Making music from bedpans and heart bleeps
Ivan Hewett talks to the creatives marking the institution’s 70th year in an unusual way
Britain’s great institutions have often inspired music. Think of those grand odes and marches in praise of the monarchy, all those stirring marches for the army, and hymns for the church. When it comes to institutions of more recent vintage, musical effusions are rather thin on the ground. It’s hard to think of any decent music inspired by the Department of Work and Pensions, or the Highways Agency.
The NHS, though, is different. Saving lives, often in conditions of acute crisis, stirs our sympathy and interest, as the numerous TV hospital dramas attest. And, according to recent Ipsos MORI polls, the NHS is the best-loved institution in Britain: 61per cent of us would pay more taxes to support it, up from 41per cent only four years ago. And 46per cent expect the state of the NHS to become much worse. So, perhaps it isn’t surprising that someone has had the bright idea of celebrating the achievements of the NHS by composing a symphony in honour of its 70th anniversary.
The NHS Symphony is part of a slew of programmes commissioned by the BBC to mark the occasion, and will be broadcast in BBC Radio 3’s longrunning series, Between the Ears, on Saturday. However, this is no ordinary symphony. There are no violins, clarinets or kettledrums, and no conductor. No public performance of the piece is planned – it can exist only in the medium of radio. And it’s been created by a team of two. One of them is Laurence Grissell, the Radio 3 producer whose brainchild this symphony is.
“My day job is making radio documentaries,” he says. “I like to think of myself as someone who tells narratives and stories, and it struck me that hospitals are full of human stories being enacted all at once. But I’m also interested in sound, and hospitals are full of fascinating sounds. So I got the idea of bringing together sounds and stories in a portrait of the NHS at 70.”
But why call it a symphony? “Well, a symphony is a grand statement that often deals with big issues. It projects important topics on to a high serious plane. What I imagined was an aural portrait of life in hospitals that would take on a musical quality.”
There’s a long history of making “musical” narratives using only the sounds of the place itself, stretching back to the Symphony of the Lone Man created in a Paris studio in 1950.
Will Grissell’s “symphony” be anything like that? “No, not really,” he says. “I didn’t want to create something abstract, and I didn’t want to treat the sounds in any way, I wanted to keep them real and lifelike. And I wanted to focus on the human angle, so I was interested in interesting stories as much as sounds.”
To gather them, Grissell visited two hospitals in Birmingham. “I wanted to avoid London, and there was something symbolic about going to the very heart of England,” says Grissell. “I spent six days on location in all, two in an A&E unit, two in a maternity ward, and two in a cardiology unit.”
Once on site, Grissell realised that the job was more challenging than he expected. “Hospitals are enormously complex environments,” he says, “there are conversations constantly crisscrossing each other, doctors and nurses calling out to each other, patients beginning conversations, but not being able to finish them because they are interrupted. And in the background there are constant suggestive noises of machines humming, telephones ringing, monitors beeping.”
Grissell’s idea was to assemble these fragmentary sounds and conversations – including the thoughts of a mother and father as they prepare for the birth of their first child – into a “symphony”. But something was missing. “I needed something to bind all these elements together and bridge the gap between sections, and also lend a certain emotional tone to particular sections.”
A real composer was required and, fortunately, Grissell was acquainted with one, through his work at Radio 3. This was Alex Woolf, who had won the BBC Young Composers’ Competition in 2012, and has made a name for himself as a composer of emotionally direct and appealing choral music. How did he feel about the challenge of marrying notes with the sounds of a hospital? “Well, it was quite a challenge, and at first I wasn’t sure whether to write an underscore, like a film composer does, or to write something more operatic. In the end I felt that the emotions were more authentic if they came from the recorded conversations of the patients. I realised the voices in my piece should be wordless, so I could catch something in the feelings of the patients’ own words without getting in the way.”
Then came the job of apportioning responsibilities, as both parties could legitimately think of themselves as the composer. Grissell certainly brings a musical intelligence to his contribution. “While I was recording in the hospitals, I became aware of certain motifs in the sounds, which could serve a structural function. For example, the sound of a curtain being drawn to close off a cubicle had a nice sense of finality to it, which I could use to close a section.”
Did Woolf make any use of these things? “Only once, in a section where the repeated note B from some machine in the ward that Lawrence recorded gave me a harmonic point of reference. It became clear my job was really to provide recorded sections of music, which Lawrence can move around and combine with his material.”
To make these recordings Woolf had to recruit a new choir. “It seemed appropriate to make use of singers in the NHS itself, so I advertised for singers to join an ad hoc choir. Just to be safe, I added some singers from the Bach Choir, to help with pitching some of the harmonies, and I accompanied myself at the piano.”
‘In the background there are constant noises of machines humming, telephones ringing, monitors beeping’
These recordings were made around two weeks ago, and since then Grissell has been busy shaping them into the final piece, mixed with conversations and sounds he recorded. “The piece is shaping up to be a four-movement symphony,” he says, “and each one has a definite character and style of movement. The third movement is a kind of allegro based on the material I found in A&E, which of course you’d expect to be hectic and busy. The first and final movements are based on material from the maternity ward, and the adagio second movement, which is more reflective and based more on interviews and conversation, is a portrait of the cardiology ward. Here things are calmer.”
The brief rough cuts of the piece I’ve heard are a tantalising mix of personal stories and reflections on life’s big questions, mixed with sounds that sometimes take on a musical flavour. And then from time to time, without warning, Woolf ’s music will gradually inveigle itself into the texture, lending an atmosphere of tension or consolation. He admits to a certain amount of nerves prior to the first broadcast. “It took me a while to find my way into the piece,” he says. “I was flying in the dark, because I had no models to guide me. But once I latched on to the idea of choral voices lending their weight to spoken voices, things fell into place. I’ve certainly got all fingers crossed for the broadcast!”
The NHS Symphony will be broadcast in Between the Ears on BBC Radio 3, on Saturday at 9.30pm