Is There a Doctor in the House?
In the picture-perfect world of theatrical dance, spectators
don't expect to hear that question called out from the stage.
Imagine the surprise of performers and audience alike when a
principal dancer collapsed onstage two-and-one-half-hours into a
performance of Pacific Northwest Ballet's Cinderella in March of
2002. Two physicians and a nurse in the audience responded,
hurrying backstage to check on the fallen dancer. Also found was
a prince to finish the performance. While a CPR-certified
physical therapist administered first aid backstage, the new
lead couple quickly discussed their impending unrehearsed
performance. The company continued, repeating the final pas de
deux. Says Olivier Wevers, the prince
who came to the rescue, "It was ah amazing moment. We were all
nervous but we knew what to do: 'The show must go on.'"
Emergencies are an ever-present, if uncommon,
risk in dance. The types of emergencies range from ah accident
on the stage to ah acute episode of a pre-existing medical
condition to the rupture of ah Achilles tendon.
Dancer choreographer Dan Wagoner, who teaches
at Connecticut College, recalls ripping his foot on a protruding
iron nail in the floor when dancing with the Martha Graham Dance
Company in Samson Agonistes in 1961. Paul Taylor and Martha
Graham proceeded to dance around the pool of blood, carefully
avoiding the nail. (Then they got him to a hospital in a cab.)
In a recent interview, choreographer David
Parsons talked about "doing the pit"--when a dancer somehow
falls into the orchestra pit, as he himself had done while
directing a rehearsal of his signature piece Caught. The solo is
danced with a strobe light in a completely dark theater. Parsons
dove, head first, ten feet into a concrete pit. He went into
shock, was immediately taken to the hospital, and was told that
if he hadn't been in good shape and warmed up, he would have
suffered serious injury.
"My performers are adept at improvisation,"
says Parsons. "It's not like we're dancing Serenade of Swan
Lake. We can improvise through the unexpected injury of
emergency--even in front of thousands of people. The show only
stops when the lights go out."
PNB co-artistic director Francia Russell says,
"In my career, I've seen many injuries. Yet out of thousands of
performances during our tenure as artistic directors, the dancer
collapsing onstage was a first. Still, it was enough to make us
think carefully and critically and see how we could strengthen
our response."
At New York City Ballet, Marika Molnar,
physiotherapist for the company, notes that it helps for the
theater and studios to be located only several blocks from the
hospital. Says Molnar, "I can remember a rehearsal on stage when
one of the dancers was leaning over a second-story balcony and
fell onto a fence. Ah emergency response team was on the set
within eight minutes. Even now, if someone needs to go to an
emergency room, a physician whom the dancer knows, who is
familiar with ballet, is already at the hospital by the time the
dancer arrives."
Molnar says that part of the company's
emergency-response protocol involves educating the dancers to
take care of themselves and others if something serious happens.
"The dancers feel that there are many safety nets in place For
their protection," she says. "We have emergency procedures that
everyone knows--from stage hands to dancers to administrators.
This includes having everyone's cell phone number."
Says PNB's Francia Russell, "'The show must go
on'--but not at a dancer's expense. The dancer needs to take
precedence. This is also true for smaller companies. There are
usually many health professionals in the community who are
willing to help out, who are interested in dancers and volunteer
their services. It's not necessarily expensive."
Cher Carnell, a former principal with
BalletMet and Louisville Ballet who now teaches in Bellingham,
WA, agrees. Companies she has worked with have had a dedicated
volunteer doctor on hand during performances. She acknowledges
the need for such support, recalling a time when a partner
snapped his knee ligaments, sending him into shock. "We covered
him with a blanket and talked to him," says Carnell.
Companies that perform strenuous and
potentially dangerous work might need to be especially alert. A
case in point is Elizabeth Streb's high-impact movement. "With
Streb work, the risk is higher since the physical intensity is
higher," says Streb. "The trust element is critical, so I need
to know about preexisting conditions, It's hard for dancers to
talk about this because we are so vulnerable, especially in the
fragile dance economy we're in. But we depend on each other in
performance to be OK. If someone gets hurt, it won't be just him
or her--it will be other dancers as well."
At the Boston Ballet, emergency-preparedness
is a priority. According to Dr. Lyle Micheli, Director and Ruth
Solomon, Coordinator of Dance Medicine Research in the Division
of Sports Medicine, Children's Hospital, Harvard Medical School,
the Boston Ballet reserves two seats near the stage for the
physician providing medical coverage and two seats for a
physical therapist at every performance. An up-to-date doctor's
bag and physical therapy equipment are kept in the physical
therapy room at the theater.
According to Molnar, NYCB's physical
therapists are backstage for every performance until the end of
the first intermission, The New York State Theater provides a
physician at each performance, and NYCB's orthopedic consultant,
Dr. William Hamilton, or an associate, is usually in attendance.
Backstage, there is a defibrillator and at least two people,
certified in CPR, who can use it. A backstage therapy room has
crutches, aircasts, bandages, etc., as well as a fully equipped
doctor's bag.
Preparing for the unexpected--within
reason--makes good sense. Says PNB's Russell, "It's not just the
legal thing to do, it's the humane thing to do. We supply first
aid kits, a physical therapist, and ice buckets backstage--as
well as maintain a well-supplied doctor's bag. What we learned
from our experience two years ago is that, although there may be
ah available doctor in the house to administer during an
emergency, often he or she does not have a completely equipped
bag--they don't bring them into the theater." PNB now maintains
a fully equipped kit, which is periodically checked in both
their studios as well as the theater. "The dancers know that we
have such equipment," says Russell. "The more secure the dancer
is, the better the performance."
The story of the 28-year-old dancer who
collapsed during Cinderella indeed has a happy ending. At the
hospital, he was diagnosed with a form of irregular heartbeat. A
short two weeks later, the company applauded his return to class
and rehearsal.
For the rare serious medical emergency, it is
not enough to have a doctor in the house. Dance companies need
to have a fully equipped medical bag and staffers certified in
CPR and qualified to treat shock. Dancers need to mentally
rehearse for such events--so that a new prince of princess can
be found, a partner can be reassured, and the dance can go on.
Be prepared
How can dance companies (and theater
management) prepare for the odd emergency? In addition to the
physical and medical aspects of safety procedures, the
psychological and emotional aspects are also important.
Preparation for emergencies helps maintain dancers' trust and
enthusiasm, and good employer-employee relations. Dr. Richard
Gibbs, a former ballet dancer who is now the head physician at
San Francisco Ballet, notes that, "It's rare to see a dancer
collapse on stage. It's more likely that someone will drop in
the audience, not on stage if for no other reason than the
younger age of the performers." He believes that no company is
too small to be prepared for a first response. The Following are
Dr. Gibbs' recommendations for emergency preparedness.
* Ice buckets backstage
* A physical therapist at each performance
* A medical office on site
* Emergency medical supplies, complete and
updated, ready for any doctor to use
* Planned response with dancers and production
personnel--as with an earthquake or fire drill
* Staff certified in CPR |