Performing on a makeshift stage in front of an audience of more than 40 people, Astrid Heger portrays a scene uncommon in plays: a medical setting reenactment. By reviving scenes of the tensions faced between doctors and patients, the play urges participants to think of outside-the-box solutions to these situations through theater.
Through her program ACT Together, Heger, a professor of clinical pediatrics and director of the Violence Intervention Program at LAC+USC Medical Center, uses theater to teach clinical workers about empathy and responsibilities when dealing with difficult patients and medical situations. She created the program in 2017 in partnership with LAC+USC Adult Care Clinics.
“Any area where there might be conflict or disagreement is fair game for this discussion,” Heger said. “What do you do about patients who are sexually aggressive? What do you do about patients who are claiming privilege and are late for appointments and are aggressive?”
Once the actors reenact the issue, the play turns to the audience — made up mostly of clinical employees — to offer solutions, replace the characters on stage and improvise scenes. Other actors follow along with their improvised acting.
Co-director Brent Blair, a professor of theatre practice in voice and movement, said ACT Together aims to dramatize case consultations where physicians and nurses meet to discuss issues they have faced dealing with patients.
“Typically, these case consultations are just people talking, standing up and presenting ideas,” he said. “[Josh] Banerjee thought it would be a really good idea to put some of them into a theatrical form. In that way, the complex stories are better understood, they’re more quickly accessible.”
Banerjee, co-founder of ACT Together and associate medical director for transitions of care at LAC+USC Medical Center, said the program engages employees to problem solve clinical issues, especially when working with other professionals
“You encounter these really challenging situations … You need to navigate it together as a team as well as possible, and some of those situations can come up repeatedly,” Banerjee said. “Basically we’re looking at ways to help continue to improve the way we function as a team.
The underlying methodology of the program’s plays comes from Theatre of the Oppressed, a workshop that uses theatrical techniques to represent issues in real life and engage the audience to take actions, Blair said.
“Our job is not to is not to perform a play, our job is to invite a dialogue,” Blair said. “Our objective is not the production of art. Our objective is the production of a critical dialogue through the medium or the language of art.”
Blair described that one of the scenes of a play included a doctor discovering a female patient trapped in an abusive relationship with her husband who insists on staying in the examining room during his wife’s physical exam.
Heger proposed a solution by positioning himself between the couple and looking directly into the wife’s eyes to silently encourage her to tell her husband to leave so that Heger could investigate the bruises on her skin.
“Afterward people say, ‘Wow, I never would have thought that could have happened,’ or ‘I [wouldn’t] have tried that before,’ or ‘That’s a big problem in the clinic, and we’re also overwhelmed,’” Blair said. “The discussions didn’t stop in the play. They continued days and weeks afterward.”
Blair said dramatizing case consultations is important since it increases work efficiency by boosting the morale of employees and involving them in the process of team building when they are under stressful situations.
“When there’s a low morale in a workplace due to high stress or situations of difficulty in a public health facility … these stresses [lead] to a sort of a systemic breakdown in efficiency and higher than normal turnaround in the clinic,” Blair said.
Heger said she hopes ACT Together can be a standard means of education in the future, which will create lots of career opportunities for people interested in learning through acting.
“We see it as transformative for those who participate, but also as a means toward career choices for individuals that are trained and want to get involved in this,” Heger said.