Everything I needed to know about medical management I learned in acting school - Essay

Physician Executive, July-August, 2002 by Brian A. Meltzer

IMPROVISATION.

To some the word conjures up images of fumbling through uncomfortable situations. To me, the images are quite the opposite.

Improvisation allows me to be in front of a group with nothing prepared, trusting my subconscious to get me through the moment. There is nothing more exciting than reaching that edge -- the boundary beyond where most people are comfortable, yet remaining cool and collected.

Uncomfortable moments come about in every person's day-to-day interactions with other human beings, whether during a job interview, during the question and answer portion of a presentation or around the proverbial water cooler. Some handle these moments with aplomb. For others, the fear of the social unknown is paralyzing.

At a recent executive skills tutorial run by the Certifying Commission on Medical Management, I realized that my background in improvisational theater prepared me for all of the social and interactive skills that we practiced in our cohort groups:

* Listening

* Interviewing

* Presenting to an audience

* And even confronting the difficult employee

"No one travels so far as he who knows not where he is going."

--Oliver Cromwell

Let me go back in time to 1986.

By day I was a college sophomore attending classes in the accelerated medical program offered by City College in New York. By night, I was taking acting classes with the Chicago City Limits Improvisational Theater on East 74th Street and earning some money as an assistant to the theater's house manager.

After two years learning the basic skills of improvisational comedy and working backstage with a troupe of wonderfully funny and talented actors, I joined their performance workshop group and began honing this craft in front of actual audiences.

Nothing prepares you for the unknown more than getting onstage in front of 150 people with absolutely no idea of what you're going to do.

To add to the tension, our performance was 50 percent at the whim of the audience. We provided the structure. The audience provided suggestions of words, phrases and ideas. We did our best to incorporate those suggestions into songs, stories and scenes with the ultimate goal of providing entertainment.

It's because there is a built-in disconnect between the artificial world of the role-playing and the real world of dealing with people who are living their lives. Bringing improvisational skills into your managerial armamentarium blurs the distinction between role-play and reality.

It took a long time to realize the real-life applications of improvisational acting. Improvisation is role-playing in its highest form.

Why do we hate to role-play in classroom situations?

Improvisational ability allows you to skillfully negotiate and enjoy role-playing for its own sake as well as enjoy the unpredictability of real life human interactions.

Imagine the power you would have if you could harness your creative energy and apply it to your most stressful and intense moments -- to shine when others whither.

That is the power of improvisation.

"Genius means little more

than perceiving in an

unhabitual way."

William James

You may have seen improvisation in brilliant style on the television show "Whose Line Is It Anyway?"

You probably thought that what they do is nothing short of amazing -- and that there's absolutely no way that you'd ever be able to do that. Here's the interesting part. Every one of us has this creative brilliance within ourselves.

When you were 5 or 6, or even 12-years-old, your playtime involved a great deal of creativity and improvisational skill. When you were rolling your Hot Wheels cars around on the floor, your mind wasn't staging the Daytona 500 on plush carpeting; it was turning the carpet into the track at Daytona.

The structure of schooling and being forced to conform to what is considered "normal" displaced our collective creativity and tucked it away in a dark corner of our minds.

Forget showing any signs of imagination in high school, you'd be instantly ostracized or labeled a "theater geek."

Now, we're ready for an improvisational moment.

Raise your hand above your head and answer this:

Why is your hand raised? (And don't say that it's because I told you to do it.)

Give in to that first flash of imagination that rushed into your head. There are many reasons for having your hand raised.

* Is it raised because you're strap hanging on the subway?

* Because you're royalty waving to the crowd?

* Because you're airing out your armpits?

There's no wrong answer. That flash in your mind is the jumping-off point for improvisation. Improvisation as a creative technique delves into all the possibilities and circumstances that lie within that flash.

As with all things in life, improvisation does have a structural basis. Without the ability to listen, to agree, to succeed through your partner's (or adversary's) success and to be spontaneous, improvisation of any kind will fall flat.

"Talkers are no good doers"

William Shakespeare, "Henry VI"

Listening is not the same as hearing.

Hearing is achieved passively through higher functions of our gray matter. Listening requires active involvement; it is a participation sport.