Opera Superstar Renée Fleming & Experts Reveal How Music Can Make Us Healthier in New Book

240312_Conversations_Fleming_01.mp3

Speaker 1 [00:00:04] Our guest is the editor of a new book, Music and Mind. Harnessing
the Arts for Health and Wellness. And she knows the subject well, as her voice and
performances have brought countless joy and healing to fans around the world. She's
superstar soprano Renée Fleming.

Speaker 2 [00:00:21] Renée Fleming has received the National Medal of Arts. She is the
goodwill ambassador for arts and Health for the World Health Organization, has won five
Grammys and is a Kennedy Center Honors awardee. And this is Conversations on Health
Care.

Speaker 1 [00:00:41] In a Fleming. What an honor to have you on our show. And welcome
to Conversations on Health Care.

Speaker 3 [00:00:48] Thank you, Mark and Margaret, I'm so thrilled to be with you today.

Speaker 1 [00:00:52] Boy, the book is such an incredible contribution to the arts and
science. I had to have a notepad on the side because there was so much wonderful,
factoids. So. But before we get into the book, let's start with your own personal connection
to music in the mind. You write about an experience you had when you were attending
Juilliard. And your back went into spasms the day before an important audition. Tell us
how that led to your understanding of anxiety in the body.

Speaker 3 [00:01:23] Well, I also between that and stage fright, I knew there was a mind
body connection because, with stage fright I my symptom was somatic pain. And it took
me a long time to unpack that one, because this was before, people were really looking at
this as a possibility. And, I discovered that my back would go into spasm right before an
important audition when I was incredibly nervous in a high stress situation. And this
continued through, most of my career. I still struggle with it once in a while. And, you know,
the the point is that you really have to understand that we are emotional beings and then
we're thinking beings, but the emotions come first. And in my case, it was really anxiety
about having to perform and having to kind of achieve these yardsticks at every turn,
especially early in my career.

Speaker 2 [00:02:18] Well, on a personal level, you write about NIH researchers who
asked you to take part in a functional MRI experiment. So let me say, thank you for taking
one for the science team. That's generally not anyone's idea of a great time. But it was
important to then. So tell us about the experience and what was learned from the
experience.

Speaker 3 [00:02:38] Well, it was really extraordinary. I spent two hours in the MRI
machine. So this is a functional MRI that is measuring blood oxygen in the brain. And the
activity included speaking, singing and imagining and imagining singing. And my
experiment was the most impactful part of the experiment. So it activated more parts of my
brain than the other two activities. And the scientists were perplexed by this because they
assumed that singing would be the most powerful activity. But what they ultimately
surmised is that because I'm a singer, singing is second nature, whereas imagining singing
took a little bit more effort to tune out the noise of the MRI machine, and to stay focused on
the audition. So I was auditioning for the actual music at the same time. So but it was
fascinating to see, what it looks like in the brain and how many different parts, all really all
parts of the known mapped brain, show signs of experiences with music.

Speaker 1 [00:03:43] Well, that that is quite fascinating. But I also thought was fascinating
is that, Doctor Francis Collins, former director of NIH, wrote the introduction to the book.
What a wonderful introduction. We know him. We've had him on our show before. We
would have loved to been in that, small gathering of you all singing together with the
Supreme Court justice. Tell us about the connection back to NIH.

Speaker 3 [00:04:09] So I met him rather randomly at a dinner party when I first was
coming to DC on a regular basis, and it was a wonderful dinner party because we were
with the justices literally the day after the marriage equality decision. So they they were I
would say there was a little tension between them. This was such a fraught decision. And
we know how close, Anthony Scalia and Ruth Bader Ginsburg were. And they were close
friends. But, and I was seated between them because they're both opera lovers. But it took
a while for people to relax and warm up a little bit. It was a great, great evening. And
Francis Collins is now, I know this to be normal for him. Brought his guitar and we joined
with the trio that was performing and had kind of a sing along with everybody. And one of
the most I would say, I would say symbolic songs was The times they are changing. And I
asked him that night, why are scientists studying music? I and I at that time couldn't
understand why they might be looking at music in the brain. And he said, because we
have a new brain institute and we want to understand more about the brain. And we've
discovered that music in particular is, so impactful. So and I said, well, I just started at the
Kennedy Center as an advisor. What do you think about us providing a platform for
science at the Kennedy Center? Because I think audiences would be fascinated to know,
what's happening when we're experiencing great art. And so this has been and become a
tremendous passion for me to share this, work with the public and really to be an advocate
for the field of arts and health.

Speaker 2 [00:05:47] That is such important work. And as people engaged, in health care,
we really applaud. You're taking it right to that level. But, Renee, as editor of the book, you
made the choice to include authors, who also write about their experience, with or as
health care professionals who actually have begun to prescribe activities that are artistic in
nature based, whether it's music or dance or painting or being out in nature. As Yo-Yo Ma
said so beautifully in his, chapter, in order to achieve improved health outcomes, and in
fact, that these actions can play a big role in dealing with the country's mental health crisis.
Tell us about the Sound Health Initiative, specifically, and the focus of research in that
area.

Speaker 3 [00:06:32] Well, we're talking about social prescribing, which is being done in
the UK. It's being done in several states in the US as well. So there are programs
developing that enable health care to really make, well prescribing, but also to say, you
know, you might you might actually consider, you know, going into a park, you might
consider taking these classes, working with these creative arts therapists. The Sound
Health Network is actually, an organization that was, founded by the NEA. We I kept
complaining that we needed a website. We needed a resource center, that some of the
research was redundant because people didn't know what they were doing. And finally,
the NEA said, Sunil, Iyengar, who's so brilliant, who does all that, who is really head of
research for the NEA, said, okay, let's see what we can do. And, at UCSF now, the Sound
Health Network has become a fabulous resource center for all anything music related and
art, because, the research needs to be compiled. People need to have someplace to go to
see what everyone else is doing, to see what has been learned, and to also gain in
resources to help them also create better versions, of integrating arts in health care. So it's
been incredibly successful, and it's grown tremendously. The entire field has grown

tremendously. And the other organization that is creating a resource center that will launch
this fall is neuro Arts. So the neuro arts blueprint, which is located at, Johns Hopkins and
also in combination with the Aspen Institute, will have a different kind of a global resource
center for everything under the neuro arts umbrella, which includes visual art therapies.
That includes dance. It includes, our our response to nature. It's all about neuro esthetics,
which is how we, as human beings, kind of receive a set of experiences.

Speaker 1 [00:08:32] That's wonderful. I was thinking that, our movement of community
Health center started with, doctor Jack Geiger prescribing food to patients instead of
medicine, and, because that that's what they needed. And now the sort of the coming full
circle of prescribing goes, go sing in your community choir. Might, might be the thing, but
Margaret and I, Renee were reading the book and we were calling each other, trying to
figure out what was the best chapter we loved. I think we both may have, alighted on Yo-
Yo Ma's, chapter there. And. And Margaret said earlier about the imagery here he is in her.
Acadia National Park C with an indigenous, community. And, but he writes so brilliantly
about the wisdom of indigenous cultures, climate change and planetary health. That's a lot
to take on. How does he tie it all together?

Speaker 3 [00:09:25] Well, I'm doing a major project with National Geographic now that's
based on Voice of Nature, the Anthropocene, which is the album I want to Grammy with
last year. And they've created extraordinary films to kind of illustrate why why we should
love the planet and take care of the planet, and also the effect that we as human beings
have had on the planet. That's the Anthropocene part, or here from Canada or the UK, the
Anthropocene. And, so he's looking at something similar and relating it to indigenous
cultures, which who have all along, not only appreciated but respected the earth and, and,
and had to say in the practices that we're, we're great examples of sustainability. So and
by the way, this all plays into music in mind and arts and health because, climate change
is, is wreaking, havoc on our health. We're having pulmonary issues. We're having, all
kinds of depression and anxiety as a result in young people worried about the future. So
this all ties together, and I think Dahlia's chapter is a perfect, it's a perfect example of that.

Speaker 2 [00:10:35] Well, I also loved reading choreographer David Leventhal words
about music and movement and the effort to create dance for Parkinson's disease.
Certainly one of the more common as the population ages, one of the more common,
health conditions and movement disorders. And he writes that as a dancer, he's a
transistor that converted musical energy into movement. Tell us more about that work.

Speaker 3 [00:11:00] Oh, this is such an extraordinary program because it's it's well
established. Covid actually gave them a wonderful opportunity to expand the telehealth.
Whereas he was training 20 teachers, he's now training 800 all over the world at one time.
So, and, and the other good news is that the NIH has now agreed to add dance to their
research, because dance and movement are related, as we know. And certainly for any
movement disorders that would be Parkinson's or, or Ms. or some of the symptoms, even
certain, brain trauma can cause movement disorders. And, this adding rhythm is, is
incredibly impactful. So rhythm and music together can can help us. Now we use ideation
for that as well. And I started to apply it to my own walking and hiking. So I can even carry
on a conversation and hear in my mind's ear when the saints go marching in something
uptempo and to keep up my pace, because otherwise I want to slow down. There are good
health and wellness benefits for some of these techniques as well.

Speaker 1 [00:12:10] Oh that's great. You know, you were talking a little bit about
telehealth and, and, and Covid and how impactful telehealth that, came because of the, of

the pandemic that impacted us. And there have been a lot of changes that have
happened, because of it. But I want to, focus in on some of you wrote nearly half of the US
states allow for limited Medicare and Medicaid arts therapy coverage for certain conditions
and population, but reimbursement is often on a case by case basis. This is also true for
private insurance. Many would like to see greater coverage of creator art therapies. I'm
wondering, how do we overcome the hurdles, that exist in terms of these important
reimbursements? That would help people, access this important, intervention.

Speaker 3 [00:13:01] I'm so glad you asked this, because it starts with licensure around
the country. This is on a state by state basis. And so that's the first step was to license our
creative arts therapists. The training they receive is on a very high level. And and what
we've discovered is that it's it's low cost. It's it's noninvasive and it's non-pharmaceutical.
So it's incredibly beneficial also for health care providers and for, caregivers, we now
understand that they are under tremendous stress as well. But what can happen, I think,
with the licensure is that they can be embedded in health care across the board and be
incredibly supportive because we have the actual, the interventions that are created by
science that work. And this is relatively new. It comes with technology. It comes with our
ability to look at the brain and see what's happening in the body in a more meaningful way.
But it's also about the arts being embedded in health care as a sort of music medicine
way. So I started these investigator grants, that have just launched. They'll be announced
April 1st, the first recipients for this collaboration with, Johns Hopkins and the Aspen
Institute and neuro arts. So it's funding young scientists who have access to a lab. They're
using postdoc, students with an artist in a collaborative effort to create a stronger pipeline.
And this is this is kind of what it will take to be able to integrate arts interventions and
creative arts therapies in our health care system. But it's coming. It's definitely coming.
There's been such an explosion of interest in this work in recent years. Susan Salmon and
Ivy Ross's book Your Brain on Art was a bestseller last year. So that's and Dan Levitan is
coming out with another book in August that, music specifically. And of course, you have
my book, which is the anthology is a perhaps could be thought of as an introduction to arts
and health because it's so broad. It covers so many aspects of it.

Speaker 2 [00:15:10] Well, it certainly touches on, key issues to our, our society, really.
And I'm going to go back again to the, aging population as we spoke about with
Parkinson's. And get your thoughts a little bit on, music and, dementia. And I know the
research suggests that musical memories, from our early, early years are stored in the
brain right up until the later stages of dementia. And that if we can elicit those familiar
musical memories, we can reduce some of the distressing, behaviors and agitation in the
population, certainly helping those individuals as well as those who care for them. So what
are the implications? Should we be writing down, those songs that make us happy, that we
sing all the time, while we're fully aware and keep them handy for later in life for our
caregivers.

Speaker 3 [00:15:59] Absolutely. Because it's all taste based. It's all it's all based, as you
said, on experience. And we our memory, memory and music are so powerfully intertwined
that most of our major life events, if there was music attached to it, when we hear that
song again, we know we're back in our wedding. We're back at to high school graduation
or whatever, whatever major events we had. And sometimes they're their sad ones as
well. So definitely, it is the last memory to go. And patients with dementia and Alzheimer's,
which is so powerful when you think about it, it has something to do with the location in the
brain of that type of memory being not being affected by, certainly Alzheimer's disease
until it's late. Later stages. People can play guitar. Look at Glen Campbell. I don't know if
you saw that documentary. There are there are examples like that. Tony Bennett in his last

concert. I cannot believe he was such a high level. So, what what researchers are trying to
do with that coming to mind is looking at how do we sustain and extend the the
connection, the self that. Kurtz. Oliver Sacks talked eloquently about it when people
listened to music at that point. But for aging also, it's remarkable to me that research is
being done on singing and cardiovascular disease, that the adult all function improves with
just singing a couple of times a week. So there's a great research that is happening. And
this all of course points to evolution. It's because we did not evolve quickly. And arts and
arts, the expression of arts, singing, vocalization, rhythm, drumming, all of these things
have been with us since before the beginning of time and also before speech. So that's
interesting to think about before we even develop language. We had other ways of
communicating and they still work.

Speaker 1 [00:18:00] I was just thinking about my father in law, Robert Alexander, who
just passed away recently in his 90s and had Alzheimer's and the end of his life, but could
probably two weeks before he passed away, get up, play show tunes, you know, do all the
musicals on Broadway. And, it was just gave it reduced his pain, gave him such relief. So,
it's absolutely, it's so important. But, you know, you have a great chapter on music
education and a few MythBusters in there. For instance, the Mozart effect, the idea that
listening to certain types of music, Western classical in particular, can make a child more
intelligent. Didn't seem to work with me. Or at least my wife said it did. But, what does the
research really tell us about the best kind of music to listen to?

Speaker 3 [00:18:54] Well, the Mozart effect was debunked. And having to do with, with
the research that was underpinning that notion. So it's the best kind of music is the music
that's meaningful to you. However, for certain, disorders and certain training, as I said,
rhythm is incredibly important. Rhythm can also sort of, tell us if, a child has learning
disorders at a young stage, difficulty with rhythm. So again, noninvasive, that can give us a
lot of information and very much help with children on the autism spectrum. but I it
definitely has it depends on the intervention that the music therapist is working or a
researcher. Then they will be looking for outcomes that relate to specific types of music.
But in general it's what means the most to us as we as we said earlier.

Speaker 2 [00:19:43] Well, Renee, I wonder if I could, ask you to comment a little bit,
maybe on, I don't know if it's more policy than than political area, but certainly we all are,
no strangers to the budget cuts that happen in educational systems to what should be
included in our schools and not included, in our schools. And yet we can't help but
conclude from reading, all of the incredible chapters, in your book, that to deny children the
opportunity to learn music as well as to express music, to, participate fully in our has
positive mental health and cognitive intellectual development, applications. What's what's
your your sense of where the community of artists that you interact with are, and really
trying to advocate for this kind of support for the next generation to have access to these
experiences artistically and musically.

Speaker 3 [00:20:40] Well, we did take a big step back in the last 20 years and, arts
education in general because of cost. But, I was very close to, public schools in Chicago
and some initiatives that were occurring there to bring arts back into schools. And what
superintendents realized in the city school district was that, you know, the truancy has
been a tremendous problem in some of our cities. And to bring arts back into schools
means the kids have a better reason to stay in school because they're doing something
that really love and they enjoy. It also helps so much with pro-social behavior, with identity,
which is increasingly important when there's so much that they have to contend with and
trauma. And one of the things I learned from the turnaround arts, which is now housed at

the Kennedy Center, is that especially with children who experienced trauma, a visual art
therapy can help them really work through that because they can't verbalize what's
happening or what has happened to them, but they might be able to draw it or to express
it. Writing lyrics so children with cancer can get them to write hip hop lyrics. They will see
how they're feeling and what's happening with them. They'll connect with their family
again. These are initiatives that in a hospital setting can be incredibly useful. I mean, I've
really come to believe that having some kind of creative arts studio, and especially in
children's hospitals, should just be a must. It should be there from the earliest planning
stages. And one of the thing I'd like to mention, I'm working on a project called Art care
that would you would go to your, for instance, your, insurance provider and up there with
all of the health and wellness possibilities, because people understand integrative
medicine now would be, art care and by zip code, you would be able to find all of the
existing programs that wonderful performing arts venues supply for people with children's
children with special needs or caregivers and their family members with Alzheimer's who
are now so often being cared for at home. So things that are needed could be supplied in
that way. Maybe just for for creative eating, just joining a choir, as you said, or learning to
play a new instrument. Yeah. This would be a wonderful way to kind of disseminate the
research and all of the things that we're learning about the benefits of arts and health.

Speaker 2 [00:23:10] From cradle to grave.

Speaker 3 [00:23:12] Yeah.

Speaker 1 [00:23:12] Well, yeah. Thinking about, providing, folks instruments. I think I
heard on the Oscars the other day that the school system in Los Angeles still provides
every child a musical instrument. And, I think that's that's so important, across the board.
This is really for our tech and AI folks who are listening in here, because we're living in this
digital AI revolution that includes the music sector. And I just want to get your take on the
use of Auto-Tune, which alters the pitch, in vocal and instrumental music recordings do
such, I'm wondering if these technologies help or hurt, with the benefit. Of music in the
mind.

Speaker 3 [00:23:56] Well, it's interesting because, well, it's something that's done in post-
production when or also in live performance, it's used in live performance as well. I think
people are so used to the sound now that, one major recording executive in Nashville told
me that people are auditioning and they have learned, young people learn, they they've
learned to mimic the sound of Auto-Tune on the voice, which was quite extraordinary. Just
as, for instance, a lot of young children now mimic the Disney princess sound, you know,
which is something that I heard. It's a it's not just a timbre, but it's also a style of singing.
So I don't think it's had a negative effect at all, because I think whatever it is that the public
follows and loves, it's something that will enrich their lives as long as they're engaged with
music in some way, or with the arts in some way. I'm not terribly particular about what it is.

Speaker 1 [00:24:49] There's no wrong door design.

Speaker 3 [00:24:52] No. Definitely not. And in fact, technology is starting to, really come
up with some of the most innovative uses of this work. For now, there's a b r for for
cognitive decline, mild cognitive decline. I want to play that game. I want to be able to have
that game available to me. There's also VR. This is through neuro scape Adam Gonzalez
neuro escapist VR for ADHD. Now that seems really strange to me that you would play a
game to to learn how to focus, but they built it into the game and I think it's available as an
app now. Yeah.

Speaker 2 [00:25:25] Rene. You have a foundation that's focused on these issues. It
convenes experts from the fields of neuroscience and music therapy and medicine. We're
well familiar with the, application to foundations process. And one measure is always that
you have to show what kind of outcomes you're looking for, either quantitative or
qualitative. What do you see when you're, or when your foundation is considering these
applications? What are the kind of outcomes that you're hoping that people will look to,
measure and see what the impact is?

Speaker 3 [00:25:58] So because the, there are two investigator awards are new and we
have our first grant class really being chosen on April 1st. I'm hoping to see this pipeline be
strengthened not only for, scientists, but for scientists. They have to collaborate with an
artist because I believe firmly that we as artists have a lot, in common with scientific, rigor.
But also, you know, the practice, the creativity of it, the imagination that goes into what we
do. I think science is incredibly creative. You develop a hypothesis or you develop a line of
inquiry that you follow. It's the same for us. Only we have access to centuries of our art
form to kind of mine for these ideas. So pairing them, I think, is a great idea because
artists, we don't know enough not to ask questions, whereas and data scientists would
say, wow, I didn't think of that. Let's follow that track. And then we can also help in the
implementation of the science.

Speaker 1 [00:27:02] We remember seeing you last year, as we brought our audience to
Aspen Ideas, health, which is, a gathering of visionary health leaders and innovators. So
we're all big fans of Aspen, but, getting to places like Aspen or the Kennedy Center can be
expensive. So maybe share with our audience what are the best tips for bringing
mindfulness and music into our lives wherever we're located?

Speaker 3 [00:27:29] Well, I have to tell you, I started doing this for myself. I am a living
example of the power of the arts. Because I was getting very, anxious about the coming
year, the election, about what's happening in the world. If you and if you start paying too
much attention to your news feed, you're going to get very concerned. So I thought, I'm
going to step away from it. I'm not doing opinion news anymore. I am just looking at the
actual news network news once a day. And I am enjoying reading, being out in nature,
going to plays in museums again wherever I travel. And it's incredibly fulfilling finding
things that I love color, expressions of sound and color, for instance. So it's all out there.
We have to just choose to spend time and not feel guilty about spending time doing it.
Because, some of us have a tendency to want to work all day, but, like me. But I've
discovered that. No, I'm a much. I'm leading a much more balanced life. If I allow myself to
have the cultural experiences that I am touting and it's working.

Speaker 2 [00:28:41] Well, that is great. And Renee, thank you so much. Your book is
Music in Mind Harnessing the Arts for Health and Wellness. It's published by Penguin
Random House. Thanks to our audience for being here, and please be sure to subscribe
to our videos on YouTube. Find us on Facebook and X with our account name CHC radio.
As always, go online to City Radio.com to sign up for email updates and please share your
thoughts and comments about this program with us. Renée Fleming, thank you so much
for your contributions to the quality of all of our lives, and for joining us today on
Conversations on Health Care.

Speaker 3 [00:29:18] Thank you so much, Margaret. And thank you, Mark.

Speaker 2 [00:29:24] This copyrighted program is produced by Conversations on
Healthcare and cannot be reproduced or retransmitted in whole or in part, without the
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