A Parkinson’s Playlist

by Mark English

My mother was diagnosed with Parkinson’s disease more than a decade ago, and before that she had a series of other health problems. Old and very frail, she has lived in a care home for more than six years now. Her concentration span is limited and she finds speaking increasingly difficult. But music remains important to her.

She had some early classical training on the piano but her main passions as a young person – apart from movies – were dancing and pre-rock-and-roll American popular music.

When I visit, mostly in the evening, there is not a lot of talk, no dancing, and no television (apart from the ritual of ten or fifteen minutes of news). Music is the main entertainment. For the most part my brother plays recordings of pieces for solo keyboard when he visits. I won’t try to list them, but Mozart’s Piano Sonata in A major, K. 331 is a favorite. I usually focus on popular songs.

I play recordings which I know my mother likes mixed in with others which I think she might like. The chosen songs are from various periods and in various styles. We don’t discuss the music, but I notice from subtle facial expressions that some pieces work better than others. Certain themes and moods (e.g. love, loyalty, steadfastness, defiance) and certain styles and tempi (simple and slow) tend to resonate.

Her life is not easy. “Transfers” (to and from recliner chair/wheelchair/toilet/shower/bed) are generally done using a sling and an electrical lifting device (hoist) attached to a metal track on the ceiling of her room. It’s odd to see someone who had such a phobia about heights that she felt uneasy walking across a bridge or riding a long escalator hanging precariously from the ceiling, high above the floor, as she is pushed from one side of her room to the other. I would have expected her to panic, but she doesn’t. Maybe she did when these procedures first started, and the phobia gradually dissipated (as phobias are inclined to do if they are confronted).

The problem is not so much the flying (swinging in mid-air) as the take-offs and landings. And the preparation for take-off. So-called personal care assistants do most of the work. Her joints are stiff and sometimes the care assistants are rough with her when they put her into the sling, pulling her arms impatiently rather than gently coaxing. There is also regular bruising on her shins.

There are certainly lapses, but overall the staff are diligent and many appear to really like her and have a good rapport with her. The real suffering relates to her whole situation: trapped in a failing body. When the Parkinson’s first struck, she felt it as if it were a punishment for some crime of which she was unaware. Not literally (she is totally non-religious), but this is how it felt. Of course, given her extremely vulnerable situation, any roughness or rudeness on the part of staff is magnified in significance.

For legal reasons, the staff are not allowed to help her walk (because of the risk of a fall for which they would be liable). So my brother or I help her walk in the corridor. About 40 meters she can manage, and we often get surprised looks from nurses, because she has been officially designated as non-ambulant for some years now. It’s mainly this exercise which is keeping her healthy. She knows it and she sometimes gets it into her head to cover some extra ground and reach a portrait of a young Queen Elizabeth II which hangs at the very end of the corridor. “Reaching the Queen” for her is like running a marathon or climbing a mountain. Her determined spirit animates a broken body but faces a reality which is stacked against it. Mind over matter has its limits.

We pass a recreation area towards the end of the walk, and often snatches of music from a film or recorded concert can be heard. Emotional music sometimes seems to spur her on. Strangely, the folk hymn “Amazing Grace” recently seemed to have this effect. (I say “strangely”, because the lyrics are completely alien to how she thinks.)

My mother is a fighter. She has been written off many times by medical professionals over the years but has always managed to rally and come back from the brink. It’s sheer determination, not faith, that keeps her going.

The topic of funeral arrangements came up recently. I told her not to think about it; my brother and I would deal with any arrangements. Then she said she wanted me to arrange things (as she put it) “so that I don’t die.” I said I would do my best.

Not surprisingly the Puccini aria “Nessun dorma”, which ends with that marvellously defiant “vincerò” (“I will prevail”), works for her – the Mario Lanza version, at any rate.

We know we won’t prevail in the end. Though battles are won, we are fated to lose the war. We live as if this were not the case; as if victory were possible. But love and loyalty exist, and this fact stands between us and dark despair.

Generally I choose less emotionally extreme pieces than “Nessun dorma” – popular love songs, the sort of music you could dance to, ballroom-style, certain forms of jazz.

George and Ira Gershwin’s “Love is Here to Stay”, as sung by Gene Kelly, is simple, straightforward and reassuring.

Results can be unexpected. Happy songs – especially if they are known and remembered – don’t always have the desired effect. “On the Sunny Side of the Street”, a song my mother used to sing, once brought on a crying episode.

By contrast, “My Funny Valentine” (early Frank Sinatra version) always gets a good response. Another old Sinatra song which she responds well to is “Nancy (with the laughing face)”.

Another favorite is (the long version of) “These Foolish Things”, as performed by Jane Birkin and Jimmy Rowles. Philip Larkin, the English writer and jazz-lover, thought the song a bit too self-consciously poetic, but he liked it nonetheless (at least as performed by Billie Holiday). Part of what gives the song its strength for me is that it involves real memories of a real love affair.

The lyricist was Eric Maschwitz, an Englishman who became involved with the Chinese-American film actress, Anna May Wong. Some of the memories sound like romantic clichés, but many are believably specific: a cigarette with traces of lipstick; airline tickets to romantic places; a tinkling piano in the next apartment; a telephone left ringing; first daffodils; long excited cables [telegrams were charged by the word and could be quite expensive]; the sigh of midnight trains in empty stations; gardenia perfume lingering on a pillow; silk stockings; wild strawberries (“only seven francs a kilo”); Greta Garbo’s smile; a waiter whistling as the last bar closes; the scent of smouldering leaves; the wail of steamers…

Not being a musician, and being very language-oriented, I tend to see the lyrics as primary. The music is the setting. It enhances the words (or not, as the case may be).

I can’t say exactly how my mother perceives these songs, but I know that the cultural world in which she grew up – dominated by Hollywood and British movies and the popular songs of the time constitute a significant part of – and color much of the rest of – her memory base. The sense of outrage and loss she felt as a teenager when her mother found and disposed of a box of cuttings and photographs from movie magazines (like Film Fun) which she had hidden in her room stayed with her for years.

Once when she was in hospital a few years ago during a bout of pneumonia and very close to death, she said that she had been visited by Eddie Cantor. We thought she was hallucinating – until we encountered a young psychiatrist who had been assigned to her. He had very thick rimless glasses which made his eyes look prominent.

Even now memories of movies and actors and singers and dancers from that period are still active for her – singers like Frank Sinatra and Dinah Shore, for example. She had a crush on Tyrone Power, and had a special interest in French actors working in Hollywood: Annabella (who was married to Tyrone Power), Simone Simon, Michèle Morgan and – her two favorite Frenchmen – Charles Boyer and Jean Gabin.

French songs or singers were generally not so familiar to her. But Blossom Dearie’s version of “Plus je t’embrasse” typifies the ideal kind of song for my Parkinson’s playlist. It’s light and bright and jazzy. This kind of music – like the music of Mozart – conveys a reassuring sense of equanimity and provides a bulwark of sorts against the waves of depression and anxiety that are commonly associated with the condition.

Perhaps my mother’s favorite song is “Someone to Watch Over Me” by George and Ira Gershwin. Blossom Dearie’s interpretation is perfect, and certainly more convincing than the Frank Sinatra version which my mother remembers. Somehow it’s a bit of a stretch to see Sinatra, even in his young and skinny days, as “a little lamb who’s lost in the wood.”

10 Comments »

  1. Mark,
    once again I greatly enjoy your evocative sketches. You touch on so many issues.

    For legal reasons, the staff are not allowed to help her walk (because of the risk of a fall for which they would be liable)

    This is a tragedy since exercise is the most important form of treatment. It brings into question their care ethic. Who do they really care for? Their staff or their patients? They will willingly sacrifice their patients in the interests of their staff. In that case, for whose benefit do they run a care home? Are the patients merely an expedient excuse?

    She knows it and she sometimes gets it into her head to cover some extra ground and reach a portrait of a young Queen Elizabeth II

    I am a monarchist to the core and can understand its motivating power.

    Her determined spirit animates a broken body

    That is the most noble thing in the world.

    Strangely, the folk hymn “Amazing Grace” recently seemed to have this effect. (I say “strangely”, because the lyrics are completely alien to how she thinks.)

    I smile when I see your persistently anti-religious stance surface in your writings. Amazingly, I was once like you!

    We know we won’t prevail in the end.

    Ah, but I have a superior kind of knowledge that says we will prevail in the end! 🙂

    Not being a musician, and being very language-oriented, I tend to see the lyrics as primary.

    That is a mistake. Music predates language and taps into our deepest forms of motivation. Music was probably developed as a non-verbal form of mobilisation and celebration. The toyi toyi represents the return of music to its origins. I have seen so many toyi toyis like this(usually at the receiving end!)

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  2. What a fine story — and a great title. I share your mother’s liking, with you, for those great songs. “Life can be complete, on the sunny side of the street.” It’s meaningless, but delightful and uplifting all at once.

    Thanks, Mark.

    Alan

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  3. Nice piece. Our taste in music is different, and our understanding of music is different (I agree with labnut’s comment here); but anything that eases suffering is a good thing. As Bob Marley sang, “one good thing about music when it hits you feel no pain.” (Noise sometimes, music never.)

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  4. Thanks Mark, I very much enjoyed the essay.

    When I first read it I was going to comment along the lines of EJ and Labnut with respect to the appreciation of music. Lyrics ( but not vocals ), have always been a distant afterthought for me as I experience music. If the music contains vocals, the vocal delivery in the context of the music surround has always impacted me to a greater degree than the linguistic content. Maybe this is a clue as to why it is difficult work for me to compose a coherent paragraph 🙂

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  5. Thanks everyone.

    Labnut wrote:

    “This is a tragedy since exercise is the most important form of treatment. It brings into question their care ethic… ”

    This issue is complicated. On the one hand, there is the question of priorities and, like you, I would be inclined to prioritize exercise programs and physiotherapy. But you still have to face the rigidities of the legal framework, especially in respect of legal liability.

    I want to emphasize that most of the staff (care assistants, nurses, managers) are very good and committed to doing the right thing.

    “[Quoting me] “Not being a musician, and being very language-oriented, I tend to see the lyrics as primary.” That is a mistake. Music predates language and taps into our deepest forms of motivation. Music was probably developed as a non-verbal form of mobilisation and celebration…”

    I note that others (ejwinner and sethleon) have also come in on this issue.

    First of all, I accept that music (and musicality) runs deep and predates language. But language itself also has musical elements. All languages have intonation; tonal languages (common in Africa and East Asia) go even further and bring tone (or pitch) into the grammatical system. So the language/music distinction is not clear-cut.

    I was trying to say something about how I (and I think a significant minority of people) perceive things. At the very least what I want to say is that for me lyrics tend to have a prominence which they probably don’t have for most listeners. But I think it goes further than this and relates to broader issues of culture and aesthetic response.

    (I recall that a while ago we had some discussions about rock-and-roll and I mentioned that there was a particularly strong resistance to rock-and-roll in some European countries. In France, this had something to do with the French “chanson” tradition which gave special prominence to the words. Similar traditions applied in other European countries.)

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  6. Seth Leon wrote:

    “If the music contains vocals, the vocal delivery in the context of the music surround has always impacted me to a greater degree than the linguistic content.”

    I can relate to this actually. But at least the lyrics mustn’t *get in the way* (as sloppy or otherwise problematic lyrics often do for me).

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  7. Ejwinner wrote:

    “Our taste in music is different, and our understanding of music is different (I agree with labnut’s comment here)…”

    Well the piece is focused around someone who grew up before the advent of rock etc., but my tastes also come through here to some extent.

    I do not want to make any strong claims about music as such. You talk about tastes, and people can have very different tastes, sure, but I don’t see that this necessarily implies a different “understanding of music” as you put it.

    I certainly accept that music can move us deeply, reaches parts of the brain which are (in a sense) deeper than language.

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  8. Mark,
    But language itself also has musical elements.

    Yes, I can see that. This is after all the basis of poetry. Poetry is the bridge between language and music. And lyrics are of course a form of poetry.

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