An Interview with Sara Matayoshi
What led you to get involved with A Musical Heart?
I first began bringing music into health care facilities while playing in the Knoxville Symphony. The KSO has a program called “Music and Wellness” whose central mission is to bring live music into health care facilities. I was lucky enough to be there at a time where there was a grant available to 5 musicians to enroll in the Music Healing and Transition Program (MHTP). I found myself playing at a hospice, rehabilitation center, and hospital, which included working in the Neonatal Intensive Care, Oncology, and Cardiovascular units. I loved doing this work. When I moved to DC I felt strongly about continuing it. A fellow CMP (certified music practitioner which is the title you earn after completing the MHTP training) told me about Nina and I knew immediately that I wanted to connect with her.
How does playing for the public differ from playing for a single person through A Musical Heart?
For me, the experience of doing the work for A Musical Heart is healing not only for the patient, but for me as well. Sometimes when musicians perform, they can get so caught up in judging their performance that they become disconnected from the beauty and expression of the music. When you go into a space with a patient, you’re there for the patient. That music is for the patient and each session is unique. My wish to be there for the patient almost always overrides the judgmental mind, especially when you’re with someone who’s at the end of their life. Witnessing someone heal through music also reminds me that I can allow myself to do the same. It’s healing and transformative for both of us. It brings me back to the core reason I became a musician: because I love music!
Could you describe an experience in which you felt your music aided or lifted the spirit of a hospice patient?
The experience that comes to mind is one of my very first visits. The patient was non-verbal and I found them curled up in a ball on the bed. Their muscles were contracted and the breathing seemed shallow and restricted. I began to play tentatively, unsure of how they would respond. As I played their muscles started to relax, and they started to adjust their position in the bed. I started to feel more confident, and I continued to play. They began to stretch their legs out and roll onto their back. By the end of the session, the patient’s body was completely elongated and it appeared softer. They looked a lot more comfortable and appeared to be breathing with more ease. The room felt quiet and peaceful. The patient and I never spoke a word to each other (except for my initial attempt to speak to them at the beginning), yet I felt like we shared a powerful experience.
How does playing for hospice patients inspire you?
Live public performances can change people’s lives, but you don’t necessarily see it. In this setting you see it and feel it. As I am playing, I can sense that my love for music can also be of service to the world and is not just fulfilling some kind of selfish desire. When I see someone receive the music in a whole-hearted way that can bring anything from laughter, joy, cathartic relief, or peace it also reminds me of its power which inspires me to keep on the path I am on.
What is it like being an integral part of A Musical Heart?
I feel grateful to be in a community of musicians doing this work who also come from a classical background. I think it’s a unique position to be in. As of now, there aren’t many musicians who do this work and also perform professionally in the classical world. I love that A Musical Heart provides that community. While I do love doing this work, it comes with many challenges. The energy and love my colleagues have for it are inspiring. Each person has their own unique style, and I will often learn from the stories and ideas they share.

What does the training in classical music on this level, of your being a professional, give you when you go into this setting with hospice patients?
Our background allows us to not worry about technical execution on our instruments, which as a result, allows us to give more energy and attention to the patient. It also gives us a larger chest of tools to draw from. For example, we can change our articulation in a heartbeat; sometimes more space between the notes is needed and sometimes more connection is needed and these levels might vary throughout a session. We can also change our dynamic level and still have a beautiful sound without a problem; I have belted out my sound like I would on a stage for someone who was really struggling with their hearing and I have also played so soft that I could barely hear myself, but this was necessary for a patient who was extremely sensitive to sound. We can also carry around a wide variety of repertoire. I carry around a tablet with hundreds of pieces on it. If a patient requests a specific song and I don’t know it, sometimes I can download it onto my tablet, which allows me to sight-read it for them. While playing patient requests isn’t necessarily needed for this work, I do find that it can bring something extra special to a session.
Say you go into a room with a nonverbal hospice patient. Can you give me some sense how you intuit or decide what to do? If there’s someone else present sometimes they can sometimes assist in giving me some direction, but if not, I will just start playing based on instinct and watch how the patient responds If something tightens, an eyebrow furrows, a fist clenches, a shoulder starts to rise, or anything similar to that, then I know I need to change what I am doing. This is the benefit of live music. We can change and adjust things within a breath. Sometimes a patient will seem to like something for the first part of a session and the suddenly seem to not like that anymore, so again, I adjust and try something else.
Has someone actually passed while you’re playing?
Yes, this has happened on two occasions. I was alone with the patient the first time I experienced this. The family had stepped out of the room to talk while I continued to play for the patient. The breathing was shallow and slow, but that is not abnormal, so I was not anticipating how close they were to death. All of a sudden without any struggle, they stopped breathing. Sometimes there can be large gaps in between breaths, so I wasn’t sure at first if what I was seeing was what I thought it was. After I realized that they had indeed passed, I continued to play for a little longer as this was taught in my training. The music would have been the last thing they would have heard. I later I found out that the patient had been an organist.
The second time was just a month or so ago. This session involved a caregiver who sat close to me as I played. Again, the breathing was slow but there wasn’t anything unusual to tip me off that death was so close. The caregiver requested Christmas music for the patient, and I didn’t think it would hurt to see if the patient responded positively to this, so I played a number of slow soothing Christmas songs. The patient did appear to look at peace when the session came to a close. I then moved to a bed that was next to the patient’s bed and began to play for the patient there. As I played, the caregiver of the previous patient exclaimed in a panicked tone, “He is not breathing, he is not breathing! I think he has passed.” A nurse arrived pretty quickly to confirm that this was true. I wrapped up the session with the patient I was with without rushing and stood with the caregiver for some time before exchanging a hug.
I had the extraordinarily beautiful experience of working with Sara at the halquist inpatient unit in Arlington. I was the manager for public engagement and volunteerism. On a few occasions I had the incredible opportunity of being able to follow Sara as she played bed to bed for our hospice patients and their families. It was remarkable.
I watched as previously non-responsive dementia and altzheimer patients immediately connected and often reacting with applause when previously they had been almost non-responsive. I also saw family members moved beyond their pain watching their loved ones respond to Sara’s gift.
I adore Sara and will never forget my incredibly fortunate opportunity to watch her gift in action. She truly is magnificent.
Absolutely beautifully said Sara!
I feel inspired by and connected with your experiences.
Thank you for being exactly as you are,
Eva