Michael Rossato-Bennett (L) and Dan Cohen.
Alive Inside:A Story of Music & Memory fits my category Movies That Should Play in Sag Harbor. This Friday it opens nationally, as it begins its second week in NYC. Director Michael Rossato-Bennett literally ran to the post office before its midnight closing in order to submit it in time to the 2014 Sundance Film Festival. At Sundance his film won the Documentary Audience Award and it’s easy to see why. From the opening scene–equipped with an iPod and earphones, long-time nursing home resident Henry, who suffers from dementia, sits up in his wheelchair for the first time in years and starts cheerfully singing along to the Cab Calloway song–Alive Inside is extraordinarily uplifting. Watching people return to the land of the living through music is an extremelyemotional experience. For several years that has been the experience of social worker Dan Cohen, the founder of the nonprofit Music & Memory, who is on a crusade to bring iPods with personalized music into the lives of the elderly and infirm in nursing homes around the country. Rossato-Bennett has spent three years on Cohen’s trail, sharing the joy of seeing how music benefits people who were given up as lost and the frustration of trying to convince nursing homes to replace medication with music. Last week I did the following interview with Rossato-Bennett and Cohen, hoping to spread the word…no, the music.
Danny Peary: This idea of playing personalized music to Alzheimer’s patients is one of those things like suitcases with wheels. It’s self-evident that it would have a positive effect. What took us so long to think of it?
Dan Cohen: That’s exactly right. There’s nothing new here except a central twist of innovation. We all had the music but nobody thought of giving the technology to our elders. Oh, it’s technology, so they don’t want it. So my thing has always been, “What kind of music do you like?” Tell us and we’ll provide the technology to give it to you.
DP: When did you come up with the concept of playing “personalized music?”
DC: In 2006. We all heard journalists talking about how iPods were ubiquitous–kids have them, adults have them. But in a nursing home? Would I have access to my favorite music there? So I googled “iPods in nursing homes” and found there were 16,000 nursing homes in America and none were using iPods. Nursing homes are kind of in digital isolation. So I had to get the music to people who are compromised. I come from a technology background and am always making up new applications for people or leveraging technology, so this was natural for me.
DP: We always think of technology as being dehumanizing, but what’s interesting about you, Dan, is that you have a history of showing the connection between technology and humanity. That’s pretty much your personal theme.
DC: The Internet, YouTube, all of that is humanizing, really. It makes possible something that had never been possible before. We’d never had any of this without technology.
Michael Rossato-Bennett: On that point, there were so many comments that were made online about the Henry video we posted on the Music & Memory website [in hopes of raising additional funding]. “This is what the Internet is for! This is the most beautiful thing I’ve ever seen on the Internet.” There was a hunger in people to have this kind of deep human experience when using the Internet.
DP: Dan, how was it being the subject of a movie for three years?
DC: Well, at first I was very nervous being in front of the camera.
Henry is featured on the poster
MR-B: Now you’re not.
DC: No, I got used to it.
DP: Michael, I don’t know your background in terms of music. Was it something important to you, so that you understood Dan’s mission?
MR-B: I actually had a childhood that was so traumatic that I shut down in a lot of ways. I shut down so much that as a young person I couldn’t do rhythm. Other people could do rhythm but I couldn’t get it. What happened was that I was trying to protect myself, I was trying to insulate myself. It’s what happens when people are traumatized, and it’s what happens to a lot of people who are in nursing homes. So that’s why I really have an affinity for this story, because it took me years and years before I could really take music in, before I could really do rhythm.
DP: When was the breakthrough for you?
MR-B: It wasn’t until my late twenties. I didn’t get married until my late thirties because I don’t think I was capable of it. But now I have grown and healed my own self, just as Samite [from Musicians for World Harmony] heals those people in Africa in the movie by bringing their deepest memory, music, into an environment that took away all their humanity. I could identify with this, and honestly I really feel like all of us can because there is a degree of institutionalization in all of our lives. When humans are treated like objects, like things, they do not respond well, they shut down, they go into trauma. How do we take a being out of trauma? How do we do it naturally? We cry, we laugh. That takes us from one state to another, just like Samite does in the movie. Music is an ancient tradition for changing human states and doing it communally.
DP: Oliver Sacks says in your movie that “Music is inseparable from emotion.”
MR-B: Dr. Sacks says there is no music part of the brain. There’s a hearing part and a seeing part and a memory part, but there’s no music part. So over tens of thousands of years, we decided that we would make music in our own brains. A primate will not respond to music, but an infant in the fetus will respond to music. So music is sort of a primal human experience. People in nursing homes left their music behind, so that’s why the effect is so profound when they hear it again.
DC: What I’ve always thought of is a way to integrate it into the life flow of a facility. There are places that have 250 iPods and they’re doing fine. So you have 250 people who now that have this freedom of self. Their day is totally transformed because they’re having a good time and not just sitting there and watching the clock.
MR-B: If I gave you your music, you would not respond in the way that some of these elders respond.
DP: True, but my favorite song is from 1959, and when I’m surprised by it coming on the radio without being introduced, I get a chill and go back to being ten-years-old old. That’s what they experience, right?
MR-B: Exactly, exactly.
DP: The movie illustrates that music creates spontaneity in an environment where everything is about conformity. So there’s a conflict. The institutions that want to maintain control of elderly patients don’t necessarily welcome spontaneity.
DC: Institutional change is slow, right? Even young people who work in a nursing home get it–iPods, iTunes, what’s the big deal? And they roll it out to half a dozen people there, and then they’re told, “No, you can’t go any further. You can do this, but don’t bother anybody else. We have enough problems with hearing aids getting lost, and dentures getting lost, now we got iPods–forget it! Don’t do that, our staff has no time to put them on and take them off.” MR-B: Think about it like drugging. Basically, when you have so many people in an institution and one person starts acting out, like the guy in the movie who was screaming a lot, it can ruin the experience for everyone else. So they drug those people very quickly–and we have a tremendous problem with over-medication in these institutions. Music is one of the few things that can reduce that.
DP: In the movie you talk about how the elderly in nursing homes are terribly overmedicated. Is music supposed to replace the medication?
MR-B: I’ll tell you the biggest idea that I had while sitting in my bedroom and editing this film. I realized that you have this massive population of people that are beginning to show signs of dementia. When a person’s at home and starts acting out, that is the moment when caregivers say, I can’t handle this anymore. In a family, it’s so incredibly hard to deal with a family member who has dementia. You almost have to trade your life for their life. That’s not the way it used to be. When I was a kid, there was a woman with dementia living next door, and her seven daughters took care of her. It didn’t ruin any one person’s life. We can’t do what we’re doing because we’ll run out of money to put everybody in nursing homes. We barely have the money today to put everybody with dementia into nursing homes. What happens is that they’re overcrowded so if anybody acts out the first thing they do is sedate them They use these anti-psychotics or anti-depressants, and they sedate these people and their personalities disappear as well. All drugs poison one of the systems in the body. Personalized music is amazing–and I’ve seen it over and over again–in that it can give a moment of peace to both the caregiver and the person who’s suffering. Especially people with Alzheimer’s. They have this kind of dissonance, where the world becomes overwhelming–there’s just too much data coming in and they can’t filter it out–so when they put headphones on, half the world that they have to deal with disappears. The way our brains interact through music is that it wakes us up. So over the next ten or twenty years, if we can use music to keep people at home three months longer before they need institutionalization, we’ll save hundreds of billions of dollars. It’s inevitable. They did a study here in New York, and where personalized music was used, the use of anti-psychotics in the facility went down from 13% to 38% over eighteen months. If there were a drug that had that efficacy, it would be the biggest blockbuster drug in the world. Most of the drugs right now for Alzheimer’s are in demand although people don’t believe they’ll work. They just want something. There is no drug that does anything, but fortunately there’s lot happening in science right now.
DP: I ask this is a complimentary way: Is your film dated already? I know many new nursing homes have taken your advice about bringing in iPods.
DC: We don’t know yet how things will change exactly, because the movie’s really current. Michael’s been really improving it, working on it.
DP: Well, at the beginning of the movie there were very few nursing homes using music.
DC: And now there are 640. So we’re getting there, but that’s still only one percent, so only one out of one hundred people in the US has access to music. At this time 99% are sitting there being left in the hallway, wheelchair to wheelchair. And nobody’s really giving them anything to stimulate them. Give them an audio book. They were teachers? Put iTunes University in their headphones, they’ll love it. They’ll have something to talk about.
DP: So the music is part of a multi-pronged approach to bettering their lives?
DC: The music is kind of a low-hanging fruit; once a facility has iTunes set up, they now have a whole media center. Now they can have audio books, e-books, apps. There are many apps that specifically say Alzheimer’s and there are apps that don’t say it but they’re perfect–they’re for fitness, relaxation, a whole bunch of things. So yeah, our goal is to bring the tablets in. I recommend that every nursing home has three iPads–and I’ve been getting them out there and getting good feedback.
DP: And the goal is to have all this be part of insurance plans, right?
DC: Well, that would be great. To support it that way. Managed care.
MR-B: We have a lot of feelers out there, but I don’t think this film will be outdated for twenty years. And I’ll tell you why. First of all, it’s about some of the most elemental fears we have. Death. Decline. Aging. These are things that culturally we do not address. At its heart this film is about connection–the power of music to connect you to your past. Music and all the arts are an antidote to isolation present in sterile institutions. We have a massive transition period here, and it’s not going to be one year or ten years. It’s going to take us a tremendous amount of effort to figure out how we as a culture deal with aging.
DP: What would personalized music be for you?
DC: The Beach Boys, Led Zeppelin, James Taylor, the Beatles, sixties stuff, late fifties music when I was eight-years-old.
MR-B: I like Bach, Pavarotti.
DP: What about classical music? For fans of classical music, can you put on anything or does it have to be specific?
DC: Everybody’s different with classical music. If you want somebody to really enjoy it, you must go with what they like. Their top ten favorites, it depends. I’m really picky when it comes to classical music, but if it’s a dementia issue, it could work to play not something specific but perhaps violin concertos, which they’d just enjoy no matter what they played.
MR-B: While making the film we met a woman named Barbara. Her mother was a very sophisticated woman who always loved classical music. When she started having dementia, Barbara put together a whole iPod of classical music for her. But when her mother listened to the music nothing happened. Barbara kept replacing the classical music with other classical music. But her mother didn’t respond to it. One day, she put on Ray Charles singing “Come Rain or Come Shine,” which was the song her husband used to play for her. And her mom had a huge emotional reaction. So Barbara changed the iPod list from classical to Ray Charles and all the music that her mother and father had listened to together. I get chills just telling this story, because it touches something so profound in these people. She literally wasn’t responding to classical music at all.
DP: You don’t talk about religious music in the movie, but is there something even more stimulating about religious music?
DC: I’ve had a chance through Alzheimer’s groups to speak to a hundred and fifty chaplains and members. They love this because what’s more core to your youth than religious music. Religious music was with your family when you were five-years-old, and then you take it with you through life. For some people that could be one of the genres of music that is everything to someone.
MR-B: And it is often. We’ve met a lot of people, and all they listen to are hymns.
DC: The challenge is to find whatever music is for a person.
DP: Your whole thing is about personalized music. So when people with guitars and other instruments come into these institutions and perform random music, is there a positive effect on the people listening.
DC: If somebody’s good and comes in and plays the old tunes, yes. There’s interaction and that’s a positive because no one’s visiting these people. More than half these people never ever get a visitor. And studies show that if nobody’s visiting you and you’re idle, it’s a recipe for decline. If you’re not getting visitors and you’re not doing anything, that’s a toxic combination. The live musicians are usually there an hour a week. They tell me their secret guilt is that they get the people going with the music and the rhythm but when they leave the people go back to slumping in their chairs.
DP: So the solution is that you have to leave music with the people, on iPods.
DC: Well, to me it’s not either/or. The more live music people coming into their lives, the better, but also give them their own music. We don’t only want to hear music on the radio, we want to hear it in a concert. I saw the Beach Boys last weekend and it was great. I’d never seen them in concert ever! And the Rascals and the Lovin’ Spoonful, it was just great fun. And with good headphones–we provide inexpensive but good headphones–it’s like being front and center in the orchestra, for these people.
DP: There’s a line in the movie about how painful it is to believe that once you are old no one needs what you have to give. Seeing people like Denise, who is bi-polar, we realize they have a lot to give.
MR-B: They do! What I want people to understand is that it took me as a filmmaker a year before I really fully understood what was actually alive in these Alzheimer’s patients. It took a lot of time considering what is the wisdom that an elder has for a younger person. It’s a very subtle transference between the old and the young, and I feel sorry for those elders who don’t get the chance to give what they can to the young and I feel sorry for children who don’t get the chance to know elders.
DP: Was this a hard film to make?
MR-B: It was a very hard film to make. I cut it three or four times.
DP: In terms of editing, I would think that it was really hard for you to make the decisions to veer off briefly from seeing the elderly respond to music to girls in Africa who had been raped and a man who has MS. Was including their responses to music a tough decision?
MR-B: You know, it was a very gut-level decision. A lot of people have asked me Why is that MS patient in there? It was just my gut. Steve is in an absolutely incomprehensible situation, being in a place where you can do nothing but listen and talk. For eight years nobody thought to bring him music. Now we see music open up his life. I can’t illustrate it any better. And the reason Samite is in my film playing music for the girls in Africa is because he understands how music can literally melt trauma. Melt the frozen soul. That’s what we experienced hundreds of times. In a nursing home, you see some living dead people. How do you wake those people? Even to think that it can be done…
DP: Michael, did you ever say, “How do I get this and this?” Or was it mostly, let’s see what happens when we turn on the camera?
MR-B: Sometimes we tried to make some points, I guess, and other times we just said, let’s see what happens.
DP: I loved the opening with Henry, but one of my favorite moments that you got on film, probably with no planning, is of the seemingly comatose woman who is lying on her side in bed. When music plays in her ears, her feet move wildly in rhythm.
DC: People usually first see from a distance and laugh because they don’t really know what’s going on. Maybe it’s nervous laughter. Then when they see her in close-up, they become quiet, because it’s like holy mackerel! There was really very little going on with her, and suddenly she’s going to the music!
DP: Talk about when Denise touches Samite’s face.
MR-B: Incredible! Better yet, his nose! Denise, this white woman, is squeezing the nostrils of this African man because she finds his larger nostrils interesting or whatever. There’s such a beautiful innocence to that moment. I’m really proud that there’s no concept of race in this film. It transcends race.
DP: How is Denise now?
MR-B: She’s still around, She breaks my heart. Imagine your life without a daughter, imagine your life without your work, imagine your life without your husband. All of these things this woman never had a chance to experience, really. That makes me sad.
DP: In the film, she ends up with more than she had. She gets her mental faculties back to a certain degree. She’s younger than a lot of the others, so she has time ahead so we hope if she gets it together.
MR-B: She’s a fighter.
DP: I want to point out that Regina Scully was one of your producers. She has great credentials including being executive producer of Invisible War, about the epidemic of rapes in the military.
MR-B: Yeah she’s a great human being. It’s interesting that our connection is that she too recognizes how traumatized all of us are living in this commercial culture where our connections are diminished. She’s very interested in supporting anything that creates some sort of connection between humans.
DP: In the press notes, you say your life has been transformed from making this picture in ways you didn’t expect. I would think it’s such an emotional topic that you knew you were getting into something that would take a toll or reward you.
MR-B: Once in a lifetime, if you’re lucky, you get to be useful to the world. The other day there were a hundred and fifty people in this room to celebrate my fiftieth birthday, and they all said I changed their lives in some way. Just by being a good person and a good dad and a good friend. I’ve helped people who’ve had emotional problems, who are my friends, just by being a nice guy. I could see my life stretching out in front of me and I could start to see the end, and I’m like, whoa, if I keep on doing this, what am I going to end up doing for anybody? So here was my dream: on my sixtieth birthday, there will be a thousand people who can say I’ve changed their lives. I’m going to attempt that, I don’t know how, but I’m going to make that happen. I certainly didn’t think it was going to happen through this movie, I was just working. But in hindsight I chose to do for good, not for self-aggrandizement or profit or anything. I had an opportunity to be useful to the world and I never ever expected that.
DP: How do you hope your film helps people?
MR-B: I would like Alive Inside to help people see that there is real hope inside of us. Music is a path we can follow to love and aliveness, and I think we’ve forgotten that. I think we can make some real progress in the world if we have things that we can trust. There are few things we can trust–we can’t trust religion, we can’t trust philosophy, we can’t trust governments, we can’t trust our countries. However, three things that are still phenomenally trustworthy are music, love, and connection. They are really what this film’s about.