Music as Medicine

MTs Sing for Burn Survivors

By Jen Hartley and Chris Hallwas

As massage therapists, we all know the benefits of the right massage music. A combination of the perfect song intertwined with the appropriate massage techniques can envelope our clients and lull them into a deeper state of relaxation. But what if music could offer therapeutic, even pain-relieving, benefits to your work? Massage therapists Jen Hartley and Chris Hallwas discovered just that in their journey
working with burn survivors.


Jen Hartley’s Story

As a child, two things were prominent in my life—burn rehabilitation surgery and music. One I loved, and the other I grew to respect. When I was 15 months old, my 17-year-old mother was giving me a bath in the kitchen sink when she stepped away from me briefly, leaving me to splash around while she went to the door. During her absence, I bumped the hot water faucet and changed my life forever. I received third degree burns over the lower 56 percent of my body and thus started myself down the seemingly endless path of skin grafts, Z-plasties (a surgical procedure to repair constricted scar tissue), and, what I felt like as a child were, barbaric physical therapy regimens at the Shriners Burn Institute in Galveston, Texas.

As a child, I always associated touch and physical therapy with pain, fear, and trepidation. Walking up and down hallways and steps, and being made to bend my scarred legs seemed like cruel and unusual punishment. I envied the kids who had burns to their hands because their physical therapy involved playing catch or video games. I loved and respected my physical therapists, but there was nothing fun about my therapy.

The only bright spot of my day was when Dawn, the music therapist, would come to visit. My dad had started teaching me to play the guitar and Dawn wanted to make sure I had time to practice. She would sit with me for hours, teaching me guitar chords, strumming patterns, and generally playing some really hokey songs, but I loved it because it helped me forget I was in a hospital. The pain of the day diminished as the sound of the music filled the room. If there weren’t any other children at the hospital that played the guitar, Dawn would leave the instrument in my room so I could play anytime I wanted. At times, I would practice a song she had been teaching me the day before while the nurses were changing bandages or even removing stitches—it was a huge distraction from whatever was being done to my body. Little did I know that I would one day have the opportunity to combine what I learned firsthand about physical therapy for burn survivors with what I was taught by that music therapist.

In 2004, I graduated from the Augusta School of Massage. I soon became an instructor there, and later taught at the Georgia Academy of Massage. I took my firsthand knowledge as a burn survivor and combined it with what I had learned from some of the “rock stars” of massage, like George Kousaleous, James Waslaski, and David Kent, and created my own burn scar massage therapy protocol. This course concentrates not only on the physical wellness of burn survivors, but their emotional state as well. My practice partner, Chris, and I have used every opportunity to share and promote our knowledge with others. Our biggest opportunity came at the Phoenix Society’s 2007 World Burn Congress in Vancouver, British Columbia.

There, after listening to Nicaraguan burn survivor Vivian Pellas share her story of living through a plane crash in Honduras, I briefly shared my story at open mic time and stressed the importance of massage therapy for rehabilitation. Senora Pellas approached me later and said she would like us to train the staff at her burn unit for children in Nicaragua at Aproquen hospital. Chris and I agreed and in the summer of 2008, we spent a week training 10 therapists from three different area hospitals in burn scar massage. We were always looking for ways to expand our efforts to reach the children on a more personal level. We found that opportunity during our return trip in 2010 when we met Jose.

Jose is a 3-year-old survivor of a trash fire that left him with third degree burns over both legs, abdomen, and parts of both arms. Physical therapy for Jose was excruciating because he was forced to bend his burned and damaged legs. I could almost feel what he was going through, and his cries echoed through me as I remembered my own childhood therapy. Chris and I were able to gain his trust and massage his legs for him, which he enjoyed, but it was later that we saw the true miracle through music therapy. As we entered Jose’s room a second time to play and sing to him, the staff had already begun his physical therapy. The child was screaming and refusing to get up and walk. We sat across the room from Jose and began to play the first song. He continued to scream as they moved him from the bed to a child-sized plastic chair. During our second song, which was more upbeat, Jose began to pay a little more attention to us and less to the physical therapists working on him. The third song we did was “Amazing Grace,” and that is exactly what we saw. My hands trembled as I tried to play the song; across the room, Jose reached for his pint-sized walker and made the long and painful trek over to Chris and I. I was fighting back the tears as the boy held onto my guitar and swayed and tapped his feet to the rhythm. I have no idea how Chris was able to continue singing while Jose stood in front of her dancing, not realizing he was doing the therapy they wanted for him all along. Upon completion of the song, Jose clapped and then began to sing a song in Spanish for us. Again, tears threatened to spill over my eyelids and escape down my cheeks. When he finished, I got on the floor with Jose and put my guitar in front of him and let him play and sing until his heart was content. There was a great sense of accomplishment as we became his music therapists that day.

Through the course of our visit, Chris and I witnessed how music therapy can distract a pediatric burn survivor from the pain of bandage changes, debridement, staple removal, and pre- and postsurgical anxiety. We believe that if something as simple as music can help alleviate the need of narcotics and antidepressants, then it is a modality that needs to be implemented into every burn unit, and certainly something to be mindful of in the quiet sanctuary of the massage therapy room.

Chris Hallwas’s Story

Unlike Jen, I did not grow up in a children’s burn unit, but working with burn survivors has become a passionate mission for us both. Every burn survivor is different and every burn survivor I have been privileged to meet has enriched my life. I see each person as beautiful and unique. After a few minutes, the scars disappear and I see the wonderful person before me. The scars are no longer disfigurements, but a part of the survivor’s story and a testimony to their strength.   

My friendship with Jen began with our first trip to Nicaragua in 2008. I was honored to be a part of this amazing mission. We were eager to return for our second trip in July 2010, and someone was gracious enough to donate a guitar for our work. Jen brought the guitar to our first day at the hospital and immediately staff members were eager to try music therapy in the burn unit. Although our Spanish was lacking, and all of our songs were performed in English, we were asked to sing to a little girl in the Intensive Care Unit (ICU). Eva was from the east coast of Nicaragua, and they believe she was burned by hot soup—96 percent of her little body was scarred with third- and fourth-degree burns. A small section of her face and one hand were the only parts of her body spared from the scalding water. Eva was the only child in the hospital without a family member. With the exception of the loving hospital staff, Eva did not have anyone else. While other children in the burn ward had their mother with them at all times, 3-year-old Eva sat alone. We also discovered that Eva did not speak Spanish. Her village spoke a language called Mosquito and, at that point, no one could communicate with her at the hospital. The nurses told us that Eva had not spoken to anyone the entire time she had been in ICU.

Eva was covered with bandages. She had just undergone an amputation of part of her left hand, and all her wounds were bright red. Just moving the sheet to work on her bandages resulted in Eva’s heartbreaking cries. We suited up in gowns, lunch-lady hairnets, surgical masks, and gloves. Eva looked at us with big brown eyes and slight trepidation. We began singing and Eva’s nurses began moving her limbs and dressings. The screams started, but we continued to play through the first song. By the end of the first song, the child’s tears had diminished. The nurses motioned and asked if she wanted another song. Through crocodile tears, she motioned for another. The nurses were able to work on her, and through it all, she kept motioning for more songs. She actually spoke her first word in the process of asking for another song. I fell in love with Eva.

When it was finally time to go, everyone started leaving Eva’s room. I walked to her bedside and waved good-bye. She waved with her good hand. I then blew air kisses through my mask. Eva pursed her burnt little lips and blew air kisses back. The world just melted away for those brief seconds. Eva gave me more than I could ever give in return. No one will ever be as beautiful as Eva was at that moment in time. Music therapy brought happiness into a day that would normally be bleak. A smile and a kiss from a tiny pair of burned lips was not only a form of physical therapy brought forth by the music, but a true representation of what was accomplished on the inside of that little survivor that day, as well.

Lessons Learned

As therapists, we have always understood the importance of massage for burn survivors. We both love music and understand that music therapy is also important. But it wasn’t until we worked with Jose and Eva that we saw just how amazingly beneficial music therapy, in combination with massage and physical therapy, can be to a person’s entire well-being—not just physically, but spiritually, too. We hope to continue to learn and grow, and to find new and exciting techniques and tools that benefit burn survivors. And from what we have witnessed so far, music and massage do just that.


Jen Hartley, NCBTMB, and Chris Hallwas, are the co-founders of Handle with Care Burn Scar Massage, an international continuing education program that teaches the physical manipulation of burn scars as well as the compassion of touch for persons recovering from a burn injury. Jen and Chris can be reached at, Handle With Care Burn Scar Class on Facebook, or at 706-831-2889.