The Power of Song

Tori Hartshorn is about to take her son, Eliott, home from the Neonatal Intensive Care Unit (NICU) at Lucile Packard Children’s Hospital Stanford. Eliott was born with vocal cord paralysis and extra tissue in his throat (laryngomalacia). These conditions have required 10 surgeries so far. “But now he’s doing excellent, and he’s the biggest one in the NICU,” says Tori.

Tori credits the Packard Children’s NICU team with making her experience at her son’s bedside for the past three months a positive one. She grew so close to the NICU team that she took pictures of Eliott’s primary care team—nurses, nurse practitioners, doctors, ENTs, respiratory therapists—each holding Eliott. She printed them and taped them on the wall spelling out different words, starting with “Thank You” and “Eliott.” Tori encouraged each member of the staff to take home his or her photo, which had a personal note of gratitude from her on the back. As the pictures dwindled, Tori rearranged them to spell out “LCPH,” “Love,” and “Faith.”

One picture stands out as particularly meaningful to her—it’s a photo of Cassi Crouse, a neonatal intensive care music therapist, with Eliott. Tori and Cassi met when Cassi came into the NICU and saw that Eliott was unsettled. Cassi asked if she could sing to Eliott, and when Tori said yes, Cassi started humming. “Eliott’s heart rate went way down and he fell right asleep—it was phenomenal,” says Tori.

A therapeutic approach

In the NICU, babies hear near-constant noise from medical equipment, alarms, and other babies crying. “Music therapy is helpful in any room, but especially in the NICU, where it masks ambient noise and provides a positive auditory sensory experience for babies,” says Cassi. She often sings lullabies, since they mimic the natural rise and fall of speech, and the words are repetitive, which promotes infants’ neurological development. “Babies recognize their mom’s voice, so I encourage mothers to do similar things, and I model how they can use music at the bedside,” says Cassi.

Whenever Cassi visited Eliott to softly sing or hum to him, her voice had the same relaxing effect. During one session, Cassi asked Tori if she’d like to co-write a song about Eliott. Therapeutic songwriting for families and patients is one of the interventions that the music therapists offer. “We recognize that families go through a lot, and lullaby writing is a great way to provide a safe space for parents to share what they’re going through and tell their story in a focused, beautiful way,” says Cassi. “It provides a way for families to express themselves and creates a way to give them some control over their environment.”

One song ends, another begins

Tori enthusiastically agreed, and Cassi helped her create lyrics set to the Bob Marley song “Three Little Birds.” The song expresses her love and hopes for her baby and describes some of Eliott’s attributes. It became Eliott’s theme song. When Cassi visited, she’d sing it to him. And then Cassi and Tori recorded it, with Cassi singing. As she usually does, Cassi sent the audio file to the family so that they could keep it as a milestone marker. Tori paired the recording with a slideshow of Eliott and shared it with her family. “It gave them a little piece of what Eliott’s experience has been like, since they haven’t been able to visit in person because of Covid,” says Tori.

The song is now bittersweet. Eliott had stridor as a result of his blocked airway. Tori affectionately called the resulting sound that Eliott made his “squeak” and commemorated it in the song she wrote. But after Elliot had surgery to get a tracheostomy, he no longer made vocal sounds. “Now the song is a stamp in time,” she says.

Cassi helped Tori write a second song, this one called “How Far You’ll Go,” inspired by a Moana song. The song highlights how far Eliott has come and what Tori wishes for him now that he’s a few months older: to experience nature, see the ocean and trees, feel the breeze. They recorded it, and this time Tori sang it together with Cassi.

Before meeting Cassi, Tori hadn’t really considered the importance of singing to her baby, and she appreciates how Cassi encouraged her to sing as a way to bond and interact with Eliott. “These babies have a lot of pain and suffering and are in an unfamiliar place, and it benefits every one of them to hear an amazing singer—and to have her explain how beneficial it is to hear someone sing,” says Tori. She plans to start on the car ride home. “We’ll be blasting ‘How Far You’ll Go,’” she says. “We’ll play that to him forever.”