Hospice care is rarely associated with song and dance, unless the songs happen to be dirges or solemn hymns. But a new hospice-centered documentary, Seven Songs for a Long Life, sings a very different tune.
Indicative of the hits to come, the first song in the film -- "I Left My Heart in San Francisco" -- is crooned by a dapper senior named Tosh. Charming and flirtatious, Tosh carries himself like a polished entertainer, belying the fact that he has little time to live.
The film provides a heart-rending overview of everyday life at Strathcarron: getting false eyelashes to replace those that have dropped out due to chemotherapy, reviewing a will, inspecting a lock of hair from a long-ago first haircut, glancing at pictures from a youthful wedding and dealing with chronic pain.
As anyone coping with illness quickly discovers, support makes all the difference. Doctors and other staff at Strathcarron have been recognized for their exceptional abilities. This innovative hospice center offers day care that allows patients to continue to live at home. Staff work out complex schedules with hospitals, doctors and nurses to meet patients' treatment and social needs, and the emphasis is on making life worth living, even in the grip of a lethal disease. As Mandy, the head nurse, says, "When people come to me and say they are dying, to me they are still living." It is that emphasis on living, and living with delight, that may surprise viewers most.
Yet the pleasure and optimism on display don't come easily. A patient named Nicola says it has been six years since she was diagnosed with cancer, and while she values those years, they have also been very hard. "I just can't get on top of this pain," she says, while fellow patient Iain, a former cycling champion who suffers from multiple sclerosis, says his physical pain is accompanied by emotional hardship. "Your friends disappear," he says. "They just don't communicate anymore."
Head nurse Mandy explains that while she and her staff must remember that they "can't fix everything" and "the most important thing is to listen, really listen," the power of music is a key tool in lifting sagging spirits. "Singing really lets you know a person. It's a very social . . . part of the culture. It's one of the last things to deteriorate."
Filmmaker Hardie was surprised by the patients' enthusiasm for music. "I had committed to making a patient-led documentary but had never imagined that what the patients would most want would be to sing!" she says. "As so many of the songs express the growing relationship between staff and patient, patient and patient, a theme emerges: just as it takes a village to raise a child, it takes a community to make the process of facing your own mortality, and of dying itself, safe, individual and as gentle as possible."
Seven Songs for a Long Life is packed with great tunes, from "Wouldn't It Be Loverly" (from My Fair Lady) to rock standards. Tosh croons Frank Sinatra's "Strangers in the Night" as he gets a haircut, much to the delight of his small but enthusiastic audience. Not long after that performance he dies unexpectedly--a reminder of life's fleeting nature. "Each day just gets quicker and quicker," says Julie, a cancer patient. Nicola says, "I always thought I've got forever," and adds that her main concern is creating good memories for her children.
Hardie reports that the patients and caregivers were generous with their time. "I spent three years filming in Strathcarron, listening, watching, taking up time from the patients and the staff. Sometimes there was a sense of urgency--if someone is in pain then each second of pain is a second too long. Sometimes time looped back on itself and we were transported by the songs back into someone's childhood, or their first love, or the moment they lost their spouse."
Hardie also observes, "New advances in medicine have changed this generation's relationship with fatal disease. We can now live for years, rather than months, after a terminal diagnosis. But as scientific and medical treatments have increased in complexity and efficacy, they have not been matched by our emotional willingness to face those choices. Do we want to pursue aggressive treatment that may extend life at the risk of compromising the day-to-day quality of that life? Hospices in the UK carry on offering every range of treatment once patients are in hospice care. Although many of us say we want to die with dignity, and at home, very few of us do. That's mainly because we are too scared to face the choices in advance. Dealing with this increased uncertainty is difficult for patients and relatives, medical and nursing staff. As head nurse Mandy says, 'We don't know how long the future will be. It could be quite a long time, it could be a very short time, and that's what brings a lot of uncertainty.' A lot of hospice day care is trying to manage uncertainty."
In the film, while the final curtain looms for some, there is good news for others. Alicia's cancer goes into remission. She responds by planning a cruise. Another patient, Julie, gets married. There is also the hard beauty of resignation. "I'm quite at peace that if I went tomorrow, I'm okay with that," says Julie.
Perhaps the most powerful performance is a duet by Nicola and Mandy of R.E.M.'s "Everybody Hurts," with this searing line: "If you think you've had too much of this life, well, hang on." It is soon followed by a wistfully moving "Dream a Little Dream of Me," a plea not to be forgotten.
"These are extraordinary moments, or maybe they are ordinary moments," says Hardie. "Ordinary everyday heroes. That's as true for the staff as for the patients. It was a privilege to be allowed to 'hang out' for three years." And the film's impact is spreading: Hardie reports that Seven Songs for a Long Life has now been requested by doctors and nurses at 290 medical centers in the UK who want to "prescribe" the film for their patients. "They have discovered that watching the film, particularly in a home family setting, has made patients and their families feel less anxious about their disease," says Hardie.
At Strathcarron, singing unlocks the patients' pasts and guides their futures. Seven Songs for a Long Life illuminates a journey we will all take eventually, and makes a strong case that it is best accompanied by a light heart and a tapping toe.