I can't teach it to you

I forget if today or tomorrow is 4 straight weeks of writing, but either way, thanks to anyone who has read one word of these entries. Deep deep deep thanks to anyone who has shown any level of support. I feel it appropriate to play the video for Bruce Springsteen’s hit song Dancing in the Dark because you can’t start a fire without a spark

 I am thankful for the stories in my life. I am bathed in people’s stories, both tragic and triumphant, at my work. It does tend to be one type of story that involves finding yourself in the hospital. Stories involving the hospital do have a similar feel. There are countless iterations, but they do all have similar feels. My experience at improv has provided countless stories as well. People who do improv come from a variety of different backgrounds and experiences, so I enjoy hearing the stories of people that I perform with. The act of preforming improv lets me interact with stories up on the stage most importantly. These are the most important stories for my own reflection because I get to help write their ending in the moment. I can reflect on the choices that were made to lead to a fun ending, the choices that made other choices on stage even more difficult, or the choices that made fun choices flow from one to the next. This happens in shows where the scene calls me to be a character I don’t like and shows where the scene calls me to be an exaggerated version of a character from my life (my favorite type of character to be!). I must accept the reality that has been created and make choices to have fun in that reality, knowing that some realities are harder than other realities for me to do that. 

I have limited but some experience with Theater of the Oppressed, but that form of theater heavily involves improv principles to change how people view their reality. In his book Rainbow of Desire, Augusto Boal wrote a good summarization of how improv benefits participants understanding of their own story

 “The fundamental hypothesis underlying the totality of the Theatre of the Oppressed: if the oppressed himself performs an action (rather than the artist in his place), the performance of that action in theatrical fiction will enable him to activate himself to perform it in his real life”

— Augusto Boal

This is how I feel improv has helped me understand that I am in my own story, and I can make choices to move my story in the direction of my principles. I take part in multiple stories and can make choices to have fun with each unique story and with each unique participant on stage. I see that there are always multiple endings available. It is inspiring to me to know that I can change the story I am experiencing in my real life. I can make the fun choice or the choice that brings more connection. It is also a responsibility because then with this view point, I bear some responsibility for the events in my life and it is easy to get trapped trying to figure out what percentage I am responsible for. That is where improv is helpful again, because no matter what the percentage is, there is always another choice for me to make to move in the direction of my principles. Even if my choice is 100% responsible for the negative event in my life, I have another choice coming around the bend that can move my life in a positive or more negative direction. I had to discover and feel this in some way before I truly believed it. That idea is palatable for most people in healthcare and the majority of people reading self improvement content. Where I think improv has helped me even further is feeling this ability, then understanding the experience is taking place within my patients, realize the importance of matching up with their story, and finally helping them see within themselves the ability to write the next chapter of their health story. I have seen many palliative care healthcare providers do this exceedingly well. As a specialty, palliative care has embraced improv as a teaching modality more than any other specialty that I am aware of, both at my institution and nationally. It becomes obvious because they are helping their patients write the ending of the story.

I think helping patients write the middle portion while getting caught up with the beginning of the story is part of the challenge of being a hospitalist. Improv has helped a great deal in encouraging people that I only recently met to continue to write their own health story. I think my main role is creating the scene for my patients to feel like they can write their own story. I can listen to them, try understanding the challenges they have faced, and present them with the opportunity for them to move in the direction of their principles. That’s the goal at least and understanding the stories within myself and what I can do to write my own story has been a great first step. I can’t teach that to my patients or learners but I can make choices where that empowerment flows easily from the choices made.

If you couldn’t tell, much of my thinking on improv and life and healthcare is inspired by music that I listen to. Today’s inspiration is brought to you by Arcade Fire. Enjoy!