Interview by Julie Bull
Mick Sands, Arts Therapist talks about his work at St Christopher’s Hospice
Mick Sands had been a successful theatre composer, working with Peter Hall and the RSC, but he always had a parallel life, using his musical and artistic talents to work with people with learning disabilities. When, twelve years ago, his professional life took a new turn, and he became part of the Arts Therapy team at St Christopher’s Hospice, he knew that the nature and the rewards of the work he would do there would be very different to those offered by the theatre. I talked to him about his work at the hospice, about dealing with the fundamentals of life and death on a day-to-day basis.
St Christophers hospice in South London was founded in 1967 by Dame Cicely Saunders, whose guiding philosophy was that ‘you matter until the last moment of your life.’ The hospice movement exists to provide the highest possible palliative care for terminally ill people, and to not only treat them medically, but provide emotional and spiritual support alongside clinical care. They provide this support to over 6,500 people in South East London each year.
Patients who come to him will have reached the end of curative medical treatment. While clinicians will help them manage their physical pain, it is the other pain, what has been termed ‘soul pain’, that the Arts Team are there to help with. I ask what patients are bringing to the session, what kind of things they want to explore. Mick sums it up as being about the search for meaning. People are often asking why, how come this has happened, what does my life mean now and what have I done?
A referral from the clinical team will often be on the basis of someone needing something to do, but there is a lot more to it than diversion or distraction.
There’s an element of life review. Sometimes it’s putting that on record. One man, for example, wants to talk about his lifelong passion for Millwall Football Club. So I sit with him and we record him recalling it all, the magic of the Stadium of Light. We’re just two blokes talking about football, but it’s so much more than that, he is recalling and recounting his love for his wife, his friendships, his memories.
In some cases they are also facing down demons or struggling to reach a point of acceptance as their life comes to a close. Stories and metaphors have power here. Mick is reminded of the image of King Canute, how one patient became absorbed in the story, the image of holding back the tide, part of the journey to recognise that he himself must face the inevitable.
The ‘products’ of work like this can be valuable things to leave behind for loved ones. A chance to tie up some loose ends, to have some reconciliation. They can be expressing something that they can’t otherwise talk about. Working through creativity, there is the possibility of finding a language to speak about the unspeakable. Reaching some accommodation or acceptance, having the final conversation – Mick is at pains to point out – doesn’t always happen. Sometimes the metaphor just hangs, you can’t go further. That’s just how it is.
It’s salutary to be reminded that there is a context to the work – that it doesn’t take place outside of a social and economic context of austerity. This is, after all, the NHS.
There are more people in need of palliative than we can serve. There’s more focus now on brief interventions and there’s more targeting. We can’t work with people who are medically stable. The pressure is for us to have a goal for the work, a limited but focused intervention. The work, though, is relational, it depends on relationship to enable the broaching of certain subjects. The argument is for us to be providing a model of care which is much more open ended, even if it doesn’t fit with the resource argument.
The work seems a world away from the excitement and acclaim of his former life in the theatre and Mick has thought hard about the difference, probing the question of audience and attention. One story tells it all.
One Friday afternoon I get a call from a doctor on the ward asking for a musician to come and play the blues for a patient who is dying. I take my guitar upstairs and introduce myself. I’m not a blues guitar player but I play 'Summertime' for him. I play it with my whole self. It’s an experience I have before where you play for someone who really drops down into themselves and profoundly listens. It was a receiving- a profound connection. I have played in front of 25,000 people and of course this was not the same, but it was as big as.
When I ask if his job is unbearably sad the answer is of course yes. Mick tells me about the bad days, the ones when he goes home ready to cry into his dinner, but for each of those there are the days when the work brings patients to anger, inspiration, and life.
Soon he will retire from this particular chapter in his professional life to become a psychotherapist and I ask him what he will miss or not once he moves on. He’ll miss his team, working with patients.
Whatever happens, I think St Christopher's will miss him.
Julie Bull is a writer who lives in South London and Sussex, which sounds much posher than it is. In another life she was a civil servant but now writes full time. Her short stories have appeared in MIRonline and the Retreat West Anthology, The Word for Freedom. She is currently working on a story collection. She is nothing if not nosey, so she finds interviewing people to be a great non-fiction writing opportunity. You can find her @juliebu72