Today is the last of three sets of ‘simulations’ that I have been observing as part of our research and development – these are training sessions run by the Nursing department for their student nurses, an opportunity to put their clinical skills to the test in safe but ‘real world’ settings. Today’s ‘sim’ for second year students, recreates the front rooms of three people with obvious medical needs (wound care, diabetes testing, instructions of how to use a nebuliser) – but the student nurses are expected to also pick up clues about their patient’s mental state, not only reading between the lines in their conversations with the patient-actor, but also from the environment. An empty box of Krispy Kreme Doughnuts hints at an almost suicidal depression for our bereaved diabetic patient. A crumpled rug represents a trip hazard for an elderly patient on crutches. The simulation set up for Mental Health nurses is dramatic in comparison as we are plunged into a large ‘ward’ of volatile clients. Some of the role-play actors have been embodying their ‘characters’ for many years and they have deep and complex ‘back stories’. The student nurses are presented with complicated and unpredictable behaviours.
The close affinity between medicine and theatre is obvious here. Not just in the actors playing patients, but in the nurses’ performance on their role, in their reading of the staged settings and suspension of disbelief.
Milton (our sound designer) comes to today’s rehearsal in the afternoon. We ask him to take his place in the bed and perform for him some snippets we’ve been developing in the morning. We’ve continued to play with the idea of the ‘composite’ nurse – two bodies representing one person. Dominique & Phil approach his bed side, peering around his hospital chart. Archana and Thalia slide through assorted roles and tasks, ending up trapped by a blood pressure cuff. As a former patient himself, Milton is quite affected by his confrontation with what he calls these ‘hyperbolic nurses… ‘four legs, four arms, two faces’. They capture something of the multiple roles that nurse’s play, and the almost mythical quality they can acquire in a dependent patient’s imagination.
As we continue exploring the creative possibilities of today’s pairings, Milton quietly moves around the space with his laptop, turning on taps, swishing curtains, fiddling with scissors. When we gather to cool down and debrief he plays us a little composition, made up entirely of found sounds from the ward we’ve been working in. Comical and eerie at the same time.
Thank you Dominique Vannod, Phil Hambly, Archana Ballal, Thalia-Marie Papadopoulos, Adam Kirkham and Milton Mermikides for your hard work today.
Buzzing from our first rehearsal in the ‘bed lab’ (simulated hospital ward at Kingston University)
I (Alex) kicked us off with some Lecoq-based exercises exploring a couple of fundamental skills: ‘disponibilite’ (being open, available and ready to respond) and ‘complicite’ (being hyper-sensitive to verbal and non-verbal cues and able to respond cleanly and sensitively to these). These skills align so neatly with Simon Baron-Cohen’s definition of empathy: being able to ‘read’ or imagine what others are feeling, and responding with appropriate emotions and behaviours.
Some of our exercises:
Navigating the space with an ‘autistic’ level of empathy – ie no interest in people, but a ‘single-minded’ concern with pattern and system. I first encountered this exercise in a workshop run by Nicola Shaughnessy (Imagining Autism) – an amazing felt experience that might approximate what it’s like to see the world at the ‘zero-positive’ end of Baron-Cohen’s empathy scale. And it resulted in a very tidy room!
Working in pairs, we took turns to lead a ‘blind’ (eyes closed) partner around the space. An embodied exploration of what Baron-Cohen calls being ‘double-minded’ ie having to think for our partner in a highly empathetic way. Thanks to Suzy Willson (Clod Ensemble/Performing Medicine) for the insight into how this exercise correlates with the experience of medical/healthcare professionals and their relationship with patients.
The afternoon session kicked off with Bex (former doctor, and our dramaturg) guiding us through a neurological exam, a prescribed set of questions and acts/gestures that become a strange sort of choreography between doctor and patient. Discussion centred on the strange intimacy of such exchanges – staring into someone’s eyes, stroking their face are normally gestures of romance but here they are enacted between strangers with an unequal power relationship. And those moments when the patient begins to understand, through a subtle change in the doctor/nurse’s behaviour, when something is wrong.
What happens when we treat people/bodies as objects? This idea (again from Baron-Cohen who equates it with being low on the empathy scale, but also a key concept of the ‘medical gaze’) underpinned explorations led by Adam in which we pushed, pulled, lifted and sculpted our own or each others’ bodies, discovering unexpected power dynamics and expressions of both potential cruelty and exquisite care. In another exercise, the ‘double-minded’ idea was folded into an exploration of a composite person (four of us moving as though with one intention). We ended with a gorgeous discovery: a double-nurse (Viv and Archana) pulled from bed to bed on the demands of her patient. Great potential in this image to explore the ’emotional labour’ of nurses (as explored in Pam Smith’s seminal study)
Big thanks to Adam Kirkham, Rebecca Seymour, Viviana Rocha and Archana Ballal for taking part!
Delighted to announce that we’ve secured funding from the Arts Council and from Kingston University for our next project. CAREFUL explores ideas about care and empathy, through the figure of the nurse – nurses, after all, are experts and artists of caregiving and are a resonant symbol for how the (feminine?) concepts of care, kindness, compassion are valued (or not) in the wider social sphere.
We’re drawing on a rich pool of expertise: staff and students in the Nursing department at Kingston University/St. George’s hospital are filling us in on the craft and experiences of nursing today – and giving us access to their simulated hospital ward, where the first show will take place. Also on board is nurse historian, Susan Hawkins, who is enriching our explorations with insights into how cultural constructions of the nurse continue to determine how nursing is understood and performed today.
Milton features with the amazing Peggy Shaw and Brian Lobel in this evening’s thought-provoking event, In-Patients – part of Performing Medicine’s Art of Healthcare series. What amazing company! The arts as a way of exploring the experiences of illness…
Today, Alex is with medical/pathology students at Imperial College – they are taking courses in medical humanities and death, autopsy and the law. Astonished by the thoughtful and creative artworks that the students are presenting, all based on testimony from the Alder Hay organ retention scandal. We’re at Charing Cross Hospital – where Milton was diagnosed and treated, 11 years ago – so returning here to talk about bloodlines is somewhat emotional.
Alex, Milton and Bex feature as part of ‘Cancer Week’ at Guys & St. Thomas’ Hospital.
Using clips of bloodlines, we offer three perspectives on the experience of stem cell transplant: the patient’s (Milton), the donor’s (Alex) and the doctor’s (Bex). Wonderful students, asking thought-provoking questions. Big thanks to the Clod Ensemble for putting us up for this.