At the Robert Ballanger hospital’s Intensive Care Unit, France. Photo by Amelie Benoiste/SPL
For those suffering the trauma of intensive care, the soothing swoosh of otherworldly ambient music can be a welcome gift
It’s an odd gig, even for musicians who are used to some odd venues. For one thing, we can’t see our audience. It’s not that we haven’t attracted many people, so much as that our listeners are in another building. They are lying in hospital beds next door, and they are connected up to machines. Some of them are quite close to death. They are listening – those who have chosen to – on iPads linked to the ward’s WiFi, which is transmitting our live audio stream. Although the music is being broadcast on the internet, it is intended only for one group of people: the patients, carers and staff of the Critical Care Unit at University College Hospital, London (UCH).
The invitations promise ‘a performance of ambient and electronic music’. We had them printed up on good-quality card, and spent half an hour tucking them into cheerful lime-green envelopes. My colleague Nina and I went round the ward earlier, asking those patients who were awake if they wanted to listen, and handing out brand-new headphones and carefully sterilised iPads. The concert has been trailed for several months, but some of the staff need reminders of what is going on. There are emergencies unfolding everywhere. An intensive care unit (ICU), I am learning, is a lively mix of high-tech medicine and the shouty dynamics of a trading floor. We know that the success of our art project is way down the list of priorities.
The concert is slated to start at 1pm. At 12:59 some of us are still stuck in the basement of the Wellcome Trust, across the road from the hospital, trying to find a lift big enough to shift a cart of music gear up to the fifth floor. It’s all a bit Spinal Tap. Thankfully, Peter is already plugged in upstairs, and he starts the show with some airy pan drums conjured from his iPad. The rest of us are drilled in setting up quickly, and we are soon wrapping other sounds around his reflective beats. There are guitars, a sax, a flute, a bass clarinet and Os’s modular synth, with cables and switchboard like an old-fashioned telephone exchange. We’re making enough noise to be heard on the adjoining floors, and yet, if we move towards each other, we can still talk while we’re playing. Our audience can’t hear that. Despite stringent tests of the technology, we don’t actually know if anyone can hear anything. All that matters, really, is that we’re doing it. For a couple of hours on a wet Tuesday afternoon, we are putting something out there that is not just about keeping some very sick people alive. It is trivial, ephemeral, vanished into air, but for the moment it feels like the most important thing we could be doing.
Intensive care is no place for the faint-hearted. Improvements in medical technology, particularly the development of the modern positive pressure ventilator, have transformed our efforts at the boundary between life and death. A few decades ago, many of the people in that ward next door would already be dead.
But progress comes at a cost. The noise of life-support machines and vital-sign monitors is a constant background. Phones ring, bin lids bang, staff call for help and doctors are constantly being paged to the next emergency. The racket frequently exceeds World Health Organisation (WHO) guidelines for safe noise levels. In The Guardian in 2016, Helen Taylor, an intensive care survivor, described a ‘constant, frightening’ noise from which there was little respite at night. It’s one reason why a recent article likened the modern ICU to ‘a branch of hell’.
The chaotic atmosphere was less of a problem 10 years ago. If I had stepped next door then, there would have been few patients awake to disturb. The standard approach, while life-saving procedures were being administered, was heavy sedation. While the machine was being fixed, the patient was put into a coma.
That changed with the recognition that, inside those ravaged, intubated bodies, minds were still working. And those minds were not at ease. The British journalist David Aaronovitch had a stint in intensive care after routine keyhole surgery went disastrously wrong. He heard people behind a curtain railing violently against him. As his disorientation deepened, he started to believe that the sinister officers of the night shift were preparing his body for human consumption. They were feeding him oxygen in order to make his flesh sweeter. He was going to be eaten…