composer-in-residence to Yeovil District and Dorchester County Hospitals
Context and brief:
Re-found Sound is a new live music collaboration between Yeovil District Hospital Charity (YDHC) and Arts in Hospital at Dorset County Hospital (AiH), supported by Bournemouth Symphony Orchestra & the Wigmore Hall. The project runs from January 2016 to September 2016 and will:
• Commission an innovative musician in residence to work across the hospitals, researching and exploring the relationship of memory to place, resulting in a new piece of contemporary music for broadcast and performance.
The project is funded by Arts Council England, Dorset County Hospital Charity, Yeovil District Hospital NHS Foundation Trust and South Somerset District Council.
Residency and commission
YDH and AiH would therefore like to commission an innovative musician to research the relationship between music, memory and place and compose a response. We envisage a piece of music based on connections between:
• the environment, landscape and history connecting South Somerset and West Dorset
• hospitals as places in their own right, their architecture,surroundings and the communities that use the hospitals – patients, staff and visitors
• memories of place, memory-loss and the condition of dementia
Practically speaking we would like the commissioned musician to spend time at both hospitals, meeting staff involved in dementia work, patients themselves and people from other organisations who are familiar with Dorset and Somerset history and music as appropriate. There is the potential to provide space for activities to engage staff, patients or visitors at the hospitals (or facilitate engagement through other media e.g. hospital radio, newsletters etc.), but there is no studio space or music equipment available at this time.
We expect that there will be at least one opportunity for all musicians working through the other strands of Re-found Sound to meet together to share learning and experiences as part of the process. We wish to learn from the project process and to share this with others so there is also an expectation that the commissioned musician will keep a record of the project’s development, for example a diary, and participate in evaluation.
So, that was the brief. Now, onto . . . .
Writing a piece of music about Dementia – now, that really is a challenge. Where to start with such a huge topic? And, for a composer like me who believes that music doesn’t necessarily ‘say’ anything in a way that transmits and communicates clearly and consistently from one person to another, the opportunity to write a piece that is about, inspired by, informed by Dementia is perhaps the biggest compositional challenge I have ever faced, not least because it is such an important and emotive subject, a topic that will touch all our lives in one way or another at some time. This is BIG!
I have just completed my first few research sessions at Dorchester County Hospital and have come away a little clearer about what I can do creatively and what I can’t, certainly around methodology to gather content. As ever, I trust that the process of research and just thinking [informally, in the background] will make things clearer for me as I go along.
There’s art in the hospital in the most unexpected of places!
But first to recap:
When I applied for this post I constructed a model around what I ‘might’ make and how I ‘might’ go about making it. This model was purely a structure to hook ideas onto so I had something to work with. The model was disposable, adaptable; my experiences in the past had taught me that predetermined plans always changed in these circumstances, sometimes radically. I could feel some aspects of my model quickly slipping away.
My starting point was this very model:
I have a great interest in composition commissions that draw upon researching unusual starting points and content that effect decisions influencing the compositional process and finished piece of music. Music is not an exact science and notions of quality and meaning remain fully subjective.
Composers are often asked about the meaning of their work and most resort to a description of process of making to answer the question. This is never a true reflection of what any piece of music means or its value to, or impact on any one person. Music that is based on research of the type proposed here has a number of pointers that can inform composer and audience of the reasons why choices around process and outcome were made and how these choices related to the subject being researched. Even with a strongly demonstrable research background, the composer’s and listener’s perceptions will involve levels of subjectivity and intuition around the best ways to communicate meaning, be that in a narrative or non-narrative context. This is the joy and mystery of music – we really have no idea what it is!
In the context of ‘refound sound’ where issues around the impact of Dementia and Alzheimer’s Disease on peoples lives is being researched, issues of memory, perception, relationships, loss and connectivity are paramount. These are also issues that concern a composer within the composition of a piece of music as well as the formation of assumptions around how an audience will respond to it. These correlations can be the subject of compositional research that has the potential to greatly effect the decisions a composer makes around the content for a piece of work and its presentation to audiences.
In short, the challenge and excitement of this brief is in discovering exactly what impact the residency and research will have upon my practice as a composer and how this will influence the outcome of that experience – the composition itself.
What am I proposing?
As I have not yet undertaken the research I cannot predict the ultimate shape of the finished work and even less so, the content that will populate it. At this stage I am building a concept around assumptions. This concept can be moderated, broken and replaced completely and I present it here as a model of thinking to approach this application and the residency. I do find an initial model useful as a way to think how the work could be presented and disseminated [practical considerations] and therefore provide an initial structure to work backwards from, helping focus methods for content creation based around the residency and research.
This newly commissioned work could be a sound installation with the potential to be located in any room or building within or outside a hospital setting. The research and residency period could see me interviewing people affected by and working with Dementia through sensitive, gentle and informal conversation. These conversations may be recorded or I may take written notes whilst conversing. Confidentiality will be respected at all times and any permissions necessary will be sort. These conversations will be participant led [they will disclose what they feel comfortable with – I will not pry with questions] and I will explain clearly and carefully what I am doing and why I am doing it. All content would remain anonymous.
This research would result in a series of interviews containing verbal or written information. I would sort through the material and select words or phrases that have [to me] a particular potency or resonance in relation to the the project brief [environment, spaces, memory, loss, history etc.]. It is these words and phrases that could become the vocal [or possibly verbal] content for the new piece. I may use professional singers, a choir or perhaps voice artists to deliver this material through music I would have composed with the content being sung, spoken or intoned]
Studio or live recordings of the singers or choir could be recorded as they perform fragments of my composition. I would then assemble these fragments into larger musical strands or tracks. Each track may be 15-20 minutes long and each a slightly different length. I would envisage 4-8 tracks. These tracks will then be ready to load onto mini mp3 players with their connected speakers. Each mp3 player and speaker can then be installed, secretively into any space, large or small to create the installation. The performance will involve playing all the tracks simultaneously [on continuous loop] resulting in unforeseen and serendipitous relationships between all the tracks. The resultant composition could be spatially exciting, beguiling, beautiful, reflective, surprising and engaging. These hidden voices will become part of the fabric of any space it is installed in.
Music would be through-composed in its individual vocal tracks but asynchronous in its delivery leading to a richly varied and constantly renewing musical experience. A performance could last a few minutes to a few days and each installation and experience will be a unique iteration of the composition. The audience can drop in, stay, contemplate, pass through. There will be no obligation to sit through a traditional performance – people can wander through it and come and go as they please.
As the material is digitally formatted it becomes an easy step to create fixed iterations of the installation by mixing a version within mixing software [which I have] leading to the preparation of tracks for radio broadcast and easy sharing on social media platforms to help engage the widest possible audiences in the output of the project. Again, tracks can be formatted to any length.
Asynchronous delivery of the composition as described above has an additional resonance in connection with the project brief around memory, loss, changing perspectives and contexts, landscapes [musical], experience and understanding as the constantly iterative nature of the delivery of the composition means it can never be known, there will be reoccurring familiar and recognisable aspects but the piece is always in flux as it permutates its content in ever changing contexts reflecting, perhaps, the changing nature of memory and perception associated with Dementia.
Back to the first research sessions at the hospital:
So, that was the model – a concept for a piece and a bunch of techniques around how to achieve it. Luckily, enough of the model survived after my first visit to Dorchester County Hospitla for me not to feel totally crestfallen. Yes, it was going to be a work using the human voice, a choral piece. Yes, it was going to be an installation piece; dissemination and performance aspects were as yet unchanged. However, what had radically altered were the methods I was going to use to generate the content for this piece – that route was now closed to me.
Challenges around confidentiality and consent:
I had hoped to be able to record conversations with patients, families, careers, medical staff etc., on my iPhone, not to use as recordings within the piece but to listen to, post interviews, so I could copy down the occasional snippet, phrase or remark that I thought had mileage within the piece – sort of poetic fragments that I happened upon. I thought too that I may be able to take some photographs of hands to capture something of various peoples characters anonymously.
Both photographs of hands and recording conversations with various parties proved to be impossible because of safeguarding regulations, permissions and consents. As you can imagine, gaining informed consent from people who are confused is impossible and a legal minefield.
So that was that. My idea of getting verbal content straight from the horse’s mouth was no longer tenable. I should have known really; the regulations around permissions of this sort are complex and rightly so when peoples’ identities, families and friends can all be implicated in unforeseen ways. Best to avoid the need for consent entirely.
The complications around consent became very clear to me after my morning conversation with Alex Murdin, Arts in Hospital coordinator at Dorchester. I had to think on my feet as my research sessions were about to start. I needed to know how I was going to collect information so I could capture anything valuable I found for the piece without contravening permissions and confidentialities. It was whilst we were talking around this challenge that I had a light bulb moment based on a seedling idea I had a few days ago whilst brain-idling.
It occurred to me that like a storyteller, I would listen and perhaps write down the odd comment; or not, and absorb what was being said; the intent, emotional weight and content, as someone who was telling another person a story of what they had seen or experienced. Rather than collecting material ‘in the first person’, I would come away from my research sessions and regurgitate what had stuck in my mind, the impressions and phrases as best I could remember. If I embroidered or exaggerated or invented a little, it didn’t matter. This wasn’t a news real or a work of science; I wasn’t trying to reconstruct a work of fact; how could I? – this is music; it can only mean what the audience bring to it no matter what I put into it. However, the words and phrases could carry a great deal of weight if sufficiently resonant. It’s ‘golden nuggets’ such as these I’ll be on the lookout for.
One of the nursing staff told me of a short phrase that was uttered to her over and over again by a patient. The phrase stayed with her. It stayed with me too!
“I was locked in a cupboard.”
A little phrase with a huge, complex resonance. This will become one of my ‘golden nuggets’.
After speaking to the staff at Dorchester County Hospital on a range of wards and also seeing activities designed to help engage people with Dementia with their own memories, lives and surroundings it is apparent just how much dedication, humanity, compassion and professionalism is offered to patients by the teams who look after their wellbeing. All members of staff are undergoing constant training and support to understand how best to care for people who are confused or suffering from Dementia. Exact diagnosis and aetiology isn’t always clear to establish but the sensitivity with which any person entering the hospital is met, especially those who are frail and confused, is excellent and well thought through.
On certain wards the decor has been changed to make the hospital a less daunting environment, wards and bed-bays have been colour coded with specially commissioned artwork to break up the uniformity of the ward layout with more personalised and attractive spaces. On wards specialising in the care of the elderly the nursing stations have been redesigned and sometimes moved to create more open, social and comfortable spaces for patients and relatives to meet.
All in all a lot of thought has gone into the hospital environment to make it as friendly and unintimidating to confused patients as possible.
I was particularly taken by the Day Room on Barnes ward where older objects, clocks, fireplaces and radios had been brought into create more familiar and age appropriate spaces for elderly people who are more comfortable in surroundings that reflect or connect with their lives and experiences. The Day Room is also an area that is used for various activities such as music making, listening, conversation and crafts.
Patients who are confused or have Dementia generally enter the hospital via Accident and Emergency departments because of trauma [broken bones after falls, for example] or medical reasons such as infections and illness. Their confusion is a secondary consideration that brings with it further challenges for the medical staff caring for them over and above the primary condition. Patients coming into hospitals may experience many degrees of confusion and it is true to say that entering the hustle and bustle of a busy hospital environment away from personal routines and familiar surroundings can exacerbate any sense of confusion someone may already have. People with Dementia on trauma and medial wards are frequently with other patients of all age with similar primary conditions [trauma or medical]. Here, the nursing staff skilfully provide a full, personally tailored and considered care plan for everyone on their wards. Being able to manage such varied and challenging needs with such good spirit is a true testament to the calibre of people working on the wards. One thing was clear from the outset; these wards are happy places where staff are well motivated and engaged at the highest level with their work and the wellbeing of others.Ideas of structure and anonymising information:
I have already mentioned using myself as a collector of anecdotes and pieces of information that I hear and writing these down ‘after the fact’ as third party observations to use as content for vocalisations in my piece.
Additionally I have had the idea of collecting first names and surnames [and mixing these up] or even made up, to create lists of imaginary people, to do the same with occupations and ages, places where people live, a few medical terms, a range of anecdotes and phrases and so on to create this sort of ‘hive mind’ of people and experiences.
I can see [hear] these as being different trains of though all brought together at the same time and interacting with each other to create an ever varied world or people and experiences all related to Dementia.
Why am I thinking like this?
Because I realise that Dementia is something that touches and will touch all of us, that it is no respecter of class, religion, faith, occupation, lifestyle, experience or race. That is can effect young people as well as older people, that it is, in fact, everyone’s condition – it is human-wide. To reflect that I want to create a piece that includes all voices, all names, all occupations and so on, to make it feel universal and relevant to everyone.
Additionally, and going back to my original thoughts, I would like the way these various strands of musical activity interact asynchronously with each other to in some way affect those who experience the installation – to make them feel a little bewildered, out of context, surrounded by an environment where nothing remains the same and perceptions are challenged and where the content is poignant and resonant causing reflection and awareness around the human condition that exists within and around Dementia.
That’s a pretty ambitious goal to have!