Wednesday, July 31, 2013

Professional Conflict

Wednesday morning, July 31, 2013....cloudy, humid and SUMMER!

I have given a lot of thought to my Session with my current patient yesterday.  She suffers from Alzheimer's and I have had 2 other Sessions with her previously.  They have been very successful and have created great joy for her Daughter and myself, experiencing these positive reactions.

Yesterday when I arrived, and the patient was in the Dayroom, fairly calm and when I told her I was there to play music for her (Patient is Blind) she just smiled and squeezed my hand..so happy.  I took my Harp to her room and I found her roommate was really fidgety and restless (she is very sick with Cancer).  I spoke to her and tried to calm her.  I asked her if she wanted me to play music on my Harp and she responded with a big smile and said "yes, I love your Harp Music".  I then asked her if she liked Hymns, to which she smiled and said "oh yes, I love Hymns"  So this conversation with this roommate changed my planned Session for my scheduled Patient.  I was going to play general Music, up to 80 BPM but decided that the roommate would benefit more from slower, yet familiar music.  I also decided to add several hymns to the Session and to keep my selections a bit more simple than I usually play for my Patient.  I expressed these changes to my Patient's Daughter and she completely understood and agreed that the roommate was in greater need at that moment.

Unfortunately, the Session was interrupted continually by the Companion, chatting and asking questions and sharing her stories, which were so funny, however not appropriate for the setting.  I noticed during the first half of playing that my patient was not as relaxed as usual.  She wasn't agitated, but wasn't "one with the rhythm" either.  The roommate was very content and eventually drifted off to a very deep sleep, Yipeeee!

This situation is not uncommon during a Session.  You can have 1 person in the patient's room or you could have 50...there are constant interruptions by medical staff, visitors and family members.  The best approach for me is to keep on playing, trying to ignore and continue to focus on the Patient.  For me the conflict comes when it is the Companion doing the disruption in this intimate setting.  How do I address this?  Do I speak to the Daughter or do I go directly to the Companion.  Do I say nothing?  Is it unprofessional of me to ask that communication be kept to a minimum and perhaps take the conversation out of the room?  We are in a small, crowded environment with the background noise of the machinery, air conditioning and hallway activity all around us, and nothing to be done about these distractions.   But I feel I am able to create a relaxed and peaceful environment despite the unchangeable distractions.   I did notice that my Patient was trying to listen to the conversation going on in the room, as well as the Music.  She may not communicate, but I feel she is aware.  Her body language is amazing....the more I am with her, the more I understand her reactions.  She and her roommate deserve the best I can offer in Services......

I will share my situation with my Mentor from the Course Certified Clinical Musican, today when we speak.  I am sure she will have good advice from her years of experience in this field.

Tuesday, July 30, 2013

I am Mobile

Tuesday, July 30th...the second most beautiful day in July...cool, clear and sunny, more like a fall day

One of the things I've learned while Harping at the Hospital and Assisted Living is there is little space to pack and unpack my Harp.  Trying to get set-up in a restricted space is nothing short of working a puzzle....the case is large and cumbersome after it's removed and then I have to have space to put the Harp on it's Base, open the Bench,  attached the IPAD to the IPAD Holder (it has some weight to it) and then carry my Harp, which is NOT light, to a spot.  Taking it down is the reverse order but you have to add strapping all this together on my Magna Cart.

Musicmakers has come up with the most efficient and well thought of equipment to make my life so much easier.....now I can arrive with little stress and get down to Servicing the Patient.  I bought a Wheeled Platform....the Base of my Harp is detachable...so it stays strapped to the Wheeled Platform at all times, even at home!  All I do is unzip the bottom of my case when I reach my destination,
and attach it to the Base on the Wheeled Platform!  Whoohooo....I'm done!  My folding stool fits perfectly on the Wheeled Platform, under the Harp Base.

Musicmakers also makes a removable Music Stand for my IPAD...it attaches to my Harp Column.  It fits in my Harp Case for travel and I attach it when I get in the Patients room.  A perfect set-up!  Today I will be using it for the first time, as I am headed to Future Care to play for beautiful Louise this afternoon.  Looking forward to trying it out.....I'll let you know how it works for me

Wednesday, July 24, 2013

Validation

Wednesday afternoon, July 24th....not as humid but still a Summer's Day...as it should be :)

I have not doubted that I am on the right path.  I have not doubted that I have been called to do this.  I have not doubted the information and the heat-felt stories that have been shared in all the books I have read on the subject of Therapeutic Harp.  However!!!!!  it is a wonderful thing when the work you do is validated by an inspiring event such as yesterday.

I have been working extra hard on organizing my Therapeutic Music.  That's important because what you play matters as much as how you present it to the Patient.  So, as the weeks have gone on, I have separated my Music into categories.  Judging from my experience so far, these are the situations I will be playing in  "Palliative Care (end of life care)"  "General Music (Hospital Lobby or any other public setting)"  "Dementia and Alzheimer's (specifically from their Genre for memory recall)"  "Chemo Infusion Center (similar to General Music, but not quite)"  "Children's Music (for the Ped. Ward and NIC Unit)"  "Post and Pre-Op (Non-rhythmic as well as Pulse)"  Private Clients (various needs depending on the client)"

I am happy to say that my Organization paid off yesterday with an hour of seamless Music (well, except for the couple times I screwed up) in the Dementia and Alzheimer's Folder.  I always learn from my experiences and I try to keep notes to remind myself to correct the ones that I have control over.  So yesterday I felt like there were 2 things I didn't do well.  The first was to position myself so I had a good view of Louise...without interrupting my Music.  The second was I failed to take the time to focus on myself first, before I started to play.  I needed to play quiet notes, focusing on each tone and taking deep, relaxed breaths.  Hopefully, now that I have written it down and said it out loud, I will remember.

So, my Patient has a rare form of Alzheimer's Disease called "Benson's Syndrome".  She is blind and requires complete care.  She just recently started to communicate, after our first 1 hr. Session of Live Therapeutic Harp Music.  Yesterday was the second session.  Again, this was 1 hour of Pulse Rhythm and the Music was mostly Familiar to help with Memory Recall, but there were a few Non-Familiar, lovely flowing pieces thrown in.

When I got there my Patient was in the Day Room with about 6 other Residents.  She was in front of the TV so she could hear, as she is Blind.  She was VERY agitated.  She was not comfortable in her Wheelchair and she was fidgeting with her leg and shorts.  Her skin was cool and she was moving her head around.  I went to her and held her hand and told her who I was and asked if she remembered me coming to play my Harp for her.  She stopped moving and moved her lips.  She seemed to calm a little, but I was happy when her Daughter arrived and soon after that her part-time Companion also arrived.  So we got her all settled in her room, covered her with a blanket and I got started.

I also want to mention my Patient has a roommate with advanced Cancer, who was sleeping when we started.  When the roommate heard the Harp, she opened her eyes and I said "Good Morning, would you like to hear some Harp Music?"   she smiled and closed her eyes.

About 20 minutes into playing, not only did my Patient settle down, but the Companion was just about asleep on the bed, lol   Clearly, my Patient loved all the pampering from her Daughter, brushing her hair, talking softly to her and making sure she was comfortable.  She moved her feet slightly, back and forth to the Music.  Her head was back and her eyes were closed, but she was by NO means asleep.  She smiled a couple times and it was clear when she really loved a piece of music.  "Somewhere Over the Rainbow" is one of her favorites!  It's hard to stop playing, you just want continue for as long as your fingers hold up, but I am trying to set a 1 hr limit for myself as well as the Patient.  It would be easy to over stimulate.

During the Session, my Patient's roommate had a severe episode of coughing but I think the Music helped settle her down again.  Before I left I stopped to say goodbye to her and she smiled and asked if I would come back ...she said "I love the Music".    My Patient smiled when I told her I would be back to play for her.

Below is the Email that my Patient's Daughter sent to me late last night....For anyone that needs validation that Live Therapeutic Harp Music has a profound effect on us all....the Patient, the Caretaker, the Family and the Musician, this email should cover that.  Also below the Daughter's email is part of an email I received this morning from her Companion....Amazing and Inspiring


Hi Jackie,
Once Mom was situated in her chair comfortably (sorry for the kerfluffle while you were starting to play) she relaxed and began to listen to the music.  It was not long before her feet started to move.  She moves her feet when she listens to music that she likes and when she is happy.  Today I believe it was both.  I noticed that Mom was more animated in her reaction to the music, yet relaxed enough to doze off now and then.  Both Mom and her roommate seemed to be very relaxed and receptive to the music today.  The energy in the room was very positive and I felt like we were all floating along on the music together.
After the session, when I was leaving for the day, I told Mom I would be back soon.  She said "okay".  Mom has not uttered a word to anyone in the past week.  She has not even acknowledged anyone in any way for the past week.  Not even an eyebrow raise.  I told her that I loved her and she said "I love you too".  I did not think I would hear those words again because in the past week Mom seemed to have moved to a new level with her disease.  
I was walking to my car and decided to go back and say goodbye to Mom again.  I wanted to see if she would tell me she loved me again.  I never know when it will be the last time I hear those words forever from her.  I went back and kissed her again and told her I loved her and told her what a wonderful mom she is and always has been.  I said goodbye again and walked a few feet toward the front door when I heard her say "Therese".  She said my name!  She knew who I was!  I have not heard her say my name for a very, very long time.  In fact, I did not think I would ever hear her say it again.
Thank you Jackie

From the Companion

 Your Patient really did enjoy you music yesterday.  She was trying to tell me something yesterday after you left.  It's the most she has spoken to me.  She usually says yes and no.  But, she actually said a sentence.  I will figure out soon how to understand her.  God will help me figure it out. 


Thursday, July 18, 2013

Observe, Act and Adjust

Thursday afternoon 7/18/13....I hate to keep saying this but HOT HOT HOT!!!

This morning I went to Household of Angels to Volunteer.  I am trying to get a paid position there, if only once a Month.  I used to play my Harp there every week, especially when I first bought my Harp, it was a great place to practice.  I've felt bad that I am so busy with the Hospital, Teaching and working on my Certification, that I haven't been over in such a long time.  So I stopped by yesterday to drop off an Informational Flyer about my Services and I was just flooded with emotions.  I have missed them terribly.   It is such a small facility (14 Beds) and usually 2 Caretakers at a time, I think it gets lost in the shuffle and they have very few visitors or volunteers come by.

Today I noticed several wonderful benefits from Live Therapeutic Harp Music.  When I was setting up, on of the Gentlemen Residents was asleep at the breakfast table.  They moved him to the couch in the living room where I was going to play and he promptly fell back to sleep (lots of meds)  I played from 10:15 to 11:45am....my second Tune was "You Are my Sunshine"...ok this Gentleman is now awake and singing and he stayed awake the entire time!!!

Sweet Southern Lady, I love her.  She doesn't sleep much at night so she sleeps right through lunchtime.  I used to go to her room and get her up or take my Harp in to her.  She was so excited that I was coming, the caretaker said she was getting dressed when I got there....it took her about an hour to get to the Living Room and when I was finished playing, she said, "I don't know if it was worth getting dressed for, you only played a little while".....OMGGG

A very interesting man, nothing wrong with his mind, he just needs Assisted Living for daily care.  He is soooo smart and so interesting to talk to...the only time he comes out to be with the other Residents is when I come with my Harp.  He always is such a wealth of information on the history of music in Middle Ages....fascinating guy.  He stayed in the kitchen chair the entire time....telling me about certain tunes I had played...very cool.

The Resident Singer, she used to have a Country/Western Band.  From what her family says, she was a fantastic Guitar player and singer.  She can still carry a tune like she is 20!  She is the ring leader of the Household of Angels...what she says, GOES   She sang every tune and told me she was going to get her Guitar and practice up...Music made her Alive again!

The oldest Resident is this beautiful, 99 yr old Woman....very striking and her husband lived there with her for 5 years, he died last year.  She is very quiet and it takes her a few minutes to grasp what you are saying to her.  She loves Classical Music so when I played Ode to Joy she just grinned and tapped her hands on her walker....she is so gracious and always thanks me for playing.  I think she is one classy lady.

I could go on and on about each Resident, but what I also love to see is the Staff relaxing.  They have a very stressful and physically exhausting job.  They go about their work in the kitchen or whatever, but their step is slower and more relaxed and they will sing along too.

It's a most rewarding experience and I love all the information I am getting from my course materials..it helps put a new and interesting spin on my experiences.  I am using my new knowledge to offer a better Service by observing, acting on my observance and adjusting my playing to fit the needs of the Residents.  Why oh why did it take so long to find this Calling?



Monday, July 15, 2013

"The Little Details"

July 15th..HOT HOT...it's also Emily's 25th Birthday...

This morning I went to Infusion at the Hospital.  I thought I would jot down some of my Routine before I start playing.  The first thing I do before leaving the house is play my Singing Bowl....I draw in eternal peace and breath out eternal love, breath in eternal compassion and breath out eternal kindness.  It's the coolest when I add "toning" with my voice.  I am getting pretty good at matching the Singing Bowl's Tone...I know what you're thinking...She's a Nut!

By the time I reach the Hospital, find parking, lug the Harp over the river and through the woods to the Infusion Center, I wish I had my Singing Bowl again.  Stressed and HOT.  I am always greeted with smiles and warm "good mornings"  I unpack my Harp in a back hallway and then take a walk around the Infusion Center, trying to get a feel for how crowded it is, how much area is there for me to set up in and what position will reach the most Patients.  The Nurses are so awesome...and today was no exception.

It was like a zoo when I got there at 9:15am   Almost every room was filled.  I stick my head in and introduce myself and tell them I am from the Therapeutic Music Program at the Hospital and if they would like to listen, they could turn down their TV...if not...turn it UP.  So picture several hallways, each one lined with small cubby rooms with curtains.  Each room has a TV and a Recliner for the Patient and usually one chair for a friend or family member.  I can move my Harp to another area of the Infusion Center, but right now I am not mobile enough to wheel it anywhere, so I pretty much stay put.  The Gear for that is expensive and will have to wait.

After doing my "rounds" I go back to my Harp and Gear and do my Singing Bowl Meditation without the Bowl....same breathing in eternal peace, etc.  Surprisingly, I am so relaxed and ready to play after doing this, I can't imagine not preparing myself for the Session.  I spend the next few minutes just getting a good feel for the atmosphere of the Infusion Center...watching the Nurses ready everything for the Patients, the drugs, blankets, pillows, snacks and drinks and most of all, the compassion and kind words to ease some of the fear and discomfort.  It's actually a pretty jolly place with lots of smiles and little jokes back and forth with the Patients.

Today, after about 20 minutes of playing, I started taking mental notes of the most obvious effects of my Harping.  You could almost hear a pin drop.  There was soft chatter in the rooms with the Nurses.  Most of the TV's were off or turned down.  Although the Nurses were just as busy, there was a noticeable reduction of stress.  The Nurses would walk by singing.  The Patients with their IV Poles would pass by and thank me, or they would be singing too.  An Oncologist stopped on his way by to see his Patient and listened for a minute and said, "a very nice feeling".

Right before I left at 11:30am...a Patient was brought into a room at the far end of the hallway, facing me.  She was so thrilled to have music....and very disappointed I was wrapping it up for the day.  So I told her I would play 2 more songs...to pick 2 of her favorites and if I knew them, but I doubted I would, I would play those, otherwise I would pick something close.  One of her favorites was "Somewhere Over the Rainbow"...got that!  The second one was "Bridge Over Troubled Water"...GOT THAT TOO!  we laughed together and when I was done, I hugged her and told her I hoped to see her again....but I would rather she be done with Treatment and on her way to a Healthy Life....I actually got a little teary.

Sunday, July 14, 2013

Just for 2 Minutes

Sunday Morning....July 14....Cloudy and gonna be a HOT one today and all week.  I am looking forward to some Moderate Temps so I can take my Harp outside.  The Humidity just kills the Instrument...but the joy of playing with Nature can't be measured.

Friday morning I played my Harp at the AAMC main lobby.  I love playing there.  It's so crazy busy, people coming and going from the Parking Garage...headed to the right if they are going to the Baby Building...with big Brothers and Sisters holding hands....or frantic family members asking for directions to their loved ones rooms and headed to the left to the elevators.  Staff of every kind zipping past, cleaning carts clank along the tile.  It may seem too hectic to sit and play the Harp, but it really is a perfect place.

The sound of the Harp resonates down the long Hallways.  People coming from the Baby Building can't tell where the music is coming from until they round the corner into the Main Lobby.  They always have this big smile on their faces and slow their walk when they see the Harp.  Sometimes they will stop and listen, or just pause for a moment.  Kids are fascinated and most of them have never seen a Harp, except possibly on their favorite Children's Show on TV.  It's always fun to let the kids touch the strings.

When I am playing in the Lobby, I try to keep the tempo moderately slow....not dragging, but a nice walking speed.  This Entrainment is so effective...I marvel at the results every time.  I have a great view of the main hallway.  I can see someone coming from pretty far away and most times the Doctor or Nurse is doing double-time coming off the elevators.  About the time they hit the Coffee Shop they are aware of the Music.  By the time they reach the Information Desk they can see me and their step has slowed to my rhythm.  That's Entrainment...their heart rate and step are following my rhythm.

On Friday, as on many other occasions, a Doctor slowed in front of me and left the hectic Hallway to sit in a chair across from me in the waiting area.  He stayed for the rest of the tune..."What a Wonderful World".  He had his head resting on the pillar, eyes closed and his feet stretched out in the middle of the  area.  When I was finished, I continued to transition into another key with chording and that is always beautiful to listen to on the Harp.  As I went into the next tune he stood up and said, "2 minutes...that's all I needed and I can't thank you enough, I wish you were here all day, everyday"

Wednesday, July 10, 2013

The sweetest Tunes

Wednesday, July 10th....wow I opened the door at 6am and it's like a Steam Bath out there....I had thought of taking my Harp on the deck sometime today but quickly changed my mind....I had a quick flash picture of the wood swelling instantly and all my strings popping ...

Yesterday I spent a couple of hours setting up a Playlist for the Dementia Unit.  Memory Recall is the most important aspect of what I will be doing so I wanted to have some Music from several Decades.  I tried the usual Google Searches and came up with a few but I wasn't finding what I wanted.  Feeling a little frustrated, I just took my coffee into the Living Room and sat on the couch with my Laptop and started to remember all the songs my Mom and Dad loved.

One by one, tunes would come to mind and I would find a Lead Sheet online and print it out.  My Favorite..."Que Sera"...my Mom lived by this...what will be...will be.  My Dad loved "Send in the Clowns"...."Country Road".......and the much loved "Moon River".  All in all, a very successful adventure!

What I love about the Harp, it lends itself to play in a "moody" sort of way.  If I am feeling a simple tune, I can keep it simple, but yet engaging.  But if I am feeling more depth on a certain Tune, I can add beautiful runs of broken chords.  The Lead Sheets also allow me to be more creative...I usually end up replacing some of the suggested Major Chords with Minor ones...I like the Chord Changes and it keeps the piece interesting....I am so excited to get started on these Sweet Tunes....hopefully I can master a few by next week!!!

Tuesday, July 9, 2013

House of the Rising Sun

Tuesday, July 9th....Yesterday I played at the Infusion Center at AAMC.  It was surprisingly slow for a Monday, usually it's bustling with Patients and Staff.  Where I play is along the Wall in a Hallway, across from the Nurse's Station....it's a tight squeeze, especially when a Patient is moving around with the IV Pole, to and from the Restroom....or just stretching their muscles.

In the Room next to me was an older woman, accompanied by her Son.  She looked just exhausted...you can read the stress and weariness in her face.  They had their TV on, so I introduced myself and told them I was going to play the Harp for a while so they could turn up the TV if they didn't want to listen.  They both smiled and said ok....but I heard the TV go off before I sat down.  In the next room was a man who was really sick from the Chemo.  My heart ached for him and I had to force myself not to feel sick in sympathy.  There was a really young man across from me who was thrilled to have live Music...we chatted a bit and I told him I hoped he would relax and doze off while I played.

I played for 1 1/2 hours.....When the older woman was done her treatment, she came out and said, "I have NEVER heard "House of the Rising Sun" on a Harp....it was Beautiful and all your Music was so relaxing...even my Son loved it.  Before I left, the young man said ...."All those great Tunes on the Harp are awesome....especially "House of the Rising Sun"!

I asked the Nurse about the man that had been so sick.  She said he had finished his treatment and had fallen asleep to my Music....because they were so slow in the Unit...she was leaving him to rest until he woke on his own.  So much Kindness...so much Compassion and so much appreciation for a little bit of my time.

There are groundbreaking studies of what's called "Chemo Brain".  Patients experience confusion and cognitive changes during and after Chemo.  The Studies have done Imaging on Patients BEFORE any Chemo is given.....during Chemo without a Live Harpist and AFTER Chemo...the Imaging shows areas of the Brain that are effected by Chemo.  Imaging is done on Patients in the same way but WITH a Live Harpist and the Imaging shows little or NO signs of any changes.  Amazing.....


Sunday, July 7, 2013

"I Love you" in a Breath

It's Sunday Evening...July 7th...on Friday I drove with a Friend to see her Mom who suffers from Alzheimer and has been in Assisted Living for about 18 months.   I offered to play my Harp for her Mom and she was pleased I could fit it in last week.

When I first got to the Assisted Living, her Mom was in an Activity Room with about 6 other Residents.  They were watching TV, or sleeping in their Wheelchairs.  I introduced myself to her Mom,  and told her I was going to play the Harp for her back in her room.  This lady in the room said, "I want you to play music for me"....I still feel bad about not going in that room when I was finished that afternoon.

This was a good experience for me...I learned some things on Friday about myself, my Harping and about my Patient.  As I was unpacking my Harp in this room with 2 Residents, I realized I didn't have much room for my Case, Harp Cart and enough room to put together my Harp Stand and Chair.  Next time, I will go to the Nurse's Station and ask if there is an area I could unpack and leave my Harp Gear while I am playing.  Even though it was "tight", I managed to get set up.  My Patient's Roommate is very sick from Cancer and my Friend told me she is in pain most of the time and can't sleep.

My Patient was in a Wheelchair next to her Bed and her Husband was sitting in the Chair with my friend sitting on the bed.  My Patient is Blind and cannot speak, so I went to her and rubbed her arm and told her I was ready to Play the Harp for her...her Roommate was resting, but I knew the Harp Music would be soothing so I didn't tell her I was going to play.

I started playing in the key of F...that is my Resonate Tone...the Tone that makes me feel good inside, especially when I am playing the Harp.  I played slowly and watched my Patient as I played.  She was listening...I could see it in her body language.  She was no longer moving her head in a restless manner, but had rested her head back and I watched her eyes dart about when I played "Somewhere Over the Rainbow".....my friend asked if she wanted me to keep playing...squeeze once for no...twice for yes...it was a double squeeze!  When I played "Jesus Loves Me" and transitioned into "Amazing Grace" her right foot was moving with the Music.  Her entire body was relaxed and there was a Peaceful Aura in the Room.

Her Roommate woke up, looked around and I introduced myself to her....she said she loved the music and went into a deep peaceful sleep, one that my Friend had not seen her enjoy for a very long time....relief from Pain.  oh, and my Patient's Husband....yep, he's dozing in his Chair!!

I played for about an hour...moving from the Key of F, to C to G, to D....some familiar tunes and some Celtic and less familiar music.  When I was ready to leave, I told her I would come back and her eyes were darting around and she was trying to speak.  I asked her if she wanted me to play "Over the Rainbow" one more time.....so I did.

When my friend was leaving she told her Mom that she loved her.... her Mom mouthed the words "I Love You" with her breath...which she had not done in a very long time.  I left there with such Peace.  Whatever force has put me on this path, is a strong one.  There is no doubt that I am walking on the right Path......

Saturday, July 6, 2013

Another Foot in the Door

I haven't written in my Blog for about 2 weeks....Summer Family events took precedence, but now I have a few extra minutes and thought I would update the latest Harp info....

Last weekend I got an email from Howard, the Director at Sunrise Senior Living.  I had played my Harp there for Gommie several weeks before and then I followed up with an Email, asking if Sunrise would like to have me come once a week to play for the Residents...a Paid Position.  I hadn't heard anything for weeks, despite my attempts to contact him.  So it was a wonderful surprise to hear from him and even more surprising to hear he wanted me 3 Days a week!  He thought my Fees were too low, but I am feeling we can always address a raise in fees down the road.  To me, the important thing is to get that other foot in the door........

So if the "other" foot is in the door...what door is the first foot in you might ask?  From everything I've read in the Therapeutic Music World, the most difficult part of the Certification is looking for employment afterwards.  It is difficult to even find a Hospital or Facility willing to host you for your Internship Hours.  I read about Certified Clinical Therapy Musicians pounding on doors of Hospitals, Hospice and Assisted Living Facilities, trying to educate the Staff on the benefits of Therapeutic Music.  Not only is the Course Work a huge time commitment, but as in any Course the cost is big...so what a downer if you can't find a place to give your Service.

I am so fortunate to be volunteering at AAMC a couple days a week and for AAMC to already have a Therapeutic Music Program in place.  Not only do I have a place to do my extensive Internship Hours, but an offer of Employment when I complete the Certification.  There is the location of my first foot....