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The Silent Treatment

Drama, like palliative care, is concerned with exploring crises and change. So often characters in plays, like patients, find themselves facing shock, uncertainty and conflict. I have spent much time over the years thinking about how to meet these challenges and help patients and their families.

My son is a drama lecturer and we’ve often talked about how great playwrights like Shakespeare and Pinter can help clinicians to learn more about empathy and compassion. Although there has been work on the value of Applied Drama in a medical context, there has been little on the intersections between theatre texts and clinical practice. We decided to write a book exploring key areas of end of life care and relating these to insights from theatre texts.

The selection of plays was not easy - the dramas are challenging and often upsetting in their focus on suffering. In the busy clinical world of end of life care ethical dilemmas are heightened, and plays such as these highlight some of the key tensions in the human condition.

Within our book, we explore how particular plays provide useful lessons in enhancing empathy and compassion in a clinical context. As we all know, compassion is a vital element in the silent treatment and provision of effective care. The plays also illustrate the potential for good communication to help and to heal in time of crisis. From the time of the Greek tragedies to the present day, we owe a debt of gratitude to the authors of the plays who continue to teach us about communicating in a sensitive way.

Called Enhancing Compassion in End-of-Life Care Through Drama : The Silent Treatment, one of the themes the book explores is use of silence. Silence often drives the plot forward and creates tension for the characters. Some of the most powerful moments in the plays are those that take place without dialogue; for instance, in Journey’s End, when Stanhope comforts the dying Raleigh simply by moving a candle nearer his bed.

We hope the book will be a springboard for a wider consideration of how theatre can help healthcare professionals to increase their understanding of the dynamics and demands of end-of-life care. We wanted to show how theatre texts can engender creative problem solving ideas which promote an empathic approach to end-of-life care. Of course, as well as reading the book, I’d encourage people to attend performances of the plays - theatre text is only a formula for an act that should be live and engaging in the spirit of the moment.

This blog is by Dr David Jeffrey, Honorary Lecturer in Palliative Medicine , University of Edinburgh. The book he refers to is:

Enhancing Compassion in End-of-Life Care Through Drama : The Silent Treatment by Ewan Jeffrey, Lecturer in Drama, Queen’s Belfast and David Jeffrey Honorary Lecturer in Palliative Medicine, University of Edinburgh. Foreword by Professor Steve Field. Deputy National Medical Director, Health Inequalities, NHS England. Radcliffe Publishing , London 2013 CPD Certified.

The plays and themes referred to in the book are:

King Lear, William Shakespeare (1606) - Communication

The Caretaker, Harold Pinter (1960) - Care

Journey's End, RC Sherriff [1928] - Connection

Antigone, Sophocles (441 BC) - Choice

Little Eyolf, Henrik Ibsen (1894) - Change

All My Sons, Arthur Miller (1947) - Concealment

Blasted, Sarah Kane (1995) - Crises

Cloud 9, Caryl Churchill (1979) - Complexity

Behzti, Gurpreet Kaur Bhatti (2004) - Culture

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