Doctors as performance artists

A summary of Doctors as Performance Artists. Supports my thesis that we can benefit from viewing our work as peformance on a stage; drama, tragi-comedy and all. More to follow.

1. Strange habit of visiting patients = performance • Counsellor • Motivator • Assessor
2. Learning from experience = audience
3. Doctors whom patient feel better for seeing have elusive quality of empathy
4. Source of empathy same for artists = discovering the person behind the façade (authentic encounter) by seeking the real reasons (as opposed to good reasons) for action (Drives?)
5. Successful performance requires the appearance of truth • 9/10 mind and body • 1/10 mind = pilot
6. Manifestation of artifice = harm
7. Performance (creative activity including essence, motives, personality) cf role (Brando)
8. Role play = bed-side manner. “Almost all absurdity of conduct arises from the imitation of those we cannot resemble
9. Limits to the parts playable (e.g. coarseness) • Personality • Physical shape • ‘spiritual comprehension’
10. Teaching doesn’t go beyond ‘communication skills’ • Role play (Skelton) • Patronising (Hammond) • Banality (Skelton)
11. Banality = list of communication skills e.g. eye contact etc (obvious)
12. Diminution of craft to role-playing encourages us to ignore quirks/variance (limitations on acting), e.g. eye contact, due to various influencing factors
13. To accommodate and maintain the illusion of mechanical skill, we talk about appropriateness/reasonableness.
14. Performance not plagued by such equivocations. Personality sometimes the most powerful generator of empathy and understanding.
15. Tricks cf craft = “reductionist snobbery” (Silverman), not only scientific approach to complexity
16. Skelton: Attitude to medicine and professional life more important than communications skills. Teachers of drama and creative writing concentrate on ‘the self’ (cf comms teachers)
17. Good practical reasons for following example of these teachers (Emotions influence us and our patients – regret, guilt, fear, betrayal, loneliness, other perplexing emotions)
18. Perception of the nature of illness • EBM • Individual’s needs • Dr’s knowledge and experience of patients • Understanding from the arts
19. The ‘healing art’ of outcomes as spreadsheets (the more a medical performance is based on understanding, the more likely it is to be therapeutic.
20. Targets cf ‘helping people survive in some sort of harmony with the world around them’