Furniture therapy - Allegro

Fifty years ago today, Brian Eno recorded “Discreet Music” using a synthesizer that had on-board memory, along with a graphic equalizer, an echo unit, and two tape recorders, and 50 years later you have an ambient music button on your iPhone.

It’s correct to say Eno didn’t singularly invent ambient music as we know it—that credit needs to be shared with Judy Nylon, who introduced Eno to the idea by playing a record of harp music at a barely audible volume while he recuperated from a car accident. Nor did either of them invent the concept of ambient music, which goes back to at least Erik Satie, who coined the term “furniture music” in 1917. But it is entirely fair to say he popularized it like no one else, and that started in earnest with the 31-minute long “Discreet Music.” Source, retrieved 10 May 2025

From the series Svitlo (Light) by Nika Krykun. Source.

In the first two pieces in this series I talked about the origins of Eric Satie’s furniture music, and some of its core principles.

For this third piece I want to see if we can take the principles at furniture music and apply it to healthcare.

Healthcare is often performative. It frequently involves a specialist or an expert seeing a patient episodically for a brief moment of organised care, often lasting just a few minutes, sometimes repeated over the course of a few weeks.

This kind of healthcare is expensive and inaccessible to lots of people who don’t have the disposable income or time to meet their half of this sick role play.

In many ways this is akin to the kind of classical music that Erik Satie struggled with when he was listening in the early part of the 20th century. He saw it as too much of a spectacle, too dependent on the skills of a narrow set of expert musicians, as bourgeois and elitist.

So his approach to furniture music was not just about changing the way that music was made, but changing the way music was experienced.

Satie’s approach would democratise the way that people performed and listened to music. It made music simpler, much more accessible; taking it out of the hands of the classically trained musicians, and putting into the hands of everyday people.

It redefined what music was, and changed the very politics of music.

So could we apply a similar approach to healthcare?

If we take one of the basic tenets of furniture music and minimalism, that being repetition, we can see some obvious parallels with healthcare.

For instance, minimalist music is often made up of simple phrases that are easy to learn and perform and therefore more accessible, easier to play, more empowering for the musicians, and more democratic.

Minimalist repetition also emphasised different rules of combination, so the way that the various small components fit together determines the originality of the work.

Originality becomes effectively limitless with the participants deciding how to progress through the piece, how long they want to play for, how many repetitions to perform, and so on. Indeed, some performances may last many lifetimes.

So here we have a couple of interesting propositions for the way healthcare is performed.

• What if healthcare could be performed over years and not in short 30 minute appointments every three weeks?

• What if the patients themselves decided the rules of combination to produce a piece of healthcare that was original and specific to their particular needs and situations?

• And what if simple therapeutic phrases could be developed between the carer and the patient in such a way that they were easy to learn and perform?

In that way, might healthcare, like furniture music, become entirely open?

As a health professional I'm very familiar with some of the objections that people might make here. For instance:

• What would this do to the health professions themselves?

• Aren't there some healthcare practices that can't, or shouldn't, be democratised?

• And isn't this process of simplifying repetition in practice just the same kind of routinisation and demystification that's been happening in healthcare for over the last 40 years under successive neoliberal governments?

These are all absolutely fair concerns.

An approach to healthcare like this would be a significant threat to the prestige and privacy of healthcare experts and specialists.

But as Daniel and Richard Susskind have argued before, one of the problems with healthcare today is that the expertise of the best is only ever available to the few (Susskind & Susskind, 2015).

So one of the problems with our current model of healthcare is that it leaves too many people out. Often, paradoxically, the people with the greatest need.

So one of the principal motives for moving towards furniture therapy would be that it would increase people’s access to basic healthcare therapeutic tools and skills.

With regards to the second concern, yes there are some healthcare practices that should remain in the hands of experts and specialists, especially those things that require acute and critical care.

However, this kind of healthcare is mercifully uncommon. The majority of healthcare that goes on in the world is informal, often routine, mundane and quotidian. So the existence of some special cases shouldn't be a barrier to reform for the rest.

The third concern about the ongoing demystification and routinisation of healthcare is absolutely the reality for most people today.

Healthcare practices are being decomposed and automated at a rapid rate as healthcare becomes increasingly atomised.

Neoliberal forces are trying to turn healthcare into a series of marketable commodities for private interests whose primary motivation is to make money, not to make people better.

Furniture therapy absolutely does run the risk of accelerating this process.

Perhaps my hope, though, is that we see a similar thing happening in healthcare to that which has happened in music which, for over a century has seen the flowering of an extraordinary range of new genres, approaches, techniques, and technologies, that have put music into the hands of everyday people, without taking away the joy of the special event: the classical concert, the one off live performance, the record produced by an artisan.

There is nothing to suggest that the one off spectacle can't coexist with furniture therapy, but at present healthcare places too much emphasis on the former at the expense of the latter.

Reference

Susskind, R., & Susskind, D. (2015). The future of the professions. Oxford University Press.