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Beginning of article

ABSTRACT

Ever since Gary Graffman and Leon Fleisher, both renowned pianists, made public disclosures of their playing-related injuries in 1981, the many health issues that are faced by musicians in their profession have gradually come to light. The research and study by medical professionals, musicians, and educators that has followed continues to blossom, bringing with it an ever-growing body of literature and educational programs. At the turn of the twenty-first century, the National Association of Schools of Music included the first language in its handbook encouraging schools of music to address these issues. In response, additional research and projects have been undertaken that have led to some important changes in educational approaches in a variety of music programs. This article provides an overview of the field of musician wellness, examines its history and literature, and details the traditional and nontraditional roles that have been played by the author in various aspects of health promotion for musicians. Collection development, circulation and replacement patterns, and reference sources are discussed along with information about the course, Mind and Body Health for Musicians, and the 2004 Health Promotion in Schools of Music conference. A list of essential resources for collections and reference along with information on wellness courses taught in the United States are provided.

**********

Two roads diverged in a wood, and I,
I took the one less traveled by,
And that has made all the difference
--Robert Frost, The Road Not Taken

Music history is full of evidence that musicians have serious health concerns that affect their profession. Traditionally, these stories have been told in the context of describing the eccentricities of great creative geniuses: Beethoven lost his hearing; Chopin's tenuous health affected his playing; Schumann had a self-inflicted hand injury, attempted suicide, and committed himself to a mental institution. More often, the many musicians who struggled throughout the centuries as well as those who struggle today with injuries and other physical and mental-health concerns have relegated their problems to the shadows in secrecy. This began to change when the playing-related injuries of Gary Graffman and Leon Fleisher, both renowned pianists, were made public in a New York Times article in 1981. (1) Since that time, information about the many health issues that are faced by musicians in their profession has gradually come into the light.

Within the decade following the publication of the Times article, medical practitioners hosted their first Symposium on the Medical Problems of Musicians, the first issue of the journal Medical Problems of Performing Artists was published, results of a major research survey on the medical issues of orchestral musicians among the forty-eight professional orchestras belonging to the International Conference of Symphony and Opera Musicians was published, (2) and the Performing Arts Medical Association (PAMA) was established. Research and information dissemination continued to expand in the 1990s as an online musician-health survey sponsored by the University of North Texas was undertaken; the Textbook of Performing Arts Medicine was published; and an ever growing body of programs and literature documenting the research, study, and experiences of medical practitioners, musicians, and educators emerged. (3) These three distinct groups share similar interests in and concerns about musician wellness, yet they each have a very different focus.

The group with the largest output and earliest publications is the medical professionals. Although most of their publications are clinical in nature, some of their later writings have an educational focus. Their educational programs and materials can be divided into two categories: one goal is to train other medical practitioners, and the other more recent goal is to educate musicians. Musicians were the next group to actively come onto the scene. Much of their output can also be divided into two categories: one for the purpose of gathering and sharing information in the form of bibliographies, written primarily as theses and dissertations, and the other by injured musicians who struggled through a maze of insufficient knowledge and uneducated medical practitioners to bring their personal messages to fellow musicians. The injured musicians' contributions are often very passionate, with a strong desire to share their hard-won knowledge with other musicians. (4) As more information became available, music educators added their voices to the conversation. Although the Music Educators National Conference's (MENC) Handbook of Research on Music Teaching and Learning was first published in 1992, it was not until the second edition in 2002 that information on wellness was included. (5) As educators began their own research and started writing from a pedagogical viewpoint, they also added arguments for the need to include wellness education in the music curriculum.

An important milestone was reached in 2001 when the National Association of Schools of Music (NASM) included the first language acknowledging the need for attention to these issues in its handbook. (6) In later editions the association expanded on earlier language, which had merely encouraged programs to connect students with qualified medical professionals, to encourage schools of music to provide access to education about physical and mental health issues as well as providing prevention information. (7)

THE MUSICIAN-MUSICOLOGIST-LIBRARIAN AND MUSICIANS' WELLNESS

From the beginning of my career as a music reference librarian in 1981, I observed music student and faculty needs for health information and resources relating to their profession. These needs were not only obvious from their requests for research assistance, but also from my interactions with them while performing and socializing. (8) As students got to know and trust me, they often would ask wellness questions, and would seek me out to find a neutral sounding board to discuss their issues. As a performing musician, educator, musicologist, and librarian, I have always looked for practical applications of my research and study, and have easily combined these worlds by focusing on performance practice and information literacy. With a practical and service orientation to life, and my information specialist hat firmly in hand, I began searching for both informational and human resources that could help these students answer their questions. I found interesting information about publishing and research trends as well as implications for the traditional activities of a librarian: collection development, circulation, and reference.

Publishing and Research Trends

As one might expect, publishing patterns followed the development and historic events in the field. To get a better sense of the history of the field and to confirm what I had learned from over twenty years of observation, I compiled a list of books and theses from searches in OCLC using the main subject headings that relate to musician wellness (for a list of subject headings used, see appendix A). I added important titles to the list that did not show up in these searches. This gave me a detailed picture of research and publishing trends in the field. As the "Mono-graphic Publishing and Research Trends" chart shows, few works were written in the first half of the twentieth century. The number of books and theses increased slowly from the 1950s to 1980 with a tremendous growth rate from the 1980s to 2010. While there were a few more theses than books written in the 1980s, the number of published books grew at a much faster rate starting in the 1990s, more than doubling the number of theses in the first decade of the twenty-first century.

There were few dissertations and theses about musician wellness written before the 1980s. Those that appeared in the middle decades of the …