Performing Medicine

Performance and medicine may not seem like the most likely pairing, yet since 2006 the Clod Ensemble has been running a project which brings these two disciplines together, providing training to medical students and healthcare practitioners using the performing and visual arts. ‘Performing Medicine’ is a collaboration between the Clod Ensemble, Barts and The London School of Medicine and Dentistry, and the Department of Drama, Queen Mary University of London. The medical anthropologist, Arthur Kleinman, has described an “absence of presence” in the medical profession. This idea of presence is key to improving the performance of healthcare. Like theatre, medical consultation is a live event – an unrepeatable moment in history. Methods found in performance and theatre can help improve what we might call the ‘stage presence’ of our doctors – the way they present to patients and, indeed, to each other. As Director of the Performing Medicine project, I am aiming to introduce students to what theatre teachers might call pre-performative skills: physical awareness; stamina; calm; balance; concentration; voice skills; confidence; listening; and readiness for action.

Physical language
Notions of scientific objectivity sometimes make demands on doctors that divorce them from the reality of patient’s lives and bodily experiences. Medicine is not a pure objective science, and medics need to nurture interpretive skills and accept the subjective elements of their profession – especially with patients who might be very different from themselves. Medicine was ‘performed’ totally differently 50 years ago, and it will be different in the future, so it makes sense not to leave this to chance or a sense of natural development. A poetic understanding of the body as physically expressive can sit beside a scientific model of analysis, without compromising it. This approach, the product of a dialogue between arts and science, can enrich the experience of consultation for both doctor and patient. We have delivered over 250 arts-based workshops to medical students across London. During this time we have had many conversations about the benefits of collaboration between artists and medics. What can the arts bring to medical training? How can we ‘humanise’ and restore faith in a medical profession that many people find intimidating and alienating? What do we mean by the rights of patients? How can we unwrap some of the political issues around ethnicity, gender, power and dignity in relation to medicine and public health? There seemed to be a shared interest in these questions from doctors, patients, policy makers and the general public alike, so in autumn 2008 we invited a wide range of artists, medics, ethicists, health carers and cultural thinkers to bridge academic and institutional divides to investigate. This took the form of a series of public events in London.
We invited contributors whose work might illuminate contemporary medical practice and vice versa. Acclaimed performance artists, Bobby Baker and Kira O’Reilly, spoke about their own work in relation to the idea of a medical gaze, and explored ideas of detachment and empathy in art and medicine; Peggy Shaw performed ‘Must’ – a show she made with the Clod Ensemble – offering audiences a poetic look at the way she inhabits her own flesh and bones. Antonio Damasio, Professor of Neuroscience at University of Southern California, revealed how emotions play a central role in social cognition and decision making, and Elaine Showalter discussed charisma, authority and power in medical practice with Faith McLennan, senior editor of the Lancet. Clare Matterson, Director of Medicine, Society and History, at the Wellcome Trust, which funded the season, describes the benefits of the project, “We were delighted to support the public elements of Performing Medicine, as part of our ongoing commitment to provoke and promote dialogue between artists, scientists, clinicians and the rest of society.” This dialogue and discussion is what the project is all about – an opportunity to examine our expectations of the healthcare profession, to share responsibility for its evolution, and to enrich the ways in which we think about and experience our own bodies.
A healthy prognosis
For the Wellcome Trust, the advantage of bringing the project to a wider audience was clear. “By opening up to the public the work they do with healthcare professionals, the Clod Ensemble has broadened debate around the various cultural contexts in which doctors practise – or ‘perform’ – medicine in the UK. It has allowed people to add their voices to the discussion and to engage with some of the many important social and ethical issues around modern healthcare through seminars, debates and the performing arts.” Yet these discussions have not been without controversy. In the target-driven, evidence-based culture of medicine, arts work within the NHS is interrogated for being a potential waste of time and money, and this goes for medical training as well. Its proliferation in medical schools relies on the willingness of staff to collaborate with artists and arts departments, as well as a commitment from medical schools to rethink ways to access a packed core curriculum. In my experience, the desire to collaborate is there and is growing.
Life support
Artists work in very different ways from doctors and academics. On a very practical level, in order for these relationships to be fruitful, it is important that institutions understand the stresses and strains of surviving as a small arts company or independent artist. Many artists are nervous of working in these contexts for fear that their work will be appropriated, swallowed up by the institution or simply that their pay claim will not move through the system quickly enough. Despite these institutional challenges, medical schools are embracing this type of interdisciplinary work more and more. Professor Chris Fowler, Dean of Education at Barts and The London is clear about the benefits of this kind of arts-based project within a medical setting: “Performing Medicine gives our medical students a set of powerful and novel tools that help them to interpret and interact with the world around them.”