Abstract

Medicine in Motion is a partnership between the arts organization Jacob’s Pillow Dance, with Berkshire Health Systems, one of the largest employers in Berkshire County, and Volunteers in Medicine, a small non-profit primarily serving recent immigrants to the county. A Creativity Connects grant in 2018 from the National Endowment for the Arts launched Medicine in Motion. It is an extension of Miller’s work since 1995 with medical humanities. The artists working on Medicine in Motion are drawn from the national roster of Curriculum in Motion® Founding Artists. 

We believe in dance as a complex system of physical, mental, emotional, creative and spiritual knowledge construction located in body-based intelligence. We practice dance as a site for shaping meaning and possibility, with dance for Every Body as the core methodology. 

Our work investigates dance as a resource for arts and medical practitioners working together to enhance humanistic and holistic practices on a pathway of social and emotional health and flourishing for individuals, and by extension their communities. The work occurs through movement workshops designed and facilitated by Miller and a team of artist/educators. Workshops are designed to offer a breath, a pause, a space for participants to use embodied creative experiences to reflect on relevant themes as identified by the partners toward shared goals of nourishing flourishing communities. In our work, dance-making practices intersect with the interdisciplinary field of Medical Humanities, a field that puts a humanistic lens on medical education and medical practice. In both practices we arrive at the Undeniability of the Body. This article chronicles the growth and timeline of the program from 2018-2020, in the time of both personal and global health crises: My own journey through cancer, and the COVID-19 Pandemic.

Curriculum: the content of learning what it means to be human

I am a dance artist¹ . My practice is an iterative weave of performance work, teaching and community engagement. As a teenage artist-to-be in 1969, I was torn between being in the studio or being on the streets protesting. I want/ed to make art that mattered, and to understand what makes meaning in the world. I have spent my life finding the intersection of those spaces. I practice dance as a complex system of physical, mental, emotional, creative and spiritual knowledge construction located in body-based intelligence. I engage with dance as a site for shaping meaning and possibility, with dance for Every Body as a methodology.  

The focus of this article is my work in bringing together dance and Medical Humanities through a program of Jacob’s Pillow Dance, Medicine in Motion.  The evolution of my involvement with dance-based practices and medical practice weaves through my personal narrative.

My story begins at birth, my mom was a nurse. My 2-minute solo, “Nurse Mom” (1990), chronicled in text and movement the experience of being the child of someone who provides care to others.  When I became a mother at the age of forty, I worked with dancer/musician Dawn Pratson on “The Nurses Project” in the small coastal community where I was living at the time. “The Nurses Project” (1993-94) was a year-long series of community engagements that culminated in a performance “to celebrate, honor and give voice to the nurses of the Cape Ann community”, with nurses telling their stories through dance, music and storytelling. In 2013, as a professor at Grinnell College, I built a partnership with the Medical Humanities program at Des Moines University (DMU), a college of osteopathic medicine. Through this partnership my undergrad students from both dance and pre-med studies met with DMU medical students in dance/movement-based workshops, designed for broad-based inclusion, as an embodied ground to reflect on how socio-cultural presuppositions effect interactions between medical professionals and their patients. This work was written about in The Dancer-Citizen,  Issue 7.  The next development in this narrative was the Jacob’s Pillow Dance Medicine in Motion partnership that launched in western Massachusetts in 2018, with the support of a NEA Creativity Connects grant. There are two ironic threads that also weave throughout this story:  One personal one and one global. As the Pillow program was unfolding, I was unfolding my own journey through cancer; and as I sit down to finish writing this article we are in the midst of the COVID-19 pandemic.

Medicine in Motion is an organic development of Jacob’s Pillow Dance Curriculum in Motion® which I co-founded in 1993 with Pillow Director of Education “JR” Glover. It has been an essential part of the Pillow’s community engagement work for over 25 years. Curriculum in Motion® began, and continues, as a partnership with dance artists and classroom teachers in K-12 classrooms using dance as the mode for learning academic curriculum. As Curriculum in Motion® evolved over the years, I began to wonder what other places might exist where dance-based practices of creative inquiry, expression, reflection and rejuvenation could be used to replenish our humanness?

Curriculum in Motion® uses the word curriculum to encompass a learning agenda that ranges far beyond the academic, to denote the life-long cultivation of our selves as response-able humans in an ongoing process of becoming towards human good – the curriculum of learning of what it means to be human. John Dewey reminded us that instruction in the arts of life “is a matter  of communication and participation in the values of life by means of the imagination, and works of art are the most intimate and energetic means of aiding individuals to share in the arts of living² .” By “works of art” I embrace not just the products, but the human acts of process in creating art – whether for personal or public existence. Wright and Pascoe held that “The arts offer both tools for inquiry as well as expression, they offer both depth through linking cognitions, affect and somatic ways of knowing, and breadth through multi-modal forms for sharing and engaging with diversity viewpoints, experience, ideas and visions³ .”

I braid these ideas with social scientist Donna Haraway’s concept of Response-ability. “Committed to ‘staying with the trouble’ in multispecies worlds where suffering and flourishing are unevenly distributed and always at stake⁴ ”, she proposes we can develop our ability to respond meaningfully, and responsibly, to life and the world around us. I embrace a pursuit of being able to respond with love, compassion, and a sense of justice using critical and creative imagination – not only through art-making but in the act of living.

Medicine in Motion cultivates, for the artist/facilitators, partners and workshop participants, our response-ability muscles.

An Aside: Where in the World is Waldo?

A tricky part of understanding my work is trying to figure out where I am and where the work is taking place!  Jacob’s Pillow Dance and the Medicine in Motion program are located in Berkshire County in western Massachusetts, but I live in Iowa. Before Iowa I lived mostly in Atlanta. In my long career as a free-lance artist, many of my engagements involved traveling to different towns and cities for performance and community engagement projects.  Since 1993 I have been in residencies of one-two weeks at a time at the Pillow for Curriculum in Motion® (1993-2000), Director of the Dance & Community Partnerships Choreography Lab (1993-2010) and now for Medicine in Motion (2018-).  Jacob’s Pillow has not only been a site for some of my most important work, but it is also a spiritual home for me. At the Pillow, I walk in the footsteps of my ancestors.

Building Medicine in Motion

Thasia Giles, Director of Community Engagement for the Pillow and longtime collaborator, was the on the ground force to build the Medicine in Motion partnerships. After an initial round of meetings with a wide variety of health care services and providers in the area, we narrowed down to two partners who shared our goals, and had the interest and capacity for the focus of Medicine in Motion, which is to work with medical practitioners and employees in the health care system on the principle that “stronger healthier employees, means stronger healthier patients⁶ .”

Our partners are Berkshire Health Systems, one of the largest employers in Berkshire County; and Volunteers in Medicine, a small non-profit primarily serving immigrants in the county. The artists working on Medicine in Motion come from the national roster of Curriculum in Motion® Founding Artists. These artists are Liv Schaffer, Tom Truss, and intern Naomi Worob. Medicine in Motion is stewarded by Thasia and myself with stakeholder leaders from our community partner organizations.

Conversations with our partners centered around deep listening and sharing of the themes that were relevant to all three organizations and to the artistic inquiry. As in any work like this, we enter with broad desires and we leave with inspiration and the incremental stepping stones towards meaningful action.

Identifying the Stakeholder Leaders

With each partner organization key personnel were identified to be the Stakeholder Leaders who would provide entry into the subdivisions within their organizations. The different scale and scope of each organization were unique for each one. At Berkshire Health Systems (BHS) the directors and department heads connected us to the personnel within divisions to attend the workshops, from residents and nurses, to wellness coordinators and hospital administrators.  At Volunteers in Medicine (VIM), the organization is more compact and could be subdivided to three categories: staff, volunteers and clients. The volunteers are the doctors who provide care in the clinic, as well as those who provide services like transportation to appointments for the clients.

Out of our meetings, the following broad-based themes were identified as areas that could be enhanced by dance-based exploration as a reflective practice.

• Self-awareness
• Resiliency
• Morale
• Creative problem-solving

How do we promote health and well-being of our selves so that we can better serve the health and well-being of our patients, and by extension our community?

Walk the Talk or “Let’s get to the Dancing”

After deep listening meetings with each organization, it was time to walk the talk and get to dancing. In our field there is sometimes the assumption that dance is learning steps to a beat. Our partners immediately saw beyond that, and we moved forward into discussion of how embodied experience might directly enhance the agenda of the curriculum for their personnel. The Medicine in Motion workshops use dance-based improvisations as a space for participants to reflect on how workshop themes express themselves in each individual’s work/life and to build community around those themes. 

Essential to all the Curriculum in Motion® work, partner planning includes actual body-based experiences for the people in charge of making our connections into their communities.  In this way, our stakeholder leaders are best able to communicate to their personnel the value of the workshops, and how this work fits into the overall agendas of their organization goals. Additionally, by actually “doing” the broad-based themes can become more specific.

The Event, A Day at the Pillow

A Day at the Pillow (Summer 2018) was designed with a multiplicity of purposes including providing an actual experience of what the on-site workshops would be like. The event was also an opportunity to introduce the stakeholder leaders to the resources of the Pillow -– from the performances, to the archives, to food venues and the Pillow community of staff, faculty, artists, audience and students. It was also an opportunity to build community amongst the stakeholders and artist leaders. The full day at the Festival included a workshop, a community meal, Pillow tour, tickets to a performance by the Houston Ballet, and lots of time for conversation. Eleven participants joined us for A Day at the Pillow:  from BHS, a surgical resident, the Director of Wellness, Wellness at Work Program Manager, Physical Therapist (and dancer), Outpatient Rehabilitation Manager, Program Coordinator/Surgical Project Manager and Student Clerkship Coordinator, and Health Educator and Body/Mind Instructor from Berkshire Health System; as well as their Chairman and Program Director /Psychology and the Director of BHS.  We were also joined by the Human Resources/Volunteer Manager from Volunteers in Medicine, and Jacob’s Pillow community artist Tom Truss.

The Workshop

Based on our partner discussions, I designed the workshop on principles drawn from investigation on what it means to flourish as a human being as is being discussed within medical humanities programs. I was particularly drawn to the work of the New Economics Foundation, as articulated by Wright and Pascoe⁷ , which identifies these five pathways as essential components for human flourishing: connect, be active, keep learning, notice and give/receive⁸ . For the guided workshop experience we used dance-based improvisation to embody each pathway for reflection on how we flourish as humans, and how our work helps others flourish. In summary I described the workshop:

After the Pillow Day Angela Wilson, Health Educator & Body/Mind Meditation Instructor from BHS shared her reaction:

The Stakeholder leaders identified the following areas as themes they felt could be strengthened by the movement workshops.

• The power of touch
• Building inner resiliency
• Deepening our capacity to notice, including noticing the spaces we work in
• Team and community building
• Taking care of self as an important piece of healthcare work

Dr. Mark Petus, Director of BHS, summarized the potential of the work: “Enhancing our wellness and resiliency as caregivers on one side, enhances how we better serve others⁹ .”

Medicine in Motion 2018-19

In December 2018 and May 2019 two intensive 2-week workshop-based residencies were offered for both BHS and VIM. Eleven workshops were offered to over one-hundred participants. At BHS the workshops were offered to a wide cross section of the organization. In addition to health care providers and interns, participants came from Outpatient Rehab, Health Science Library, Wellness, Clinical and Applied Research, Accounting, Patient Relations, Human Resources, Volunteer Services, Outreach, Surgical Services, Community Relations, Patient Care, Education, Diet/Nutrition, Internal Medicine, Mother/Baby Unit and Lab technicians.

At Volunteers in Medicine two workshops were offered, one at the VIM Clinic and one at the Pillow. At VIM, the workshop was designed for staff as a way to re-see, imagine, and re-energize their clinic/office spaces. At the Pillow the workshop was about building community. Participants included VIM staff, volunteer doctors, volunteer drivers, and clients and their families. After the workshops VIM Executive Director Ilana Steinhauer reflected:

March 2020: Follow Up Meetings
In the time before the time

On our original timeline for Medicine in Motion, the week of March 8, 2020 was identified as my  return to the Pillow so Thasia and I could do follow up meetings and next-step planning with our partners. It’s hard to remember what that time was like. I was finishing up chemo treatments and my doctor said that as long as I was cautious, traveling should be fine. (I would be flying between Atlanta and Massachusetts). But between March 8 and the writing of this paper (April 5) much has happened, and rapidly. COVID-19 was declared a pandemic on March 11¹⁰ . President Trump declared a National Emergency on March 13, and stay-at-home orders are now in place in thirty -five states. I left Massachusetts on March 14^th. My chemo treatments (which were close to the end) were suspended and I went immediately into self-quarantine.

While in Massachusetts, I opted out of any face-to-face meetings.  Our meetings with the BHS partners were postponed as all staff were triaging the emergency.  We were, however, able to conference call with VIM Executive Director Ilana Steinhauer and Human Resources Manager/ Volunteer Coordinator Michele Shalaby.

The VIM meeting felt like a small respite in the atmosphere of escalating fear and worry. The meeting gave us a chance to reflect back on pre-pandemic times, and to place a quiet prayer for when we will return to this work. 

Ilana recalling the workshop for staff at the VIM clinic, reflected, “…it actually did re-energize the space. People got into it, it was beyond what we could have really expected for everybody. We were high¹¹ !” She continued, “The one at the Pillow was different because it was patients, with staff, with volunteers, it was a different kind of joy. It humanized the interaction… to humanize the hierarchy that comes with the doctor patient relationship, because you all went in at the same level. The doctor went in with the patient, and actually the patients were better at teaching the doctors or me. There was laughing, there was silliness. It re-humanized that interaction¹² .”

“You talked about flourishing, and that was flourishing happening right in front of our eyes,” Michele acknowledged¹³ .

Our feedback method for BHS workshops was a one-page form with questions for participants to fill out immediately after the workshops, before they rushed back to work. This left us with more “snippets” than anything else. But out of fifty-three responses, the notion of taking care of oneself and connecting to self as an essential component of doing their work well, emerged as a key response. When asked how often they might like to have more of these workshops in their workplace routine, out of fifty-three responses forty-nine responded: “yes” – ranging from monthly (16) to quarterly (15) to yearly (10); to just “yes” (8)¹⁴ .

Medicine in Motion Foundations

Between the artists and partners, we identified four foundations as we move forward.

Undeniability of the Body:
We believe that dance-based embodied experiences are of benefit to both the field of dance and the field of medicine because we commonly share The Undeniability of the Body. During the DMU partnership, Professor Gary Hoff asked “why dance?” as the method for delivering our workshop to the DMU medical students. My undergrad student and Theatre and Dance major, Lauren Sheeley replied, “Because dance and medicine both share the undeniability of the body.” That phrase has become a keystone in the work. MacLachlan has argued that “the individual experience of flourishing is resolutely grounded in our bodies¹⁵ . As dancers we understand and are always in the process of being “in body” as a resource for thinking, reflecting, imagining, and flourishing. We offer what we know in this realm, and hope that it might serve the work of health care workers, their institutions, and all of us as citizens who want to create environments for flourishing as a basic human right, trait and desire.

Methodology: Dance for Every Body:
Dance is the central mode for this work.  Dance, in mainstream white Euro-centric culture, is often construed to mean steps to a beat, and sometimes limited (in our imaginations) to a particular body type, level of flexibility and other levels of physical virtuosity. In dance for Every Body we bring an inclusive dance-based methodology that acknowledges the power of the lived body experience we all have. We celebrate it as our foundational base for being able to access embodied intelligence. Through the workshops, participants get to be active in the presence of the art of dance – sharing in “the arts of living.” They engage in what Mark Johnson refers to as “the way the body gives rise to possibilities for making and discovering meaning¹⁶ .”

The Medicine in Motion workshops offer participants a Pause, a Breath, a Space - for embodied reflection on themes that resonate in, but are not limited to, their work in the medical profession.

For Providers:
There are many programs in place that use dance in patient care. Medicine in Motion uses improvisational dance technique to provide a space for self-reflection for medical providers; to enhance a reflective clarity of purpose that then gets transferred to their work with patients¹⁷ . The workshops offered to medical practitioners at our partner sites are “hands on/body in” explorations, where participants are guided through dance-based reflective activities to give embodied thought to their professional/personal lives through the sensorially-based modality of inclusive dance-based practices. Medicine in Motion focuses on medical practitioners and employees in health services; and will be expanding for work medical students. We know that the caregiver in us all wants to apply the arts-based work to patients, and there are many great programs out there that do that. But as Maureen Daniels (BHS) reminded us following that first Day at the Pillow our work centers on the conviction that “stronger healthier employees, means stronger healthier patients⁶ ” and Angela (BHS) added, Medicine in Motion “offers us another process to work through some of the challenges we face day to day in order to find a greater place of integration and presence and whole self-availability.”

Artists: Keep Learning in the Process
In keeping with the Curriculum in Motion® principle of valuing the artists’ planning time and peer-to-peer exchanges as an essential component of professional development, each Medicine in Motion residency begins with a Think/Dance/Action time period where the artists, often joined by additional Think Partners, plan, develop and cultivate the activities for the residency and the methodology and theoretical frameworks for the future development of the program. Guided by Thasia and myself, the team meets with BHS and VIM stakeholders and engages in continual practices of reflection/evaluation as part of the scope of delivering the work. It is our hope that our partner organizations organize their own peer to peer learning exchanges as well.

IRONIES: PERSONAL & GLOBAL

Ironically, just after we began this program, I was diagnosed with cancer. (Good news update: After about a year of treatments and interventions: the cancer is in remission, and I feel great).  My diagnosis, treatments, and interaction with the medical systems reinforced even more strongly my belief in the importance of what we have set out to do. In my  interactions with the health care system, it was so clear, and the effect on my physical/emotional status so palpable – from doctors to receptionists, infusion nursing staff to MRI technicians – what a difference it was to be attended to by those who were centered in themselves with love; who were resilient; whose spirits were in a place where they took care of themselves and therefore could provide my clinical care with clarity, confidence, and honesty; who provided the empathy and compassion that supported my overall wellbeing/healing/surviving/best attitude possible during trying times. I can’t tell you how many times I wished that I could have danced with my health care personnel, and how different I think some of our interactions could have been if we had had that kind of vulnerable and simultaneously creative space together.

And in the midst of our work, the COVID-19 Pandemic reared.

As an artist I have to ask –of what use is our work now? There certainly is no space for a workshop for the healthcare providers now.  I don’t know the answer to this. Here is what I am doing.

• Trying to stay healthy
• Sheltering In Place, to protect myself and my local and global community
• Thinking forward – what will we have to offer when we find ourselves in life after COVID-19?

My prayer:
For the workshop participants, I pray that in this hardship there is a remembered “in the body, subconscious” take away that might provide them with a moment, even if fleeting, of the body remembering emotional/spiritual/creative resilience, or presence from a workshop.

For me, I remind myself to stay connected to my body, as I move through fear and panic.

When I am sick, dancing is the last thing I want to do. I just want to feel better. How can I hold onto my embodied knowledge if I become sick?

In facing cancer, I danced often when I needed to find inner strength. A friend came with me to my appointment when I first got the diagnosis. After the doctor left the room, I asked her if she would dance with me. She was surprised, but did. Usually when you say to someone, “let’s do a little dance”, it’s to celebrate. So, she did a kind of little jig. Mine was more somber, but it was what I needed in that moment. I needed to move from a heart/spirit place. I needed to do anything but be leaden in my body, and dancing is what I needed.

In Closing

I hope this article exists in five years. 2025.

I hope that we are in a place in 2025 to look back on the pandemic and to what we have learned.

I join in mourning for the souls who died, and for those who lost loved ones.

I hope to still be alive in 2025, to invite you to dance with me. And if I’m not, I know my spirit will be in the rocks and trees, streams and mountains, and in the stardust of our dances.