The music doctor

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The 62-year-old doctor Nguyen Van Tho (L) with a patient.

The soft tunes of Beethoven's Symphony 4b waft through the room. A middle-aged man is on a bed listening with his eyes closed. Dr. Nguyen Van Tho stands attentive next to the bed.

"What do you see? What does the music bring you?" Dr. Tho, former director of National Mental Hospital 2 in the southern province of Dong Nai, asks his patient.

For Tho, there is no boundary between music and science. He has spent more than 50 years using musical therapy to help those suffering from mental illnesses.

When the music stops, Tho asks his patient to open his eyes.

Tuan has been suffering from schizophrenia for more than ten years.

"When he first heard the music, he jumped up from the bed. That is how most patients react to Beethoven," says 62-year-old Tho, who has treated countless patients with musical therapy.

The results were apparent after the first four treatments, each lasting 40-60 minutes. For the first time in months, Tuan, who used to be a painter before he was committed to the hospital a few years ago, picked up his paintbrush again. He also opened up the lines of communication with his doctor.

Tho explains that the doctor and selected music become one in musical therapy; the music plays the role of a strong co-therapist helping patients get in touch with their unconscious. It evokes feelings and emotions and helps patients reach an awareness where they can resolve their problems.

Tho is one of few pioneers in Vietnam to have studied and applied music in psychiatric treatment. He is also the first Vietnamese practitioner of a musical therapy system developed by American therapist Helen L. Bonny.

Doctors practicing "The Bonny Method" usually have higher education in both music and psychology. In order to determine what music will appropriately help the patients explore themselves, doctors conduct extensive evaluations to determine medical history.

Tho, who was inspired to be a musical therapist in university by Professor Le Hai Chi, former head of the Mental Military University's Psychiatry Department, has used 12 different musical therapies, including The Bonny Method. This method, he says, works on mental disorders such as depression and schizophrenia and also temporarily increases IQ.

Of all the genres of music, it is most common to use classical music during therapy, since it is organized, complex, has varying levels of intensity, and acts like a narrator telling a tale without words. Classical music has a profound impact on the listener's brain, Tho says.

"However, one should not underestimate the power of rock or pop music; any genre of music can be used as long as it reflects the listener's mood, relaxes them, and fits their interests," he said.

Tho was born in Hanoi and trained as a musician early on. He has an impressive list of original compositions including his first song, Huong dem benh vien (Hospital's fragrant night).

Tho won several awards at national military art performances between 1979 and 1984, and was invited to play for the Air Force Art Troupe in 1982.

Vietnam had been torn by war for more than 25 years and mental disorders such as post-traumatic stress disorder were common in those days.

"When I was in the military, I realized many people were suffering from post-war psychiatric issues. I decided to combine my love for music and people, and devote myself to further research in musical therapy.

"Mental disorders are also social disorders. They can also be a side-effect of a rapidly developing economy," Tho said.

According to a WHO (World Health Organization) report in 2001, one in four people suffer from some mental disorder at some point in their lives. 121 million people worldwide suffer from depression, one million of them commit suicide and 10-20 million consider suicide every year.

Tho says Vietnam is in the same boat - 20 percent of the population needs psychiatric care or therapy. According to statistics, there are approximately 400,000 epileptics and 240,000 depressed patients in Vietnam.

Shockingly, there are only 600 psychiatrists in a country of 89 million people. The Ministry of Health has only 4,500 hospital beds for mental patients, while the Ministry of Labor, War Invalids, and Social Affairs provides another 2,000 beds.

Tho added that research and treatment in this field was difficult before the 1990s due to a lack of information and training. Things got better in the 1990s, when students began to go abroad to study and intern at established foreign hospitals.

"I was director of the hospital in Dong Nai Province in 1998, and my position allowed me to freely develop and apply different treatments on my patients," said Tho.

Tho even transformed T'rung, a traditional instrument from the Central Highlands, into a new instrument that was easier for patients to play.

He disassembled the instrument into a single bamboo tube to play different monotones. In an innovative use of musical therapy, patients would have to coordinate with each other to play a complete song. By the end of their therapy sessions, they were able to successfully perform Tieng chay tren soc Bombo (The sound of the pestle from Bombo village).

"It exhausted me and other doctors in the hospital. We had to run around "the band" to get them to sit down and join the others," Tho said.

Still, it was rewarding in the end as 100 members of the choir performed the song in front of guests, some of who were accomplished musicians.

Tho, who retired last year, hopes his successor at the hospital continues to use music in treating patients. He is concerned that the the development of musical therapy in the north suffered after he was sent to serve in the southern hospital in 1990.

Tho is a pioneer in bringing musical therapy to Vietnam. Doctors throughout the country see the success of his efforts and continue to develop this effective alternative treatment.

Keeping the needs of the Vietnamese population in mind, the veteran doctor is planning to open a center for psychiatric therapy in Ho Chi Minh City soon.

Reported by Priscilla Aquilla

Nguyen Van Tho, a member of the Vietnamese Musicians' Association, plays the piano at his home in Bien Hoa Town, Dong Nai Province

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