Composing Care: Aesthetics and Affect in the Clinic

What makes care matter? In clinical settings, certain interventions are recognized as essential, while others are treated as supplementary, or fail to register as care at all. Yet some of these marginal therapeutic practices can feel profoundly meaningful to those who receive them. A brief encounter in music therapy can feel like “everything,” even as it remains peripheral within the clinic. Composing Care (monograph in preparation) asks how forms of care come to matter and how they register—or fail to register—as clinical care. Drawing on two years of multi-sited clinical ethnography in hospitals and their affiliated long-term care settings in Canada and the United States, this book follows music therapists working at the margins of biomedicine as they transpose musical acts (playing, listening, improvising, songwriting) into clinical care. This work includes making ephemeral encounters recognizable as clinical treatment—from charting sessions to establishing their legitimacy within interdisciplinary care teams. Their efforts are informed by longer histories in which clinical authority and scientific evidence are entangled with colonial, racialized, and gendered assumptions that constrain what can be taken seriously as therapeutic intervention.

Composing Care asks: what happens when therapeutic efficacy and evidence do not produce clinical recognition of care? Interventions do not become clinical simply because they work, but because they are perceived and understood as such within normative frameworks of evaluation. Moments that exceed these frameworks continue to matter as care, not only for what they do therapeutically but for how they register relationally, offering forms of recognition otherwise for patients at the margins of clinical and social life. Composing Care develops the aesthetics of care as an analytic that attends to both how care is experienced and made intelligible. It shows how affective intensities register care through felt immediacies and relations, while aesthetic arrangements organize what can be perceived, valued, and recognized as clinical in the first place. Clinical care unfolds through tensions between commensurability and dissensus, as practitioners align their work with clinical logics while simultaneously enacting forms of care that exceed them—indeterminate moments that do not make sense within dominant aesthetic regimes. These moments disrupt expectations of intelligibility, unsettle hierarchies of value, and reconfigure what counts as care. By foregrounding these dynamics, Composing Care shows that care is not simply delivered through interventions but composed through aesthetic and affective processes that are unevenly recognized and valued within clinical settings. In doing so, the book offers a new account of how clinical worlds are in the making and identifies both the possibilities and constraints for reimagining care in the clinic.