Practicing Compassionate Creativity

Was your morning an epic journey? Did you smite the butter before spreading on your toast? Slay dragons on the road to Starbucks? Rescue your village of commuters from the drivers texting on the highway?

The performance artist Kali Quinn asked the audience to share with each other stories of their day  in Practicing Compassionate Creativity: From Neonatal to Geriatric, her powerful performance yesterday evening that opened season five of the Creative Medicine Series at Brown University, a unique collaboration between the Department of Emergency Medicine, the Cogut Center for the Humanities and the Creative Arts Council. Then, she asked us to take a few details and now describe them in such a way as to make them sound epic and larger-than-life. During both exercises, people jumped into conversation, often with complete strangers. The room buzzed loudly.

Trained in physical theater, and whose work has earned her a national and international reputation, Ms. Quinn took the audience on a wild and profound journey through the arc of a life. Her performance carried me to a deep inner space that resulted, paradoxically, with a feeling of great connection with those around me. In effect, I was clubbed by the magic of theater.

As an emergency physician, someone who must establish rapid trust with his patients, I was astonished by how Ms. Quinn created a spirit of trust with an audience that spanned students to retirees, healthcare providers to theater professors, dancers to public health experts, caregivers and patients. We hear rumblings that society has lost trust in medicine. The trust patients once held for their physicians has disappeared along with affordable tickets to Red Sox games. Maybe this deterioration belongs to a greater erosion of faith in the professions. Though, if we trust a Gallup poll, physicians are still keeping their heads well above ground, not as high as nurses, but far, far away from the trust dungeon, which is packed mostly with lobbyists and members of Congress.

Unlike Ms. Quinn, I’m not trained in performance. I lack her angelic voice and comedic gifts. My audience is also much smaller in the emergency department: a patient, along with his or her family and friends. They don’t know me, whether my medical chops are up to the task, or if my heart is tender. But I must earn their trust, or at least a measure of comfort, if I expect them to share their story with a stranger, albeit a stranger in a white coat. Their voices might crack from embarrassment or fear. Sometimes, they disclose habits, behaviors, and symptoms that, until then, were veiled from people closest to them. In the hectic thrum of the emergency department, it’s easy to forget that minor complaints to us might take on epic proportions in their lives.

There isn’t one method for establishing trust. No script, map or instructional video. Patients aren’t the same. Each doctor is cut differently as well. Ms. Quinn described the function of storytelling in our lives, the narrative arc that moves us from one point to another. The emergency department might appear to be a narrative disaster zone, but the important work we do, clinically and emotionally, operates only if we recognize and understand each other at the level of story.

When considering creativity in medicine, it’s important that we avoid drawing with broad strokes, resist the urge to work the arts to hard, turn it into a pill for humanism and empathy. Rather, we need more creativity in medicine because it focuses our attention towards process, expects us to make surprising connections, demands that we understand ourselves. Ms. Quinn incorporated scenes from two longer performance pieces to create a completely new experience. That process, she admitted, was fraught with roadblocks, anxieties, and yes, wrong turns. But the performance was an undeniably experience that I would call ‘epic.’

Creativity and innovation requires courage and vulnerability, a willingness to take chances, embrace discomfort, and risk failure. That is, creativity invokes those parts of us that make us human.I can’t examine the complex challenges facing patients and healthcare providers today without believing that medicine needs artists and creative thinkers, people who look and think about the world differently, fueled by compassionate creativity.

Jay Baruch (@JBaruchMD) is Associate Professor, Department of Emergency Medicine at Alpert Medical School of Brown University, as well as fiction writer, essayist, speaker, baffled participant in healthcare, and unabashed advocate for more creativity in medicine.

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