Medicine & Research

Arts in Medicine

By Whitney Wilson & Cathy DeWitt

My name is Whitney Wilson and I am a Dancer in Residence employed by a major research hospital - UF Health Shands in Gainesville, Fla. You might be asking yourself, "what is a dancer doing working with a hospital?" The short answer is, I have the great honor and privilege of providing creative dance experiences that make the disease and healing process more joyful, more human, and more meaningful.

Specifically, I teach dance classes for people living with neurological movement issues such as MS and PD, and the classes are open to their families, loved ones, and caregivers as well. I hope this article helps shed light on the important role that the arts play - specifically dance and music - in the pursuit of optimal healthcare.

I have been dancing since I was a teenager, and I fell deeply in love with the artform. I remember tagging along with a friend of mine to her dance rehearsal and I was struck by the way in which the dancers interacted. There was a contagious and overpowering sense of joy that filled the room, along with camaraderie, support and a deep sense of belonging.

I didn't know the first thing about dancing, but I knew I wanted to be a part of what I felt in the room that day. So I learned all the styles that I could - ballet, jazz, hip-hop, tap, lyrical. I attended public arts high school, where I was introduced to dance composition, which opened up a whole new world of expression and creativity for me. 

I found myself studying dance at the University of Florida, and this is where I had the greatest transformation in my body and mind. The art of dance allowed me to express myself in ways that made me feel whole, authentic, and empowered. As I moved through my dancing career, I aimed to help others feel the wonderful things I had discovered through dancing - whole, authentic, empowered, and a sense of belonging. 

While at the University of Florida, I was also introduced to the field of Arts in Medicine, which opened up many doors for me to be able to share the benefits of dancing with people from all walks of life. As a student, I taught dance and creative movement to people living with Alzheimer's disease, as well as young girls in the local juvenile detention center. These early days in the practice showed me just how transformative and supportive the arts can be within the context of healthcare. 

After traveling around the country, dancing, choreographing, and teaching in various situations, I eventually found myself back in Gainesville, working as a Dancer in Residence with UF Health Shands Arts in Medicine. The Arts in Medicine program, which has played a critical role in shaping the field of Arts in Healthcare for more than 30 years, employs roughly 16 artists in residence including dancers, musicians, visual artists, writers, and integrative therapists who offer their skills to patients at the bedside, hospital staff, and members of healthcare communities outside of the hospital.

The dance classes I teach are tailored to meet the specific needs of the MS community, and symptoms such as fatigue, over-heating, loss of balance, sensory issues, and weakness are taken into consideration. Each class explores different dance styles, including various social and folk dances from around the world, as well as ballet, modern, T'ai Chi, and yoga. The movements are fun, challenging yet achievable, and they focus on improving memory, balance, mobility, proprioception, strength, and creativity. 

The class provides participants with the opportunity to connect with their peers in a playful, safe, and supportive environment. At the end of the class, I will often hear participants share things such as, "I came feeling completely unwell, and now I feel calm and better," or "I was tired before class, and now I feel like I got a good workout and I am energized." Another great comment that sums up what I hope participants experience from the class is, "when I am in dance class, I am no longer a person with MS - instead I am a dancer."

Another critical component of the dance class is music, which provides an external focus that can help participants bypass certain perceived movement limitations. For example, we might focus on the rhythm of the Cha Cha. Instead of overthinking the steps, we focus on the rhythmic pattern - "slow, slow, quick, quick, slow" - and before you know it we are all doing the Cha Cha! 

The class utilizes both recorded and live music, and there are benefits to both. It is, of course, a little challenging to find a musician who has the skills to accompany a dance class such as this one, so I am very grateful to Cathy DeWitt, musician in residence, for her expertise and her willingness to play music for the class. I will now pass the baton to Cathy to describe the benefits of music on the mind and body from her perspective. 

My name is Cathy DeWitt, and I have the privilege and the joy of doing some live accompaniment for Whitney's Dance for MS class. Dance and music, music and dance, they go together like love and romance. Music has always been a big part of my life. I grew up in a musical family; my brother, a prodigy pianist, gave recitals at 5. When he was in high school, he would practice in the mornings, so I would often wake up to the sounds of Chopin, Liszt or Rachmaninoff. Sometimes they really impacted my morning dreams. 

When I was very young, my father's sister and her family lived with us for a while. Their son, Pete, was very kind to me, even though I was just a toddler for much of that time. A few years later, Pete joined the Air Force and was a test pilot for new radar controlled airplanes.

One day when I came from school, my mother told me that Pete died in a crash. I was about 8 years old. "I know you have choir practice at church today, but if you'd rather just stay home you can," she told me. I decided to go to choir practice because I knew singing would make me feel better - and it did! I guess that was my first personal experience with the healing power of music.

I continued singing and playing music all through school and college, and was playing with my bands out in the community here in Gainesville when Arts in Medicine artists found me and recruited me for the program at Shands Hospital. When I joined AIM at UF Health, then called Shands, nearly 30 years ago, I became the first musician in residence. The only other musicians were guest performers who came very occasionally to do music, dance, and other performances in the lobby. And one thing I noticed right away was that there was no piano.

Being a pianist myself, I went about remedying this ASAP, writing a grant with the help of our director, Dr. John Graham Pole, and the head of Pediatrics, Rick Bucarrelli, to the Children's Miracle Network organization, who kindly paid for AIM's first grand piano. In addition to playing in the lobby, screening and recruiting piano players, I started going to various units in the hospital and playing for patients at the bedside. I would also bring in other musicians to do concerts with me in the hallways on special units such as pediatric oncology, cardiology, and the Bone Marrow Transplant Unit.

Intuition guided my work quite a bit, and still does. I didn't really know that much about what I was doing - none of us did, at that point - but I quickly started learning, so I could come up with some guidelines and information for my volunteer and guest musicians. My research quickly showed me that, even though I was not a music therapist, the music my cohorts and I were bringing into this setting often had very therapeutic effects, both psychological and physiological.

Some of the psychological benefits of music included distraction (from depression or illness), relaxation, memory enhancement, and emotional release. The physical effects could include lowering blood pressure, relieving stress, improving respiration, reducing heart rate. Many of these effects are shown in the comments made by participants in Whitney's dance classes, i.e. "I feel so much better now than I did before!"

And, like in dance, the tempo and rhythm of music can serve to help produce the desired outcome by either energizing or relaxing the listener. I've used music in the hospital to help someone get to sleep by reducing their anxiety, and for getting the patient to walk during their physical therapy treatment by playing a favorite song with a familiar beat.

My studies led me to the work of Oliver Sacks, a neurologist/musicologist who is the author of Musicophilia, Awakenings, and several other books. His work inspired the organization which is now called, and the documentary Alive Inside

This film is moving, inspiring and well worth watching. I became very involved in this work, focusing more on older populations and people with memory disorders. The effect of music on this population is usually immediate, often tangible, always surprising. Even Dr. Sacks himself, after a skiing accident, used the music of Beethoven to teach himself to walk again.

One of the most amazing aspects of this story of Dr. Sacks' own experience is that it got to the point where he did not actually have to play the music of Beethoven to get its therapeutic effect on his relearning to walk; he could just think of the music and it would have the same effect. 

Research has shown that music affects the entire brain. If you look at a picture of the brain when music is being played, you will see different areas of the brain lighting up and popping off like popcorn - the prefrontal cortex, motor cortex, corpus, especially the amygdala (which hosts emotional memories), and the hippocampus (home of music memories, experiences, and context).

Thus, as reported by the Mayo Clinic, "Singing and listening can have emotional and behavioral benefits for people with dementia and Alzheimer's. Key brain areas linked to musical memory are reletively undamaged by disease."

This is why even people who have been nonverbal, or having difficulty speaking, can remember the words to their favorite songs and sometimes even talk about the memories that they bring up. Many singers who stutter when speaking do not stutter when they sing.

Dr. Sacks said music can create a neural pathway, a bridge back to language, especially for people whose language aphasia is caused by injury, stroke, or temporary lapses that may be eventually or occasionally overcome. "The past which is not recoverable in any other way is embedded, as if an amber, in the music, helping people to regain their sense of identity," Dr. Sacks said.

This is most visible when using preferred music, the music that means the most to the person - music of their favorite era, or music that is connected to special memories. Even though Whitney's participants are not people with primary memory disorders, I think about their preferences when I choose music to accompany Whitney's themes.

Many of them are older, so songs from iconic musicals or movies sometimes bring up stories of dancing or singing in these musicals, sometimes in high school, sometimes professionally. These are ways for the class to share and find out more about each other.

At the same time, I often improvise and just play music that goes along with and enhances the choreography Whitney has prepared, giving people a chance to more fully express their own creativity while experiencing the emotional release that music brings.

Along these lines I would like to suggest a tool to use music in your own life: create your own personal playlist - a mixtape that has your favorite music on it. Of course, you may want to make more than one, as can be used to create or enhance different moods - it may be used for energy, rest, fun, joy, safety, ease, love, inspiration, calm. 

Also being dancers, you may want to figure out what tempo, or beats per minute, may work best for these different moods. Use music intentionally. Many people are creating a playlist for their loved ones, so they can play their playlist for each other if one is sick or in latter stages of life. Maximize your use of music - and remember, music acts on the brain, like a drug. Use it responsibly. 

If you wish to try out a Dance for MS class for yourself, you are in luck because most of the programs are utilizing Zoom, so you can practice from the comfort of your own home. Our program through UF Health Shands Arts in Medicine is free and open to all who are interested. The Scottish Ballet and Georgetown University also have wonderful Dance for MS programs that are accessible online. 

While there are not many Dance for MS programs like there are for PD, rest assured that research is underway, which paves the way for more classes around the world. For more arts and health resources, the National Organization for Arts in Health is a fabulous network and place to learn about Arts in Health services in your area. We hope you feel inspired to get moving and grooving!