The following week Lucy and I returned to the same hospital bay where Louise, the former concert pianist was resident. Louise was in a bed by the window. My colleague, Lucy, was working with a patient diagonally opposite from her whereas I was directly opposite her with a very demure elderly patient. My thinking was that I could observe Louise from where I stood, without her really noticing me.
Louise was sitting up in bed with a fixed glazed look in her eyes. I had been told by a nurse that she was blind in one eye, but by the way Louise stared out, I could easily believe she was blind in both eyes. I began speaking quietly with my patient, trying to be as inconspicuous as possible. I had no intention of going across to Louise – it would be like putting my head in the lion’s den, for Louise was still shouting out aggressively.
The two nurses on duty were not really making any response to Louise’s calls. I can only presume they knew her well enough to avoid her; knowing they weren’t able to give Louise what she wanted. All Louise wanted was to get out, or have some logical explanation given as to where she was, and why she was there. But logic goes out of the window for people living with dementia. I presume the nurses were simply exhausted with Louise’s constant calls for attention.
But I had an idea in my head, a kind of light bulb moment. . I decided to play birdsong on my Bluetooth speaker. I wanted to test whether Louise would notice, or be in any way affected by the sound of birdsong. Spotify has many examples of garden and woodland birds – and Spring is almost here, it was not out of season. Many people like the ‘dawn chorus’ or just a blackbird fluting away. You can almost get any sound from the Spotify database: whale, owl, dog, pig. You name it and Spotify will have something. I have played seaside sounds, bugle, church bells, running water and even a butler's bell. One guy once asked for the sounds of the seaside but to exclude any squawking of seagulls! Perhaps he had his fish and chips pinched! Anyway, I digress.
As I said, I was curious if I were to play the birdsong, whether Louise might show any kind of response. At the time I switched the birdsong on, Lucy was outside the bay, and later told me she had heard the bird song but wondered how on earth a bird had managed to get into the hospital. After all, we were on the 10th floor and the windows are sealed. It wasn’t that I was playing the birdsong loudly, just enough for it to be in the background.
But would you believe it? As soon as I began playing the birdsong so Louise stopped shouting. It was as if time had stopped still. A ‘moment between moments’ (as a friend of mine used to say.) I was thinking Louise would suddenly shout out again but no. Seconds passed; half a minute passed and still Louise was silent. I wondered what was in her mind. And how long could this magic last? - There we were on the 10th floor of a London hospital with the chirping of birdsong. It felt like paradise.
As soon as Lucy returned to the bay I beckoned her to come to me where I was standing. The birdsong was still playing but I had decided to push this situation further. I whispered to Lucy that I would initiate a conversation with her about gardens! So, I began saying to Lucy, “Lucy, do you have a garden?” Lucy answered yes .We had a couple more exchanges when I asked Lucy how large her garden was. Lucy replied quite proudly, “Oh its big, about 140 feet long.” To our total surprise, Louise, sitting in the bed opposite us said, “You lucky thing!” Wow. she had been listening to us!
Lucy began to describe some flowers and grasses in her garden. She was still in conversation with me. (We were not directing any of this to Louise.) I told Lucy that in the Spring of each year, a robin usually visits my garden, just for a few minutes, and then flies off. Louise opposite piped up in response,” A robin visits me too; I think it’s a friend of mine who died some years ago.” I think Lucy said, “Yes I have heard that robins do that.”
I remember that Louise saying she was lonely. I responded by saying that I also live alone but that I put different pictures up around the house to remind me of things, people, or holidays. Louise said that she does that as well. It occurred to me that Louise might well have thought that she was sitting in her garden and that two neighbours were passing by her garden gate. That she was listening to our conversation, and then joined in, totally distracted from the reality that she was in hospital. When it was time for Lis and I to move to the next bay, we each said goodbye to Louise. Louise asked if I would pray for her. I said I gladly would.
Lucy and I related this account to our manager. He was so impressed, suggesting he film us both recalling the two meetings we had with Louise; how, despite a bad first engagement, we had thought outside the box to allow this patient to participate in an ordinary conversation. Two weeks later Lucy and I were filmed in one take, sitting in comfy armchairs recalling our two sessions with Louise. We felt so natural and comfortable in recollecting the story. The film (8 mins long) will be embedded into a training programme on dementia, as well as demonstrating how a patient’s immediate environment or mindset might be changed to facilitate their wellbeing.
We have yet to see this film, but I know we delivered the goods! And putting on the birdsong was indeed a risk worth taking.
