Karen Mechanic, director of psychiatry at Fox Chase Cancer Center, was thinking of the patients when she contacted Temple University's music therapy program.
She wondered whether it would like to use Fox Chase as a training ground. That would help bolster the integrative medicine program she was building. As the conversation continued, though, Mechanic, a violinist who attended a performing arts high school, began to wonder how music might also heal a staff beset each day by the powerful emotions that accompany cancer.
The results of the discussion were on display last week as Brooke Carroll, a guitar-strumming Temple music therapy doctoral student, led Mechanic and about a dozen Fox Chase employees in Christmas carols around the hospital.
On a snowy evening, the new choir, dressed in bright colors and a few Santa hats, stayed late to sing standards like "The Christmas Song," and "Carol of the Bells" in four-part harmony at the infusion room and several nurses' stations.
A receptionist waved as they walked by. "Sing good for me now," she said. "Represent."
Curiosity pulled Nancy Kamnik-Holleran, who was recovering from uterine cancer surgery, away from her television and into the hall. "It brought my spirits up," she said. "It made me get up and find out what's going on."
Other hospitals have staff musical groups. Abington Memorial, MD Anderson Cancer Center, and Cooper University Hospital have choirs. Thomas Jefferson University Hospital has a female a cappella group, a jig band, and a chamber orchestra.
Though all recognize music can be therapeutic, it is more unusual to have started a group with mental health in mind.
The Duke University Health System is another exception. Its arts program for patients and staff includes an employee chorus and orchestra.
Sharon Swanson, who runs that program, said the founding doctor saw that music helped calm patients. She has seen how the two-year-old chorus raises staff spirits.
"It's interesting to watch one of their concerts, just the absolute joy that comes out of it," she said. "You can see it on their faces . . .. They take that back to the unit with them."
At Fox Chase, Mechanic is trying to move music therapy from the pilot phase to an official program with a supervisor who could help students.
Though the choir is not as overtly therapeutic as, say, a support group, Mechanic said it's a safe way for staff to release emotions and work together.
"I think of it as an active psychological immunotherapy," she said. "It sort of allows us as caregivers to be able to release ourselves emotionally by singing."
She said work at Fox Chase was rewarding but hard. Patients tell her things they won't tell anyone else. They ask questions she can't answer. "Tell me, Doctor, when am I going to die? What's going to happen to me?"
Like everyone there, she bonds with them and grieves when the cancer is more powerful than anything the staff can offer. "I have a whole filing cabinet in my office for people who haven't made it," she said. "Every day I come in and that's the first thing I see."
When she works with patients, Carroll usually has specific goals, like helping them with anxiety about a test. The choir is meant more broadly to help employees take a break and recharge. The deep breathing during warmups and then the singing and breathing together have benefits similar to yoga or meditation, she said. She said research had shown music can improve mood and choral singing can make heart rates synchronize.
At a lunchtime rehearsal, it was easy to see choir members relax and brighten as the singing started, as though they had shed burdens, found new energy.
Carroll said the choir helps build camaraderie across departments. Mechanic is the only doctor. The group also includes a transport worker, nurse navigators, a genetic counselor, and fund-raisers.
Michelle Rodoletz, a Fox Chase psychologist, said singing together created a shared energy that's more powerful than singing alone. "You can practice yoga at home. You can sing in the shower, but there is something about coming together as group," she said.
Andrea Forman, a genetic counselor, said singing in harmony always made her feel better. "I like to think that it brings a human element to a cancer center with this scary word in the middle of our name," she said.
The room where patients get chemotherapy was the first stop for caroling. Even late in the day, many sat quietly or dozed as drugs dripped into their veins.
Eleanor Finch, who was getting a blood transfusion after chemo for ovarian cancer, appeared delighted as the group sang "Silver Bells." "I love it because I sing in my church and since I've been sick, I haven't been singing," she said. "This is wonderful."
A man across from her seemed to sleep through the set and the smattering of applause that followed the mini-concert. But as the choir said goodbye, he raised his head. "Thank you," he said.