The Story Of American Health Care On Stage

Actress, playwright and academic Anna Deavere Smith spent years listening to people’s experiences with healthcare. She weaved these stories into a one-woman show, which looks at broad concerns about healthcare through the eyes of celebrities and everyday Americans. Host Michel Martin speaks with Smith about “Let Me Down Easy”, which began a national tour in Washington DC last month.

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MICHEL MARTIN, host:

I'm Michel Martin and this is TELL ME MORE from NPR News.

We'll hear from a Haitian American artist Jowee Omicil. We talked with him recently about his roots and his music and we also asked, what's playing in his ear. And we'll find out in just a few minutes.

But, first, the new Republican-led Congress has begun its work to try to repeal the health care reform passed after a tough legislative fight last year. So we decided to talk to performer and playwright Anna Deavere Smith, whom you might know from TV programs like "The West Wing" and "Nurse Jackie" and movies like "Philadelphia."

What does she have to do with health care, you might ask? Well, her new one-woman play, which was as is her custom, she researched, wrote and performs herself, takes on the interesting question of health and health care through the eyes of both celebrities and everyday Americans - people whose words she delivers verbatim in the new play, "Let Me Down Easy." It's just kicked off a national tour at the Arena Stage at the Mead Center for American Theater in Washington, D.C.

Here she performs as Brent Williams, a rodeo bull rider from Idaho, who talks about one of his numerous visits to the hospital.

(Soundbite of play, "Let Me Down Easy")

Ms. ANNA DEVEARE SMITH (Playwright, Actor): (As Brent Williams) And when they straighten out your nose, they take these two metal rods and shove them up your nose and work their way up and it felt like it was just going out through my brains and out the top of my head. And everybody said it should've killed me. But the good thing about it was, once they straightened out my nose, I could breathe, and I couldn't breathe since they broke my nose in the high school rodeo.

MARTIN: Anna Deveare Smith as herself joins us now in our Washington, D.C. studio. Welcome. Thank you so much for joining us.

Ms. SMITH: Thanks for having me.

MARTIN: Now, this actually, this project began in a very unusual way.

Ms. SMITH: Yes. I was invited to come to the Yale School of Medicine to interview doctors and patients and to present these, quote, unquote, characters, although real people, at Medical Grand Rounds, which is a lecture series, really, usually. I would imagine scientists and people like that participate. So, yeah, it had a very unlikely beginning.

MARTIN: As I recall it, you said initially, no. When they first invited you, you said no, but then you did decide to go.

Ms. SMITH: Yeah. Well, I heard from Dr. Ralph Horwitz, back when you got letters on fancy stationary. And I said no because I just didn't want to make a fool of myself around doctors. And, also, this was part of a visiting professorship. So all of that sounded like, well, I don't think that I would be able to do that. But I ultimately said yes in large part because I was very charmed by Dr. Horwitz.

MARTIN: Well, I'm sure a lot of people are familiar with your television and film work. But a lot of other people are also familiar with your theater work, which takes a very particular form. You talk to people, sometimes for hours and then you stitch their stories together, which you perform yourself. And I think a lot of people will wonder, how on earth did you think you could get a play out of the whole question of health care and its related topic, which is sickness and death?

Ms. SMITH: Well, you know, the job at Yale was 10 years ago, long before health care became a part of common parlance for us in America. And I've collected over 320 interviews. And though it's certainly focused in a way so that I would like this show to be a part of what we're calling the health care debate, I think of it more broadly as about the vulnerability of the human body, the resilience of the spirit and the price of care.

So I went to Africa. I went to a forest in Uganda and talked to traditional healers. I went to Rwanda after the genocide. I went to South Africa to talk to folks there about AIDS. I went to Germany to talk to our soldiers who go to Ramstein and Landstuhl to get patched back together enough to come home after the war in Iraq. So the journey has been very long. But I've been on quite a journey, just learning about what matters to people in terms of their wellness and about their mortality, to tell you the truth.

MARTIN: Well, to that point, though, I mean, with all those interviews, with all those, you know, very powerful stories, you would have enough, it seems, for seven plays. And I'm just wondering how you possibly managed to narrow it all down to a manageable form.

Ms. SMITH: Well, it's hard. I don't have a way of describing it, but you also have to edit down the conversations that you have, so it's probably not unlike that process, just on sort of a bigger scale and that I'm doing it for the theater, which is different than what you do here on the radio.

MARTIN: I'm speaking with Anna Deveare Smith. We're talking about her latest theatrical work, "Let Me Down Easy." It just kicked off a national tour at the Arena Stage at the Mead Center for American Theater in Washington, D.C. And the timing really could not be better, in this kind of amazing way that the universe works, because the fact is, as you are here, the health care debate is being reinvigorated after a very bruising battle last year to get through the Congress.

It's now with a new Congress, many of its members coming here with explicit intention of reversing what was just done. And I'm just, you know, wondering what you think about the fact of what we just went through in discussing health care reform, and the fact that so soon after that many people came here with the explicit intention of saying oh no, that was all wrong.

Ms. SMITH: Well, I think that probably it gives the opportunity of those who are defending the bill to have another opportunity to describe what's in it. I think that across the board people would probably say that, you know, it could have been communicated differently and maybe better so they have another crack at it. And I think it's obviously a very, very important discussion for us to be having as Americans. In fact, I hope that people from both sides of the aisle will come to see Let Me Down Easy, because the question I'm asking is really how we as Americans think about care. That is, how do we position ourselves as caring people in the world and with each other? And so if the bill as it exists isn't right, then where does care sit in our culture?

MARTIN: You know, there are some truly shocking moments in the play, even coming after a period in which health care was very much discussed, very top of the mind during the presidential campaign in 2008, all through the first Congress, and yet, there are still moments that speak to the quality of care in this, which is the richest, if not one of the most richest countries in the world, that are absolutely shocking. And I, you know, I hate to kind of give something away for those who have not yet seen the play. But I do want to just play a short clip.

Here youre portraying Ruth Katz, and shes visited a doctor. Shes a cancer patient. He's told her he can't find her files. And then at some point in the course of the interview the doctor asks her about her profession, and this is what she says.

(Soundbite of play, "Let Me Down Easy")

Ms. SMITH: (as Ruth Katz) I said, I'm Associate Dean at the Medical School.

(Soundbite of laughter) (Soundbite of applause)

Ms. SMITH: (as Ruth Katz) Now he looks up. At this medical school? I said, at the Yale School of Medicine. He found my files within a half an hour.

(Soundbite of laughter)

MARTIN: Now, the performance that I saw, people were talking about that moment for many minutes afterwards, because it really felt, particularly given, you know, who can afford to go to the theater? Generally people who have some money, right? Who are generally used to being treated in a certain way. And there were these knowing glances and people nudging each other and saying yeah, absolutely, yeah, absolutely. I just wanted you to talk little bit more about that, if you could.

Ms. SMITH: Well, first of all, the wonderful thing about Ruth Katz is that she's been in the play longer than any other character and she's been in every single version because she was in the Yale version because I met her when she was dean at the Yale School of Medicine.

I think that what pleases me about audiences that come is that in many of the ways that they react to the play and other characters as well, they're very well aware of the disparity in this country. As you know, there's a character in the play who is a doctor at a public hospital, the opposite end of what Ruth is talking about in New Orleans, Charity Hospital, and many, many, many people in an audience of people who have advantages respond, I think, to what also Kirsta is bringing, which is a message that says wow, I worked in a hospital for poor people, mostly black, and after five days we still weren't evacuated. And privileged people in private hospitals were helicoptered out.

MARTIN: And theres also another moment which I think is extremely disturbing to many people is the dialysis patient and how she was treated. And it isn't just the technical aspect itself, but just the callousness, just the way she was treated and the indifference.

Ms. SMITH: The callousness and the carelessness. The carelessness. I think even Ruth being able to be in that position of being an inside person, being horrified by just the carelessness.

MARTIN: What do you draw from all this? I mean not just the work that you've done over such a long period of time, traveling around the world, talking to so many people about their experiences, what do you make of it? I mean I just think a lot of people still find it, the health indicators for the United States are not at the top at all in some key areas like infant immortality and maternal, you know, death, for example, HIV-AIDS and things of that sort. I'm just curious what do you think is the message here?

Ms. SMITH: Well, I think that the message is well spoken by Dr. Phil Pizzo, who is the dean of the Stanford Medical School right now; who says that we are slipping into a health care system that will look very much like that of a developing nation. In other words, if you have resources, you can get the best care in the world. Absolutely. But if you don't, you're not going to get that.

And so, one, it means we have to think about that. Is that the country that we want to be? But beyond that sort of moral question or the, you know, the question of sort of consciousness of what our identity is, theres another suggestion here that we are just not going to be able to have everything. So does that mean that it's going to end up being that what we do have is for the haves and not for the have-nots? Or is there another way that we are going to deal with the fact the reality is we can't have everything and what are we going to do about that? It's the kind of conversation that we need to have. And if there is anything charitable to say about the political friction around this, it could be that the nation is insisting on that conversation, even though it's sadly is pitched in a fractious political fight.

And one of the reasons that I hope other artists will consider doing work like I have is that the arts have something to offer, which is that the one thing we do know how to do is to tell the human side of the story so that we can maybe open up a space to come away from the screaming and yelling and the jargon and the rhetoric, to ask ourselves some real questions.

MARTIN: To that end, there are more celebrities in this piece than I think that people are used to seeing in some of your earlier works. Is that your sense too, that they are more famous people in this piece?

Ms. SMITH: No, I think it...

MARTIN: Like Lauren Hutton, like Lance Armstrong, movie critic Joel Siegel.

Ms. SMITH: I think it's proportionate. I don't know. Wed have to look and see. I mean Twyla has 46 characters so I'm really not sure.

MARTIN: Well, its an interesting point though, because one of the arguments it's like housing, everybody lives in some kind of a house. Everybody has some relationship to housing. And one of the points that the piece makes is that everybody's got some relationship to health care, even though we dont necessarily think about it.

Ms. SMITH: Right. Look, celebrity isn't going to save you, its just not. Governor Ann Richards, a friend to many people here in Washington, who could believe that the esophageal cancer was really going to conquer Ann Richards? It did. And so I think this play has to do with all of us.

What this play is about, which is the quality of your life and how you live it, given the fact that life isn't fair and you never know when death is going to come knocking on the door. Its a terrible word, right? Life is precious. That reality faces everyone. You know, Lance Armstrong, the great victor, was still hit with cancer, right. Lauren Hutton was hit by a pretty bad horrible motorcycle accident. She had great care but she was vulnerable. And shes very aware of the advantages that she had because she is Lauren Hutton and speaks to those to say that she too understands how wrong it is that if you ain't rich and famous, you ain't going to get the consideration that you should have.

MARTIN: Its an unfair question. I'll just admit it up front, but did you have a favorite character?

Ms. SMITH: No. I really dont. No.

MARTIN: Would you tell me if you did?

Ms. SMITH: Well, the fact is that out of 320 interviews, out of how many productions of this play, four or five different productions, these 20 or 21, I'm not sure, people all speak to me very deeply. And secondly, each one of them is carrying a message, I think of the play like a string of pearls and each one of them is bringing a beautiful and rewarding message that I'm hoping will become a part of my own consciousness. That's why I keep saying those words over and over.

MARTIN: Let Me Down Easy was conceived, written, and is now being performed by Anna Deavere Smith at the Arena Stage in Washington, D.C. She's professor of performance studies at NYU. Formerly a drama teacher at Stanford, and she was kind enough to come by just after an afternoon performance to visit with us at our studios in Washington, D.C.

Thank you so much for joining us.

Ms. SMITH: Thank you for having me.

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