by Jon Moskin
When Dr. Susan Schneider sees a new patient, she conducts a thorough medical history. But there is one question she asks that you would probably not expect: “What’s your favorite song?”
This is far from idle chit-chat. In fact, the answers to that question often play an instrumental role in her patients’ care.
Susan, a professor of geriatric medicine at UCSF and physician at the San Francisco Campus for Jewish Living, has been studying and documenting the effects of familiar music on patients with memory loss. And the lessons she has gleaned from her ongoing studies have been implemented with extraordinary results.
“You know how sometimes in later stages of memory loss people might forget the names of their loved ones, but they can still play the piano?” she said. “Well, it’s also clear that people can still appreciate music, especially if it’s spiritual or has a long history of cultural significance.”
Indeed, the multicultural component of her research has been greatly enriched by the diverse demographics of her SFCJL patients. While some may have the impression that the campus census is predominantly Jewish, in fact, it has one of the most culturally varied patient populations in northern California with many patients of Filipino, Russian, Asian, and Spanish speaking backgrounds. That rich cultural landscape offers Susan the opportunity to connect with patients through a world of music that seems embedded in their minds and memories. ‘’
“I’ll put their favorite music in their chart. And sometimes, they are hesitant to even share it because they think it may be impossible to understand or find, but we can usually track it down,” she said. “So, if I play their song when I come to visit, they’ll remember me in a way they don’t remember other people…It’s fascinating and heartwarming. And I have the opportunity to hear spectacular music.”
But Susan is not the only one who gets to hear it. Another aspect of her project involves the involvement of sitters in hospitals, rehabs and skilled nursing facilities. Or the lack thereof. “Sometimes, in certain environments, people have sitters that are hired to just watch. And all too frequently they are just on their phones. But what if we can use their phones for something helpful like music?” Accordingly, she has found a way to transform many of those passive “sitters” into active caregivers through the gift of music.
Yet another area of research involves measuring the effects of music on people with memory problems who are agitated. The typical intervention for agitated patients is to distract them until they can calm down. But when there is a language or cultural barrier, that can be incredibly difficult. “They are in a new place, they don’t know anyone, they don’t speak the language, they can’t understand anyone… But to hear a familiar song…” It just may be the most soothing intervention there is.
It wouldn’t be the Bay Area if technology wasn’t involved in her research. Susan and her colleagues have been working on developing an AI tool to predict patients’ favorite songs. “I’ll put in their basic demographics and so far, it’s always wrong,” she laughed. “But it’s close and people will say that’s not my favorite song, but I really like that one. And in cases where somebody is nonverbal and we only have basic demographics, I’m hopeful that there’s a way to find something soothing even if they are from another culture and another language.”
Of course, artificial intelligence is increasingly involved in many areas of medical practice: yet another aspect of Susan’s study as both a researcher and clinician. She recently participated in a massive project in which trials using artificial intelligence to copy discharge summaries for people transferring from hospitals to settings such as the San Francisco Campus for Jewish Living. “The question was: who’s better?”
The winner? Well, while AI certainly has a robust future, so far, it seems to be people… by a nose.
When it comes to summarizing what happened in the hospital and communicating everything that doctors need to know, the AI was certainly more concise and included many details. “But it often left out the human quality that only real live doctors can explain and appreciate because you can’t cookbook everybody’s care.”
That conclusion seems to comport well with Susan’s personal approach to patient care.
“It really is an honor to care for these folks and to learn from them. We’ve been trained to focus on what matters most for each individual that we’re caring for. And of course, there’s vital signs that have to be taken and medications that need to be given and tests that need to be done, but it’s still more important to focus on how someone feels than what the numbers say.”
That’s music to our ears.
