In disease and in health, our bodies tell stories. But more often than not, these stories are left unheard and unseen. A meaningful method for illuminating untold stories is through traditional and classical dance forms. Dance especially is a space for knowledge and roles to be authentically represented. For marginalized communities in particular, traditional dance has for centuries been a medium for creative expression and healing despite how circumstances and society have complicated their access to care. Narratives of sickness and recovery are embedded in these rich and culturally significant dance forms through carefully curated choreography, rhythm and expression. Interpretation of dance can help physicians and trainees better orient ourselves to understanding patient narratives and ultimately improve the communication, compassion and connection we bring to patient care.
South Asian classical dance forms (bharatanatyam, kathak, manipuri, mohiniattam, odissi, kathakali and kuchipudi) have been passed down through generations. They combine intricate footwork, graceful movements and facial expression to portray emotions within the context of larger narratives. These dances are composed specifically of natya (expression of temperament), nritya (footwork, gestures, expression) and nritta (presentation of rhythm through movement). Together, these elements serve as tools for conveying diverse narratives through synergistic body movements.
Illuminating dance narratives can provide a useful approach to interfacing with racial and ethnic biases in health care communication and documentation. Language practices in health care shape patient experiences and provider perspectives deeply. Physicians become storytellers as they translate patient narratives into charts that document and communicate the intricacies of illness.These translations can be harmful as negative stereotypes can be perpetuated in the medical record as marginalized patients are frequently depicted as resistant to care, “shifty” and less sensitive to pain. Descriptions of patients’ adherence to treatments and interventions also differ based on race. Black patients’ health behaviors, for example, are often portrayed as less adherent to treatment recommendations than patients of other races. In the era of open access notes, these descriptions can greatly diminish patients’ perceived agency over their care and deepen a sense of objectification and dehumanization. If not clarified, these descriptions can not only impact patients’ emotional well-being but also perpetuate racial and ethnic health inequities.
Narrative medicine is an interdisciplinary field that bridges the gap between medicine and the humanities. By emphasizing the importance of stories and narratives in healthcare, narrative medicine seeks to help healthcare professionals better understand patients’ experiences and perspectives. Over the past decade, narrative approaches to ethics have been increasingly used to encourage reflection among health professionals on personal biases and patterns of communication. Importantly, narrative approaches can allow us to interface with racial and ethnic inequity by helping professionals and trainees be more intentional about written and spoken language. The value of narrative in medicine can be harnessed in the context of dance, especially South Asian classical dance forms that traditionally construct and express emotional experiences. Together, the choreography of these forms coupled with narrative can begin to ameliorate the racial and health inequities embedded in the ways we intersect with minority patients. Rhythmic movement of the body can be used as a tool to understand cultural stories as we strive to achieve greater ethnic and racial equity in medicine.
The Aseemkala Initiative is an interdisciplinary collaboration between physicians, artists and scientists who use traditional South Asian dance forms to perform stories of illness and health. This initiative is a hallmark of mobilizing the power of classical dance forms to represent patient and physician narratives on illness, treatment and the experience of care. Their Mahavidyas in Medicine dance series archive is a compilation of the illness experience of female physicians and patients who embody the Mahavidyas, a group of ten demi-goddesses each representing a unique strength and character. Through carefully constructed choreographies, this series animates stories of triumph, loss and healing in medicine that are often invisible. The two recordings described below are especially strong examples of how embodied dance can illustrate the nuances of the illness experience.
In the video recording of “Bhairavi’s Addiction,” the bharatanatyam style of Indian classical dance is used in the exploration of a physician’s battle with alcohol addiction. The performer invokes the demigoddess Bhairavi, who combats evil and anger, through a sequence of steps that enact her fight against addiction. As the performer struggles at the beginning through her looser movements, we see that her condition has taken control of her body and mind. The fact that she must invoke a warrior goddess to regain her vitality reminds us of the deep rooted grasp addiction has on the mind, body and spirit. Towards the end, her coordination and renewed strength are a testament to the possibility of recovery. Themes of fighting and healing are widespread in healthcare and it is important that they be applied to not only patients, but also to the physicians who seek to provide care for patients. The healing of the healer, embodied by this tribute, challenges and expands our assumptions surrounding mental health and addiction as well as the healing journeys of those with addiction disorders.
For many around the world, traditional dance forms are spaces to celebrate knowledge and roles, despite changing societal structures that can create barriers to care. Innovation through choreography and performance can enable us to combine narrative medicine and explore social justice and equity in healthcare. Both creating and viewing these forms of art can enable physicians and other caregivers to reframe disempowering medical narratives and better comprehend the physical, emotional and spiritual intricacies of healing among themselves and patients. As the humanities are being more deeply integrated in modern medical education, we should create dedicated space in medical curricula for physicians-in-training to choreograph and interpret dance as a means of enhancing empathy and compassion. With a better understanding of patient experiences through performance-based medical storytelling, we can hope for more compassion around communication practices in healthcare — and ultimately for a restoration of the connection between physician and patient.
Pulses of Connection is an attempt at delving into mind-body connections in medicine. This column will strive to emphasize how mobilizing the deep connections between our mind and physical bodies can enhance our sense of oneness, health, and well-being. Through narrative and exposition, I will explore how practicing physicians, medical students in training, and premedical students can integrate mindfulness in their lifestyles, as well as how such approaches can be crafted to bring healing to our patients.