In this enlightening talk, we learn all about her amazing work integrating the creative aspects of music and theatre to help foster better patient outcomes and improved relationships and conditions among healthcare workers.
Click here to listen to the full episode now – or read on for a quick written excerpt from the show.
Dr. Haidar Al-Hakim: One thing that comes to my mind when I look at your profile is being a medical pioneer! How did you get that?
Dr. Cath Crock: Well I’m not sure who wrote that down it sounds quite weird so I think it came from just the way I like to think differently about how we do healthcare, and sometimes that’s been seen as a little bit pioneering or maybe a bit of a threat to the status quo.
Dr. Haidar Al-Hakim: And where does that come from?
Dr. Cath Crock: I think potentially from my parents. Both my parents were doctors – my dad an orthopaedic surgeon who was very innovative and creative, and always looking for a way around things if there was a problem. I grew up with that as my environment so I think it’s really come from that.
Dr. Haidar Al-Hakim: And you’re working in Melbourne at the moment?
Dr. Cath Crock: I work with children with leukaemia and other life-threatening illnesses. My journey in innovating and thinking a bit differently started when I had young children at home and I was doing procedures on children with cancer and finding that they were getting terribly stressed by the whole experience.
Back in 1998 I set down with a group of parents and I said could we talk through the experience when you have a child with a life-threatening illness, and what are the things in that journey that are the hardest for you and your child and family – and what could we do differently to help you through that.
It did cause a little bit of fuss and concern, I think, from some of my colleagues who thought that this was going to open the floodgates and the families we’re going to be demanding things from us that we might not be able to give. In actual fact what I found was this extraordinary wealth of knowledge that the families had about the journey, and things that us as health professionals actually knew nothing about. We’re not walking that journey. It was quite extraordinary to sit with them and just hear what they had to say and the things that they notice about the healthcare system that they can pass by telling us and we can improve it together. I found that really exciting.
So, together with this group of families, we ended up making a whole lot of changes in how the pain management for the procedures was done and then looking even further at the whole hospital environment, and how harsh and challenging that can be when you come into hospital. So the family said ‘what about some music? That might help to reduce the stress and anxiety for us.’
At the time my children were learning music from professional musicians so something I’d quite like to do is bring in expertise from other people who might know more about it than I do, and I spoke to these musicians and said the families are really after some calming and relaxing music in the hospital environment. That started what’s now called the Hush Foundation, where we bring musicians and composers into hospital spaces and they then reflect on what they can see and hear and they help by providing the most extraordinary music that is specifically designed for that environment.
Dr. Haidar Al-Hakim: That’s amazing – from something that is really simple. Sitting down and listening.
Dr. Cath Crock: It was really simple and quite exciting. And once you do sit down and listen and you connect with the families in that way, you learn so much and I think you sort of grow through that as well.
Dr. Haidar Al-Hakim: What was the biggest thing you learnt when you sat down and listened to them first time? What was the big a-ha moment that you got?
Dr. Cath Crock: One of the things is that families can be going through some really extraordinarily bad times and they don’t necessarily volunteer it to you. They often think okay we’ve just got to basically suck this up and cope with it – but if you do give them the opportunity to tell you what’s really going on for them, that’s when you can come up with some solutions and you can make that journey as easy as possible for them.
Dr. Haidar Al-Hakim: And, you know, resources are available in hospitals and in these institutions – you know, it’s resource rich.
Dr. Cath Crock: Yes but in some ways we think that we’re time poor. So we think that these things are going to cost us too much in time to sit down and listen – but in actual fact that is the best part of my job. Just sitting with people even if you only need a couple of minutes really to make a very special connection with someone and then find out what are the real core things that are bothering them. Sometimes it’s really not very much and we can make a big difference.
Dr. Haidar Al-Hakim: Yeah I mean even spending an extra ten minutes or twenty minutes really connecting and feeling deeply concerned about the situation does make a massive difference in the long term.
Dr. Cath Crock: Yes and I feel sad when I meet families who might have been in the hospital system for quite some time and nobody’s really had that time to connect with them and find out what’s going on. You might see sometimes people getting upset in hospital – so, families where there’s an escalation of some sort of a situation and they even end up calling security. It can be a really simple thing, like the final straw for that particular person and they explode, and often you’ll see if they had been listened to earlier on in that journey and someone had made a really personal human connection with them, that escalating situation may not have needed to happen.
Dr. Haidar Al-Hakim: You brought up an important point about bringing in experts and professionals in other fields, and music is such a universal language…
Dr. Cath Crock: Yes, and it was sort of strange to me… I’d had music in my upbringing and my life and most people have music in their lives at home – and you come into hospital and that’s almost taken away from you. It’s not encouraged that you should bring that important part of your life with you into the hospital. So when we’ve brought composers in, it’s been fantastic to have them reflect back to, us as the staff, what the environment is like. So creative people coming into our hospital space will go ‘my goodness, this environment is really quite harsh.’
And it’s really challenging – there’s a cacophony of noise going on in here that we get used to. We’re there every day and we think this is normal, but actually, to them, they’re saying ‘this is far from normal and we’re going to have to think really carefully where in this soundscape the music can sit so that in fact it doesn’t make it worse and raise people’s anxiety more.’
So you can turn on rock music and things in the background that can quite easily raise people’s anxiety and just make the situation worse. I’ve loved listening to [the composers] talk about what they hear – I mean, their ears are so finely-tuned to what’s going on they can tell you what key the emergency buzzers are in and things like that!
They then work carefully to make sure the music is going to sit in a really good place and make people feel more calm.
Dr. Haidar Al-Hakim: What were the difficulties that you encountered?
Dr. Cath Crock: There were other staff who were quite threatened by this at the beginning, and they came out quite loudly – they said things like ‘we’ve done it the same way for twenty years and frankly we don’t like change. You’re stirring up the families and making them complain.’ Now, no family ever complained about the treatment they we getting, but when they were given the chance to speak about it they actually had this whole list of improvements that we then went on and made.
So it ended up being very constructive, but in those early days there was quite a bit of push back from people who obviously didn’t see a problem.
Dr. Haidar Al-Hakim: And how did you get through that [with the staff]?
Dr. Cath Crock: The patients and families were a great support. To have them appreciating the changes and helping with the changes was really fantastic, and they as a group were able to say this is really [making] major leaps and improvements in working this patient-centred way. And gradually the opposition died away and people would say ‘look, actually, if it was my grandchild needing this treatment I can see that this is how I would like it done and how our family would like it done.’
Dr. Haidar Al-Hakim: Yeah, at the end of the day it’s about better patient outcomes, and if you can get them on your side then no-one can really argue with that.
Dr. Cath Crock: That’s right, and it makes it quite a joyful experience – I wish you could come and see it sometime.
Dr. Haidar Al-Hakim: For me, experiencing working in the medical sector, it is pretty black and white and pretty cold – and that was something that you just got used to rather than trying to change. Change is difficult.
Dr. Cath Crock: Change is difficult and the status quo is quite a comfortable place. Once we had the music up and running I started then to think ‘this has really changed the team we work in.’ It’s made us – when we’ve got the music on – the team is more grounded and way more kind to each other and respectful, and the atmosphere in the room is so good. Why is it that in healthcare we seem to have a lot of bullying and bad behaviour among staff? And we know that that leads to poorer patient outcomes; we know that it leads to poorer staff satisfaction with their jobs, there’s a lot of burnout and all sorts of problems that are coming from how we treat each other.
I wanted to try and represent some of these issues in a creative way we could use to get some conversations going, so I approached a playwright who’s now in his eighties, Alan Hopgood. He’s been writing plays for the last sixty years in Australia, and I spoke to [him] about could we have a play that I could share some of the patient stories and staff stories with you, and then we could put this play on about healthcare issues. I sent him all of these stories and he’s written a half hour play that we’ve now put on in hospitals over a hundred and forty times in the last five or six years. The play is a story about a devastating medication error, and what you witness in this play is a mother who’s trying to get a message across to the staff. She’s worried about her daughter; she knows something’s not going right. A junior doctor who’s written the wrong dose of medication up – a potassium overdose – that unfortunately doesn’t get picked up because the junior doctor’s afraid of her consultant and has been humiliated previously by him, won’t speak up, and the young person dies as a result of this.
Following the play, which we put on in the tea room or seminar room or auditorium or whatever, we have a discussion with the audience of health care staff and patients and families, and this becomes so interesting. Bringing that creative side and the actors into the room somehow unleashes people’s emotions and they start talking about what’s actually going on in their organization or what happened when their mother was sick, or when my themselves were sick. Not only their experience as a health professional, but what it was like when they were on the other side.
I think it brings back this shared humanity – we’re all in this together – and the dramatic effect of seeing the mother who’s so distressed by losing her daughter, and knew that something could have been done if people had been listening. It’s quite an amazing experience.
Click the link below to visit the Surgical Spirit Podcast page and hear all this, plus much, much more from Dr. Crock about her continuing – and hugely inspiring – work using creativity to soften the often harsh reality of healthcare.
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