Medical interns perform their discomforts on stage in DeLaMar
Last week, medical interns from the UvA stood in a sold-out DeLaMar theatre. They gave an insight into their – sometimes uncomfortable – experiences and held up a mirror to the field. “I hope that everyone who visits the play will also see how things can be done.”
The idea for the theatre performance about the life of a medical intern (coassistent in Dutch, red.) came about a year ago, when medical intern Anahita Randjgari was exchanging experiences with two fellow interns and concluded that she had felt that day in the hospital like a walking bin bag. “That useless feeling, standing in a corner watching operations will be something all medical interns will recognise,” she said. How funny would it be, I wondered, if we did a play and we all stood there on stage as bin bags?”
That night, the realisation that theatre can be an important outlet for all the experiences you go through during your internships was born, and with it the theatre group Theaterium Sinistrum. Under Randjgari’s direction, that group of 12 medical interns performed their first play “Kruk, koffie, kop houden”, (literally translated as a stool, coffee and, shut up) at Crea in May. From black-outs in the operating room, having to eat lunch separately and doctors not knowing your name to the old-boys network, burn-outs and endlessly asking for feedback forms for your assessment.
Attendees from the teaching organisation also saw the performance as an opportunity for reflection on their own organisation. “I immediately felt support from all layers of the Amsterdam UMC for the idea that this topic deserved a bigger stage,” says Niekie Spoorenberg, programme director of the master of medicine at the UvA.
Last week, the performance played in a sold-out DeLaMar for a private audience. Some 600 interns, doctors (in training), administrators and people involved in education – from inside and outside the Amsterdam UMC – attended. Friends and family were also present. Later that week, Folia spoke with the director and training director at the Amsterdam UMC’s Starbucks.
Did the co’s actually have separate lunches?
AR: “That did happen. Medical interns from the UvA also came to me afterwards because they recognised the scene.”
There are also many jokes about feedback forms. For the outsider, what exactly is that like?
“As an intern, you don’t get a grade for your fellowship but a portfolio of feedback forms. You have to ask the doctors themselves to fill in a feedback form about yourself. This results in uncomfortable situations: in the show, you see two interns rescuing a man from an acute nut allergy then, somewhat hesitantly asking for feedback.”
Which irritations are typical for the UvA?
AR: “I wrote the performance from within the UvA but I think every medical student can identify with the performance.”
NS: “And I think that is precisely its strength: that the performance is transcendent. This is not just about the interns at the UvA. I understand there is also interest from the law faculty: law students have to deal with similar situations. The tensions that come with training in a hectic workplace in the slipstream of someone in a higher hierarchy are very recognisable to everyone. It is very valuable that students in particular have made a start here to open up that conversation. You could also taste that in the enthusiasm with which this performance was received. And for that reason we are now in DeLaMar.”
Is the play still mainly an outlet for the experiences of interns or does it now stand for more?
AR: “That’s how it started. As a way of processing our experiences and making something with it: a very vulnerable process that can be very connecting. Meanwhile, it has also become clearer that the play can also create awareness. Awareness about the impact a hierarchical workplace can have on the people at the bottom: in this case, the intern. We want to take that further.”
How can a theatre performance help with education?
NS: “We can use it to improve teaching in the master of medicine. That teaching mainly takes place in the hospital. Therefore, we try to instruct the supervisors of interns – often doctors and junior doctors – on how to help interns in their learning process. We do that with training sessions and we are also going to use the recordings of the theatre performance in those training sessions.”
“The theatre performance shows in very concrete, small anecdotes how carelessly we sometimes treat each other. In the lack of time and attention, that doctors don’t know your name, in that you can see that it hurts. That may not be surprising because of the workload and the acute situations that healthcare has to deal with, but nevertheless you can be human in that and pay attention to each other.”
“The students hold up a mirror to us and I hope that everyone who goes to the performance will also see the opportunities how it can be done: that you are warmly welcomed on your first working day, that you belong and that attention is paid to your learning process.”
Could this performance also lead to a culture change in the hospital?
AR: “Who knows. In any case, it sparked conversations, especially after the performance in DeLaMar. Doctors also mentioned having named it in their department. I received an e-mail from the neurologist where I am doing my last internship that she had treated the residents to syrup waffles and told her colleagues to get coffee for the residents instead of the other way round. So people really do take it to the next day.”
At the same time, the play also leaves a lot unsaid, such as transgressive behaviour. Some doctors also felt it could have been a sharper.
NS: “I am a doctor myself and I know examples from practice that are more shocking. But what I really like is that this piece is very recognisable for everyone and thus addresses the broad undercurrent from which undesirable situations arise. It really is about a culture change. If you start zooming in on the excesses – which are clearly transgressive for everyone and certainly do happen – then a lot of people won’t be able to recognise them and they won’t feel encouraged to change their behaviour.”
“On the other hand, I actually heard from people further away from the hospital that they already found this very intense. I think there is normalisation in the hospital, which is why those who are on the work floor say afterwards that they actually thought it was not that bad. We no longer realise the culture we have ended up in with each other. But if you think this is normal, you may wonder if you are really doing so well.”
Other medicine schools also want you to come and perform the show. Will you be touring now?
AR: “Yes, although that sounds very big. There is also interest from the internist training and the congress of surgical assistants. So we want to take it wider. I myself start as an Anios (doctor not in training to be a specialist) at the Flevo Hospital in Almere in November, so who knows, maybe that will serve as inspiration for a next performance. We also plan to make Theaterium Sinistrum really an association in which everyone in the hospital can participate.”
