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Episode 33: Jill Sonke: "Call Arts in Medicine, STAT!"
Episode 336th October 2021 • Change the Story / Change the World • Bill Cleveland
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Jill Sonke is a creative healer in service to a community of doctors, nurses, artists, educators, and most of all, patients on a journey that reunites the arts and medicine in their age-old roles as healing partners.

BIO

Jill is director of the Center for Arts in Medicine at the University of Florida (UF), and is currently serving as Senior Advisor to the CDC Vaccine Confidence and Demand Team on the COVID-19 Vaccine Confidence Task Force. She is also an affiliated faculty member in the UF School of Theatre & Dance, Norman Fixel Institute for Neurological Diseases, the Center for African Studies, the STEM Translational Communication Center, and the One Health Center. Jill serves on the editorial board for Arts & Health journal and as a consulting editor for Health Promotion Practice journal. She is also director of the EpiArts Lab, a National Endowment for the Arts Research Lab at UF, and the national initiative, Creating Health Communities: Arts + Public Health in America. 

Dr. Sonke studied dance at Interlochen Arts Academy, the Florida State University, in London, Paris, and Athens with teachers of the Horton and Duncan techniques including Bella Lewitsky, Lynda Davis, Milton Meyers, Joy Kellman, Lori Belilove, Julia Levine, and Hortense Koluris. She has been a principle dancer and soloist with Lori Belilove & the Isadora Duncan Dance Company in New York and a guest performer and choreographer with Dance Alive! and Stuart Pimsler Dance and Theatre.

With 27+ years of experience and leadership in arts in health, Dr. Sonke is active in research, teaching, and international cultural exchange. Her current research focuses on the arts and health communication, the arts in public health, and the effects of music on cost and quality of care in emergency medicine. She is the recipient of a New Forms Florida Fellowship Award, a State of Florida Individual Artist Fellowship Award, an Excellence in Teaching Award from the National Institute for Staff and Organizational Development, a UF Internationalizing the Curriculum Award, a UF Most Outstanding Service Learning Faculty Award, a UF Public Health Champions award, a UF Cross-Campus Faculty Entrepreneur of the Year Award, and over 300 grants for her programs and research at the University of Florida.

Delicious Quotes

We were very fortunate to be in an institution with leaders who understood that the arts fit and we're important in a healthcare setting. That people should have the ability to engage creatively to make that experience of healthcare better, not just patients, but staff, and visitors and others.

I remember going into rooms and introducing myself, you know, " dancer in residence," and people would furrow their brow and say, “I'm in the hospital, that doesn't belong here.” … Then the view of our program kind of evolved into “It's really nice. … it's really lovely.” And then after a bit more time, the overarching recognition was that this is really important …because our, our care providers we're recognizing that artists are really crucial members of the interprofessional care team.


We interviewed all 31 members of the nursing staff on a medical surgical unit over a period of about 18 months to learn about how they perceived the effects of the work of artists in residence on their unit. …So, we learned that nurses recognized the benefits of engagement in the arts for their patients. They were asking the artists to come in when their patients needed distraction and relaxation, those sorts of things. … from a clinical perspective, they noticed that blood oxygen saturation. It would go up. That wasn't the focus of our study. I want to be clear, but observationally, they were noting the clinical things like that.

(Dr. Daisy Fancourt) has been able to, to articulate very significant associations between arts and cultural participation in health. For example, people over the age of 50 who go to museums or galleries, … just once a month or more are almost half as likely to have the onset of depression or age-related disability. Similarly, kids who engage significantly in creativity are 48% less likely to be maladjusted, which is a very significant determinator of lifelong health. and she has as well repeated some Scandinavian studies … that determined that yes, people who participate in arts and cultural activities do live longer or are less likely to die early. In fact, 14%, less likely to die early.

(In) Uganda …I learned how the Ministry of Health and the government in Uganda has used the arts as a very central primary means of health communication and of public health since the 1950s. …One of my first interviews was with a very high-ranking member of the Ministry of Health. And I said, “Why do you use the arts in public health?” And he furrowed his brow at me, looked at me like I was an idiot, and said, “You can't do public health without the arts. You can't just tell people health information; you have to engage them.”

One day, I had a photographer with me, and she said, (to the patient) “What happens to your pain when you dance?” And she said, “It's still there. I don't care because I feel so good” And that particular day, I'm thinking of when we were dancing for about an hour and a half, her physician quietly came into the room and just sat and watched, and our eyes were closed, and we didn't really notice.
And he left the room and put a big note at the front of her chart that said, “Dancing works better than meds, call Arts and Medicine.”

Notable Mentions

University of Florida Center for Arts and Medicine:  “Transform health and wellness through the arts. Use your creativity to advance health, wellness, and equity as a trained arts in health professional. Promote health one creative moment at a time.”

The University of Florida, Center for Arts in Medicine, EpiArts  Lab:

A National Endowment for the Arts Research Lab exploring the impact of the arts and cultural engagement on population health outcomes in the US through epidemiological analyses of US cohort studies.

Shands Hospital’s artists in residence: Starting with two volunteer visual artists working on the Bone Marrow Transplant Unit, Arts in Medicine now has 16 paid artists in all art disciplines working in six separate buildings throughout the UF Health system, covering the Gainesville and Jacksonville communities.

University of Florida Health Shands Arts in Medicine Program: Artists in Residence work annually with over 100 volunteers from the Gainesville community and the University of Florida. These artists and volunteers engage patients, families, and staff in the creative disciplines of dance, writing, music, visual arts, and contemplative arts.

Centers for Disease Control, Vaccine Competence, and Demand Team: The Centers for Disease Control and Prevention appointed Jill Sonke, director of the UF Center for Arts in Medicine, as senior adviser to the Vaccine Confidence and Demand Team on the COVID-19 Vaccine Task Force this summer. 

Interlochen Arts Academy: “Our umbrella organization, Interlochen Center for the Arts, encompasses six distinct program areas, each founded to propel arts education and engagement: Interlochen Arts Camp, Interlochen Arts Academy, Interlochen Online, Interlochen Public Radio, Interlochen Presents, and Interlochen College of Creative Arts.” 

Dr. John Grand Pole: Dr. Pole co-founded Arts in Medicine (AIM) at the University of Florida, arguably the nation’s leading university hospital arts program. As well as over 120 scientific publications, he has published more than 60 poems and essays on the healing arts, and performs as an improvisational actor and clown.

Dr. Mary Rockwood Lane: is a professor, nurse, healing artist, painter and works as a professional Caritas coach with individuals and healthcare settings, both nationally and internationally.

Dance in Medicine Program, University of Florida: The University of Florida Center for Arts in Medicine, in conjunction with the School of Theatre and Dance, offers an Undergraduate Certificate in Dance in Medicine to UF students.  This certificate can serve as a credential for developing post-baccalaureate educational pathways and career options. 

Duke University Arts in Health Program: “Arts & Health at Duke was founded in 1978 by James H. Semans, MD, in collaboration with Wayne\ Rundles, MD, professor of hematology and then-president of the American Cancer Society. First known as Cultural Services, the program originally offered monthly musical performances in the hospital cafeteria with the support of the Mary Duke Biddle Foundation.”

University of Michigan Medical Arts Program: “The Medical Arts Program aims to enhance medical students’ and house officers’ ability to provide high-quality, humanistic clinical care through experiences and analysis of the musical, theatrical, literary, and visual arts that focus on essential but often overlooked skills such as empathy, awareness of social context, and comfort with the ambiguity and uncertainty that are a pervasive element of clinical care.”

Dr. Daisy Fancourt, University College, London: Fancourt worked with the World Health Organization to develop an agenda that connected the arts, health and well-being. In one of her WHO reports, Fancourt concluded that arts interventions, including singing in a choir to improve the outcomes of chronic obstructive pulmonary disease, present low-cost treatment options for healthcare workers.[18]

 What is the evidence on the role of the arts in improving health and well-being?  A scoping review: World Health Organization, 2019: Results from over 3000 studies identified a major role for the arts in the prevention of ill health, promotion of health, and management and treatment of illness across the lifespan.

Ellen Dissanayake is a bio-anthropologist who studies, whether there is selective value to the arts, whether we need the arts and creativity in order to survive.

Creating Healthy Communities Through Cross-Sector Collaboration: This paper presents a case for how collaboration among the public health, arts and culture, and community development sectors is critical to addressing the issues and conditions that limit health in America.

Creating Healthy Communities, Arts and Public Health in America Initiative: Creating Healthy Communities: Arts + Public Health in America is a two-year national initiative led by the University of Florida Center for Arts in Medicine in partnership with ArtPlace America. The initiative will expand the intersections of arts, community development, and public health through strategic cross-sector collaboration, discovery, translation, and dissemination.

The Arts and Health Communication in Uganda: A light Under the Table - This qualitative interview study brings the voices of 27 public health leaders, health communication experts, and artists who work in public health in Uganda together to articulate the principles and practices that make the country a shining example of effective, evidence-based use of the arts for health communication.

Centers for Disease Control - How to Engage the Arts to build COVID-19 Vaccine Confidence: “Local artists can communicate vaccine information in a way that often makes it more understandable, memorable, culturally relevant, and actionable.”

Transcripts

Jill Sonke: Calling Arts & Medicine, STAT!

Narrator

In an instance a life can change.

Patient

th,:

MUSIC SINGING

Patient

And at that moment I felt like me, I didn't feel like a patient, I didn’t feel sick.

Narrator

The Arts and Medicine Programs at the University of Florida specialize in using the arts to help people whose lives have been interrupted by illness or injury. Here our artists in residence impact the culture of care by engaging patients, families, and staff in creative activities that transform the hospital experience. Together. We are advancing how creativity transforms health.

Bill Cleveland:

That little story came from a video on the Arts and Medicine Program at the University of Florida. In it you heard from a young heart transplant patient, in recovery. In the video, surrounded by tubes and wires and beeping machines, he describes how he found both solace, and joy in a song --- not just listening, mind you, but joining in the making along with one of Shands Hospital’s 16 artists in residence. Watching and listening to this short video, it's amazing how quickly the wires and machines give way to the human healing story being told.

In this episode, we explore the 30-year history and impact of the Arts and Medicine Program and its clinical partner at Shands Hospital with the program's director,

Like most of our guests, Jill wears many hats, dancer, educator, writer, researcher, and most recently as a senior advisor to the Centers for Disease Control, Vaccine Competence and Demand Team.

Bottom line though, Jill is a creative healer in service to a community of doctors, nurses, artists, educators, and most of all, patients on a journey that reunites the arts and medicine in their age-old roles as healing partners.

BC:

This is Change the Story, Change the World: a chronicle of art and community transformation, my name is Bill Cleveland.

Part One: A Dance Epiphany:

BC

I've been thinking about what it would be like to be in a healthcare environment in the middle of a, a healthcare emergency that is complicated by so many other things other than just the biology of it all.

Jill Sonke:

Yeah. The politics are challenging.

BC:

Let me just begin with where are you physically, geographically.

JS:

So, I'm in Gainesville, Florida, which is the land of the Tuniquah and the Seminole people.

BC:

You wear many hats. You poke around in a lot of different areas. How do you describe what it is you do?

JS:

At its heart, much of my life, and all of my work is about enabling and supporting and advancing the connections between the arts and health.

I'm an artist. Myself, I'm an educator and administrator or researcher, a practitioner. And I feel really fortunate to wear a lot of hats, though, it certainly can be complicated and exhausting in some instances. I love wearing all of those hats and I love being involved in a lot of different things, but for me, it is all about arts and health and being very centrally, an educator.

It's, it's about empowering and enabling the students and others to explore their interests and their capacities in that area. And it's about field building, building a field of people who, who have deep understandings of the connections and the potentials at the intersections of the arts and health.

BC:

Compared to when I started in the field of community arts, there are many, many more people engaged in the path that you've taken, but it would be interesting to know how you came to your work

JS:

As it's not unusual, quite accidentally, and it really started quite early in my life. I was headed toward a career in medicine as a kid. I started volunteering in a hospital and a nursing home. The day I turned 14, I couldn't wait to get into that environment. I loved the idea of caring and I was very attracted to the healthcare environment and very interested in the human brain and body.

I also was a competitive gymnast and, um, in my junior year of high school, I had what I described as the first epiphany of my life. I was, as usual, in the gym practicing and a dancer came in to help us with our floor exercise routines and I had the most halting and extraordinary moment of moving artfully.

I had moved competitively and athletically, but I hadn't experienced moving artfully. And I was just blown away by it. And it was the first big turning point in my life. And so, I just looked around and found a dance class and got in and. I auditioned for Interlochen Arts Academy, which is a performing arts boarding school, in Northern Michigan, an amazing place. I got in by the skin of my teeth and was just a fledgling dancer among other really extraordinary dancers. But began to make my way in the world of dance and went down that path and dance professionally in New York.

And then I had, I second that epiphany, when I came to Gainesville, Florida with what was intended to be a year. And heard about this Arts and Medicine program bubbling up. And the thought of being an artist in healthcare was just amazing. And so, I became one of the first two artists in residence in the U F Health Shands Arts and Medicine Program.

BC:

So, you started with where you are. That's totally amazing. So many people bounce around, but you have found your home there. When was that?

JS:

So, I got involved in the program in 1992, started attending meetings that were just coming together around this new Artist in Residence Program. And then I had a baby in 1993, and then early 94 when my son was six months old, I started working as an artist in residence.

BC:

So, the program has evolved from the fledgling program you described to something that's pretty significant, that you now have a major role in. Could you describe it?

JS:

Yeah, so the USF Health Shands Arts and Medicine Program is a truly extraordinary program. It's one of a handful of programs that started in the United States in hospitals.

program together in the late:

And it grew rapidly. We were very fortunate to be in an institution with leaders who understood that the arts fit and we're important in a healthcare setting. That people should have the ability to engage creatively to make that experience of healthcare better, not just patients, but staff, and visitors and others.

So, we were very fortunate to be well supported in our endeavors. Now, now, are a very comprehensive program with 16 artists in residence and every discipline artists who have been with us for years who understand their practice deeply and do extraordinary work with the hospital inpatients and in the community.

BC:

Now you were teaching as well. How did that fit with your work at the hospital?

JS:

When I started working as an artist in residence in 1994, I was also teaching on the dance faculty at the University of Florida. And my students started to wonder about what I was doing in the hospital. And so, within months I had half a dozen students doing independent studies and volunteering with me in the hospital. And so, my colleague, Rusty Brandman, and I decided it was time for a course. So, in 1996, we created the Dance and Medicine course, and that quickly led us to an undergrad certificate in dance and medicine, which has led us now to both undergraduate and graduate curricula. We've got 91 graduate students in Arts and Medicine right now.

So, it's grown quite a bit and a robust research enterprise. So, the fledgling program has grown into a very comprehensive program with two halves of a whole. So, the, the clinical program, you have health Shands Arts and Medicine and the academic and research program, the Shands Center for Arts and Medicine, which is housed in the College of the Arts.

Part Two: From Weird, to Nice, to Transcendent.

BC:

So, I'm going to ask you a number of questions about the research. But before I do that, I have a personal question. And this is by chance. Yesterday, I returned from a two day stay at a hospital and knowing that we were going to talk, I paid particular attention to where I was and what was happening around me.

And notwithstanding the fact that probably nobody lists going to the hospital as one of their top 10 things they like to do, the experience was extraordinarily positive, and, in large part because of the nursing staff that were there, because they carry the heavy load.

But one of the things that rose up for me and its related to this is that, is it struck me how utterly alien the health environment is probably for most people who enter it. And I, I really paid attention to things like the sounds, and the architecture, and the vocabulary that was being used ---the clothing, the rhythms, the machines, even the attention to detail, which we don't really experience at the level we do when we're in that kind of environment and for good reason, but it is all so different from the normal human experience.

And I'm wondering, given that there's this clinical side to your work, how does this relate to your thinking about art and healthcare and navigating that.

JS:

Yeah, so, when I first started, I actually… I love remembering people thought it was weird and some people thought it was inappropriate. I remember going into rooms and introducing myself. You know, dancer in residence and people would further brow and say, I'm in the hospital that doesn't belong here.

Um, but it, it didn't take very long, you know? And I think then the view of our program kind of evolved into “It's really nice. Yes, this really fits here and it's really nice and it's really lovely.” And then after a bit more time, the overarching recognition was this. Really important, right? It's not just nice, but it's really important because our, our care providers we're recognizing that artists are really crucial members of the interprofessional care team. When a, when a nurse can ask an artist to come in to help a patient relax, and just feel better and experience some happiness, some joy, some connections, some creativity, some distraction --- all of those things are profoundly transformative in the hospital. And our chair providers just don't have time for that really fundamental part of caring, but when they can facilitate it, they feel a sense of significant success in their work.

So, I think it works on a lot of levels and it fits, right? There were times when I, as an artist in residence early in those years, did things that didn't fit very well in the hospital environment. I wasn't performing in the right places or at the right times. But it didn't take us too long to really understand the healthcare environment and understand where the arts were really helpful, and were really useful and not, you know, not, uh, problematic, you know, not providing things like negative distraction, which they can do. And we have to have that understanding in order for the arts to work in a healthcare environment.

BC:

One of the things that I, and I've always understood, but when you're in the middle of it as a recipient, it's very different from thinking about it from afar. And that is that we have awful lot of people inside a hospital that have to interact in ways that are clear and precise, but also human. Doctors, I think, can sometimes get away with being highly clinical and, in and out. Nurses I don't think can. I think they, at least the ones I encountered are doing both at the same time: paying attention to little tiny things and sequences and protocols and information, and now computer, and then asking, “Can I fluff up your pillow.” and, and “How do you feel?” And I know that healthcare is beginning to really focus much more on the client, the patient-centered experience, and that nurses are in the forefront of that. And you've done some research on that. What have you learned?

JS:

Yeah, and I, I just want to say you're so right in that Bill and I really appreciate that comes from your recent experience, as well. And I think as patients, we need all of those things that you described. We need absolutely focused precision, and we need really humanistic care. We need that whole spectrum.

We've done a couple of studies of the impact of arts programs on nursing practice and on the environment. One of our studies did articulate, as I mentioned previously, how artists in residence play important roles on the interprofessional care team. They provide that kind of humanism that you've just described. And when care providers can reach to their artists in residence colleagues to provide that care, it helps them provide more holistic care---their active in that. So, I think that's critically important.

We learned in that study that the care providers rely on artists in residence for those things. And we, we learned that they recognize their unique skill sets and their professional skill sets. We learned in a study, a similar study, we interviewed all 31 members of the nursing staff on a medical surgical unit over a period of about 18 months to learn about how they perceived the effects of the work of artists in residence on their unit.

And we learned all kinds of things that we expected to learn like that… We dubbed one phenomenon that we identified as “the happy patient, happy staff effect” They described, “If my patients are happy, I'm happy. And if I can send an artist in my patients are going to be happy and that makes my job easier and it helps me take better care of my patients. So, we learned that nurses recognized the benefits of engagement in the arts for their patients. They were asking the artists to come in when their patients needed distraction and relaxation, those sorts of things.

They also recognize things like from a clinical perspective, they noticed that blood oxygen saturation. It would go up and things like that. That wasn't the focus of our study. I want to be clear, but observationally, they were noting the clinical things like that. Another really important thing that we learned in that study is that music in particular can be a negative distraction. So, staff members described things like I love music, but when I'm standing in the hallway, counting meds for a patient and the musician in is performing in a room with the door open it's I, it causes great anxiety and I worry that it may cause a patient care error, right?

So, we learned that it's critically important that artists are really well-trained to understand when and where and how the arts are appropriate and helpful in the hospital. So that, for, from my perspective was one of the most important studies that we've done. And putting that into the literature, I think was very timely in the evolution of the field of arts and health.

BC:

So, one of the things that has been central to my work and I know your work. And that is that often artists are thought of as hors d'oeuvres to wherever they are, other than if they're on stage, they're the main event. But in this circumstance, you're really talking about professional collegial relationships that take place where there's a skillset that is across sectors that allow for the integration of the artist, into the actual function and understanding of what's going on inside the institutions.

The question I have is do artists become problem-solving colleagues sometimes in circumstances I'm sure that come up all the time in the medical environment.

JS:

Yeah, they can. In our program, we have had artists in residence who are really embedded in particular units. And in some of those units they've attended weekly clinical staff rounds meetings where they go patient by patient and talk through the patient needs, and treatment plans, and things like that. And in those instances, they've asked our artists in residence to participate. Because if the artist can bring some insights, and also, they can be there to understand the needs of the patients. And to again, act as a member of that interprofessional care team.

And I want to be really clear here that artists in residence are not arts therapists. They're not clinicians. And our artists in residence and others in the field understand that scope of practice and the boundaries of their practice. They're not working diagnostically in any way. They're not making or suggesting any decisions about care. They're not engaging with patients around how they are, how they're feeling.

They are strictly engaging patients in creative practices and processes. And again, that's really important and impactful, but it's not clinical. In some situations, we have some artists in residence who work very actively in partnership with clinicians, helping those clinicians to meet their clinical goals.

So, for instance, we have an artist in residence who work in our Rehab Center. And he works with speech and language pathologists. So, they're working with people who have had strokes or are otherwise recovering speech and other capabilities and those speech pathologists and the OTs and PTs, and that unit will work with the musician in residence when they're working with their patients and say, okay, now I need something at this tempo, and I need something like this. And so the musician is literally an instant. For those clinicians and they have such a beautiful partnership. They have such an understanding of each other's work that the artists in residence can be responsive to the needs of the clinician. And it works. If there's music that's motivating a patient, the tempo is picking up a little bit and musician in residence would never make those clinical decisions.

Right. But the, the, the clinician is, and they're able to engage the musician as a partner in that way to meet their clinical goals.

BC:

And anybody that's done any kind of just even physical training or whatever knows the effect that, that music, rhythm, a beat, or a tone can have on how you feel.

JS:

music is motivating. I mean, the whole exercise industry, right? There's so much music.

BC:

Part Three: Headlines.

I'm going to ask you a very unfair question. You have an awful lot of research that you've done in a lot of areas related to arts and medicine and healthcare. It really has broad scope. But, I'm going to ask maybe for people that are really wrapping their minds around this idea of the creative process and its relationship to healing and medicine and science, are there any headlines that rise up from your research that say something about how art can affect human health?

JS:

Yeah, there's some really great research out there. And I'm going to point squarely to my colleague, Dr. Daisy Fancourt at University College, London. Daisy and I are co-directors of the Dr. Daisy Fancourt at University College, London. The work of our lab is built on work that she's undertaken in the UK over the past eight or so years.

h Organization’s, November,:

Her own research is incredibly compelling. She uses longitudinal big data sets, large cohort data sets, and she's able to basically simulate randomized clinical trials. So, they're causal inference studies in which there, there are so many people involved in these studies and people whose data is tracked across their lifetimes. She has just under 400 questions about arts and cultural participation in the datasets she works with in the UK and all sorts of health and lifestyle data.

And she's been able to, to articulate very significant associations between arts and cultural participation in health. For example, people over the age of 50 who go to museums or galleries, those sorts of things, just once a month or more are almost half as likely to have the onset of depression or age-related disability--- really compelling population level findings.

s that were undertaken in the:

The population level data that we have right now is really compelling. And right now we're using Daisy’s statistical models and running those studies with seven longitudinal large cohort data sets here in the United States were about seven of 20 statistics, statistical studies in the Epiarts Lab.

BC:

Wow. For me, obviously you're preaching to the choir here, but hearing about this and also going through a lot of the other work that you and your colleagues have done, it seems to me that there's a pretty important story to be told. And that can be a challenge because the studies themselves can break down into an esoteric language pretty quickly. But at the end of the day, it appears to me that what I and my colleagues knew from the get-go and our work in places like prisons and mental hospitals, that they impact of art making of arts participation is significant, that it is in an intrinsic human need relative to ongoing ability to thrive and be healthy.

Now there's a lot of people that would roll their eyes at what I just said. And I guess my question is

What are the translation strategies that go along with the incredible work that, that you all do, so that it seeps up into more common understanding about the relationship and art and healthy communities.

JS:

Yeah, and for me, I love that question. Thank you. For me, the story, you started with the story here is that being creative, engaging in the arts is like eating well and exercising and wearing seatbelts and not smoking. It's just a thing that we have at our disposal as a part of a healthy lifestyle. It's a part of our toolkit for good health.

And I think, I think we're at a place, especially since COVID. In this pandemic, I think the relationship between the arts and health has been more generally visible than in my lifetime than at any other time. So, I think we're closer to a place where that understanding is more pervasive and, and I think that we're going to see more participation in the arts with an understanding that, you know, if I, I do creative things three times a week, if I exercise every day or three times a week, I'm just going to feel better. And remember, this is something that I have and can do.

And also, to your point, you know, human art behavior, right? Human beings have done art have made art, have expressed themselves creatively throughout our human history. We have evidence of it throughout our human history. It. Persists across cultures across time across conditions. It is a human behavior, right? Our art behavior. I love Ellen Dissanayake, a bio-anthropologist who studies whether there is selective value to the arts, whether we need the arts and creativity in order to survive. And she, she calls this human art behavior, which I really appreciate.

So yeah, I think we are, although you're right. Not all of us are going to choose to do art. Not everybody wants to do art. Not everybody is going to get value from doing art, but I think there, there are a lot of people in this world who can and will find value in doing art.

And I'll, if it's okay, I'll share a personal experience.

BC

Oh, absolutely

JS

A recent personal experience. Just to say as background, I'm a person who's literally, truthfully mouthed the words to happy birthday, my whole life to spare the people around me. Just, I've been a dancer, I played the violin when I was a kid. But I always have felt that I'm just not a singer. And a couple of years ago, I was with friends, and they were singing, and I adore music and I just adored harmony, listening to harmonies all my life and secretly wanted desperately to do it.

And I was listening to two friends, sing harmonies, and I just couldn't stand it. I just burst in and said, “I can I Join you I'm going to make noise. I'm sorry, but I think I'm going to enjoy it.” And they were very generous in letting me join. And it was, it was maybe my third life epiphany. It really changed my life from that moment. I stepped into music. They were so… And my friends continued to be so generous and inviting me in. Took up the guitar and February, we're just this February. I got a six-string guitar. I play and sing every single day. I pray play myself. I have several sets of friends that I sing in play with. I can't get through a day without playing and singing.

And throughout the pandemic, it was an extraordinary lifeline for me. I would take a break between zoom meetings and play one song and just look forward to the evening. To the time I could play. It's been interesting over the past year to step into a new art form. I'm 55 years old and I've discovered a new art form and discovered a relationship to that art form that is as, if not more, transcendent than my relationship to dance has been. And I have it at my disposal all day long. And I've relied on it for my health and wellbeing in a way that has literally made me feel like my understanding of the relationship between the arts and health has been understated for all these years, where I have a deeper and it's, it's bigger than, it's greater than, I've understood for the past 27 years of being in this career.

BC:

As a songwriter musician who has in many ways survived this pandemic period with that go-to place, which is: The way I describe it as “I can change my mind in an instant if I pick up my guitar” --- even when I'm resistant, when I'm in the worst possible mood, and I'm just down in the dumps, just “Okay, pick up this stupid thing. Go for it.”

And my experience in the prison system was of course, seeing prisoners who had never even thought of themselves as anything approaching, being an artist, literally transferring substance abuse, addictive behaviors to playing guitar until your fingers bleed, which is amazing.

And it says something to me about the embodiment of the creative process-- the literal physical embodiment of singing, playing guitar, making a pot, drawing, something that is not just about the computer in our brains. There are all the sensory systems that we depend on for knowing the world and making meaning or engaged in a way that has nothing to do with judgement, and nothing to do with anything other than you're doing it and let's see what happens. And what an amazing gift for humans to have.

Now, I have another question about your research, and this is a paper that you're a part of, which is the Creating Healthy Communities Through Cross-Sector Collaboration. Cross sector is an important concept for my work, at least over the last 25 years. But the interesting focus is public health. Which obviously is critically important now. And… but public health as defined by, by five areas that some people may not even think of as related to public health. And to me, the fact that this research touches on this and it really broadens the idea outside of the symptomatic issues that we deal with and medical facilities to the community--and translates it all to the community. Could you talk a little bit about that research?

JS:

So, the white paper itself isn't a study, but it was a part of what we frame as a really big mixed methods study. So, over a period of three years, we collected data and all sorts of ways, including through round table dialogues.

So we did thematic analyses of dialogues with a lot of people that. The process that we went through of writing this white paper also had its own distillation process and was, it was a step in the data integration process and this overarching mixed methods study. But yes, this Creating Healthy Communities, Arts and Public Health in America Initiative and in the process of developing the white paper, we were very interested in thinking about the arts in relation to social determinants of health, and the upstream drivers of health inequities in particular.

And that's why you see this range of the five areas that we thought were critically important for public health to be thinking about. And we're not the only ones public health is of course, thinking about all these areas. And they're also areas that we felt were really ripe for arts and culture to be a part of change, to be a part of helping them. So, yes, we look in the paper at collective trauma, racism, social exclusion, and isolation, mental health, and chronic disease. And we give examples for how arts and culture programs can help address those issues in communities.

BC:

What that says to me: We've divided our society up into various sectors and interest levels, and expertise. What you're doing, which is what I think healthcare needs to do and has actually been made obvious in a significant way in the pandemic is that healthcare isn't about just hospitals or doctor's offices. It's about what happens in everybody's life every day.

And particularly when a health crisis hits. It's not about. “Joe's sick.” or “Mary's sick.” It's about, we are dealing with a systemic medical issue that requires a systemic societal response. And you make some recommendations in this paper about what kinds of things might advance progress in this area. Can you say a few of those that you think are particularly important?

I would say one of the striking things about it is that it reiterated the idea that was articulated in your study about the interprofessional work inside a hospital, which is that interprofessional work in the community is it's the same.

JS:

Yeah, it is. This paper calls for that cross sector collaboration and not just between arts and culture and public health, but community development in particular. And yes, it is not unsimilar. The work that I've been doing with the CDC over the summer is all about driving the same kind of partnerships between public health department's public health professionals, and arts and cultural organizations, artists, and culture, bearers in community. They need each other, right.

nd of public health since the:

And in my study, one of my first interviews was with a very high-ranking member of the Ministry of Health. And I said, “Why do you use the arts in public health?” And he furrowed his brow at me, looked at me like I was an idiot, and said, “You can't do public health without the arts. You can't just tell people health information, you have to engage them.”

And he described understanding how the arts engage people through narratives. They engage people emotionally, and most primarily, he understood that what he described as high levels of art, like really art that a lot of people will really be drawn into through aesthetic experience has the potential to create a level of resonance, and that's the word that he used, that can really helped facilitate the communication of information in ways that are understandable and memorable and also in ways that people will share with others. And so, they have a deep understanding there. And I think that that's so in much of the world.

I've been working this summer with the CDCs Vaccine Confidence and Demand Team on the COVID-19 Vaccine Taskforce. And members of that Taskforce who had come together to address vaccine confidence in the United States at this time, are people who have worked in other parts of the world. And they collectively knew you wouldn't launch a health communication campaign in a critical moment without artists, without song, without theater, without murals, without music.

And so they felt that it was time to really encourage that in the United States. So the CDC has just released two field guides last Thursday that are designed to enable partnership between public health and arts and culture, and to help those partnerships, design, um, campaigns, health communication campaigns, and programs. So, those are available now, which is exciting.

BC:

So one of the things that's just so obvious to me, because I live in a world with a lot of different people, with different opinions about all these things. It's not a bubble. And I have had numerous experiences of people traveling a road from, from being very resistant and defiant to finally recognizing that a vaccination is okay.

And in large part, because of the stories that have been shared by other people that they trust. We still live in a community, you know, of, of person to person communication. And that may be frustrating to some people who think that we can just use the internet and blast everybody with information to get them to understand what's right. But that's just, we're still humans.

Part Four: Dancing Better Than Meds

BC

At the center of these conversations often is a story that personifies the work of the person I'm talking to. So, I'm wondering if in the thousands of encounters you've had in your experience, what story rises up that maybe personifies what you're up to?

JS:

So, one of my most important teachers was a patient who I met in the first months of my work as an artist in residence. She was six years old at that time. And her name is Bertis and I have permission to share her story. She had has sickle cell disease. And so, she was in the hospital with a pain crisis. I came in. It’s the artist, and offered dance and she was like, “Nah, I don’t want to dance.” No, but she loved fashion and fabric. And I had some fabric with me.

And so, she wanted to dance with that fabric. So she came into this process of dancing. And we developed a relationship. I would see her every time she was in the hospital, she wanted to at a point learn dance. So, as well as just playing and dancing creatively together, we would do ballet lessons. And every time she was in the hospital, we would work together.

And I, …One very significant experience we had was when she was 14 years old, her pain crises were really bad in that phase of her life. And she was in the hospital sobbing in her bed, and I came into the room. We had known each other for so long and worked together for so long that it would look crazy to an outsider. I leaned over and said, “Bertis, do you want to dance?” And she said, “Yes.” And pulled herself up.

And I would usually start by guiding her, and then she would quickly close her eyes and begin to lead the dance. And I will say though, from an artistic perspective, Birtis as an artist could go into a deep creative more efficiently than any artists. I know who work at it, their whole lives. And she's definitely motivated by pain, which is big motivation. And that she's an extraordinary, she is an extraordinary artist. So, we would dance together. And those moments of dancing would last an hour and a half. And they would really shift her pain.

One day, I had a photographer with me, and she said, “What happens to your pain when you dance?” And she said, “It's still there. I don't care because I feel so good” And that particular day, I'm thinking of when we were dancing for about an hour and a half, her physician quietly came into the room and just sat and watched, and our eyes were closed and we didn't really notice.

And he left the room and put a big note at the front of her chart that said, “Dancing works better than meds, call arts and medicine.” And so that changed an element of the clinical part of her care. So, when she would be admitted, I called. We would schedule time every day per her request. She would reduce her pain meds by half an hour or so before I would come in. So, she would feel really clear and she would be able to sustain that lower dose into the wee hours of the night. And so it brought to light for the clinicians, how that kind of creative engagement can be really transformative.

And Bertis is 31 years old now. And I got an email from a physician two weeks ago, who said she encountered her, and she said, “What do you do for your pain?” And Bertis said, “I dance.” So, she's had a lifetime of dancing to manage her pain.

BC:

Wow. And this is something that every single human being has the capacity to use their own body and mind to engage their self-healing capacities. So, it's not. Because a gigantic increase in the healthcare budget, actually, even just to pay a few artists to come and learn and do that kind of work.

So, if somebody listening to this says, “Oh, I want to do what Jill does.” what do you say to your, your students who are brand new, who are just getting introduced to this whole interesting world of health, art and healing?

JS:

I'm telling them to trust their gut and trust their passion. There's so much space for discovery at the intersections of the arts and health.

Today. There's so much for us to learn and discover and understand better. And everyone's going to bring a different inclination and perspective that's going to grow this field in new directions. And there's the field has grown and evolved tremendously. And there are now jobs, which is pretty amazing. I feel 10 years ago when we were starting our educational programs based on demand, people were coming to us and wanting more education and credentials.

I was reluctant because what are you going to do? You're going to make this investment in the education, and then you've got to get a job. Now. I feel. You know about the ways in which people are being employed in this field and the opportunities for people. And especially as this public health area opens up. When I'm in Uganda, people literally say to me, “Thank God, I'm an artist because I can always work.” because there's, there's work in public health for artists.

So, I envision a day when that's true in this country as well, and public health departments employ artists, and when public health teams include artists. There's just so much room from practice to research. There's so much room and so much need for artists in the realm of public health today during

BC:

my stay in the hospital I encountered a nurse talking to one of her colleagues about her retirement. And I said, “So you're leaving. And so, she was in her early fifties so, she wasn't necessarily at the end of her career. And she says, “Yeah, I'm burned out.” And I told her about Shands. And by the time we finished our conversation, she said, “Oh my God, I had no idea. This is where my heart is. If I had known that!”

And I also think about those people who are drawn to a healthcare profession, who also have these other stories in their lives and never imagined that the two could come together like yours.

JS:

They are so deeply connected. There's a huge proportion of. Health professionals, health science professionals who have really well-developed artistic backgrounds.

There've been some studies that have suggested like 75% of health professionals have well-developed arts backgrounds. And many leave their art behind when they enter into either education or their profession. Historically, I love like, so many of the Greek gods in Egypt God's are both gods of health and the arts, especially like historically there is no absence of connection in that way.

That suggests that there are not, not only in the human beings who choose both science and the arts, but we know that art and science are so much alike. They're both about questioning and understanding, and exploring, and communicating. So, there's deep and natural connections.

In this country we have professionalized, the arts to the extent that we feel like with my singing, I felt that I wasn't good at it, and so I didn't do it. And so early in our lifetimes, and I'm generalizing grossly here, in our culture. if we're not good at a thing, we tend to step away from it. You know, I'm either an artist or I'm not an artist and, and it's different than other parts of the world I've visited where people don't lose their relationship to the arts. Whether they feel that they're good at it or not, there's not so much of that judgment around in some places anyway. But here we lose our relationship to the arts, I think more than in other parts of the world.

BC:

Yeah. It's interesting that in that Creating Healthy Communities Through Cross Sector Collaboration, there's a section there where you reiterate the, the organically integrated nature of art in, in healing that has existed in traditional society forever. And you obviously encounter that in Uganda, but it is everywhere. It's just beneath the surface because it's only in recent human history that these separations have occurred. And I actually experienced even people who are skeptical when I asked them. So what do you think about this idea that, you know, art, it could be a part of a healing journey and they go, “Well no.”

Now. And I said, “Well, talk to me about your kids. Your grandparents sang songs on the front porch when sad things happened? What happened and even your experience in church, what was that about? Because that's not all just celebration. That's hard times. And humans intrinsically, organically understand and know we are makers, as you said, this is a human behavior. It is, it's not some modern invention.

So, two final questions. One is the current time we're in. You mentioned your work with CDC. When you think about these critical times. One of the things that I realized that happened in my encounter with the nursing staff in the hospital was that, at the end of the day, the most important element of the relationship is trust.

So, is there anything that, that you could say about what your work has taught you about the engendering of trust, particularly between folks that may be predisposed to not trusting.

JS:

That's a really interesting question, Bill. So, my research hasn't looked in particular at trust, but when you asked that question, I think back to moments of being an artist in the hospital and being in a patient room, working with a patient and a care provider would come in and rather than a quick turn and exit, because art is happening, when they would come in and join and participate in the art process, I could see a building of trust between the patient and the care provider. And mostly, I think it was transformative for the care providers who just remember what it feels like to slow down and to be with patients and other ways.

And I don't mean to globalize. There's so many care providers. Deeply nurturing and do, you know, take time. But mostly our care providers are under a lot of pressure to be on the move pretty quickly. So, I think that when a patient and a care provider have a creative experience together, it can really shift a relationship and they'll try it.

BC:

So, final question is what creative work have you encountered recently that have inspired you and why.

JS:

Yeah, a, a performance that Bill T Jones directed on at Times Square on Afrofuturism. And it was an absolutely magnificent and thought-provoking performance that was coupled with a day of dialogue around the notion of Afrofuturism and that's available online.So, I really recommend that.

I also have spent a time this summer at Little Island, in New York and west 14th street. It's a new installation in the city. And, in the gardens, there are incredible varieties of flowers that I've never seen before. That just make an incredibly compelling visual installation.

And I have a friend who I play music with, who his name is Cobblestone, and he has been playing music all his life. And he just can remember every song, and every riff he's ever played. He is a human tube box and I am just super inspired by him as an artist. Right.

BC:

So you mentioned your number one fear of singing and then hearing harmonies and wanting to be in it. Are you now a harmonizer? Are you in that mode? Can you do that?

JS:

I am in that mode. And I will tell everybody I feel I don't do it well, and it's really it's--- I don't want to be on a stage, but I am finding my voice and the people I'm singing with are either very tolerant or they are enjoying it, but it's incredibly joyful and that's the quest for me. It's I just love the joy in it. And I also love the craft in it. I love developing my voice and I love building my repertoire and I like the work in it. So yeah, I love it. I love harmonizing.

BC:

So if its of any solace. You may be aware, I don't know if you're a fan of Nancy Griffith who is such an extraordinary musician song writer, creator who recently passed. And I read a story where John Prine, who is, who is well-known for a songwriting, not particularly for his beautiful voice and how he latched on to Nancy Griffith, like a magnet, understanding that every time that she sang with him. He sounded beautiful. And how terrific that was, is to join. And that's really what a harmony is: taking the best of both parts and making something that's more than the sum.

JS:

It is incredible. It's joyful and transcendent, so grateful to have it.

BC:

So, Jill, thank you for spending this time.

JS:

Thank you so much, bill. It's been a

BC:

pleasure. Jill, the feeling has been mutual. And we hope for our audience members it's yours as well. Thank you for tuning in. As you can imagine, there are going to be many interesting links and references in this episode show notes. So, check them out also, please know your listening is the lifeblood of this program. So, click on the subscribe button on your podcast player, and share us with your fellow travelers.

Change the Story Change the World is a production of the Center for the Study of Art and Community. We are forever thankful for the extraordinary soundscapes of Judy Munson and the fabulous sound effects that we get from Freesounds.org

So until next time stay well, and spread the good word.