Using the body to heal the body … Underglass, by Clod Ensemble, part of the Performing Medicine project. Photograph: Manuel Vason
Amid hi-tech machines, a blood-smeared body lies on a hospital bed with what looks like a bullethole in its side. It’s a mannequin, but one that sweats, breathes and bleeds. The room feels like the sort of eerily accurate A&E ward you might stray into at a Punchdrunk immersive theatre performance. But this is not a scene set for an audience. Instead, it’s part of a new £500,000 project at St Thomas’ hospital in Londonto train doctors, nurses and paramedics in physical theatre.
Performing Medicine is led by director Suzy Willson and her company Clod Ensemble. She has been working with medical students for a number of years, but this project – funded by Guy’s and St Thomas’ Charity – is the first to be embedded in a real hospital, working with frontline staff. Performers will work with the Simulation and Interactive Learning Centre (SaIL) at St Thomas’, which allows doctors, nurses and paramedics to experience emergencies before they have to attend them for real.
“It’s sometimes quite hard to get doctors to realise there’s an art to medicine,” says the centre’s Dr Peter Jaye. “Because to some extent it’s been pummelled out by science.”
Walking into SaIL, you immediately find yourself in a theatre of sorts. The hospital already uses sets and actors to train staff. Now, Performing Medicine will teach body language and communication skills through clowning, mime, and dance techniques. Willson will teach “the neutral mask”, a technique for getting actors to notice their own physical habits that she learned at the Lecoq theatre school in Paris. They’ll also work with touch – important for staff who have such an intimate relationship with patients, and improvisation – an overlooked skill in medicine, says Willson.
“Arts can offer a more lateral way of thinking,” she says. “There’s been a lot of research in medical humanities about people’s tolerance for ambiguity, and medical students have a very low tolerance for ambiguity. They’re so scared that they’ll get the wrong answer, they freeze.” The training will allow medical staff to step out of what Willson calls a “macho, competitive culture” on wards.
“Medical training is fairly regimental,” says Jaye. “I came out of medical school thinking I’d be able to diagnose everybody I saw with a condition that I could treat. That turns out not to be the case.”
For Jaye, the most important thing to impart in training is compassion – a key NHS buzzword after the fallout from the Mid Staffordshire hospital scandal. “There’s no doubt that healthcare may have lost its way with compassion as we’ve pursued this medicalised model of care,” he says. “I’m really frustrated by the way we’re reducing people to targets.”
Dress rehearsal … staff at the Simulation and Interactive Learning Centre at St Thomas’ hospital in London
Anne Marie Rafferty is professor of nursing policy at Florence Nightingale Faculty of Nursing and Midwifery at King’s College London, which will be involved with Performing Medicine. She says dance could help nursing staff create a better environment for patients. “Someone said to me once, 60% of our communication is non-verbal, so being aware of your physical presence, how you move and carry yourself and the energy you give out can set the tone in a ward.” For the patients, says Rafferty, “It’s about how safe you feel. If you walk into a ward and there’s a calm hum and people are smiling, there’s a lightness, as opposed to people running around like headless chickens.”
There is a growing body of evidence that artistic interventions can be beneficial for patients. Choreographer Joe Moran runs the Dance Art Foundation, which is currently touring hospitals. The dancers perform in public hospital spaces – foyers, coffee shops, waiting rooms – and in wards, often to people who have never seen contemporary dance before. “I feel like the hospital is a new frontier in performance,” Moran says.
If watching dance can be beneficial for patients, it’s also rewarding for the artists, says Moran. “We’ve had some very experienced dancers who’ve said this has been the most powerful performance experience they’ve ever had,” he says.
The close proximity of the audience, their lack of expectations and, most poignantly, performing in a place where people are acutely aware of their own bodies, adds up to something profound. Hospitals are often places of extreme emotion and distress. “I think the weight of that informs the nature of the encounter and the sense of meaning of the work.” Although Moran admits he has to be careful about those meanings taking on unplanned significance. In a hospital setting, a piece of Moran’s titled All Clear suddenly became loaded with significance, while a score with a single metronome sounded like a life-support machine. For doctors and nurses, Dr Jaye says the most important thing theatre and dance techniques can impart in training is humanity. “You’re present at the worst moments in people’s lives,” says Jaye, and doctors insulate themselves from those emotions in a way that can be detrimental to their own mental health. “I was taught to build a box around myself to protect myself. I built it really strong, out of concrete,” he says, which cut off his empathy with patients as well as his own emotions. “We’re not compassionate with ourselves, and it’s imperative that we start dealing with that.”
• Dance Art Foundation perform at St Thomas’ hospital, London, on 3 November, then touring.
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