When the Music Played Me
On Memory, Flow, and the Way Music Knows Before We Do
This reflection explores how deep practice, presence, and procedural memory come together — and what that means for us as therapeutic musicians.
Today, walking through the hospital with my harp, something happened — something that reminded me of why we train the way we do as therapeutic musicians.
On my way up to Oncology, I was still forming a plan for my rounds. I’d intended to start in Emergency, but after running into staff in the hallway making last-minute room requests, I started thinking it might make more sense to begin at the top and work my way down from the sixth floor. I’d come up through the bowels of the building, past mechanical rooms and maintenance offices, near the secure rooms where we stow our gear in lockers and I tune my harp. It’s not really “down”(technically it’s half a floor up) but the service nature of the space gives it the illusion of being basement.
When I emerged past the chapel, by the new pharmacy in the main hallway, something sweet caught my attention: a new built-in curved bench under construction. While I didn’t stop to play there, it made me smile and preoccupied my thoughts. “For me?!” I joked to myself. My mind went straight to acoustics — “You built me a band shell, that should be fun” I thought, as I played and walked down the main hallway toward the green elevators.
While I was walking and chuckling to myself about that, the tune Gentle Maiden automatically came out of my fingers.
It’s one of those pieces that lives close to the surface — sweet, familiar, easy to slip into without effort. I wasn’t fully focused; my mind was half on the curved bench, half on which units I might visit. But my fingers knew where to go without paying much attention.
Gentle Maiden is an old tune that comes out of my hands often — spacious, tender, quietly steady, really useful for patients because it offers a poised kind of gentleness that seems to meet people exactly where they are.
The melody doesn’t ask for attention, it offers ease. It doesn’t push forward or resolve in any dramatic way — it circles softly.
The tune itself isn’t just easy, it’s available. Available to memory, to hands, to the room. And maybe that’s why it surfaced in that moment — not because I wasn’t paying attention, but because some part of me was already preparing to be present.
That shift always happens instinctively as I walk. By the time I reach the green elevators, I know I’ll be playing for visitors. And something in me adjusts — not with a plan, but with presence.
It’s not a mental checklist. It’s more like an internal settling. My clinical musician mode switch flicks on, and I enter “the zone.” A softening of focus. A widening of awareness. Like my attention starts listening forward — not for specific needs, but for tone, energy, possibility.
It’s a kind of preparation, but not the kind you do by thinking. It’s the kind your body knows how to do when it’s practiced being present.
I wasn’t playing in a focused sense. I was still thinking about the bench, the patients, where I was headed, which wards I could manage that day. I’d started the tune on autopilot — somewhere in the first hallway or near the blue elevator, while chatting with a kind visitor who enjoyed my harp.
And as I moved through the Oncology unit, greeting staff and playing at bedsides, something happened that I didn’t catch until a few measures in…
My music had changed unconsciously. I’d begun improvising intentionally, but I’d started playing a different tune — without realizing it.
My fingers had shifted into an air, Bridget Cruise (3rd setting). I wasn’t actually thinking of the tune. I don’t think I had played it recently. I didn’t have any music in front of me. But there it was, unfolding through my hands as though it had been waiting quietly, just under the surface.
Then came the moment I did notice: my hand reached to lower the F lever — just one F in the treble — to accommodate the F natural in the melody. I caught myself in the act. Not thinking about theory or remembering sheet music. Just responding. And then the thought: “What am I playing?”
I didn’t stop. I let it happen. But the awareness startled me — not in a bad way, just in the way you realize you’ve walked further than you meant to, and the scenery has changed.
Later, after the visit, I tried to remember what exactly had happened. I had to think hard to recall the name Bridget Cruise. Certain songs are stored in my brain from having played them for decades, but I can’t always name the titles. One song that pops into my head like this periodically is Fairy Queen. Sometimes the tune calls me to the point where I have to get up and pick out the melody to try to recall the title. One time this was so memorable that I started wondering: What part of me knows this music? What compels bringing it forward?
What Plays When We’re Not Looking
Today at the hospital, I had been improvising consciously, and meant to segue to Mixolydian — intending to return to the same tune I had been playing, just transposed. But somehow my fingers decided to play a Mixolydian tune instead of just a variation. It just happened. I wasn’t analyzing modes or keys or levers or transitions. I was simply present to my patient, the atmosphere, the moment.
That’s why it happened.
What took over was a deeper kind of knowing: procedural memory, muscle memory, auditory memory. The kind of memory that bypasses language.
Procedural Memory: Your Body Remembers
This kind of memory doesn’t live in conscious thought. It stores how to do things — tying shoelaces, riding a bike, walking…and playing music.
It’s what lets a musician’s hand move from chord to chord without pausing to “remember” — because it never really forgets. It remembers gestures, shapes, finger spacing, and how a phrase feels.
I didn’t recall Bridget Cruise. I didn’t even remember the name until later. But my body knew the path.
That’s the power of procedural memory: it can move through your hands while your conscious mind is focused elsewhere. It’s not a trick. It’s the result of deep, embodied learning — not just practicing a piece, but absorbing its shape.
Flow State: When the Brain Steps Aside
There’s another layer, too. What I experienced aligns with what psychologist Mihaly Csikszentmihalyi called flow — the state where you are fully immersed in an activity, and time, effort, and planning fall away.
Enjoy his TED talk here:
https://www.ted.com/talks/mihaly_csikszentmihalyi_flow_the_secret_to_happiness
In flow, you’re not calculating — you’re simply being. There’s a neurological shift: the brain’s analytical center (the prefrontal cortex) quiets down, while regions responsible for rhythm, motion, and learned action (the cerebellum and basal ganglia) take the lead.
This helps explain why thinking about what you’re playing can actually break the spell. Conscious thought lives in a different part of the brain than fluent action. The more internalized a piece becomes, the more effortlessly it can surface, especially in moments of heightened presence.
What happens in the brain during flow?
In a flow state, the prefrontal cortex — the region involved in self-monitoring and executive control — shows reduced activity, a phenomenon known as transient hypofrontality. At the same time, deeper brain structures like the cerebellum and basal ganglia, which support coordination, timing, and practiced movement, become more active. This shift enables fluid, automatic performance with minimal conscious effort.
Why It Matters (Even If We Don’t Name It)
It’s tempting to assign meaning to the choice of tune — why Bridget Cruise, why now — and maybe that’s worth exploring. But I keep returning to the how.
That moment didn’t come from mental recall. It came from deep internalization, the kind that only happens when a piece has lived in your hands long enough to become part of your expressive vocabulary.
Not memorized. Absorbed.
This kind of moment, when your fingers lead the way, isn’t rare for CTMs. But it’s worth pausing to notice it. Because what allows it to happen is exactly what makes our work so responsive and alive.
Why This Matters for CTMs
This is the part that matters most to us in this work.
This is why we train beyond the page. This is why we immerse ourselves in modes and patterns, why we break tunes apart and rebuild them by hand. Because in therapeutic settings, music is not something we deliver. It’s something we enter into.
Sheet Music Is a Tool, Not the Music Itself
Reading sheet music uses short-term memory and visual decoding. It’s useful, but in a hospital room, it can become a barrier. It asks your attention. It fixes your gaze. It keeps your mind in a different room than your patient.
Our goal isn’t to memorize pieces for performance. It’s to internalize patterns so deeply that they become part of how we move, listen, and respond.
Music as Language, Learn the Grammar
Think of language: we don’t spell out each word when we speak. We string together phrases. We speak in breath, rhythm, inflection.
Music works this way too. Especially in modal, and folk traditions, tunes share structural DNA — progressions, motifs, modal turns. When you know those shapes by feel, your playing becomes fluid, intuitive, responsive.
You don’t just play a tune. You speak a musical dialect.
In therapeutic settings, this fluency means you can adapt mid-phrase, responding to a breath, a shift in energy, a sigh. You’re not tied to getting it ‘right.’ You’re there to make something real.
Freedom to Respond
In the hallway, in that hospital room — I wasn’t playing from a script. I was meeting a moment. And because the tune lived in my hands, I had the freedom to follow where it led.
This lives at the heart of our skill as CTMs.
When music is internalized, your harp becomes an extension of your presence. You don’t have to look down. You don’t have to stop. You can walk, improvise, pause, return, listen. You are musically available — and so is the moment.
I didn’t plan to play Bridget Cruise today. I didn’t even realize I was playing it until afterward.
But my fingers remembered. And they responded before I did, in a moment when my full attention was on another human being. My presence was musical before I even knew it.
That’s what we prepare for.
We study. We repeat. We dive deep into patterns and progressions and phrasing — not to perform, but to disappear. To allow music to move through us without needing to ask permission.
Call it memory. Call it flow. Call it grace.
Whatever it is, it played through me today.
And I’m still listening.
…taking shape…
What Plays When We’re Not Looking
Diptych of breath, presence, memory
These two images (drawn using Procreate on an iPad) began with a question:
“What part of us remembers music before we think of it?”
The first piece — Flow — is all motion, with warm translucent color washes, gentle lines, a sense of movement without hurry. It doesn’t aim to represent anything literal, but it holds the feeling of breath, of motion through water, of the way a tune rises when it already lives in your hands. Like muscle memory. Like a whisper you didn’t expect to hear.
The second — Listening — introduces two soft, overlapping circles within that same current. They might be musician and patient or simply two presences, quietly sharing space. What matters is that they’re held by the flow, not outside it. Responsive. Together.
The moment that inspired this was simple: while playing at a hospital bedside, a tune surfaced in my fingers without warning. I didn’t plan it. I wasn’t thinking about it. But there it was, Bridget Cruise (3rd Setting), unfolding gently, as though it had been waiting just under the surface. Not recalled but simply known.
This air by Turlough O’Carolan is quiet and inward. It doesn’t tell a dramatic story. It circles, breathes, and never quite lands. He wrote four settings for Bridget, his first love, and the third feels like a memory that no longer needs to ache. It’s spacious. Familiar. A tune that knows its own way.
These images don’t try to explain that moment. They try to honor it.
They wonder what happens when we stop directing, and just allow something deeper to speak through our hands.
Trusting what we’ve practiced.
Letting memory and presence meet.
Flow isn’t a background. It’s the whole landscape.
And the circles? Not symbols. Just relationship — layered and listening.
I created these two images, Flow and Listening, tonight after my rounds — not with the new hallways in mind. But now that I’ve laid out this essay, I can see the connection. The soft arcs in the new construction — the way the ceiling and desk seem to move like water — echo something I was already feeling. I didn’t mean to mimic the space. But maybe I was carrying it with me.
There’s something to be said here about design — yes, in architecture, but also in music, in therapeutic presence, in how we move through space. The new hallways weren’t built for me, but they echo how I feel, how I move through the hospital, how I listen, maybe even how I play. The curves I drew later echoed back what my body had already absorbed.
Design doesn’t always announce itself. Sometimes it just creates the conditions for ease — for breath, for relationship, for quiet knowing. And maybe that’s part of what we’re doing as CTMs: shaping presence. Offering form without demand. Making space for what’s already waiting to rise.
I’ve already got plans for that band shell…