In a place where people go to die, four women have come to sing.
On a hot day in July, natural light floods Carol Beck's room at Dobson Home, the Chandler branch of Hospice of the Valley. A few personal touches remind the occupant of home: framed family photos, flowers, a "Thinking of You" card. A calendar filled with family members' photos is tacked to the wall nearest the bed, marked with the days different relatives intend to visit. The TV is off.
Carol Beck has adenocarcinoma, the most common form of lung cancer.
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The women introduce themselves to Beck and her niece, the strangers they've come to comfort.
Beck is chatty, her bright red toes propped on a pillow. She guesses she's been here about seven weeks. Her niece and goddaughter, Amanda Klimczak, is visiting from New Jersey, where Beck once lived.
The choir forms a half-circle around the bed, and its leader, Kellie Walker, asks for requests.
There's no Sinatra on the set list. Instead, they begin with "Honey in the Rock," a traditional African-American spiritual. The harmonies resonate through the stillness of the home.
"Very pretty," Beck says after the song ends.
Both Beck and her niece get emotional during the second song, "Edelweiss," from The Sound of Music. The older woman's blue-gray eyes glaze over, tears welling up behind her glasses. A distant look crosses her face. She is lying in a bed at a hospice facility in Arizona, but, really, she is somewhere else.
"Beautiful. Thank you. That brought back memories of when I was a kid," says Beck. "My mom was a singer, as well. My dad was our main singer and they always sang . . . Thank you very much for that. And Mandy thanks you, too. She can't talk right now because she's crying," Beck adds with a laugh and a nod toward her speechless niece.
"Yeah, music can go right to your heart," says Walker.
"Well, that's where it's supposed to go. If people try to tell you anything different than that, they're wrong. They're totally wrong," says Beck. "You can listen to any genre of music, but it's always the same — it takes you right where you need to go if your heart is open toward it."
Talk turns to Beck's funeral arrangements — including hairstyle — and her young grandson's desire to care for her. "He thinks his job when he comes here is to feed me ice," says Beck. "Because, 'Granny has an owie in her belly, and when Granny's owie hurts, I eat ice.'"
Later, Walker says they rarely have someone that responsive — and talkative — when they visit. So when the choir sings again for Carol Beck, they include upbeat hymns and selections from musicals.
When Walker announces "Amazing Grace" as the second-to-last song, Amanda Klimczak quietly slips out of the room.
The music is comforting — but it can be tough, too. No one knows that better than Kellie Walker. She started Voices Lifted after singing to her sister and her father on their deathbeds years ago. Then a year ago, her husband Russell was diagnosed with stomach cancer.
"I thought, Oh, God, this is a little too close to home," Walker says.
So little by little, Walker is handing over management and even singing duties to her fellow choir members.
Voices Lifted is far from a traditional church choir. Although it was formed two years ago through the Valley Unitarian Universalist Congregation, the group is not exclusive to members of the church. Rather, the all-female group is open to the entire community, with one of the only exceptions being that girls under the age of 10 are not admitted.
After all, the choir's audience isn't the kind of crowd a young child would normally be accustomed to performing for.
Kellie Walker, 53, is soft-spoken and petite, her brown hair in a pixie cut. She takes a seat one July afternoon at a coffee shop in Tempe, exhausted after having just returned from a weekend music conference in North Carolina, and quickly consumes her fruit parfait.
A music therapist by training, she began her career in a medical psychiatric unit but since switched gears to become music director of the Valley Unitarian Universalist Congregation in Chandler, where she's held the position for 20 years. Once she joined the church, she had the opportunity to sing at the bedsides of people from the congregation.
But not before she experienced her own share of loss.
Walker describes the scene at her sister's deathbed as if it happened yesterday. But July marked the three-year anniversary of her family's loss of Katie Walker to breast cancer.
Walker arrived at her sister's side in Bellingham, Washington, with her daughter, Jolie, and husband, Russell, in tow. She can recall as many as 11 family members filing in and out of the room, trying to comfort her ailing sister while maintaining a sense of normalcy.
"If you haven't had this experience, it's surreal. But it's also ordinary life. Life is still going on around," says Walker as she describes the constant bustle around the house, complete with fussy children.
Everyone tried to do his or her part to comfort Katie. Some of the children applied lotion to her skin and doted on her, while Walker and her younger brother, Joe, sang and played guitar.
"Her eyes were open for much of that time. She hadn't spoken in a couple of days. But I'm certain she knew we were there," says Walker.
Walker remembers the last song she sang to her younger sister, about a half-hour before she passed away. It was a song she'd learned from a Kate Munger workshop. Munger is the founder of Threshold Choir, the group Walker in part modeled her own Voices Lifted after. Some of the other women in the workshop had sung it to Walker in the hopes of soothing her after learning that her sister's cancer had metastasized to other parts of her body. The song, originally titled "I'm Going to Lift My Mother Up," was modified, switching out "mother" for "sister."
Walker clears her throat and begins to sing in the coffee shop:
I'm gonna lift my sister up / She is not heavy
I'm gonna lift my sister up / She is not heavy
I'm gonna lift my sister up / She is not heavy
If I don't lift her up / If I don't lift her up
If I don't lift her up / I will fall down.
Her singing voice shows very little signs of the subtle raspy quality that it possesses when she speaks. And it's no longer as quiet. There is a steady strength to it, much smoother, and she sings higher notes with ease.
But she knew when to stop singing.
"I sort of felt like I needed to take my cues from her husband and kids and we needed to be quiet," Walker says. "I didn't want it to be the 'Kellie Singing Fest.' My sister loved music, so I know it was fine that I was singing to her and that she would've liked that, but as she got closer, I just sort of got quieter."
It isn't until she begins talking about her niece on the day Katie died that Walker loses composure, her voice quivering.
Walker's niece, then 17, had not been at her mother's bedside. Instead, she was in Costa Rica, unable to make it back in time. Her mother insisted she go on the trip because she'd been looking forward to it, and so she had to call home to bid her mother goodbye over the phone as a family member held it up to Katie's ear. Her daughter finally made it home later that day, only to find that she was too late. She immediately ran to her mother's bedroom and climbed into bed — the last place she'd seen her — and lay there, sobbing, with her aunt.
"It still smelled like her mom and everything," says Walker. "So I just crawled into bed with her and just told her how it was. We think Katie thought she was there. She didn't know I wasn't there when my mom died — my sister and I weren't able to get there in time. Sometimes it just happens that way."
Having musicians perform at hospices and other palliative care facilities isn't necessarily a new phenomenon, but it is a trend that's growing in popularity in recent years. More facilities in the Valley and across the country are incorporating music as a form of treatment, primarily for people suffering from different forms of dementia. Some staff members at hospices are testing a protocol known as individualized music, which some studies show can be effective in managing behavioral and psychological symptoms of dementia (BPSD) in such patients.
Maribeth Gallagher, the director of the dementia program at Hospice of the Valley, suggests music can transcend other forms of communication when trying to reach out to certain patients.
"Scientists think that when we hear music, it animates and organizes brain patterns," says Gallagher. "Think about your own life. Is there music that makes you think of your friends and family? Or spirituality? That's deeply rooted [within a person]."
Not all the people Voices Lifted visits are suffering from dementia; they say they've witnessed the effects music can have on any individual.
"It takes you to a place where you're in the arms of your young husband," says Gallagher. "It creates a virtual reality."
Voices Lifted has been visiting three of Hospice of the Valley's palliative care units for the past year, after having first approached them for an audition.
"We had them come in and sing for us. And they were wonderful," says Stacia Ortega, volunteer director for special programs. "When we heard them sing, we were like, 'Wow, this could be really beneficial.' It's like a gift for our patients."
Rotating shifts of three to five women at a time per visit, the choir has since been volunteering at Friendship Village, Lund Home, and Dobson Home. They also travel to nursing homes and personal bedsides, singing at least once a month somewhere, for someone in need.
And those people in need aren't always the ones with the illness.
Often, the women are singing just as much — if not more so — for the patients' loved ones. The music they perform varies depending on the room they're in. They'll take recommendations from family members for music reminiscent of better times, but the women will have to rely on their own instincts for what's appropriate — and what's not. They perform what they feel is right depending on the mood and the amount of pain in the room.
If the patient is closer to death, the choir may steer clear of familiar songs as they can draw a person back to the present, or to their family. That's not always something to be desired. In those cases, Walker and her fellow singers may opt to sing in Latin, or perform a song with no words that can't tie the ailing person to anything on this Earth.
"Sometimes that's more soothing. They can sort of let go and let the music wash over them," says Walker.
Before starting Voices Lifted, Walker directed a group called the Tremble Clefs, a choir whose tongue-in-cheek name refers to its members' Parkinson's disease (although not all members are diagnosed with the disease; some are family members of those with Parkinson's). But after six years, Walker moved on to the next thing. She continued taking workshops through Threshold Choir that she soon used as examples to model Voices Lifted after, while still incorporating her own personal touches into the project.
And although the group's objective is to help promote healing and compassion to strangers, its members are often the ones in need. Their practice sessions — far from conventional — usually take place with the singers gathered in a circle, and one woman (usually whoever has had the worst day or week) lying on a cot in the center. From there, the group practices "singing with intent."
"So I really do have a strong personal connection to a lot of this. I've had a lot of loss, but I'm not the type of person that hides from it or denies it," Walker says. "And maybe because of that I have a big heart and a lot of empathy for being with people and their families. I do sort of feel it's my calling right now and to help people, other people, have that experience. If it's just one person, you can only go to so many places. But if I can train other people to do it, then we can reach more people."
Music has been the one constant in Kellie Walker's life. Her parents, Bill and Carole, met in a seminary, and both played piano. Walker's father was a Methodist minister, and her mother sang in the choir.
Walker, along with her siblings Katie, Joe, and Tom, all took piano lessons as children. Kellie began at age 6. And although the four siblings moved around the country and took on different jobs, they kept in touch with their musical backgrounds. Katie led a children's choir at her church; Joe, now a public school teacher, still plays guitar and sings regularly; and Tom, the youngest of the lot, performs with a barbershop quartet.
Originally from Oregon, Walker pursued a master's in creative arts in therapy with an emphasis in music at Philadelphia's Hahnemann University Hospital (which since has been bought by Drexel University College of Medicine). There, she worked as a musical therapist before moving around the East Coast and finally settling in Phoenix.
And now she has children of her own to carry on the tradition.
Ben, 21, dabbled with different instruments but doesn't play an instrument or sing. Brian, 18, plays violin and even offers lessons, while Jolie (who was adopted from China at 81/2 months), 14, plays oboe and piano.
Walker, like her eldest son, can trace her first memories back to a mother singing lullabies.
Before Walker's mother died, she'd written the lyrics of lullabies down for Kellie in the diary she kept before and after Ben was born (the favorite to sing, by both Walker and her mother, was "Slumber Boat"). And when Ben was born via caesarean section, Walker asked the nurses for permission to sing. The nurses approved.
"So I sang all the way through his birth," says Walker. "To come into this world with music and to leave this world with music, how great is that?"
That was around the time that music began to manifest in most, if not all, aspects of Walker's life.
Her parents both died of AIDS not long after Ben was born. Her mother died in 1990 and her father followed two years later.
"At that time, I was only in my early 30s, and it was a tremendous loss," says Walker. "None of my peers were having any kind of loss like that, and it does change you."
Walker had recorded her mother singing lullabies to Ben shortly before she died. But the very same Thanksgiving weekend that Walker's mother passed away (Walker was not present because she was spending the holiday with her husband's family in Buffalo), the recordings vanished. Her husband had accidentally recorded over the tape.
"When I looked, I'd realized he recorded over the entire thing and I knew my mother was about to die," says Walker. "We have maybe three or four seconds of the end of it. And I cried more for that than I did probably anything else — more than when my mom died. "
Ben's first memories are of his grandfather dying — and singing lullabies to comfort him.
"I kind of just remember being in a room and singing different songs I'd either heard or knew in some way from my mom," Ben says. "And I was just singing along as best I could. I think I had just turned 2, so I was pretty young."
Walker originally expressed doubts that her son could remember an experience like that at such a young age. But his accounts of the evening too closely matched her own to be a coincidence.
"And that's the first thing my son remembers. He remembers singing to my dad. And three years ago my younger sister died of breast cancer. My husband has cancer now, too," says Walker. "It's sort of ironic that I do this work."
Some members of Voice Lifted, like Rebecca Riggs, find solace in singing to others approaching death. But Riggs, who's known Walker since she joined the church 20 years ago, did not join the group at its start.
It wasn't until Riggs found herself needing her own personal form of healing that she turned to the group.
"My 17-year-old son died. And when he died, he was alone," says Riggs. "And of the many, many overwhelming feelings I had upon his death, one of the things that stayed with me was the incredible regret that he died alone. And I don't want anybody to die alone."
Riggs' son committed suicide. After recuperating, she joined Voices Lifted about a year and a half ago.
"There was nothing I could do for him, so I joined the group after I sort of regrouped, so I could be part of being there in some way — in this sense, a musical way — for people who are at the end of life. And that, for my own personal story, was important to me," says Riggs. "People really appreciate it, if not the people themselves, then often the family members. They feel that the music brings a sense of peace and I think that's what we're all after . . . And that's what families and individuals in that last stage of life often need."
Riggs continues: "The rewards are worth it — that's why we keep doing it. Is it draining? Absolutely. You can really feel exhausted in a way that is entirely different from having exercised a lot. It's emotionally draining sometimes. But it's still — every single time — it's been worth it."
One year ago, Russell LoBrutto was diagnosed with stomach cancer. In December, he had his stomach removed.
LoBrutto, a biophysicist, also has Parkinson's disease, which forced him to retire from Arizona State University in 2007 after 16 years at the school.
These days, he spends his time at home reading literature on his condition, hoping he can someday be given the resources and platform to expand his research on Parkinson's. But for now, he stays home, while his wife travels back and forth between music conferences around the country, leading all music-related activities at her church, and tending to Voices Lifted. And since the cancer has spread, Walker and her husband have been taking more trips than ever before to the Mayo Clinic in Scottsdale for chemotherapy.
"It's been a busy year," says LoBrutto.
On a recent summer day, LoBrutto quietly drifts from room to room in the family's Tempe ranch home, the rattling sound of pills in a bottle his introduction into the room. Kellie sits at the kitchen table, discussing her musical past. LoBrutto walks to the refrigerator, opens the door and carefully studies the contents before closing it, empty-handed, and making his way back to the computer across the family room.
The house still shows the signs of a busy family: decorations celebrating Jolie's 14th birthday, an office stacked with towers of boxes, mostly filled with papers. A small wooden piano is tucked away, off to the side and in between shelves and more papers. A painting of Walker's father hangs above it.
LoBrutto's thin frame shows the signs of a person battling cancer. He talks the way you'd imagine a biophysicist would talk.
Music was a shared interest between Walker and LoBrutto when they met, but to this day, their preferences vary. A lot.
"There's a funny thing. Our music is fairly different," he says.
For example, "She would never put on this music on purpose," he says, referring to the CD Frankly a Cappella — The Persuasions Sing Zappa, playing in the background. "But she tolerates it. I listen to a lot of different types of music. I'm one of the few people I know who likes Captain Beefheart."
Brought up Catholic, LoBrutto rarely, if ever, hears his wife sing at church.
"I'm not very fond of church music. I'm not a church-going person," LoBrutto says. But he's been listening to Walker sing since they first started dating, many years ago.
When asked if he envisions a time his wife will sing to comfort him, he's wary of the idea on the grounds of irreconcilable differences in musical tastes.
But he has nothing but respect for the work she does.
"I think it's a very humane and decent thing to do," says LoBrutto of Walker's work with the choir. "And probably enjoyable."
"I don't sense that, if my medical problems went away, I don't sense that her work schedule would be all that terribly demanding. It's just that one more thing. She's so energetic . . . And I do sort of shake my head when I think about everything she accomplishes in a week or in a month," says LoBrutto. "But when I see people at the church or when they come here, they'll often say, 'Thank you for sharing her with us.'"
"He's a supporter of my music and he comes and listens, but he likes some strange things," Walker says. "He listens to Pink Floyd and he really loves Frank Zappa. In fact, the only thing I ever heard him sing to our kids when they were little were bits of Frank Zappa songs . . . He's already told me what he wants if he has a memorial service. He wants [the jazzy Zappa tune] 'Blessed Relief.' And that's partly his sense of humor. He has a real funny, dry sense of humor — even about morbid subjects."
Walker seems to be juggling all her roles well enough: mother, wife, music director, and choir leader. But the weight of it all may soon be too heavy to bear alone.
"He's doing pretty well now," she says. "I was able to go to my [latest music] conference and not worry about him too much, but there's no cure now, probably. So it's really weird to be in this situation where, likely, he will die, too, sooner rather than later."
She stops, sighing. "So I have to balance all that. I probably could go in and sing because I have a real ability to be in the moment, but part of me is like, 'Why do I have to?' In a way, it's forced some of the other leaders to step up and just do it whereas they would continue to rely on me too much. So I think it's a good thing and, at some point, I'll do it more. I'm still doing the rehearsals and all that, and if they really need me, I'll probably do it, but . . . right now, he's doing all right. He's not in much pain. The radiation helped shrink the bone cancers and it will likely spread at some point, but right now it seems to be in a holding."
The time comes for the last song.
"We like to finish with one called, 'I Am Sending You Light,'" Kellie Walker tells Carol Beck. "Our way of giving you good wishes, hope, prayer — whatever you need."
After leaving Beck's room, Walker and company stop to serenade a few folks at the dinner table in the salon. The women go through most of the same songs they wrapped up just minutes before, but still play with the same passion and empathy as the first time.
The small audience ignores their plates of food. With tears streaming down their faces, the two gentlemen and a woman thank the group after they've finished singing.
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As the choir leaves the diners, the woman calls them angels.
And it's on to the next room.
Walker now sits close to a small, older woman, who suffers from dementia, the rest of the choir huddled close. The woman knows every word to songs like "You Are My Sunshine," and in this moment, despite her location, she looks nothing like a patient waiting to die. She and Kellie Walker hold hands with arms locked, singing together under the dim, warm glow of a single tungsten lamp, as the rest of the room gradually falls into darkness.
Carol Beck died on August 19 at Hospice of the Valley. She was 62.