‘Theatre for Children in Hospital: The Gift of Compassion’ by Persephone Sextou (The University of Chicago Press, 2016).
Persephone Sextou comprehensively frames Theatre for Children in Hospital (TCH) as a bedside and interactive theatre approach concerned with reframing illness and the identity of children in hospital, and argues that TCH offers children the possibility to have a positive experience in an environment that can otherwise be daunting. The author shares her expertise as a practitioner and a researcher working with TCH in NHS hospitals in the UK, thereby crafting an in-depth analysis both from within the process (as a theatre-maker) and from the margins of the process (as a scholar outside the medical field). The book is written from an artistic and philosophical perspective, placing compassion at the heart of TCH artists’ work with children. This also means that readers in healthcare may find themselves frustrated with the idea of having to negotiate who is more altruistic, the artist or the healthcare professional; and which is more compassionate, the “hard data” or the qualitative research?
In describing TCH, Sextou examines the boundaries that separate this method from dramatherapy as well as from healthcare. Suggesting that TCH is interested in the wellbeing of the child but that it does not intend to engage in psychotherapy, Sextou poses that this process can be best described under the umbrella of Applied Theatre (pp. 54-55). The very notion of ‘applied’ is problematized in the context of TCH, an approach that emphasizes the child’s agency to welcome or reject the artist’s work; the child is the primary focus of a process that is offered, not ‘applied.’ Further, Sextou explores the different roles TCH artists and hospital professionals play in enhancing a child’s wellbeing. Here, Sextou defends ‘TCH makes a holistic proposition’ that is alternative to ‘traditional medicine,’ and that such a viewpoint is compatible with the suggestion that ‘no professional from within the healthcare system […] can claim holistic practice because [it] is constructed around traditional medicine’ (p. 23). On the one hand, this proposition is limiting and excludes healthcare professionals who do, indeed, approach medicine from a holistic viewpoint. On the other hand, by drawing this line between TCH artists and ‘traditional medicine,’ Sextou delineates the artists’ role and identity within the hospital system (because the artist is not ‘limited by medical regulations’), which is an important tenet to consider in the context of ethical and aesthetics standards in TCH, especially as the field develops (pp. 22-23).
The book also provides a useful example of how mixed-methods research can be harnessed in the medical humanities by highlighting the potential for theatre and medicine to inform one another. Sextou addresses her research question ‘can bedside theatre performance […] distract the child from their [sic] illness, offer moments of creativity through entertainment and relax them whilst in hospital?’ (p.65) by examining the aesthetics and the impact of TCH, and drawing from ethnographic research, pre- and post-performance questionnaires, script analysis, and references to video footage. Through art-based and qualitative data analysis, Sextou suggests that TCH enhances children’s confidence, imagination, and relaxation (pp.105-106). I appreciate Sextou’s decision to defend these findings from an artistic perspective, choosing not to use physiological data collected during the study to legitimize the TCH work (p. 67); implicitly, knowledge gained form empirical research and artistic practice are not placed in a stagnant hierarchy that privileges the former over the latter. However, future collaborations may be interested in exploring a multidisciplinary approach that does disseminate such data alongside art-based and qualitative research.
Another point in the book that caught my attention pertains to Sextou’s hesitation to describe her work as ‘political’ because TCH is not concerned with ‘social ethos.’ Instead, she opts for Michael Balfour’s idea of a ‘theatre of little changes’ to characterize it (pp. 27-28). Interestingly, I find the political character of TCH to be one of its most important and powerful aspects of this book – and here I am thinking of Jacques Rancière’s view on ‘political,’ in the sense that TCH intends to ‘“disturb” the norm’ (Rancière 2001), by challenging social perceptions of the child as a patient and changing the way children experience inpatient treatment. Bedside performances reframe the politics of the performance space, as the performance impacts, changes, and interacts with, children, families, artists, the hospital, and the hospital personnel. The bedside gains a new, rich, and complex meaning. As Ngũgĩ wa Thiong’o argues (from a postcolonial perspective), ‘the performance space […] is always the site of physical, social, and psychic forces in society’ (1997:19), an idea I find pertinent in the context of the “little changes” TCH enacts in the systems through which it interacts. Sextou herself hints at this idea of ‘politics of the performance space’ and the power dynamics within it, discussing the way ‘the artist’ and ‘the child’ experience ‘performing site-specific theatre in a hospital’ differently (p. 41) as well as asserting that ‘the artist alone cannot produce TCH unless the hospital operates as a host’ (p. 37). These ideas are associated with a paradigm shift which, I believe, intends to reconfigure the relationship between the arts and healthcare – to reconfigure the ‘social ethos’ – and are, therefore, political in nature. In addition, Sextou describes TCH as ‘radical’ (p. 34), and I believe it is: TCH has the potential to profoundly change the way children live through a difficult experience. Lastly, if TCH ‘is a right for every child as it is for every artist’ (p. 105), I cannot help but suggest that implementing it – particularly in the United States where a national healthcare system isn’t accessible – does ‘”disturb” the norm’ significantly.
Theatre for Children in Hospital is an important primer for the medical humanities because it highlights the role that theatre can have in improving paediatric hospital-based care. This book is informative for scholars and practitioners of applied theatre, especially those interested in the role of the arts in health, and it also stands out as an important volume for healthcare professionals who want to collaborate with artists. Ultimately, Sextou hints at the ability for TCH to facilitate a moment that is of the child, by the child, and for the child – and such moments are often scarce for children in hospital. Theatre for Children in Hospital plants a seed for productive and collaborative discussions between theatre-based work and healthcare – between comprehensive scholarship and compassionate praxis.
Reviewed by Ligia Batista Silverman. Originally from Portugal, Ligia is interested in the intersection of performance and medicine. After completing her undergraduate degree with a focus on neuroscience and theatre in 2013, she concluded her MA program in Theatre at the University of Colorado Boulder in 2017; she is also an alternative track drama therapy certification student with the North American Drama Therapy Association. Currently, she is a Post-Baccalaureate Pre-Medical student at the University of Colorado Boulder and she works as a clinical research coordinator in Neurosurgery at Children’s Hospital Colorado.
Rancière, Jacques. 2001. Ten Theses on Politics. Theory & Event 5(3).
Thiong’o, Ngũgĩ wa. 1997. Enactments of Power: The Politics of Performance Space. TDR, 41(3): 11-30.