Guadalajara Reporter

One morning a few years ago, psychologist Hilda Fermin looked out from her office into the waiting room and found the usual sight profoundly depressing. "I saw a room full of suffering people," she remembers. "Their heads were hanging low, their entire attitude saying they had nothing more to give. I thought there had to be more we could do."
Conventional medicine might disagree. Fermin's workplace, the Instituto Jalisciense de Alivio al Dolor y Cuidados Paliativos (Palia), is often the last stop for terminally ill patients and others with chronic pain beyond the control of any drugs.
But Fermin and other employees at Palia believe they've found a new weapon against pain: Mozart, Vivaldi and other pieces of classical music that work when morfine, methadone and fentanyl fail.
The music therapy program at Palia was born out of an experiment. "Our work begins when other doctors give up," says Fermin. "So I decided to try out a program our founder, Dr. Guillermo Arrechiga, had originally suggested as therapy for the staff of Palia. I asked whether, in spite of being sad and in pain, they liked music. They all said yes."
Fermin and her colleagues divided 38 patients into two groups: a control group who listened to classical music, which existing literature suggested could numb pain, and an experimental group who chose their own music.
"I always thought Mexican people were happy, that they had rhythm in their blood, but this is lost when you are suffering," says Fermin. "Yes, they like music and most preferred mariachi music, romantic ballads, banda or cumbia, but that doesn't work so well when they are in pain."
Not only did classical music help patients better manage their pain, but it also improved their state of mind and energy levels. Seventy-one percent of those who listened to several Vivaldi and Mozart concertos described their state as "very relaxed," compared to only 49 percent of the experimental group. Patients were asked to describe their pain with a color spectrum scale, from zero, indicating the absence of pain, to 10, the worst pain imaginable. The effects of music were often dramatic.
In his first session of music therapy, George Cope, a terminal prostate cancer patient, began with a pain level of six and ended at one. By his second session, he consistently described his end results as an absence of pain and began practicing the techniques at home.
"They sent us to the Instituto from the hospital and my mom took him [Cope] because we had nothing to lose," remembers Adriana Elizabeth, Cope's daughter. "We didn't believe. But from the first session, my father felt better, where no drugs or blockers worked anymore. It was a beautiful experience and he didn't suffer at his death."
"George looks like a child, very relaxed and stretching his extremities," read Cope's session notes. "He says he felt like a boy again and remembered moments from his youth. He says there is no pain."
The music therapy program at Palia begins with several minutes of relaxation techniques, breathing exercises and guided fantasy. "Once they've learned those and learned how to discover their place of peace, we just leave them alone with the music," says Fermin.
The music therapy room has only two vibrating leather recliners and wall hangings of beach and forest scenes. Patients receive personal attention from a doctor and psychologist, with vital signs monitored before and after sessions.
"My dream is that music can be applied not just in Palia, but with families practicing at home and with those grieving," says Fermin. "Eventually, it will be considered not just an experiment, but a legitimate control of pain. The dream of families is for their loved ones to go without pain, with a measure of peace."
For Cope's family, the program was a gift in more ways than one. "My father was from Ohio and came to Mexico when he was 24 after an accident left him in a wheelchair," says Adriana Elizabeth Cope. "He had insurance in the United States but had no way to go back to use it, or to pay for mom to go with him."
Cope's consultations with Dr. Thelma Monroy at Palia cost 30-some pesos, including the music therapy. "When we couldn't buy medicines, Dr. Thelma Monroy at Palia helped us get them," remembers Adriana Cope. "She also stayed with my father until almost the last moment.
George Cope is still one of Fermin's favorite patients. "George died about two months after starting sessions," says Fermin. "But every time I think of him, I remember that he died at peace. I can see some of these patients smiling and hopeful. I feel useful every day. I feel like a conspirator working with people who suffer when others send them away and can't do anything. Music can do all that."
Anyone suffering from chronic pain can consult a doctor at Palia. Bring your medical history and file. Palia is part of the Secretaria de Salud and accepts IMSS and ISSTE cards. For those with resources to pay, hour-long music therapy sessions cost four pesos. For more information, call (33) 3585-7794 or (33) 3585-7795. Palia is located at Av. Zoquipan 1000, building C, next to the Hospital Zoquipan near Colonia Seattle and Plaza Patria.

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