Falling ill with cancer is a turning point in everyone's life […] Previously it equalled a death sentence; currently – more and more often recovery. The success, though, has some conditions. […] Despite permanently insufficient financial resources designated for health care, we have more and more modern and effective treatment methods. However, this does not suffice.
J. Jassem, ‘Jak nie zgubić chorego w systemie?’ [‘How Not to Lose the Patient in the System?’],
The factor that makes it more difficult to struggle with the disease is the sense of solitude experienced by the sick person. As it has been observed by Professor Jacek Jassem, an oncologist, member and former president of the Polish Oncological Society:
The Polish Oncological Society – a scientific-medical association whose ‘activity focuses on issues concerning propagation of scientific achievements in the field of oncology, stimulating research in this field, the professional skills of the staff of oncological centres, and propagating health education and prophylactic principles. The Society has over 1000 members, including doctors, pharmacists, biologists, chemists, and representatives of other specialisations employed in oncological institutions or conducting scientific research in this field’, On numerous occasions when a sick person […] is experiencing a sense of loneliness, they have to face the physical and psychical burdens of the illness alone. It is, additionally, accompanied by the stigmatisation of oncological disease, which, to the minds of many Polish people, still remains an embarrassing, terminal disease that should not be publicly discussed. As a result, many patients surrender the very moment the illness is recognised. Those who want to take up the fight frequently have to act on their own to find an institution (most often several of them) where diagnostic examination and subsequent stages of treatment will be conducted. At each stage there are ‘losses’ which in oncology are irreversible. One patient became discouraged by long waiting, another received help too late or from doctors who overestimated their capabilities, another did not endure the burdens of the treatment.
Jassem, ‘Jak nie zgubić…’, p. 2.
The proposed changes which are supposed to result in an improvement of the condition of the sick patient are, on the one hand, the social work of ‘demystifying’ oncological illness on a mass scale, and on the other, the necessity of actions being coordinated on a multidisciplinary scale. According to Jassem:
[…] It is necessary to bind together all the elements of oncological care – currently too defragmented – from prevention and early detection, diagnostics and treatment supported by a psychologist, to full rehabilitation. If anything fails in the process, all the other elements collapse.
Jassem, p. 2.
Unfortunately, in practice the whole situation does not look good, especially in the case of a patient who does not require permanent hospitalisation but simultaneously struggles with an oncological illness. Such patients are often left on their own. There is a lack of systemic solutions, as the Polish National Health Fund (NFZ) – responsible for financing the system of health care in Poland – only finances stationary and home-based hospices but does not designate any resources for day-care hospices, which would be an option for sick but able-bodied patients. As an oncologist, Dr Ewa Anna Kosakowska, has put it:
NFZ (The National Health Fund) did not envisage the creation of a place where patients who do not require hospitalisation could spend time among nice and warm-hearted people, where they would be provided with rehabilitation, meetings with a psychologist (both individually and in a group), with a dietitian preparing healthy meals […], talking about the beauty of the world, places, people, and trips.
A. Mazurkiewicz, ‘Niektóre kwiaty kwitną jesienią’ [‘Some Flowers Bloom in the Autumn’], medical journal Puls, vol. 12, no. 1, Dec. 2012 – Jan. 2013, pp. 34–35,
The problem of exclusion and loneliness especially affects the elderly, whose lives revolve around the hospital. ‘Between chemotherapies and radiations [these people – fn. S.M.] often stay alone at home, whereas the other members of their family go to work […]. They are left on their own, quickly losing energy and the will to live, often falling into depression […]’.
‘Uniwersytet III wieku dla chorych na raka’ [‘The Third-Age University for Oncological Patients’], 21 June 2013, The official website of ‘Jestem’ Foundation,
The non-governmental organisation ‘Jestem’ Foundation for the Support of Chronic and Terminally-Ill Patients was created at the end of 2011 and has since then operated in Warsaw. The management board is represented by an oncologist, Dr Ewa Anna Kosakowska, and by Izabella Dembińska. ‘Let us discover the beauty of life at every stage of the illness’ is the motto that underlies the Foundation's activity. It supports patients who are undergoing oncological treatment or have completed it. The goal is to ‘revive hope and joy in order to make recovery at each stage of the illness’.
The official website of ‘Jestem’ Foundation.
In their activity, the Foundation members are doing their best to approach patients holistically by taking care of all basic spheres of human life: spiritual, physical, behavioural, and social. This approach is reflected in the sequence of meetings organised for the patients of the Foundation. They are held once a week and consist of four permanent elements: a conversation with a psycho-oncologist, rehabilitation, a conversation about broadly defined beauty as well as learning healthy dietary habits, accompanied by cooking and a common meal. Each of the four parts lasts approximately an hour. The classes are regularly attended by patients (at various stages of illness) divided into two groups, each consisting of several patients. The Foundation supports adults between 50 and 80 years of age. The meetings are also attended by volunteers and patients' relatives. Participation in the classes is free of charge. Meetings are sometimes organised outside the Foundation's headquarters in the form of joint trips to the cinema, theatre, museum, concerts, as well as trips outside Warsaw (to Szymanów, Niepokalanów, Powsin, Nieborów, Żelazowa Wola). On some occasions such outings differ considerably from the standard activities; for instance, in June 2016 the patients had an opportunity to fly a balloon.
The Foundation aims to divert patients' attention away from the illness by showing beauty (in various dimensions) at each stage of their struggle with the illness. Similarly as in the globally recognised programme created by US oncologist Oscar Carl Simonton, a pioneer of interdisciplinary psycho-oncology,
See: O.C. Simonton, R. Henson and B. Hampton, S. Taylor and D. Sherman, ‘Psychologia pozytywna i psychologia zdrowia: owocny związek’ [‘Positive Psychology and the Psychology of Health: A Fruitful Union’], in P.A. Linley and S. Joseph (eds.),
An innovative solution in the Foundation's work is the presence in the structure of the classes of the so-called ‘hour on beauty’, which is characterised by meetings with interesting people such as journalists, actors, travellers, as well as students of the Institute of Musicology (University of Warsaw). There is no doubt that music and beauty are a perfect match and contemporary musicology offers an abundance of subjects and issues which may become the basis for projects of an educational, general developmental, and therapeutic character. Demand for accommodating an ‘hour on beauty’, which originated in the Foundation, perfectly correlates with the possibilities offered by the knowledge and competencies gained during musicological studies.
In the period between November 2013 and June 2022, within the scope of regularly conducted facultative classes
Coordinated and conducted by the author of this paper, apart from the period between October 2017 and June 2019 when Anastasiya Niakrasava (MA) was responsible for the cooperation. Regular cooperation started in the 2013/14 academic year and continues in 2022.
The students' task is to design and conduct hour-long classes, attractive from the recipients' point of view, aimed at adults without prior musical education. Several years of cooperation with the Foundation has made it possible to develop innovative methods of working on the project. The starting point usually involves students' individual research interests and also in many cases their practical skills (e.g. the ability to play a musical instrument or to sing). Subsequently, students are selected to work in pairs or teams of three-to-four persons. The conceptual component consists in defining the topic of the project as well as preparing the precise scenario of the classes. All the concepts are discussed during facultative classes (conducted regularly as part of studies at the Institute of Musicology) with active participation of the students attending the classes and the lecturer.
As a result, various scenarios tailored to the Foundation's needs are created. They typically take the form of projects with music performed ‘live’ or some multimedia presentations (taking advantage, among others, of audio and audio-visual materials). In all the classes, a particularly important role is played by elements that activate patients (i.a. active, task-oriented listening to music, joint singing as well as improvisation e.g. with simple percussion instruments). Projects created so far are characterised by overall variety with regard both to subjects being discussed and methods of patients’ activation. This observation may be confirmed on the examples of selected classes held at the Foundation.
For further information on cooperation between the Institute of Musicology and ‘Jestem’ Foundation see: S. Makomaska, ‘O uwalnianiu “zamkniętych zmysłów”… Muzykologia wobec doświadczenia sytuacji granicznej’ [‘Activating “closed senses’… Musicology in the Face of Limit Situation Experience’], in S. Jaronowska (ed.),
Classes conducted at ‘Jestem’ Foundation on 25 April 2017. See: R.W. Oldani, ‘Musorgsky [Mussorgsky; Moussorgsky], Modest Petrovich’,
The classes held at the Foundation were divided into two parts: theoretical-historical (a multimedia presentation), and a practical one which emphasised auditory analysis of individual miniatures. In the first part, the students presented interesting biographical facts from Mussorgsky's life (the composer's military career, his contacts with other artists belonging to the so-called ‘Mighty Handful’, the context of composing
Less known trends in classical music (especially contemporary ones) constitute an equally interesting theme. The project titled Classes conducted at “Jestem” Foundation on 21 January 2017. See: The result was a collage in which collected sounds were mixed with one another and were later submitted to ‘preparations’ of various kinds in the studio. The mood of these weird, surrealistic ‘sound pictures’ may resemble the world of dreams, which are also full of unexpected juxtapositions of places, characters, and events […].
A. Witczak,
Schaeffer's innovative experiments contributed to the development of electronic music. Moreover, the achievements of
The main part of the classes was dedicated to auditory analyses of selected études from Pierre Schaeffer's cycle
The main theme of another project, prepared by Alicja Cieloch and Karolina Staniszewska,
Classes conducted at ‘Jestem’ Foundation on 22 November 2017. One of the most important instruments that humans have at their disposal is […] the voice. Presumably, there is a logical reason for the term ‘vocal cords’ – it is the best proof that one can actually play on them.
A. Cieloch and K. Staniszewska,
The main goal of the classes titled
The practical part was preceded by a theoretical introduction in form of a multimedia presentation. The starting point was a discussion of the structure of the vocal apparatus. The key question in this part of the classes was, among other things, why voice is important, how powerful it can be, and how and why one can work on it. Unusual ways of singing were also presented such as scat, throat singing and yodelling. The other part of the classes, with active participation of the patients, was based on practical exercises. Transition to practice began with a voice emission warm-up intended to relax and activate the participants, as well as warming up the vocal apparatus (jaws, lips, tongue, cheeks). The next stage consisted of diction exercises, with special focus on the function of vowels and accents in the Polish language. Another exercise was to read aloud several short sentences and texts. The patients especially liked the exercise in speech clarity, based on reading tongue twisters aloud with a carrot placed between their teeth. The exercise in voice emission involved, among others, uttering sentences with varied pitch. The participants were subsequently working in pairs or groups of three people, training the so-called resonators. The presenters explained how one can control the direction of sound and ‘feel’ it in different parts of the body (i.e. at the top of the head, back, nose etc.). The final point was an improvisation performed jointly on the vocal cords. With the students’ help, the patients created a piece that consisted of gradually added, individualised sounds. The high number of practical tasks influenced the group's activity in a positive way. The authors of the project believe that the skills acquired during the workshop will have a practical value and will contribute to increased awareness of one's own voice as well as drawing the participants’ attention to proper articulation.
The classes conducted at the Foundation's headquarters constitute the main but not the only way of organising the ‘hour on beauty’. Classes conducted with the participation of patients and volunteers from ‘Jestem’ Foundation, 26 June 2014. A musicology student and at the same time collaborator of the Fryderyk Chopin Museum in Warsaw. Places selected on the basis of: P. Mysłakowski, The first address of the Chopin family in Warsaw. Presumably they lived there in 1810–1812. In 1812 they moved to the Saxon Palace, where the Warsaw Lyceum was located. Fryderyk lived there until 1817. After the relocation of the Warsaw Lyceum, the Chopins lived in the present-day main campus of the University of Warsaw. Frederic Chopin's last place of residence in Warsaw. From this apartment, on 2 November 1830, Chopin emigrated from Poland. At that time the Chopin family resided in the former dean's headquarters (occupied today by the Institute of Art History of the University of Warsaw) while Chopin's father, Mikołaj taught at the Warsaw Lyceum. A musicology student and an employee of the Fryderyk Chopin Institute (NIFC) in Warsaw.
The issue of the relationship between music, health, and the so-called well-being has become the subject of interdisciplinary scientific studies in recent years. A pioneering example of a comprehensive presentation of this subject is the collective work titled See: R. MacDonald, G. Kreutz and L. Mitchell (eds), See the review of the research: M. Pothoulaki, R. MacDonald, and P. Flowers, ‘The Use of Music in Chronic Illness: Evidence and Arguments’, in MacDonald et al. (eds), See: L. Konieczna-Nowak,
The patients and volunteers of ‘Jestem’ Foundation – participants of
The fundamental goal of the classes conducted by the musicology students derives from the motto of ‘Jestem’ Foundation: ‘Let us discover the beauty of life at every stage of the illness.’
The official website of ‘Jestem’ Foundation.
Unfortunately, systematic evaluation of the effectiveness of regular activities conducted at ‘Jestem’ Foundation is difficult due to a number of factors pertaining to individual classes. The most important obstacles are the constantly changing structure of the group, the impact of external factors (such as the individual context of the classes depending on the current health of individual participants or the absence of patients assigned to a given group) and, most importantly, the fact that musicological classes are part of the entire programme provided by the Foundation.
Conducting reliable research in such a complex context, with conditions changing from one class to another, is rather difficult. The choice of research methods for the evaluation of musicology classes has also been dictated by the justified concern that interviews or surveys conducted after each class would negatively influence the patients themselves and might disrupt the time structure of meetings at the Foundation. Taking the existing conditions into account, an optimum indirect option has been applied. All the participants were invited to prepare a written response to an open-end question: ‘How did I benefit from the classes conducted by the musicology students?’ Twelve anonymous feedback forms of various lengths were obtained. Their analysis has made it possible to estimate the degree of goal achievement.
The functions most frequently indicated by the patients were: diverting attention away from the illness, the possibility of relieving negative emotions, stimulating interest in music (for instance, by individually looking for information on the subjects discussed during the classes), improved mental condition (the feeling of joy, return to childhood and adolescence, to the time before the ‘sentence’, pleasure derived from spending time with young people). It may be concluded with great satisfaction that these detailed goals were achieved.
The effectiveness of the applied methods has also been confirmed by observing patients during the classes.
On the basis of H. Cesarz, ‘Karta zachowania się pacjenta w trakcie muzykoterapii’ [‘Patient Behaviour Observation Card during Music Therapy’], in Stachyra (ed.),
Therapy through musical education, making use of various methods of patient activation, is an effective and necessary element of therapy in adults (especially in the elderly) struggling with oncological illness. Excerpts from patients’ descriptions of their experience of classes conducted by musicology students undoubtedly motivate us to continue our cooperation with ‘Jestem’ Foundation:
Meetings with students from the Institute of Musicology are a great lesson for us, broadening our musical horizons, making us curious about new types of music […] [W]e listen attentively and after returning home we look for additional information on the Internet to deepen our knowledge […] For a while we forget our troubles which bring us down and we ‘fly away’ to the magical land of music.
A fragment of a written statement by a patient of ‘Jestem’ Foundation (a 56-year-old woman). [The classes] force us to think independently, solve problems, and get involved in the subjects which are being discussed.
A fragment of a written statement by a patient of ‘Jestem’ Foundation (a woman, age not given). Thanks to […] the students I get to know music in a different way: I can see it and feel it. I get to know composers, instruments, and artists. The meetings are a pure joy in these difficult moments of my life.
A fragment of a written statement by a patient of “Jestem” Foundation (a 60-year-old woman). […] the joy of youth that radiates, the joy of life and sharing what is needed and worthy of being admired.
A fragment of a written statement by a patient of “Jestem” Foundation (a 70-year-old man). Underlined by – S. M. I am grateful to the Foundation for reminding me that, apart from the illness, there still exists another world.
A fragment of a written statement by a patient of ‘Jestem’ Foundation (an 84-year-old man).