Cambridge University Press.
One question
Tara Rajendran, M.B.B.S., M.F.A.
Department of Music, Faculty of Fine Arts, Annamalai University, Chidambaram, Tamil Nadu, India
It was my 9-month oncology electives in the United States that helped me fathom the hetero-
geneity in cancer care infrastructures of countries across the world, particularly in integrative
oncology. As a performing classical Indian musician for over a decade, I was fascinated by the
advancement in academic and clinical research on the efcacy of music-based interventions in
psycho-oncology. Te growing research and clinical practice avenues in “music therapy” in the
USA inspired me to think, while rich in music repertoire, why my home country country does
not have a national – regulatory-body accredited music therapy program (Rajendran 2023).
Tat’s how, in 2019, I launched an advocacy lecture-concert program, “Oncology and Strings,”
traveling through the length and breadth of India, raising awareness on the importance of cre-
ating high-quality randomized controlled trials on local/indigenous music among oncologists,
palliative care physicians, and medical students (Cash 2023). Afer my TEDx talk – where I
spoke about my early experiences with my grandmother ailing with leukemia, music’s cathartic
efect on her, and my exploration of the intersection of music and medicine – patients, care-
givers, medical students, physicians, and musicians from diferent parts of India reached out
to me, mentioning how they were able to resonate with what I spoke (Rajendran 2019, 2022).
Many wrote how playing favorite songs comforted them or someone they cared for; some wrote
how they wished they had played music for a loved one but did not because they didn’t know
music had such an impact.
As a medical student in an oncology elective, I once ofered to hold the hand of a patient
undergoing bone marrow biopsy. In the end, the patient expressed how thankful she was for
doing so throughout the painful procedure. Tat incident taught me that bringing a small inter-
vention, as simple as holding a hand, would ofer so much comfort and solace. What music does
is something similar. It serves as a company. A distraction. Playing patients’ preferred music
during an uncomfortable or painful procedure may bring a sense of calmness.
Music preferences are a personal choice, and how music is associated with and infuenced
by autobiographic memories is fascinating. A particular musical piece might be perceived by
two people in diferent ways, regardless of the popular perception of the tune as pleasant or
melancholic. It would not be surprising if the same musical piece evokes diferent emotions in
the listener at diferent periods in life. Conferring the ability to choose with the patient might
bring the best patient outcome. But when do we ask a patient for their choice of music?
Once, I was discussing a case I had just seen with the attending oncologist, and I remarked
that to my question of what the patient does for fun in life, the patient replied he was a motor-
bike fanatic and was planning for a long bike ride. Te attending asked me to include this detail
in the notes so that at the next follow-up visit, we can chat about this. What the attending taught
me that day is a lesson I will keep with me as long as I practice medicine! Developing train-
ing programs, establishing accreditation/licensing processes, and instituting music therapists in
hospitals may take a few years; meanwhile, can we ask our patients a small question? Can we
note the patient’s favorite musical pieces? Listening to favorite music during an uncomfortable
procedure, alone, away from loved ones, and encircled by unfamiliar faces, may help bring a
sense of comfort and calmness. In intensive care units or isolation care, the gifof music may
ofer warm company amid the beeps or silences. All it takes is one question.
Competing interests. Te author declares none.
References
Cash J (2023) ‘Cathartic’: Musician doctors help patients and themselves. Interview by Jodi Cash, July 14, 2023.
Medscape. https://www.medscape.com/viewarticle/994378 (accessed 26 November 2023).
Rajendran T (2019) Oncology and Strings. TEDxAIIMSBhubaneswar.
Rajendran T (2022) A musical ode. JAMA Oncology 8(9), 1256–1256. doi:10.1001/jamaoncol.2022.1851
Rajendran T (2023) Music therapy in cancer care: unravelling the complexities in LMICs. Supportive Care in
Cancer 31(12), 715. doi:10.1007/s00520-023-08188-2
https://doi.org/10.1017/S1478951523002043 Published online by Cambridge University Press