Healing Health Care Systems with Susan Mazer

Welcome to the Living to 100 Club Podcast. Here's our host, Dr. Joseph Casciani.

Well, hello to everyone joining us today on our podcast. You're listening to one of our Successful Aging episodes this month on the Living to 100 Club program, and I'm your host, Joe Casciani. Each week, our conversations educate and inspire, helping you get the best out of all the years we're given, regardless of what obstacles come our way. Our conversation on this podcast explores the nuances of making meaning out of experiences of older adults. The guest is Dr. Susan Mazur, a co-founder of Healing Healthcare Systems, a company that produces the CARE channel. CARE is an acronym for Continuous Ambient Relaxation Environment. This is a 24-hour relaxation channel for healthcare settings and they are now in their 31st year. We discuss the varied perceptions that the 55 and over group has of events, both external and internal, and the self-talk that goes on in our head when reacting to these events. A fall, the death of a close friend, or maybe unexpected medical findings all cause us to create some meaning about this experience in our day-to-day life. Tune in as we learn how to lighten the load from these age-related challenges that come along. First, a little background. Susan Mazur, PhD, is the author of numerous papers, articles, and books on hospital noise, patient privacy, HIPAA, patient safety, elder care, and music and nature at the bedside. She's also a contributing blogger to the Huffington Post Power of Humanity editorial platform dedicated to infusing more compassion into healthcare in our daily lives. Dr. Maeser, whose doctoral work focused on human and organizational systems, also speaks on the topics of the patient experience and patient privacy, HIPAA from the patient's point of view, patient safety, elder care, and creating a healing environment At the bedside. In addition, she facilitates meetings and retreats for nonprofit organizations, healthcare organizations, industry associations, and small businesses. Dr. Maeser, welcome to our program today.

Thank you so much.

Well, you're very welcome. I'm glad we can have this conversation. I always like to open by asking our guests to tell us a little bit about the journey brought you to where you are today. You've covered a lot of territory in your professional career, but maybe tell us the highlights that brought you to where you are today.

Interesting question, because in this wonderful mini bio, you didn't include what I've done for the longest amount of time. I am a professional harpist. And I've been playing for 62 years. I have 2 degrees in music. I played full-time for 25 years. And then I moved into the healthcare arena, having to really invent a way to improve the human experience. And I went from classically trained. And after graduate school, which I did at Stanford, my first master's, I crossed the Rubicon to the dark side and went to jazz.

Wow.

And that allowed me to integrate into my own peer generation and also to really better understand the function of music in our lives. Classical music even to this day, because it's no longer automatically taught in public schools, can feel intimidating or like a foreign language or too formal.

Mm-hmm.

However, classical music, jazz— Ahmad Jamal said that jazz is American classical music.

Mm-hmm.

So I suggest that the problem is not the music. We don't necessarily know how to listen to new music and integrate it into our lives when it isn't automatically familiar to us.

Sure. And that's so important to be able to integrate it and process it as part of our being alive and being connected with our world. Sure.

Right.

Yeah. That's a beautiful perspective. So what contributed to your developing the CARE channel? What was the need that you saw?

So in my personal history, I'm a recovering bulimic. I'm in recovery through 12-step program for almost 40 years. And I think most people who go into this work around healing, any aspect of healing, tend to go through some kind of crisis that points to that direction as having the most meaning. And when I began dealing with my bulimia, that's really what happened to me. I'd been playing 25 years and I wanted to have more meaningful ways of bringing music into other people's lives and also into where I performed. I began Recording my own original music. My first album was The Fire and the Rose, which is how I met my husband, Dallas Smith, with whom I've been together almost 40 years. And for all musicians, meaning in their own performance is really what creates their own life satisfaction. So For me, I kind of stretched it all. You know, I went into jazz, I learned how to improvise, I amplified the harp. This was in the '70s, which was heresy at the time, because the only thing that was amplified automatically at that time was actually the electric guitar. And soon after that, we had the electric piano and synthesizers. I mean, that's when the music industry itself changed. But to take this 19th century formal, very formal instrument and amplify it, the world, the harp world was not actually ready for it. But I'm pretty stubborn. So, and I started in the '70s and of course now it's 2023. And the technology's changed. The sound has changed. The demands on me have changed. Everything changed.

Mm-hmm.

So now I started playing, I started studying in public school in Detroit at Cass Technical High School, and I took harp as an elective.

Mm-hmm.

And actually, Alice Coltrane studied at Cass. She went to Cass Tech. The Supremes went to Cass Tech.

Hmm.

Many of the most famous jazz musicians went to Cass Tech. So, I mean, I had a journey to go through. I had to learn how to play the harp. Then I had to figure out for my own career how I was going to make it meaningful. I think that's an ongoing process for most musicians. Right now, because I'm now 76, I started my— I plucked my first string, I was not quite 14. I just look at the harp as the continuing thread that I've never not played. It's always been primary to my identity and moving into healthcare. There are many questions I have to answer. For example, the big debate about what is healing music, which is still debatable because I don't believe from my own experience and from all the research I've done, music is music. Whatever it is, it's just music. If a listener fully engages with a musical experience, it absolutely can be life-changing. However, the power's in the listener.

Sure.

And because the power's in the listener, I think the question should be, can you have a transformational experience listening to music, and is it about any particular music? Well, I think that if we took some amazing survey, we find that most pieces that reach the public ear, someone is going to have an aha moment. Not everyone.

Uh-huh. Of course.

Not everyone. But the power is really in the listener. And it's matching up a listener to the music that resonates with them, that is the most meaningful to them, and them understanding what that is for themselves.

So music in general, and the harp in particular, sounds like that's woven throughout all of your life, personally and professionally. And I'm wondering, as you talked about your experiences and being a patient or in healthcare. The environment really impacts our thoughts, our feelings, our attitudes about healing. How does that environment impact our healing? What can we learn from that?

So the whole conversation about healing environments really began in the mid-'80s, that music has the power to change our sense of time and place. And for myself, I found that if I was going through a very stressful time, I couldn't sleep at night. I had high anxiety. The only thing that helped me get through that was having music as my companion, having music as a companion. Nighttime hours are are the most isolating and the loneliest because everybody else is sleeping and we don't have so many resources available to us.

Mm-hmm.

But I was asked by the Center for Health Awareness out of San Jose to develop a workshop in the use of music as therapy, and I had to decide what that was for me, cuz I'm not a music therapist, nor did I have any desire to be a music therapist.

Sure.

So the question for me is, so what is it? What is it that music does? And in my experience, the golden moment is after the last note when the conductor's baton is in the air and no one's breathing because the journey was so profound and we have this very amazing sacred silence before applause, before anything. And so could we create that moment for patients who are so isolated in the hospital going through a healthcare crisis where they could be in the moment and feel more alive because that experience is theirs. It's not anyone else's.

Mm-hmm.

To every individual. And that was the goal of creating the CARE channel.

Yeah.

You know, that we, it's a 24-hour channel because the patient day is 24 hours and we wanted to provide music and nature in a way where it was accessible and whenever the patient wanted it, they could have it. And that's how we began producing the CARE Channel.

Yeah, so again, the music, especially that special moment at the very end before it hits our awareness, that special moment, that, that has a profound effect on us. And in a bigger sense though, does it shift our thinking away from negative to more pleasant, more positive? Does it help us avoid some of those limiting beliefs that we go through? I'm just thinking in terms of, you know, as we age, there are a lot of challenges that come along, internal and external, and maybe the music can shape us and help us move into a more positive experience.

Well, the truth of it is we're all volunteers. So that means that if you listen to a piece of music And you have that profound experience. You have an opportunity to start over, to reenter your life, perhaps with a different perspective.

Right.

However, it is not gonna change external reality. It might give you a stronger capacity to deal with what's unmanageable. But there's external reality and our perception of it and how we manage it. But it's not going to change. It's not a curative.

Right, right. Yeah, the reality does not change, but our perception of it can shift, right? That's right.

That's right.

Which is almost the same as shifting the reality of the event, even though it doesn't. Our perception of it is so powerful that it does help us to re-experience it in a different way, explain it in a different way.

I think so.

Yeah. So what about the negative— we have all this self-talk and chatter that goes on inside our head after a negative event. Somehow music offers the kind of antidote to that, that negative self-talk, that chatter. How does the music help with that?

I think it's a distraction, positive distraction. I also think that it can lessen the sting of negative thinking that is just a broken record in our heads that we can't let go of it. And if we do get some respite, even 5 minutes where we're not thinking about that, where we're fully engrossed in a musical event, I think it does give us a chance to breathe and take on a different point of view.

Would you say all music or only some types of music?

I think that it's up to the listener.

Yeah.

You know, I think that, and I'll give you an example. My husband and I were playing in a hospital. This is before the Care Channel. And, uh, we were on a med surg unit and we set up, you have to see the big harp. My husband played flute and clarinet.

Mm-hmm.

And we had a sound system with us. I mean, we had a lot of stuff. And the patient room right opposite of us, the door was closed and the nurse came out and told us that in that room, was an 18-year-old boy who'd gone snowmobiling on Friday and on Monday woke up a quadriplegic.

Oh, wow.

Snowmobile accident. And what he wanted most was his own music. So his friends had come and brought him in a boombox, and that's what he wanted for him to know he was alive and still relevant in his own generation. I mean, how fabulous that he wanted it and he got it. So our job is not to prescribe a particular kind of music for anyone. I think it's about empowering the musical experience. So that even as you yourself may go through some kind of trauma or high anxiety, that you can remember, you know, I'm just gonna sit down and this is what I want to listen to.

Sure. Yeah, that's a great example. Someone who wants to listen to his own music, pop his own cassette while he's into the boombox and listen to the favorite music. And I knew I had a sister, just a personal anecdote. A sister who was struggling with cancer, and she was terminally ill, and all she wanted to do was listen to her favorite music. That took the pain away and the distress away. And she listened to, um, you know, so we made sure we had the music that we actually could bring in a tape player and let her listen to her favorites. So it helped, it helped. And of course, it also helps with health, with, um, healing and kind of recovery too, right? I mean, I don't know if this snowmobile accident victim was able to benefit in terms of his recovery, but it certainly does. And how does that— I'm just curious about your attitudes about aging and how this musical influence affects your attitudes about growing older. Does it offer any solace, any kind kind of, I won't say comfort, that's not right, but some pleasure for you?

So I live in a musical house. My husband is a musician. We've been performing together since the day we met. And we have our own routine. You know, we subscribe to the Digital Concert Hall, which is the Berlin Philharmonic, and we listen every Saturday morning to symphony concerts. We also listen Friday nights to San Francisco Jazz.

Oh.

And we also play concerts in our home and we go to concerts and it is so much a part of our lives and we will never have to give that up.

Yeah. Yeah.

Ever.

You don't have time to think about aging. Excuse me. Yeah.

Well, that's not necessarily true.

Oh.

I've been playing the harp 62 years. The harp is an instrument that is physically very demanding, and I don't play as much as I used to because I'm not playing full-time.

Mm-hmm.

But the joy I get from it, and both of us feel very responsible to our loyal followers.

Mm.

During the pandemic, we did 44 concerts online.

Sure.

And then we moved the concerts. So now we do them in front of our garage and have a very loyal following. And it is just— no one has to give up music.

No.

And even if our playing changes, because I don't have arthritis, thank God, but my harp teacher, who's now 96, Mm.

Wow.

She can't play anymore. She hasn't been able to play for many years because of several physical conditions.

Uh-huh.

But her love of music has not changed. Her joy has not changed. And for my husband, who plays all the woodwinds, he plays in a big band here You know, it's a fabulous big band and that allows him to do what he knows how to do and also it challenges him to play the music. So I think we play until we can't play. And if we can't— Arthur Rubinstein, you know, what he did is as he got older and he couldn't play as fast as he used to play, then he just slowed pieces down so the fast passages sounded fast.

Uh-huh.

It's all relative, you know.

All relative.

So, and Placido Domingo, you know, he was a tenor and now he's a baritone because his voice changed. So in the work I've done on aging, and I had a paper just come out last February on aging that the our willingness to compensate, to adapt, and to accept what's real is a much cleaner path.

Yeah.

The end of our lives than to expect of ourselves to be who we were and do what we used to do.

Yeah.

30 and 40 years ago.

Mm-hmm. That's so true. That's so true. I remember the quote from Stephen Hawking saying intelligence is the ability to adapt to change, and that's so true. Yeah, we'd like to maintain our abilities, capabilities, but sometimes we do need to adapt. We do have to rely on a cane or a walker or other aids, so we do need to adapt to change. Yeah, yeah.

My sister is 80, many health problems. She can't walk very well. She had cervical spine surgery. She can't hold her head up. And I've told her over and over again that this quote from Florence Nightingale. Nightingale said, being well is using well the powers we have. So For me, that means whatever I can do, I'm gonna do, and if I can't do it, I'll move on and find something else to do.

Yeah, yeah, we don't need to focus on what we cannot do anymore. We can really focus on what we can do and what we're still good at. I love that, I love that. That's so true. So you live in a world of music, environment of music, environment of music, and it kind of fills your life with joy and spirit and energy, I'm sure. Yeah.

Yeah. So another interesting fact about my craziness. So I got my first master's, I was 22. 45 years later, I went back to school and got another master's and a PhD in a different discipline. And I finished my doctorate 2 months before my Medicare birthday. And It was pure joy to do this degree. It was enlivening. It was purposeful. It was inspiring. And that's when I've done so much of my writing. My interest in patient privacy, again, it was, it came to me because my dad was in Detroit and I called the hospital. And they would not tell me his condition because of HIPAA. And I was livid. And when I got there, the nurses said, well, if I had done that, I could lose my job. But of course, there are many ways to identify who's on the phone. And that's when I took on privacy.

Yeah.

That's when I really took on the issue.

So tell our listeners about the Care Channel. What is it? Where is it? How do you access it? Tell us about it.

So the care channel, there's no language. It is pure nature. We adopted the philosophy of Ansel Adams, famous photographer.

Yes.

He said, the person in the picture is the viewer.

Hmm.

So there are no people, there are no human artifacts. It's pure nature. It's produced so that the viewer can really see. It's not fast changes like the commercials we see. It follows the day-night cycle because nighttime, it's really important for healing to know when it's nighttime. My husband produced the whole channel for the first 18 years.

Wow.

And then we were able to, we now have a whole production department. And send them all over the world.

Mm-hmm.

And although Dallas still does do filming for the CARE channel, but it's not his full-time job anymore. And the goal was that whenever you turn it on, wherever it is, it's not plot-driven. So it's just like you being in a park, that whenever you get there and whatever you see, It's the right thing to see at the right time. So we started producing it in June of 1992. And if you think back, that was VHS time, VHS tape. Right now, the channel will be available in 4K. We are working now with 1,100 hospitals nationally. We also have hospitals in Hong Kong, in Australia, in Holland, in Puerto Rico. And we continue to grow. We have, for those of you at home, we have an app called Relax with Care. And you'll find an ample library of content there. We have one 10-hour file. You could put it on and just leave it on. We have nighttime programming. We have guided imagery. Which is narrative with a narrative. And right now the CARE channel, we have hospitals that have had the CARE channel all 31 years.

Wow. So it's available on a global level and here in the US and other countries as well. So hospitals, healthcare settings subscribe to it and they can put it in the hospital rooms, the patient rooms.

That's right.

And it's audio and That's right.

It's one channel on the patient television so the patient can choose when they want it.

Uh-huh. So audio and visual.

Yep.

But okay. No plot like that.

So the music is unfamiliar. It's not top 40. It's not generationally specific. We wanted the music to be accessible for any generation. Any ethnicity, any nationality. The industry itself, the music industry, sets us up and divides us according to our demographics.

Mm-hmm.

And we didn't wanna do that.

Mm-hmm.

It's all instrumental. It started out with our music cuz that's where the request came from. But we have about 50 musician, artist, composers contributing whose music we license.

So the music is changing.

That's right.

Yeah. And it's available in these settings, institutional settings, but it's also available for the consumer.

That's right.

Yeah.

And we also have a streaming, we have Care Connect, which hospitals can subscribe to and make the Care Channel accessible at the patient portal where patients go to see their medical records.

Has there been any research done with the experimental versus a control group, any changes in outcome, medical outcome?

You know, that's very— we've had study, we've had case studies done with the care channel. All of them are positive. But what you're asking for is whether a study's been done that will totally isolate the care channel as causal in a physiological or psychological or emotional response. And the environment is so full of so many ways we're stimulated.

Yeah. Yeah. There are a lot of intervening variables, as they say.

Intervening variables. So, yeah. Yeah.

Causal, causal could be very difficult, but maybe correlational might be an easier first step. Who knows? Yeah. Yeah.

But in all the years we've done it, We have followed the ongoing research. Nurses tend to do the research around this kind of intervention, but most important, we hear from patients.

Mm-hmm.

And what it means to them.

Those are just as important, all the anecdotal experiences. Sure. Okay. Yeah, it's crucial. Yeah, I see that we're running out of time here, Susan. What's the takeaway for the audience today? What would you hope our listeners remember from this conversation?

I'm going to suggest that you pay great attention to your home environment, that very special place you sit for comfort, what you hear, if it's bringing you comfort, how you change it when you're stressed. Become more sensitive to yourself.

Great. Yeah. Yeah, really be aware of that mindfulness strategy to be aware of what, what we hear, what's impacting us, and, and if it's not good, change it.

Yeah, that's right.

Well, looks like we're out of time for today, but before we wrap up, I just want to remind my listeners to visit my website livingto100.club, sign up for my email list, and download a free copy of my 9 tips to make living longer enjoyable. You also see an option to contact me with your questions and comments. I welcome your feedback. Susan, thanks so much for being a guest on our show today. For those who might want to contact you, how could they best do that?

You can go to music site mazerandsmith.com. Our music is on Amazon. You'll hear it on Spotify. Apple Music. And also, I'm happy for them to just contact me by email.

Sure.

Sure. Which is susan.mazer@gmail.com.

And what was the site again?

Mazer and Smith. That's my husband's name is Dallas Smith.

Mazer and Smith. Yup. Great. Great. Well, I really appreciate your taking time in your schedule, and you're doing some great work. I love the fact that you're in so many of these settings and really sharing what you've learned from your musical history and experience and professional background and how to spread the good word and spread the good music. I love that. Yeah.

Thank you for inviting me.

Yeah, you're most welcome. You're most welcome. And thanks to everyone for tuning in. Hope to see you next time.

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