Sound Will

“What’s the last sound I get to hear?” — Yoko K. Sen, ambient electronic musician

Yoko Sen’s work as an ambient electronic musician was all about mitigating discordant sound. “For a long time I performed music composed and designed for museums, art events, embassies, airline companies: places of luxury and comfort,” she says.

Then she got sick. That ushered in a long period of time spent in a hospital bed. Long hours and a musician’s ear gave her a lot of time to listen — and she wasn’t thrilled by what she heard. Monitors beeped in discord; alarms sent medical care teams rushing toward emergencies. At night, she could hear other patients moan and scream.

The grip of serious illness led her down the path of aural curiosity. “Some people say hearing is the last sense to go when we die — so what’s the last sound I’ll get to hear at the end of life?” she asked herself, listening to the alarms and cries from nearby rooms.

According to Florence Nightingale, “unnecessary noise is the cruelest absence of care.” Yoko wanted to bring the awareness of sound design into hospitals, creating spaces that alleviate suffering through sound. When she got well and left the hospital, the idea for both an art project and an entrepreneurial venture was born.

Yoko was already familiar with IDEO: she’d participated in a two week intensive internship called Fortnight at IDEO Cambridge (designing robots that learned empathy through music, voice, and code). During that time she followed OpenIDEO, hoping for a Challenge relevant to her. When the End of Life Challenge was announced, she was eager to jump in.

Her idea of a sound will encourages people to meditate on the question: What’s the last sound you wish to hear before you die? She received hundreds of responses — loved ones’ voices, a train whistle, the ocean. She compiles answers into beautiful sound compositions with a communal, powerful voice. The sound will concept was even written up in The New York Times.

“In this sort of social entrepreneur ecosystem, there’s so much emphasis on direct service,” she said of the initial stages of her idea’s development. “I thought I had to come up with a product or service, and I have to go to the hospital to do it.”

In the hands of OpenIDEO’s community of designers and thinkers, however, the idea took a very different direction.

Morgan Meinel, a palliative care nurse at New York’s Mount Sinai Hospital, found Yoko’s concept resonant. It inspired her to start playing music to patients in their final moments, before she took them off of life-support. Seeing a change in the peacefulness of the death for both patients and their families, she reached out to Yoko to thank her for sharing the idea.

“That’s the moment I realized: the idea is already making a difference,” said Yoko, noting that she didn’t even need to leave her home in D.C. to achieve that. “That was a really, really powerful moment for me.”

Yoko is now in partnership with Sibley Memorial Hospital, part of Johns Hopkins Medicine. They are piloting the project to improve the lives of staff, patients, and families. One recent shift featured a new room targeting nurses and caretakers, recognizing their need for a physical space of stillness and peace. Hundreds of nurses visited the Tranquility Room, asking how they could bring it to their own psych wards, ICUs, and recovery rooms. The hospital community was now driving the change. On the artistic side, she’s performed her sound will pieces at the Saga Artist Residency in Iceland and Stanford’s MedicineX.

From her own experience, Yoko is keenly aware of the need for sanctuary in hospitals: a moment to rest and reflect during possible terminal illness. She’s thoughtful — and curious — about what her last sound will be when the time comes. The answer for others is usually something like a loved one’s voice or the sound of children laughing.

Yoko’s answer demonstrates the beauty she sees in death — as well as her musical composition process. “I’d like to hear the music from the place I’m about to go.”

Yoko shares insights from her Sound Will project during OpenIDEO’s Re:imagine End of Life week.

Read more stories about the people, ideas, and moments of OpenIDEO’s End of Life Challenge.