Delirium is a song-cycle about intensive care. It comprises 14 discrete pieces that interweave music with recorded interviews with former patients and senior nurses.
Delirium is defined by NICE as ‘disturbed consciousness, cognitive function or perception’; indicators include visual or auditory hallucinations, confusion, and ‘alterations in mood and/or attitude’ (NICE, 2010, pp. 4 & 7).
‘He’d set a lot of wires up under my bed, with explosives on, which he kept on trying to detonate, but every time he tried to do something, somebody came into the room, so he never succeeded, but I can remember him getting very close.’
‘The first one I do remember was the one where I was in the cinema and I was in the projector room … the next moment [I was] on an opening to the street where … part of me was being served as kebabs.’ (Project participants)
ICU delirium (sometimes called ICU psychosis) is both extremely common – Cavallazzi et al (2012) cite a 45-87% incidence in intensive care units – and little known. Despite links between these experiences and both increased mortality and post-traumatic stress the phenomenon remains under-researched and under-reported, and carries little weight in our perceptions of recovery, which remain focused largely on the physical body and its visible scars.
‘I think you use part of your surroundings, and then your mind makes things up’ (project participant). Delirium reveals the ways in which metaphor and narrative reinterpret, or even reconstruct reality in ICU. The cycle asks questions about care in extremis, and the ways in which the violence of intensive medicine is lived out in the mind; but it also points to the extraordinary resilience of the individual, and the centrality of humour and creativity to this resilience.
‘As one of your voices, that really was absolutely beautiful, thoughtful, intelligent, moving, considerate … a piece of musical work with such integrity both musically and in your interpretation of and use of the interview material’ (quote from a performance comments book).
Delirium was premiered in June 2013 at London’s Old Operating Theatre, before touring to venues including the International Conference of Culture, Health & Wellbeing, The Green Man Festival and the Royal College of Psychiatrists’ Trainee & New Consultants’ Liaison Psychiatry Conference. Delirium has been presented at the Medical Humanities in Africa conference (Cape Town) and the conference of the South African Society for Research in Music at the University of the Witwatersrand (Johannesburg).
An audio version is set for digital release in late 2014 – performed by Victoria Hume, Quinta, Christopher Reed and Adem Ilhan.
Most of Delirium’s interviews result from the generosity of the members of the Reading ICU Support Group – itself born out of Royal Berkshire Hospital groundbreaking ICU follow-up team.
The creation and first performance of Delirium were supported the PRS Foundation for Music Women Make Music fund.
- Cavallazzi et al (2012) “Delirium in the ICU: an overview” Annals of Intensive Care [online: http://www.annalsofintensivecare.com/content/2/1/49]
- NICE (2010) Delirium: diagnosis, prevention and management.