Performance, Medicine and the Human

Alex Mermikides

• Publisher: Methuen Drama
• Year: 2020
• ISBN:
  9781350022164
• Edition: 1
• Topic: Mezzi di comunicazione e arti performative
• Subtopic: Teatro

Performance and medicine are now converging in unprecedented ways. London's theatres reveal an appetite for medical themes – John Boyega is subjected to medical experiments in Jack Thorne's Woycek, while Royal National Theatre produces a novel musical about cancer. At the same time, performance-makers seek to improve our health, using dance to increase mobility for those living with Parkinson's disease or performance magic as physiotherapy for children with paraplegia. Performance, Medicine and the Human surveys this emerging field, providing case studies based on the author's own experience of devising medical performances in collaboration with cancer patients, biomedical scientists and healthcare educators. Examining contemporary medical performance reveals an ancient preoccupation, evident in the practices of both theatre and healing, with the human. Like medicine, theatre puts the human on display in order to understand and, perhaps, alleviate the suffering inherent to the human condition. Medical practice constitutes a sort of theatre in which doctors, nurses and patients perform their humaneness and humanity. This insight has much to offer at a time when established notions of the human are being radically rethought, partly in response to emerging biomedical knowledge. Performance, Medicine and the Human argues that contemporary medical performance can shed new light on what it means to be human – and what we mean by the human, the humane, humanism and the humanities – at a time when these notions are being fundamentally rethought. Its insights are relevant to scholars in performance studies, the medical humanities, healthcare education and beyond.

1

Introduction

Performance and medicine might at first glance seem to be distinct practices, separated in their opposing orientations towards the arts on one hand and the sciences on the other. But let us think of them as holding some fundamental concerns in common. In particular, let us consider their shared preoccupation with ‘the human’. This thought experiment reveals some parallel features and intents. Each domain positions human beings as its main object of enquiry. In doing so, each presents human bodies and behaviours for display and comprehension, whether this be upon the illuminated stage of a theatre or on the doctor’s examination bench. Both theatrical and medical technologies are designed to prioritize and enhance our ability to see: space is orchestrated around optimal viewing distances; the act of looking is enhanced through technologies of light and of expertise; a process of revelation is enacted. What is brought into focus in these acts of display and spectating reveals something about what we think humans are in any given historical and cultural context: is our attention upon the cell or the soul? What we see when we look at the isolated human cases arranged before us might construct, as well as reveal, our concept of the human, of humanity more generally. The individual humans who are presented in both performance and medicine might also represent something beyond themselves, they act as specimens and case studies: an interplay between the specific and the universal, the staged and the real. And through this reciprocity between the particular and the general, these performances have the power to shift our understandings of the human, as when medical discoveries (of genetics or mirror neurons, for example) reframe existing conceptions of what we are made of, what we are and what this means or when stage characters come to symbolize psychoanalytical constructs of human desire, as is the case, for Freud, with Oedipus.

Moreover, in both disciplines, these acts of presentation, representation, looking and comprehending are all prelude to an attempt at comprehending the human condition and, perhaps, alleviating human suffering. This is most evident, of course, in the clinical practices of medicine when investigation and diagnosis lead to a treatment plan. However, performance too invites the possibility of some sort of recuperative effect. This therapeutic potential is made literal in dramatherapy, of course, but a remedial orientation also underpins applied performance practices wherein there is an explicit intent to counter personal, social or psychological distress or dysfunction. It is also implicit in less literally therapeutic forms of performance, for example in the Western dramatic tradition theatre becomes a public arena in which fears, desires, suffering are played out for the entertainment, elucidation and empathy of the audience. Understanding theatre and performance to be, like medicine, a practice that is oriented around caring for and making better furthers the parallel we might draw between these distinct disciplines. And it invites us to examine both performance and medicine for what they tell us about the humane, as well as the human.

Because of this shared preoccupation with the human and the humane, performance and medicine have much to contribute to contemporary thought at a time when these concepts are being seriously interrogated. Since the late twentieth century, the notion of the human has been problematized, especially within the humanities. Indeed, recent cultural scholarship has proposed that we can no longer claim to be human and, furthermore, that we never were. Our posthuman condition constitutes the latest stage of a cumulative undermining of a model of the human, derived from the Renaissance revival of classical antiquity, which has until now been particularly dominant in our understanding of our own species. Dismantling the concept of ‘Man’ as the measure of all things has led to a questioning of our embodiment (to what extent does the human inhabit or constitute a body?); the privileging of some humans over others (are some humans less human than others?); our commonality to other entities that once demarcated our limits (how are humans distinct from non-humans such as animals, technologies and divine beings?) and our duty of care to those others and to each other (what does this shared kinship mean in terms of ethical behaviour?). Of course, advances in medical science and biotechnologies are a significant factor in these assaults on the human. However, our cultural products – including the theatre we make – also serve to reflect and construct what we make of ourselves.

Performance, Medicine and the Human explores some of the complex, layered and sometimes contradictory ways in which ‘the human’ is enacted in theatre and performance, in medicine and, above all, in those practices that sit in the interfaces, overlaps and splices between these domains. There is a long-established affinity between theatre and healing practices – after all, the ancient theatre of Epidauros shared a location with the supposed cradle of scientific medicine, the Temple of Asklepios. However, the early twenty-first century has seen a fascinating convergence between performance and medicine in the Western context, one that, I argue, has become notable enough to merit recognition as a discrete seam of practice. I will call this medical performance. On theatrical stages, performance-makers and audiences reveal an appetite for exploring experiences of ill health and medical treatment: the social, ethical or personal import of medical advances and new biotechnologies and political concerns about our public health services. This inter-sectoral reciprocity is evident too in what Brodzinski characterizes as the ‘developing field’ of ‘medicine, health and care and the performing arts’ (2010: 2), which includes, for example, theatre productions that take place in hospitals, in anatomy museums, or performance employed in public health missions or medical education. This book draws from across these and other settings, describing productions of canonical and new theatrical works that represent medical experiences, body art that incorporates medical technology, applied performance in healthcare settings, simulation-based medical education and ‘real world’ medical encounters between healthcare professionals and patients. For what I will here call ‘medical performance’ crosses a broad range of interdisciplinary and inter-sectoral engagements that might not otherwise be categorized as a singular field of practice. It is the diversity of forms, approaches and perspectives, however, that makes medical performance, thus defined, an especially rich site for exploring current fantasies and anxieties around the human.

Performance, Medicine and the Human, then, triangulates three main objects, each situated within fields of critical enquiry that overlap and diverge to varying degrees. Allow me, please, a few words of definition and orientation in relation to each of these objects in order to further define the purpose and scope of this study.

Performance

In using the term ‘performance’ this study draws upon the legacy of performance studies, a scholarly field which, in the late 1980s, radically expanded the remit of theatre scholarship beyond the world of the arts. For Richard Schechner, Marvin Carlson and others, ‘performance’ describes a continuum. At one extreme are ‘aesthetic’ performances that are clearly recognizable as artworks: the sorts of theatre productions that are investigated in this book, but also music concerts and recitals, circus, ballet, stand-up comedy, peep shows and so on. At the other end are ‘social’ performances, including parades, public lectures, rituals, ceremonies and, following Goffman, professional and social behaviours. All these performances share some basic features. They are events demarcated from others in time and/or place, for example by the opening and closing of theatrical curtains or the entrance and exit of the patient into and out of a doctor’s consulting room. They involve the presentation of human activity by at least one human to another (though the roles of performer and spectator can be blurred and inhabited simultaneously). There is an intention (not always conscious or explicit) to make something happen, to change what the participants and those who view them know, feel, understand and might do as a result – this is the ‘performative’ aspect of performance. And, at least in the definition that I employ here, this presentation takes place in a live encounter, so that there is a possibility that the performativity, and any resulting changes, is reciprocal. It is these features of performance that recommend it as a vehicle for exploring current conceptions of the human.

Having claimed to be adopting an expanded definition of performance, this study does at times foreground theatre more specifically, loosely defined here as the Western dramatic tradition derived from Aristotle. This is the case, for example, in the next chapter where an analogy is drawn between the formal arrangement of theatrical watching and of medical diagnosis. Although limiting some of the discussions to theatre ‘proper’ risks conservatism, it is justified because theatre can be understood as a special incarnation of performance and one that most clearly demonstrates the link I seek to make between performance and a prevailing concept of what we are. Kelleher makes a similar point in his essay, appropriately entitled ‘Human Stuff’. Outlining the ‘anthropocentric tendencies’ of theatre, he notes:

Theatre tends to privilege the representation of human life. It tends to be enjoyed – when it is enjoyed – by human beings, so much so that a general account of theatre as a mechanism of human interaction, or more elaborately a means of representation from – and to – a human point of view, hardly seems worth elaborating. (Kelleher in Kelleher and Ridout 2006: 21)

Indeed, in performance studies, performance (and theatre in particular) tends to be characterized as a distinctly human activity, a manifestation of our apparent sophistication as symbol-makers and language-users and our propensity to organize our social interactions and rituals for the common good. Bentley famously defined theatre as ‘A impersonates B while C looks on’ (1968: 150). In its rehearsal and enactment of actions, it draws on our self-awareness, our ability to imagine the minds of others and, with this, our capacity to pretend and dissemble for survival advantage over others, but also with playful or social intent. These anthropological and evolutionary accounts foreground theatre’s roots in ritual: it is our talent for language (spoken, but also visual, musical and bodily) and abstraction that enables us to tell stories in dramatic form, to conjure historically distant or supernatural or otherwise imagined characters and events. Doing so has a social or spiritual effect: it motivates public celebration or mourning, worship or warning. Assembling to participate in or watch a performance involves a sharing and dissemination of information and values; it is a cultural activity. Whether humans are indeed distinct from animals in these talents may well be contested – Huizinger reminds us that the ability to pretend is also common to predatory animals, for example in their play-fighting, Sheets-Johnstone suggests that there is a continuum between bacteria and dance artist Martha Graham, in terms of corporeal symbolism and sense-making (2009) and de Waal argues that the supposedly human monopoly on empathy is also shared with apes (2009).

What is presented on stage, and how it is presented, is revelatory of historically specific understandings of the human. This is apparent in the pictures that the stage presents of the world, for example in the extent to which the human figure is prioritized as the object of our interest, relative to the other occupants of the stage. In the Western theatrical tradition, stage pictures and stories tend to constellate around a central human character whose subjectivity, agency and action drive the dramatic narrative. Shakespeare’s Hamlet typifies the genre. The famous use of monologue in this drama of a young prince’s hesitant plans for vengeance exemplifies the Renaissance emphasis on the thoughts, feelings and linguistic expressiveness of an (often male, often socially, economically and politically privileged) individual, as they come up against the ‘slings and arrows of outrageous fortune’. This is a Renaissance model of Man, which has its roots in classical antiquity and that persists through Enlightenment humanism and to the present day. The challenge to this concept of the human posed by Modernism and then Postmodernist thinking is reflected in theatrical form. For example, Dada, Surrealist and Absurdist performance offered a radical devaluation of logocentricism, causality and rationality, emphasizing somatic, intuitive or aleatory approaches. The emergence of what would now be called physical theatre prioritizes the body over intellect and rationality, though it also included investigation of the object-like, mechanical qualities of the human body (particularly apparent in Meyerhold’s biomechanics or Decroux’s attitudes). Implicated in such theatrical genres are challenges to prior assumptions of how the human might be situated in relation to her universe and of the hierarchy between mind and body. Occasionally, theatre offers an intentional response to changing definitions of the human, for example in Beckett’s Waiting for Godot, if we accept Rae’s reading of this play as a medication on The Universal Declaration of Human Rights (2009).

The sort of performance that Lehmann described as postdramatic theatre also constitutes an important site for troubling established notions of the human. For in estranging the ‘partially conscious and partially taken for granted’ motifs of the dramatic tradition, Lehmann implicitly contests the models it generates of human subjectivity as the primary object of the audience’s attention. Likewise, his interrogation of ‘catharsis’ and the ‘social bond’ that this is assumed to create ‘emotionally and mentally’ between actor and audience also throws into question the supposed ‘humanity’ of theatre as a social event (1999: 21). As this suggests, the ways in which different theatrical and performance genres configure the live encounter between performer and audience expose assumptions about human interaction. For example, a Greek tragedy that invites the audience to observe ‘from the gods’ as inevitable catastrophe engulfs its protagonist might imply a certain futility in the face of human suffering. A participatory workshop in which a facilitator engages with, let us say, a group of children on the autistic spectrum or a movement therapy session for people in rehabilitation from stroke, will be framed by different assumptions about our moral responsibility to each other.

This definition of performance, then, implies a wide reach. I attempt to contain this scope, partly through a focus on performance practices of the late twentieth and early twenty-first centuries, and mostly in my attention to those performances that engage, in various ways, with the medical domain. For, as I will argue throughout the book, performance thus defined offers a fertile ground for exploring, engaging in and interrogating medicine and the experiences and encounters it entails.

Medicine

Like performance, medicine is broadly defined in this study, going far beyond the dictionary definition of drugs taken for the treatment or prevention of disease or to distinguish non-surgical therapeutic interventions from the surgical. It conflates what might more strictly be delineated as the myriad branches of biomedical science; clinical practices; aspects of public health but also experiences of illness and trauma. So when I refer to ‘medicine’ in the abstract (as though this vast and diverse array of human activity were a singular entity), it is as a shorthand to encompass the scientific project of understanding the human body, its processes and functions, the deployment of the resulting knowledge for the prevention or alleviation of pathology (including through less obvious ‘medical’ practices such as nursing) and biopolitical implications of how health, disease, well-being and illness are promoted and policed in the social domain. Although this definition of medicine is broad, it refers to Western medicine (which, of course, is not exclusive to the West). Little or nothing is said in the chapters that follow about healing practices that sit outside medicine thus defined: alternative, complementary, traditional, ‘folk’ medicine and so on. This is partly to delimit an already ambitiously broad field of study, but also because it is Western medicine, and the fears and desires that surround its practices and possibilities, that has drawn the attention of performance-makers and audiences and other communities of thinkers.

Born of the practices of dissection and anatomy, this conception of medicine has a historical point of emergence in the sixteenth century when, as Porter puts it, ‘the black box of the human body was being exposed to the medical gaze’ (2002: 59) and, as I will outline in the chapter that follows, instituted a new way of understanding what we are and how we might address our bodily frailty. In seeing anatomical dissection as the root of Western medicine, I am following Foucault whose Birth of the Clinic conceives medicine as an epistemological position based on rational and empirical principles and, in its professionalization and institutionalization, as a state apparatus and a disciplinary power. A second limiting factor is my predominant focus on medicine (and performance) in the UK, where, as I will suggest below, interdisciplinary engagements between medicine and performance constitute a burgeoning area of practice.¹ An effect of this locale is that the particularities of my own national context inflect some of the discussions. For example, it could be argued that the existence of a National Health Service (NHS) – in which treatment is funded through the taxpayer and offered free of charge at the point of delivery – might more convincingly characterize medicine as a ‘humane’ practice than insurance-based healthcare systems. However, what is significant beyond culturally specific permutations is an underlying definition of medicine that views it as both a scientific project that seeks to understand the human and a collective enterprise based on humane values of care and the alleviation of suffering.

It should be noted that what is not attempted here is a comprehensive survey of the many professional roles, specialisms or conditions that are encompassed by medical and healthcare practice. It is not for me to identify which of these should take priority within a volume that could not possibly cover everything that medicine does. I have not, for example, focused on priorities identified in public health and healthcare policy (our ageing population, for example, or the health effects of rising rates of obesity), nor those branches of biomedical discovery which are firing the public imagination, and, within this, the theatre community (e.g. the so-called brain sciences). Although a more methodical taxonomical exercise would certainly be of value to those mapping the field of medical performance, this is not my project. Rather, my study foregrounds medical experience and above all, the medical encounter as its primary theme. Experience of ill health, serious or otherwise, go to the core of what might be deemed the central tenets of ‘the human condition’: the fragility and impermanence of our mortal body, its vulnerability to environmental ills, to pathogens and to injury. When we seek to ward off or remedy ill health, even the most routine medical encounter – an eyesight test, a dental check-up, a mammogram – brings our embodiment into focus, reminds us of the vulnerability of our flesh. The pursuit of health and well-being also renders us dependent upon the surveillance, expertise and care of others, and the ways such care has been institutionalized within specific socio-economic and political contexts, as healthcare. Our subjugation to rituals of physical inspection and self-disclosure draws attention to our interdependence upon others, to the human capacity to participate in collective enterprises of both scientific and altruistic intent. Even when we are not directly under medical care, exposure to new biomedical understandings or technologies can disturb our no...

Table of contents

• Cover
• Halftitle Page
• Title Page
• Contents 
• List of Illustrations
• Foreword
• Acknowledgements
• 1 Introduction
• 2 Gazes and Stages: Looking at Bodies in Theatre and Medicine
• 3 Playing Doctors: Performing the ‘Humanistic Physician’
• 4 Chimeric Bodies: Posthuman Selves in Medical Performance
• 5 Taking Care: Cultivating Compassion in Nursing and Applied Performance
• 6 Conclusion: Performing Encounters and Entanglements
• Notes
• Notes on Productions
• Bibliography
• Index
• Imprint