My name is Gareth, as you just heard, and I am a composer.

Already, I can feel a tiny flush of shame at the uselessness of my job title.

(Laughter)

Because composers; who needs them, eh?

I think that little bit of shame encouraged me to create something useful,

and that was a project to try and improve

the life quality and the life expectancy of people with cystic fibrosis.

For most of my career, I have worked in opera.

I write operas.

As you can imagine, I work with very big, very powerful, very agile voices.

They can fill auditoriums much bigger than this,

they can cut across an orchestra of 120 people,

they can even shatter glass, so the story goes.

They are like the professional athletes of singing and breathing.

But "Breath Cycle" is a project;

It's a community opera and singing project for fragile voices,

people who you don't expect to find in an opera or in a song,

kind of disenfranchised or excluded from the world of singing.

It's a series of exercises, opera scenes, duets, and songs,

and lessons, and interviews, and online sharing,

alongside the monitoring of health and well-being.

All the music I made

is informed by, and performed by people with cystic fibrosis.

I'll tell you a bit about cystic fibrosis.

It's a genetic, incurable disease.

It causes mucus to build up in the lungs.

This causes breathing problems, as you can imagine,

so a persistent cough would be a symptom.

Lung infection, shortness of breath, the pancreas can become obstructed.

Over time, the lungs become scarred;

the lungs become damaged, and they stop working.

The average life expectancy for somebody with cystic fibrosis in the UK is 31,

which I find very shocking.

From first-hand experience,

I met 25 people in my pilot study with cystic fibrosis.

In the last 18 months, four of them have died.

They were all younger than me.

I have a good pal with cystic fibrosis so we meet for a cup of tea now and again.

She has good days and bad days.

On the bad days I can tell

because it seems to take quite a bit of time

to get to the end of the sentence.

She said something that really stuck with me,

and it's that on the bad days,

she feels like she has to remember how to breathe.

We're very lucky.

That's not something that occurs to us.

We do take breathing for granted.

For example, I've been breathing this whole time on stage,

and you haven't even noticed!

(Laughter)

Let's not take the next one for granted.

Sit up straight.

Engage the diaphragm, as they say.

And let's take a big breath.

(He breathes in and out)

I really enjoyed that one. That helped!

We are very lucky because that was very easy.

That's not so much the case for people with cystic fibrosis, on their bad days.

I'd like to do another breath.

Let's take a breath,

but this time I'm going to give you a note to sing.

I want you to hold that note for as absolutely long as you can.

Let's see who in the room can hold it for the longest,

bearing in mind that I have to be wrapped up quite soon.

(Laughter)

Don't think there's a big jump from breathing to singing.

There isn't, as far as I am concerned; singing is just beautiful breathing.

Here's your note:

(Sings a note)

One, two:

(Audience mimic sung note)

(Laughter)

(Applause)

If I over-run it's your fault.

(Laughter)

I did the exact same little thing with people with cystic fibrosis

at the start of our journey;

I timed them to see how long they could sing a note.

It's one of the little markers we put in the sand.

The average was about 3-4 seconds.

You can see what I mean when I say they are somewhat disenfranchised

from that world of breathing and singing that we find so natural.

Everyday, someone with cystic fibrosis has to do physiotherapy.

This is a daily regime, a very ritualistic series of exercises and techniques

to get that mucus, to get that fluid, out of their lungs.

It's quite an arduous process, for up to two hours a day.

This is one of the first places I thought, "I'd like to help here."

I created a series of vocal exercises,

targeting lung function,

but in collaboration with physiotherapists at Gartnavel Hospital in Glasgow.

We asked the participants, over a period of time,

to do these vocal exercises, alongside their physiotherapy.

In many ways, I already see a lot of parallels

between the lives of the singers I know and work with,

and the lives of people with cystic fibrosis.

In that, there is this ritualistic regime, every day,

of keeping this instrument in top health and in good shape.

Alongside those vocal exercises, we went into Gartnavel Hospital,

with the support and collaboration

of Dr. Gordon MacGregor and his wonderful team in the respiratory ward.

We give singing lessons in the ward.

And this is the absolute highlight of this whole thing I talk about:

it's coming into the ward in the morning,

and hearing Marie Claire Breen, my gorgeous vocal coach,

singing with a participant,

and these beautiful voices coming down in the corridor.

That grabs me.

Because there's nothing more thrilling, as far as I'm concerned,

then hearing art or music

somewhere when you don't expect to hear or see art or music.

I would like to stop and show you a little clip of the kind of things

they get up to in these lessons.

One, two, three,

four, five, six,

seven, eight, nine, ten.

- Are we good? Ha, ha, ha. - Always speak and whisper.

- A-ha. - Aaa!

- Brrrrrr. - Brrrr!

Hi.

- Uuuu! - Uuu!

Sh-sh-sh-shhh!

Prrrrrrrrrrr!

- Eee-eee! -Eee-eee-eee!

- Eee-ee-eee, try that! - Eee-ee-eee!

-Eeeeeeeeeee!

-Eeee--! - Eeee-eee-eee!

- Aaa-aa--! -Aaa-aa.

So, thank you, thank you, thank you. Good.

That is a very traditional way to teach singing.

It's one-to-one, face-to-face,

and those are warm-up exercises and little vocal techniques

that singers use all the time

to keep that instrument working, and keep it at its maximum strength.

I've mentioned that for people with cystic fibrosis,

there are certain barriers that exist between them and singing.

This is a community singing project.

Not only are there barriers to singing,

there are barriers to that other word, "community",

because people with cystic fibrosis aren't allowed to meet.

They're not allowed in the same room as each other

due to the dangers of cross infection.

When I had the idea to make a community music project

for a community who can't be together, it did seem vaguely impossible.

But completely necessary.

I think the simple solutions are the best.

We opened up an online forum.

A place where they could upload their videos;

of doing their homework, doing their exercises, singing their favorite songs.

I wanted it to be a positive learning environment online,

that was about singing, nothing else.

They started to meet each other, they started to talk,

they really supported each other,

and we got that sense of involvement that can be difficult

when working with this group of people.

Our vocal coach, Marie Claire, uploaded here too.

She would upload feedback, videos, and little pointers, things to try out.

This was the little beating heart of our project, right here.

I'd like to show you another little clip.

This is the kind of videos that was turning up in our inbox,

and on our forum each week.

They'll probably kill me for showing these!

Man: Week two, track number one.

A-aaa-a-aaa-aah!

Woman 1: Aaaaaaaah!

Woman 2: Eeee-eeee-aaaa-aa-aaah!

Woman 3: Smile, though your heart is aching.

Smile, even though it's breaking.

Woman 4: Hey, Big Spender!

Speeeeend a little time with me.

Woman 5: Aaaaaaaaaa-aaaaau!

Uuuuu-uuu-uu!

(Applause)

I think you'll notice that some of them

have more of an understanding of showbiz than others.

Some of those camera angles weren't arrived at by chance, methinks.

(Laughter)

As to what I did then, at this stage,

I worked with a writer called David James Brock

who lives in Canada so we two collaborate online together.

We talked to the participants and from those conversations,

we made lyrics, we made libretto and text,

and then I sat in and I watched them learn to sing every week.

From looking at their range, getting to know them

and wanting to help push on their vocal development,

I created very bespoke and tailor-made melodies and vocal lines for them to sing.

I do feel I wanted there to be that sense of ownership in the musical material

that it genuinely belonged to all of us.

We made things like Skype-duets

where they could practice and perform together online.

We made some YouTube video installations,

and we made some ensemble pieces that we assembled

in the recording studio together

because I wanted them to be able to inhabit the same song,

even though they can't inhabit the same space.

Why do we make these things?

It's because there's nothing more exciting

than having people who traditionally aren't supposed to be in an opera,

in your opera.

It's the best thing.

I want to tell you now about the results that we have so far.

This is our pilot trial project.

Most patients showed a decent increase in lung function.

One delightful measure which is FEV1, their marker,

which is the amount of air you can blow in one second

and which is very closely linked to your life expectancy, actually.

We got an average rise here of 14%, which is very encouraging.

We are at the stage where we are looking for more participants.

Other hospitals are coming online to try this trial out.

We have hospitals over in Toronto, New York, and across the UK,

and we need to see 330 people with cystic fibrosis

over the next few years.

I'm very excited by this because I can't wait to write music

for people with cystic fibrosis all over the world, to perform together.

That's very exciting.

All these things make me wonder, and I always ask the question,

what's opera all about?

And "Who is it for?", and "Who should be in it?".

I think the answer is, "Everybody."

I guess if I had one hope and dream for this whole project,

it would be that in the future,

singing and vocal training will very much be part

of the way we treat and care for people with cystic fibrosis.

That's my take-away hope.

I'm going to stop soon, but before I go, let's have another breath together.

Inhale.

(He inhales and exhales)

I think that's how you know you're going to be OK in the future.

Just keep breathing.

(Applause)