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IDEAS

Lullabies for the dying

A group of singing last responders help usher the critically ill from this life into the next.

Members of Threshold Choir in Concord, Mass., sang at the bedside of a dying patient in 2019. Left to right, Richard Friday, Patty Fraser, and Fran Hunt.Suzanne Kreiter/Globe staff

The story starts with Kate Munger, who in 1990 sat at the bedside of a close friend dying of AIDS. Seeing his agitation, she did what she knew best as a trained musician: She sang. Her friend immediately calmed, and Munger ended up singing to him for two and a half hours. The idea for Threshold Choir was born.

Munger began Threshold Choir in 2000 with two chapters in Northern California. Interest in the organization exploded. By the time she retired as executive director of the choir in 2017, there were nearly 200 chapters all over the world singing at the bedsides of terminally ill patients.

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Local chapters write their own songs, which take on themes like peace, grace, and letting go. “Familiar songs anchor people to this world and life; unknown songs help them to let go,” Munger says.

Groups of three or four sing bedside for 20 to 30 minutes. The gentle, repetitive songs are mesmerizing, says David Grube, a retired physician who is on Threshold Choir’s board of directors.

Peaceful music at the end of life is palliative: It lowers blood pressure, lessens pain, slows pulse, and decreases muscle tension and anxiety — all with zero side effects. “You can notice the physiological benefits happening,” Grube says. “A person who is grimacing or upset becomes very relieved.”

Heidi Dressler, Threshold Choir’s executive director, says the music can soothe the frayed nerves and worried hearts of the caregivers, too. “Everyone is in the exact same energy field, and it’s a remarkable thing,” she says.

Katharine Kirner has been a singer with Threshold Choir for 11 years and credits the organization with completely changing her life. “Working with the dying is one of the luckiest things I’ve ever done,” Kirner says. “The veils are gone — there’s nothing but human connection.”

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Singers have witnessed incredible moments, like nonresponsive patients suddenly waking up. “There’s a connection with music that touches every part of the brain,” Dressler says.

While the pandemic has made their work more challenging — singing creates aerosols, which are the main way of spreading COVID-19 — they have found ways to adapt and continue their work as vital last responders.

In 2020, the organization managed over 6,000 bedside sings, mostly by telephone and Zoom, in comparison with the 10,000 they conducted in 2019. One workaround had three choir members with masks and face shields singing in a New Jersey conference room, speakers broadcasting the music through the PA system.

According to Munger, there is a relationship between song and death: Both are weightless, colorless, evanescent, and deeply spiritual. “Song is a stepping stone to what lies beyond,” Munger says.

Dressler compares the group’s songs to lullabies: sweet, simple, comforting. They echo the cycle of life — as we age, we become more like babies, returning to the void from which we came.

Julie Zigoris is a writer based in San Francisco.