Cassidy Cottle is a fourth-year medical student at the University of Vermont’s Larner College of Medicine.
In the following blog post, she reflects on how her musical journey evolved from traditional performances to deeply personal connections through singing for individuals with dementia and terminal illness, discovering the profound emotional and healing power of music in these intimate settings.
“Reflecting on my three years of hospice singing, I can only hope that my own end of life is defined by comfort, the love of family and friends, and music.“
Performing for a New Audience
I was lucky to grow up in a household that seemed to have its own soundtrack; almost every task was accompanied by music, from the twang of Shania Twain to the parodies by Weird Al Yankovic. Like my sisters before me, I was enrolled in piano, then voice, then flute, and then guitar lessons as I got older. I was in choir, band, and my high school’s symphonic orchestra where we performed the works of classic composers for quiet, applauding audiences.
It wasn’t until I was in my junior year at Northwestern University where I was studying opera that my voice teacher asked me if I wanted to work for her non-profit, Songs by Heart. She explained that her mother had suffered with dementia towards the end of her life, slowly losing the spark and wit that had previously defined her. Yet, when my teacher tried to muddle her way through playing piano while singing some familiar tunes, her mother spoke to her for the first time in months.
“You know that’s not very good, right?”
I spent several months working for Songs by Heart during the spring semester, traveling by bus to the closest memory care facility where I would sing with and for the residents with two other musicians. These performances looked nothing like the concert halls I had been in before. Many of the residents would sing along with familiar tunes by Elvis Presley or the Beatles and none would clap when we finished. The vocalists would travel around the room, engaging with as many individual residents as possible. It was unfamiliar, but when I held the hands of a non-verbal resident as she cried and mouthed the words to Over the Rainbow, I realized that this is the kind of connection that made music special.
Singing Through Life’s Final Chapter
When I started to study medicine, I figured I was leaving music behind for everything except singing in the shower. However, shortly into my first year, I saw a blog post from a fourth-year discussing her time volunteering at the McClure Miller Respite House. As someone who worked as an emergency department technician in my gap years, I had a lot of exposure to death, but it always portrayed death as the enemy and the ultimate failure. I was hopeful that, by volunteering with the Respite House, I could start to develop a more nuanced understanding of the end of life.
During my volunteer training, I was introduced to a hospice singing choir called the Noyana Singers. They were a collection of auditioned volunteer singers who rehearsed twice a month and performed in smaller groups every Saturday at the Respite House. I immediately emailed one of the co-directors and asked to attend a rehearsal.
Beyond the initial hospice training, all the prospective singers are required to shadow a sing at the Respite House to allow them to better understand the emotional impact that singing at end-of-life can have. In the first room during my shadowing experience, despite my hundreds of hours working in close proximity to death, I cried. Grief flowed through me in a way that seemed to parallel the grief seen in the tears of the client’s family members. The other singers assured me that it was normal, recounting tales of their own first visits to the Respite House where they too had found themselves in tears.
The next room was different. Despite being a younger woman with late-stage cancer, she grinned at us when we walked in.
“I hope you brought something fun!”
She was at the end of her life, but her vitality and sense of joy remained powerful. She sang along with us and encouraged her family to as well, laughing loudly when she didn’t have the right lyrics.
That patient taught me a great deal about grief, death, and dying that day in a way that a clinical curriculum struggles to match. Death is not inherently bad; for some patients, having autonomy over the end of their own life can bring peace and a great deal of comfort. Death is not something that exclusively happens in a hospital bed, surrounded by quietly weeping family and friends. It certainly can look like that, but it can also look like a young woman, laughing, singing along to the Beatles.
Reflecting on my three years of hospice singing, I can only hope that my own end of life is defined by comfort, the love of family and friends, and music.
And I hope they bring something fun.
Any students who are interested in experiencing what Noyana does first-hand through a shadowing experience are welcome to reach out to the author at Cassidy.Cottle@med.uvm.edu.