Playlist Prescriptions

Jack sat upright in the hospital bed, his fingers tapping faintly against the thin blanket in time with the swing of jazz. The room was quiet except for the soft hums and beeps of machines, blending with the unmistakable voice of Frank Sinatra: resonant and soulful. Jack's eyes were closed, his slender frame still, but his mouth ever so slightly formed the shape of the iconic chorus. I did it my way. As Jack and I conversed, his eyes danced with nostalgia and pride. He had done it his way through 91 years of life. After listening to a customized playlist made by unit volunteers, Jack told me tales of growing up as one of eight children, fighting in the Korean War, and the strength with which he had faced life's greatest hurdles. Jack spoke of the moments that had defined his legacy of perseverance and resilience. Sinatra's “My Way” was a medium to vocalize emotions, a chorus through which to reminisce. Jack said that this program opened a door to the past, reviving memories he hadn't considered in years. Music resuscitated decades of his life. Jack described the services as one every patient should access. I had never been called an angel before. And yet, after a compilation of hymns, Mozart, and Bach, Edna said God had sent me, an angel, to watch over her just at the right time. Edna was 98 years old and had been in the hospital for weeks undergoing dialysis. She wiped tears away from her eyes as she described the most recent decade of life: taxing, both mentally and physically. She needed this, she said gratefully, propped up on a mound of pillows. The music, Edna said, had been “better than medicine” and had taken her fears away. She didn't just like the music, she kept repeating—she loved it. It made Edna feel as though she were “already in heaven.” The music made Edna feel as though she were already in heaven. Artwork by Jody Sharninghausen. I met Jack, Edna and many other patients through volunteering at the Personalized Playlist Project. I have always known the power of music; it's been an integral part of my life since childhood. As a violinist, I'd performed outside of nursing home windows as a high schooler during the pandemic, and in senior living communities as a college student. Unlike my previous performances, the Personalized Playlist Project allowed me to build ongoing connections with older adults. Under the guidance of program leaders, volunteers learned to take “music histories” on hospitalized patients in the geriatric ward, delving into preferred genres, albums, and artists. The interview often included family members, allowing us to gain a fuller understanding of each patient. Volunteers then constructed individualized music playlists that patients could listen to throughout their stay. Participants' song selections often accompanied significant life events and relationships, creating a strong emotional association. The Personalized Playlist Project was inspired by Music and Memory, which emphasizes music not as entertainment, but as a therapeutic tool—one that can ease pain, reduce anxiety, and improve communication in patients with cognitive decline [1]. By integrating evidence-based practices and training staff to deliver personalized care, Music and Memory aims to make music a standard component of holistic treatment [1]. Our project built on this concept, using an interdisciplinary approach in which nurses and physicians could refer patients to receive customized music playlists [2]. Nearly two decades ago, neurologist and writer, Oliver Sacks, described how music affects us all, but that for many neurological patients, it is not a luxury, but a crucial form of therapy [3]. He was an early champion of Music and Memory. Since then, neuroscience studies have demonstrated positive structural and functional brain outcomes. Despite mounting evidence, healthcare systems have been slow to integrate music-based interventions into clinical care. Programs, including ours, have struggled with sustainability. However, more than numbers, it's the stories of individuals touched by the Personalized Playlist Project that continue to inspire new iterations. Patients like Jack and Edna reconnected with their past, finding solace in familiar melodies and experiencing moments of joy amidst challenging circumstances. Program participants also allowed me to expand upon my past musical experiences, transforming them into something relational, responsive, and deeply human. Moreover, I saw the power of individual attention in combating loneliness; just having someone to talk to was a crucial part of the experience. Simultaneously, the diversity of patient responses made me aware that not every patient connects with music in the same way. Some seemed melancholy in response to the plethora of induced emotions, and some simply did not want to listen. This awareness deepened my appreciation for the importance of sensitivity and flexibility in this holistic intervention. As Edna prepared to go home, she asked to bring the music with her. “How much is this?” she inquired while examining the tablet curiously. As I attempted to describe its role as a medium for the playlist app, the limited accessibility of technology across generations became apparent. I typed up a page with notes and instructions. Her grandson would help. Jack and Edna's stories would continue after discharge, as would the therapeutic benefit of their playlists. Sophia Ruser wrote the initial draft of the story. Jody Sharninghausen collaborated on editing and draft revisions and created the illustration. Sophia Ruser finalized the piece and submitted it. The corresponding author affirms that we have listed everyone who contributed significantly to the work. We have permission from Jody Sharninghausen to use her original artwork for this piece. We would like to additionally thank Dr. Richard Marottoli for his guidance and support of the Personalized Music Playlist Project. Jack and Edna are pseudonyms to protect patient confidentiality. The authors declare no conflicts of interest.