Ray Hart’s vocabulary consisted of just one word after his August 2022 stroke.

“Yep” was all he could say, said Pamela Jenkins, his caregiver and partner of 24 years.

Like many survivors, Hart, 62, can understand what’s said to him almost as well as he could before the stroke, but it’s still hard for him to form complete sentences.

Now, though, a year after adding music therapy to his rehabilitation schedule, he can sing them.

“I’ve got sunshine on a cloudy day,” he sang during a recent session at Sentara Fort Norfolk Plaza, relief and pride glowing on his face as the pent-up words escaped. “What can make me feel this way? My girl!”

Jenkins urged medical professionals to consider including music therapy in their rehabilitation recommendations as a panelist in Friday’s Stroke Symposium hosted by Sentara in Williamsburg.

“That therapy, we have found, has helped him more than anything else,” she said.

Hart sees Tracy Bowdish, the only music therapist Sentara employs. Bowdish had worked with a task force to help pass music therapy licensure legislation in Virginia in 2020.

Despite its effectiveness for stroke survivors, Parkinson’s and Alzheimer’s patients and others with various types of cognitive deficit, music therapy is generally not covered by insurance, Bowdish said.

To make it accessible, Sentara takes a loss on the program and charges patients a $40 fee for each session. That amount hasn’t increased in Bowdish’s 12 years with the hospital system.

“I’m inherently skeptical by nature, so I know people look at music therapy and think it looks all fluffy,” Bowdish said.

But neurologic music therapy engages various parts of the brain, involving emotion, rhythm, memory and language, she said. When functional magnetic resonance imaging emerged, she added, practitioners thought they’d be able to find where music lives in the brain. It turned out, though, that unlike speech, which is controlled from the brain’s left hemisphere, music shows up all over the place.

“We use more of our brain when we sing than we do when we speak,” she said.

Music therapist Tracy Bowdish works with stroke survivor Ray Hart, 62, and his partner Pamela Jenkins during a session at Sentara Fort Norfolk Plaza in Norfolk on Thursday, May 16, 2024. (Kendall Warner / The Virginian-Pilot)

Dr. Alexander Grunsfeld, Sentara’s medical director for neuroscience and the director of Friday’s conference, said the power of music has always fascinated him.

“Everything else that moves you as a human being, you can correlate that with some value for survival,” Grunsfeld said. From love to fear, there’s a clear relationship, he said, but music doesn’t seem to have the same obvious correlation.

“I’ve always been really curious about that,” he said. “Why is music so powerful?”

Related Articles

10 questions and answers about drinking and alcohol use in older adults

Presidential election could decide fate of extra Obamacare subsidies

Safety-net health clinics cut services and staff amid Medicaid ‘unwinding’

Wins at the ballot box for abortion rights still mean court battles for access

Push for defibrillators in schools becomes personal

The neurologic reasons music therapy helps after a stroke are a bit easier to understand, he said. A stroke is caused by an interruption of blood flow to the brain, usually triggered by a blood clot. Those clots, in turn, are often caused by damaged blood vessels, Grunsfeld said, adding that significant increases in stroke rates over the past several decades are associated with metabolic syndrome in a Western diet and sedentary lifestyles.

“It’s very difficult to change lifestyle,” he said. “But for people who really don’t want to have a stroke, the best option for them is to eat healthy and to engage in physical activity.”

Since clots usually occur in a limited area, they also cut off blood flow to the brain in a limited area.

“The brain is unlike any other organ in that it cannot last for more than a few minutes without oxygen,” Grunsfeld said. “If the blood was interrupted long enough, the neuron cells will die, and then that part of the brain will no longer be able to function normally.”

Recovery or improvement after a stroke typically depends on other neurons growing new connections to take over the functions of the brain cells that died, he said, but overall understanding of recovery has changed dramatically over the past decade — especially the assumption that recovery is only possible for the first six months after a stroke.

“What we found out is that is not true, and it was a bit of a self-fulfilling prophecy,” Grunsfeld said. “People should know that if anyone tells them that ‘you’re just never going to get better than this,’ that isn’t accurate.”

“The more you use your brain, even as you get older and even after a stroke, your brain has the ability to adapt and to improve,” he said. “And so I would say that recovery or improvement is possible at any stage. You just have to do the hard work.”

Music therapist Tracy Bowdish works with stroke survivor Ray Hart, 62, and his partner Pamela Jenkins during a session at Sentara Fort Norfolk Plaza in Norfolk on May 16. (Kendall Warner / The Virginian-Pilot)

Music therapy can make that work a little less hard, Grunsfeld and Bowdish both said, simply because it’s fun.

“Obviously, we know what we should do,” Bowdish said. “We know we should exercise more. We know we should put down the cigarettes. We know we should do things, but that doesn’t mean we do them.”

The same is true for therapy, she said, which requires both efficacy, meaning the therapy really works, and compliance, meaning the patient actually completes it. It’s hard for someone to keep a frown on their face and sing along glumly with their favorite songs, she said.

Bowdish, who has been completely blind since birth, said the occasional patronizing attitudes she encounters have affected how she treats her patients.

“I don’t ever want to be condescending or have low expectations for people,” she said. “Just because somebody had a stroke, that doesn’t automatically define who they are now.”

“Yeah!” Hart interjected emphatically, paying close attention to Bowdish’s passionate comments.

“Yeah, say it!” Bowdish responded, laughing. “That’s just one day that one thing happened. It definitely changes the rest of your life, but it’s not necessarily a major part of somebody’s identity unless they choose for it to be.”

The signs and symptoms of a stroke, from the Virginia Department of Health.

Have a health care or science story, question or concern? Contact Katrina Dix, 757-222-5155, katrina.dix@virginiamedia.com.

Related Articles

Prince collaborator Sheila E. says she’s ‘heartbroken’ at being turned away from Paisley Park

Concert review: Who is this Noah Kahan and how did he sell out two nights at Xcel Energy Center?

What to stream: Go behind the music with these new documentaries

What’s up with the canceled tours and slow ticket sales for arena concerts?

Ringo Starr talks candidly: ‘I’m giving away all the secrets here!’

By BRIAN MELLEY and PETROS GIANNAKOURIS (Associated Press)

RHODES, Greece (AP) — Dr. Michael Mosley was his own guinea pig.

In the name of science, the British television host put his body to the test by ingesting tape worms, injecting snake venom and letting leeches suck his blood.

What didn’t kill him made him more popular and he reached millions through BBC programs like “Trust Me, I’m a Doctor,” other appearances on TV and radio, and through bestselling diet books.

In the end, his death came during a hike in the blazing sun on the Greek island where was vacationing.

Greek police said Monday there was no sign of foul play, though an autopsy was underway to find the cause.

Here are some things to know about Mosley:

He was steps away from reaching a beach

Mosley, 67, was found dead Sunday, four days after he went missing on the island of Symi.

His wife said he took the wrong route on what was supposed to be a short walk to the next town and appeared to have collapsed.

The path would have taken him over or alongside a steep unforgiving slope littered with rocks and no shelter from heat that hit 37 Celsius (98.6 Fahrenheit).

His body was found within a few dozen steps of the water.

“He almost managed to reach his destination,” Lefteris Papakalodoukas, the mayor of Symi told Greek Alpha television. “It was only another 10 meters (33 feet) to the beach. But that must be when his strength left him.”

Dr. Clare Bailey Mosley said her family took comfort knowing her husband almost made it to safety.

“He did an incredible climb, took the wrong route and collapsed where he couldn’t be easily seen by the extensive search team,” she said in a statement.

The banker who became a doctor who didn’t practice medicine

After graduating from Oxford University, Mosley became an investment banker before going back to school to become a doctor. After qualifying for a career in medicine, though, he took another dramatic career change. He trained as an assistant producer at the BBC and that eventually led to a profession in front of the camera.

Mosley was widely admired for his ability to communicate complex science clearly and his willingness to be the subject of experiments that made others shudder.

In a BBC program called “Infested! Living with parasites,” he swallowed tapeworm cysts. He used a “pill camera” to explore his insides and was watching on an iPad in an Indian restaurant when he first saw the tapeworms attached to his intestine.

“I shouted out: ‘Blimey! There’s a tapeworm in me!’ The other diners looked very surprised,” he said. “I was delighted, but at the same time, it was rather horrible.”

When he was diagnosed with stage 2 diabetes in 2012, Mosley turned to health science and developed a diet that beat the diagnosis and became the basis for one of his books.

He later popularized intermittent fasting and low-carb meals through his 2013 book “The Fast Diet,” which he co-authored with journalist Mimi Spencer, that proposed the so-called “5:2 diet” to minimize calories two days a week while eating healthily the other five.

His “Just One Thing” radio series launched in 2021 advocated simple changes that could transform health and wellbeing.

“I remember him as a bright spark who although now sadly extinguished, will live on through his influential ‘Just One Thing,’” said Mark Miodownik, a materials science professor at University College London, who had worked with Mosley. “Science has lost one of its best and most influential communicators. His warmth and connection to the audience was remarkable.”

Tireless search from the air, ground and water

The search for Mosley began when he didn’t return after leaving his wife and friends and going for a walk from Agios Nikolaos beach near where he was staying.

Searchers on foot, divers in the water, helicopters and drones from above and parties combing the shore from boats spent four days looking for Mosley.

CCTV footage that was believed to be the last known sighting him had shown him walking through a village with a black umbrella overhead to protect himself from the sun.

But footage released Monday appeared to show him scrambling down a rock slope next to a fence and falling out of view where his body was later found.

On Sunday, a boat with the mayor and a group of journalists was scanning the rugged slope when a cameraman saw something dark among the rocks.

The mayor took a photo of the camera display and zoomed in.

“It has a good resolution,“ he said. “It was the missing man.”

Ilias Tsavaris, a bar manager at the Agia Marina, said he scrambled up the hillside after getting a call from the boat telling him to confirm the sighting.

“When I walked up I saw something like a body,” he said. “You don’t see a dead body everyday, it is not a warzone, it’s summer, you are supposed to have fun and swimming.”

Clare Bailey Mosley thanked the people of Symi for their tireless search for a man they didn’t know.

“Some of these people on the island, who hadn’t even heard of Michael, worked from dawn till dusk unasked,” she said.

___

Melley reported from London. Associated Press writer Costas Kantouris contributed from Thessaloniki, Greece.