ST. PETERSBURG — Jomanivz Aristhyl, 11, moves her lips to the lyrics at first.
Sitting on her hospital bed, the slender girl with bright eyes seemed small, surrounded by sterile sheets and blinking machines.
There's always gonna be another medicine,
I'm always gonna wanna not take it,
Always gonna be a side effect
Sometimes I'm gonna have to lose.
Muffled by the twangs of a guitar, her eyes skim the words of a rewritten Miley Cyrus song The Climb.
As Meryl Barns, All Children's Hospital's music therapist, guides her into the chorus with the guitar, Jomanivz picks up the volume.
Battling a bone marrow disorder called aplastic anemia, Jomanivz's song sums up her life in the past few months — the lost appetite, a urinary tract infection and invasive procedures.
"Ain't about how fast I get there,
Ain't about what's waiting outside this room,
It's the transplant."
Like many young patients at All Children's, Jomanivz is in for a long haul.
When they're that small, cancer and other diseases are big and incomprehensible. So are those clanging scanners, needles and doctors in scrubs.
Experts believe music helps alleviate that fear. That's why the hospital has a policy: all patients must undergo music therapy. The program has been in the hospital for 13 years.
"People who don't understand it well think it's distracting children," said Dr. Michael Nieder, director of the hospital's bone marrow transplant program. "Distraction is an important coping mechanism. Distractions make painful procedures less painful, so there is less anxiety. When there is less anxiety, it promotes healing."
Research has shown that music calms the sick and takes the edge off pain.
But whether it has medicinal properties that can be physically measured has yet to be thoroughly examined, said Dr. Raffi Tachdjian, a pediatric specialist and assistant professor at the University of California, Los Angeles.
Though Tachdjian believes in music therapy — he even started an organization that raises money to buy instruments for chronically ill children — he wants to see stronger research.
"There is still a lot of stuff to be done ahead of us," Tachdjian said.
Strength through songs
"Would you like a shaker?"
Barns, 24, passes out a bag with tiny maracas to a group of toddlers.
A couple of times a week, All Children's only music therapist leads group sessions with some of the hospital's youngest patients.
Many are often groggy from meds and tests. Many bear large splints on their forearms, to keep in needles for IV drips.
"Okay, here we go," Barns tells them, before launching into a tune.
Through songs, small instruments and simple instructions, the tots wiggle and giggle.
Barns relishes these moments, the highlights of a job where reality is often harsh.
"These positive times make up for those sad times," she said.
Those are the moments that pulled her through recently, after learning about the death of a young patient.
He was 16 and had been making regular visits to All Children's for some time.
He liked playing the guitar. On the Friday before Labor Day, Barns dropped by his room to lend him hers. She didn't want him getting bored during the long weekend.
He looked tired and slept a lot, she remembered.
She got the news two days later.
"The worst part of it was the surprise. But after thinking about it, I am able to have some closure. He's had a good life," she said. "Even though it's really sad to see him go, when I see other kids smiling, or just seeing other patients, it made it easier."
Coursework and counseling
The young woman with the soothing voice fell into music therapy by chance.
She had always been a fairly musical kid, learning the violin at 6 and singing in a choir. Even then, she knew she wanted a job that helped others and even thought of nursing.
Barns found her niche at Radford University in Virginia, one of only 74 schools that offer an accredited music therapy program. Her coursework was a blend of percussion and voice lessons, psychology and anatomy classes.
She interned at a private practice in Pasadena, Calif., working with autistic and developmentally delayed children for a year, then applied to All Children's.
Her passion for working with kids came across to the woman who hired her, Luci Weber, the hospital's director of Child Life Services.
"A lot of people think music therapy is the same as being musicians and music lessons," Weber said. "The whole concept is not someone who is good in art or music, but they have counseling skills behind that."
All together now …
It's not unusual to see Barns toting a guitar around the intensive care wards, or carting a large box of tiny instruments to the hospital's playrooms.
Doctors and nurse practitioners in the hospital routinely refer patients to Barns, whose position is being funded through a $2.5 million donation by local businessman Bill Edwards. For some critically ill children, Barns conducts one-on-one sessions.
She often improvises her lessons.
The trick is to get the younger kids to interact with each other and to move a little, she said. That's when the little drums, shakers and even slivers of bright ribbons come in handy.
With the older children, she takes popular songs, removes parts of the lyrics and asks them to fill in the blanks. They then sing the song together.
The responses are often instantaneous.
Traygon Felver, a 1-year-old who is battling seizures and an infection, would have gotten up and danced if not for his medication, said his mom, Amanda, a Pasco County resident. "He loves music," she said.
Cali Vaes, almost 2 and diagnosed with anemia, did exactly that during a sing-along with Barns.
"She is so excited," said her mom, Sabrina. "This is a real positive experience in a negative world."
The patients aren't the only ones music affects. Most of the time, parents sing and clap along during Barns' sessions.
"Music can be used to enable people …," Nieder said. "It becomes an interesting vehicle that allows people to cope with their situations and cope with their families."
For Jomanivz, rewriting songs and singing them with Barns offered a respite from boredom. In her journal, sessions with Barns are often noted with relief. The gratification for the young patient, a former choir member from Fort Myers, is simple.
"I just like the singing," she said.
For children like her, such reminders of better times are welcomed.
"Kids need interactions, so that they're not thinking about procedures," Barns said. "This is about the normalization of the hospital, so they are not thinking about their pain."