Performing Medicine

By John Graham-Pole 

 

For more than three decades, the University of Florida’s Arts in Medicine program (AIM: artsinmedicine.ufhealth.org) has brought visual, literary, and performance artists into the hospital’s wards and clinics. Its mission has been simply to enrich the experience of patients and caregivers through countless forms of creative expression.

When my nurse colleague Mary Rockwood Lane and I co-founded Arts in Medicine in 1991, we held a strong conviction—we had little objective data to prove it—that art could be a powerful healing force for both care recipient and caregiver. Our first visiting performers were dancers Stuart Pimsler and Suzanne Costello, founders of the Stuart Pimsler Dance & Theater (SPDT).² They moved gracefully through the hospital atrium, their gestures echoing the rhythms of breath and pulse. Patients and staff gathered to watch, transfixed. In those moments, the hospital atrium transformed into a deeply human and hopeful space.

Four years on, we established the Center for Arts in Medicine (https://artsinmedicine.ufhealth.org/the-center/education/) to teach and to explore how these creative encounters were shaping our care.³ What we have found, through countless moving stories and performances, is that art restores a sense of agency, play, and imagination to places often stripped of all three. And over time, something even deeper became clear to me. The practice of medicine itself is, at heart, a performance art. Whether at the bedside or in the operating theatre, we doctors are performers as much as practitioners. How we carry ourselves—our gestures, posture, tone of voice, even our pauses between words—can heal or harm, as sure as drugs or scalpels.

The Art of Presence

It was a child who first awoke in me this awareness of caring as performance. In 1969, on the very first day of my pediatric internship, I opened the door of the toddlers’ ward and a three-year-old advanced fearlessly upon me, arms stretched straight up. The message couldn’t be clearer. I dropped to a clumsy kneel and she clambered into my arms, pressing her bib—coated with ice cream, spaghetti, and rice pudding—against my brand new shirt and tie. I hugged her right back, savoring this instinctive bliss. Soon after this, I had to break dome heavy news to a teenage boy that our chemotherapy was no longer working to keep his cancer in check. He listened attentively, then chided me:

“Lighten up, Doc—I don’t need a bunch of solemn doctors around here!”

This boy’s protest had me adopting a costume of funny ties and odd socks on my ward rounds. To staunch my patients’ frequent snuffles, I would slowly and dramatically draw from my trouser pocket a three-foot-by-three-foot square Union Jack silk hankie.

“It’s okay, I haven’t used it,” I reassure both my patients and their parents.

These unscripted acts of performance taught me that our bodies speak a language all their own. Every caregiver struts the stage, whether we acknowledge it or not.

The writer Anatole Broyard, in Intoxicated by My Illness, has a hilariously courageous description of living with advanced prostate cancer ¹. Hooked up to both intravenous and urinary catheters, he found himself with “an irresistible desire to make jokes,” crying out for “a witty doctor who could appreciate the comedy as well as the tragedy of my illness.”

The Theatre of Healing

Hospitals are packed full of drama: the urgent choreography of the surgical team, the hum and hiss of machines, the anxious audience of family members. Our medical language reflects these theatrical roots: we attend rounds, we perform procedures, we work in operating theatres. That word theatre derives from the Greek theatron—a place for viewing, historically, a public amphitheater where surgeons performed before physicians, there to be both entertained and taught.

 

Learning to Perform

Doctors, nurses, and other caregivers are rarely trained in performance. Yet every day we play roles that demand physical awareness and emotional nuance. The speed with which we enter a patient’s room, how close we choose to sit, how well we make eye contact—these all communicate energy to our patients. I would often ask our medical students to experiment with their performance as physicians. We role-played difficult conversations together: diagnosing cancer, discussing end-of-life care. I pressed them to attend not just to their words but to their actions. Were they inviting confidence or defensiveness? Trust or distance?

“If you have to go into a patient’s room with bad news, what do you do with your body? Do you open the door confidently, or tentatively? How fast do you cross the room? Do you sit before opening your mouth? How do you interact with family members?”

Most students started out embarrassed to act out these roles with their peers, but soon overcame this self-consciousness. They got the point quickly: their every patient interaction is a performance, and practice builds self-confidence and skill. Just like actors. No accident we use the word art to describe both creating works of beauty and offering loving care.

Artists Performing

Sidney Homan is a professor of theatre who worked with young patients on the Shands Hospital psychiatric unit, teaching them how to perform: how to move, how to hold each other’s attention, how to pick up on visual and verbal cues, and how to breathe through their bellies, like babies. I watched him play his favorite game with sixteen-year-old Linda*: Linda the doctor and Sid the patient.

Sid (grimacing): “Don’t feel so good, Doc.”

Linda (grasping stethoscope): “Okay, so where’s it hurt?”

Sid (making faces): “All over, doc!”

Linda (light bulb): “Hmm—better get the shot box!”

Sid (cringing): “Oh, no, not the shot box!”

As they stood toe-to-toe fighting their battle of words and gestures, Sid tapped into Linda’s self-awareness, freeing her from the crusted-over place she had been stuck in, which no amount of professional psychotherapy had managed to pierce.

Sid (relaxing): “So how’re you doing?”

Linda (grinning): “Great, man! I’m just gettin’ into this—this breathin’ with my belly.”

A clinical psychologist, Daniel Shapiro, asked me to help him with his doctoral dissertation. He had recruited forty healthy women at increased risk for breast cancer, and I was to play the role of a doctor describing the results of a mammogram that showed equivocal results.⁴ He divided the women randomly into two. One group watched a videotape of me as an anxious doctor presenting these equivocal results; the second group watched a video in which I played an empathetic and calm doctor while giving identical information about this equivocal mammogram.

Those watching the “worried” tape showed significantly greater anxiety, had significantly less recall, and perceived the situation as significantly worse, compared with those watching the “non-worried” videotape. Dan’s conclusion: physician affect plays a substantial role in patients’ emotional and cognitive reactions to medical information imparted to them..

Playback and the Power of Story

Among AIM’s most transformative projects has been Playback Theatre—an improvisational form in which actors listen to a patient’s story and at once perform it back through movement, dialogue, and music.

One evening on the oncology ward, a woman with breast cancer shared how she felt “split in two”—the person she was before diagnosis and the one she had become. The actors portrayed her as a single figure gradually reuniting with her reflection, until both stood in quiet embrace. When the lights dimmed, she whispered,

“That’s the first time I’ve seen myself whole again.”

Such performances show storytelling, too, is medicine. In witnessing our own stories brought to life, we reclaim them.

The Masks We Wear

Medicine has always involved ritual and costume. The “plague doctors” of medieval Venice wore long bird-beaked masks filled with herbs and spices, believing that the fragrant air would ward off disease. Today’s sterile gowns and masks serve a different function, but still mark the transition from ordinary life into the ritual space of healing. When I donned my white coat, I’d feel the subtle shift into my role as listener, witness, healer. It is a costume of trust—but one that can also create distance. The art lies in knowing when to step out from behind it, to meet another human being face-to-face.

The Healing Exchange

If all the world’s a stage, hospitals play out its most charged scenes. Every gesture has consequence: the simple act of pulling a chair close to a patient’s bed, of holding a hand in silence, can become acts of grace. Over the years, I’ve come to see that what truly heals is not only science, but relationship—the shared performance between patient and caregiver. It is a duet of presence, vulnerability, and imagination.

In the theatre of healing, we are all both audience and actor. When we perform with authenticity—with open eyes, open voice, and open heart—we remind one another what it means to be fully human.

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Acknowledgments

This essay grows out of more than three decades of collaboration with artists, caregivers, and patients through the University of Florida’s Arts in Medicine program. Their courage and creativity continue to teach me that healing is not a science but a living art.

References

1. Shands Arts in Medicine, University of Florida.
2. Pimsler, S. The Choreography of Care. Clydesdale, Nova Scotia: HARP, The People’s Press, 2021.
3. Center for Arts in Medicine, University of Florida.
4. Broyard, A. Intoxicated by My Illness. New York: Penguin Random House, 1993.
5. Shapiro, D. “The Effect of Varied Physician Affect on Recall, Anxiety, and Perceptions in Women at Risk for Breast Cancer: An Analogue Study.” Health Psychology, 1992;1:61-66.

*Not her real name