Actor, playwright and journalist Anna Deavere Smith talks about the health care crisis and her play about people dealing with illness, health and the health care system, Let Me Down Easy. Web sites related to this episode include www.arenastage.org; www.pbs.org/moyers/journal/11132009/profile.html
Steve: Welcome to Science Talk, the more or less weekly podcast of Scientific American, posted on December 20th, 2010. I'm Steve Mirsky. This week on the podcast…
Smith: So my overall oeuvre, as it may be called, has been really since the late '70s, early '80s, going around America with [a] tape recorder interviewing people with the idea that I could absorb the country by absorbing the words of its citizens.
Steve: That's Anna Deavere Smith. You know her as the hospital administrator on Nurse Jackie and the national security adviser on the West Wing, but she's best known for portraying numerous real people, sometimes a couple of dozen, in a single evening of theater. aAnd she has been investigating the health care crisis in her unique way. The theatrical production she developed, Let Me Down Easy, came to New York last year and will be staged again starting soon in Washington D.C., more on that later. Right now, Anna Deavere Smith. We spoke at our office at New York University where she is on faculty.
Steve: Can you tell me about the origins of the health care work?
Smith: In the late '90s, Ralph Horwitz, who is now at Stanford as a professor with the medical school and internist, invited me to come to the Yale School of Medicine to interview doctors and patients and to present these characters at Medical Grand Rounds. And so I was so drawn in to that whole project and to Yale and to Ralph and some of his colleagues that I remained interested in the issue. And then over the next 10 years and I interviewed over 300 people on three continents all around the issue of the vulnerability of the body and the resilience of the body and ultimately wrote Let Me Down Easy. It had several different versions: Two of the versions focused more on human rights and I was thinking the body as vulnerable to the State. But as I began to prepare to come to New York the health care debate really, really ramped up last summer, summer of 2009 rather; and so I decided to refine the play and narrow it down to issues that had to do with health care. But it's really not a political play in terms of a political debate; I would say it tells more the human story.
Steve: Which by necessity sort of is political though.
Smith: Oh, oh, yeah! It's political because it would be hard for you to come away from the play and have a question about whether I thought health care, universal health, care was a good idea.
Steve: Right. You've spoken to other interviewers about the reactions of audiences to some of the people in the play who are really in bad shape and how sympathetic [the] audience[s] become—maybe an audience that you wouldn't expect to feel that way about a particular character or person.
Smith: Right, that's right. Audience is who come to the theatre in New York tend to be, it [skews] educated, [it skews] privileged, [it skews] white—although I am very happy to [the] extent to which the audience[s] for this play were diverse. But I would say one of the most popular characters in the play is a young doctor who was in New Orleans right after Katrina, working at Charity Hospital, which was one of the two earliest hospitals [for poor] people in America. And I would say most audiences really, really responded to her—Kiersta Kurtz-BurkeAnd what she is really saying, in [a] way is, [it's] a disgrace how we treat poor people; and no matter how much you're committed to and how hard you work to try to give poor people good medical treatment, in the end their lives are still over-characterized by their poverty, because there are just too many other forces. And she's followed by the current Dean of the Stanford Medical School, Phil Pizzo, who says, you know, he's concerned that where [we're heading], is a health care system that's going to look like that of a developing nation, which is, like, shocking. And when he said that to me the first time I couldn't believe it, but Phil Pizzo is not really the, you know, when you meet him, he looks like a scientist; he doesn't seem to be the kind of person who would exaggerate something like that. And he points out that between obesity and also the number of new infectious diseases that we have around us, the system is just, going to, in addition to all the other [problems] the system has, the system isn't going to be able to bear it.
Steve: You mentioned Phil Pizzo, and I am going to go off in that direction because you brought him up. In an interview that you did with Stanford, you talked about how his precision of language made it more challenging in some ways to perform him. I am sure people who are listening to this know what you do, but why don't we tell them what your basic, kind of, procedure is so that, you know, if there are a few people who aren't familiar with you, they'll know what we are talking about when we talk [in] these terms.
Smith: All right, so my procedure is to take something that somebody said tape recorded and video taped and to learn exactly what they said, which isn't usually what you think they said; and by that I mean the number of times they say ah… or umm…. Where they say ah…..or umm…. Words that in your mind you would think [would] be a part of a sentence that are not there. So, training my tongue to do what somebody did. When I was a girl my grandfather said, if you say a word often [enough] it becomes you, so my overall [oeuvre], as it may be called, has been really since the late '70s, early '80s, going around America with [a] tape recorder interviewing people with the idea that I could absorb the country by absorbing the words of its citizens; and certainly casting a wide net and always having a pretty diverse group of people who end up in my [plays].
Steve: Is everybody interesting by the way?
Smith: That's a wonderful question. I almost would say no, but I think that my work as an interviewer is to try to find that place where they are interesting. I was interviewing a young woman once who did not seem very interesting to me, in large part because she spoke in a monotone, or rather I should rephrase that and I say I was worried about trying to perform her because her language was so uniform, and there was very little movement. So part of what I have to be concerned about is how an audience is going to maintain its interest.
Smith: And suddenly she told me about being in college and studying grass, that she took this whole class just on grass and it was like, you took a whole class—[we're not talking about]… We are talking about grass…
Smith: In the ground.
Steve: Lawn grass.
Smith: Lawn grass.
Smith: I said a whole course on grass? And she got so excited about how, you know, when you look at grass you think it's green but there are so many different kinds, and she was just like, everything opened up, I mean, she was a different person. And so I do think that my job is to bring people to that point where you tap into something that they think is extraordinarily interesting and once you trip on that you're fine. I mean, for years one of my favorite questions was, "Have you ever been accused of something that you didn't do?" Because it would bring this really dramatic kind of talking, because all of us are very, very interested in ways that something isn't fair or that, you know, an injustice has been done to us or our heart's been broken. And that really that question is one of the questions that taught me how to listen because that provided me that kind of vocal variety that I'm looking for.
Steve: That's really interesting. We'll get back to Pizzo, but you took me to another place now: Another character that you perform is the bull rider, and I saw a clip—I will give out the URLs after you hear the interview out there for places where you can see some of the clips of you performing some of the people—and the bull rider has, what's his name again?
Smith: Brent Williams.
Steve: Brent Williams had a very particular, kind of, halting speech where he might, [he might, he might] repeat, and I wanted to ask you: What do you learn about what's going on inside the person by that kind of a speech affect?
Smith: Well I learn, first of all, I am learning something kinetic about them, which is hard to put into words, but I do think that part of what we are is our kinetic experience of ourselves. So I have a certain experience of myself physically that I experience everyday or when I am in the gym or if I'm swimming; and so part of it is beginning, when I begin to feel different kinetically, then I know I am close to the state than I need to be in for acting. So if my mouth starts to feel different; so the words are going to make that happen, it's not just the accent.
Smith: But the words are going to make my mouth start feeling different and then for many, many years I didn't videotape—this play, Let Me Down Easy, is the first one out of 18 or 20 plays where I've used video—and so I would do interviews over the phone and then [I] always invite people to see themselves performed; people would come or their friends would come and they would say, "Well how did you get the body?" and it's because it's the way, that act of speaking—you know, it's really not happening just even in your mouth; it's happening all throughout your body…
Smith: …begins to inform the whole thing.
Steve: And I know that I've had the experience just goofing around doing an impersonation of a friend, where all of a sudden by adopting what appears to me to be that person's physicality, these emotions start to hit.
Steve: And it's overwhelming sometimes, and I don't know if you can really say that you're then able to have an experience of what they're actually feeling, but it sure feels that way.
Smith: That's empathy; or maybe you'll have the experience of going to a movie and watching an actor and coming out on to the street and you are walking like him.
Smith: That's the way that our body itself has the opportunity to have a kinetic response, that empathy is in—what we call empathy—is in part that; it's not just the imagining.
Smith: Somebody else, or let me say that I know that imagination lives throughout my whole body, it's not just in my head. And my work as an actor has been to develop a specific kind of imagination, which is a physical, vocal and mental imagination; and being [in] the presence of people for [a] long time and studying [them] and being moved by them and being attracted to them and then studying their words over and over again with my headphones on is what gives me this bigger sense of them. So that you feel, to use a sort of a dangerous word, possessed of them. I don't mean in terms of voodoo, but you feel occupied by them.
Smith: So if I am working well, and I play the bull rider, I feel like I have a longer torso, smaller hips, and it's very easy for me to really strut like him; not a way that I present myself in the world.
Steve: Right… and getting back to Pizzo now you commented in this other interview I heard about how his precision of language, even on the rare occasions when he would say, "uh" or "um" was so constraining, but that's the way you work.
Smith: Not, I wouldn't call it constraining it was very demanding, because he is able to speak in paragraphs. He has that particular kind of intelligence that he can speak in a long paragraph. He speaks like he writes. You know, some people are able to write like they speak, but he speaks like he writes, so if I am not careful; where the challenge is, the performance can seem like an essay because he is able to speak that way.
Steve: That's really interesting. Let's go back to the actual subject matter. What do we get as the audience—because we could watch the videos you shoot of the people that you're interviewing—so what do we get as the audience by your effort to turn this into a performance?
Smith: Yeah, a really smart linguist told me what I should say when people ask me that question, and I can't remember, but I think what you're really watching is not the same as a video, obviously because I can't render perfectly what really happened. You're watching, even as I attempt to make it look effortless, you're interested in my effort to become somebody else and so you can't believe it when I…
Steve: When you become Ann Richards.
Smith: When I become Ann Richards, when I become something, particularly something that you identify as really, really different from me. And with Ann Richards it could be that you, many people know her, so you know, they can't believe it. But you on another level, you know, you know that type of person, right. We sort of catalogue people, so you know that type of person. Like the bull rider—people don't know Brent Williams except people who are very involved in bull riding. But you know I am not that type of person, and you'[d] be really surprised, if you had never met me before and I walked in a cocktail party looking like I look [and] talking like Brent.
Steve: Sure. We would think there was something probably psychologically wrong with you.
Smith: Or you would just think: that's odd.
Steve: Yeah, yeah….
Smith: "Where did she come from?" And "Wow, that's not what I expected to come out of [her] mouth."
Steve: From your hundreds of interviews and also with health care practitioners, the political system seems completely dysfunctional right now, and it seems like it's going to be impossible to have a functional health care system with a dysfunctional political system. So, what are we to do?
Smith: I really don't know what we are to do. It seems to me to be a no-brainer, every time I go to the doctor or any time any body I know goes to the doctor that this system doesn't work; and it's so, the only way we can do things [as] a society [and] a democracy is [through] a political system. But honestly, you know, when you think about it then you have to be grateful for things [that] did change. You know if we were to look back and how we were in 1955 living in Jim Crow, living in segregation, living in segregated schools, it's hard to believe that it was America, but it really was. And we can only assume that if this argument over health care continues, it's going to lead us to be in a place where in another 50 years, citizens are going to say "I can't believe that was America." Because inevitably we have to do something about this even [at] the level of how much our economy is tied to it. And the other thing that Phil Pizzo and others have talked to me about is that, we are really getting to the point—and this is hard for us as Americans—where we can't afford to have everything. And so we're going to have to make some decisions that are ethical, and I think we need to get on to the business of that rather than continuing to spin our wheels. You know, one of the things Pizzo said that's not in the show is that when he was a kid, if the doctor came to your house—this [is when] doctors still made house calls—and you were sick and the doctor took a look at you and said, "He's fine; he will be all right in a couple of days, just let him rest"; if the doctor didn't give you medicine or an injection, your mother felt like, "Well why [did I] bother to bring you here? Why am I wasting my money if you're not going to do something?" And so we've become sort of addicted to procedures. And we know that there are so many things that we could be doing in terms of what used to be called preventative medicine that we are not doing; we are not asking Americans to live well. And there are a lot of things that make that harder: No gym in the schools; the abundance of food that we don't need—the food that's not really food; it has no nutritional value.
Steve: As the government is trying to promote anti-obesity measures, they're also promoting the consumption of much more cheese so that….
Smith: [Oh right, I saw that.]
Steve: [Right,] with Domino's pizza. So Domino's sales are up because their pizza is a lot cheesier now.
Smith: Right. Well one of the doctors at Yale pointed out to me that that one place where medicine and the market and the government have been able to work effectively—well maybe [leave the] market out of this, but at least in terms of advertising and perceptions—is in the area of smoking. You know, still there are too many people who smoke, [but] when I was a kid, you know [it was] still glamorous, you know the Marlboro Man all that stuff, the Virginia slims. That's gone. And so there's a model for how different kinds of groups can come together with [the] medical community to collaborate and get people to live differently. And in terms of obesity this is huge, because right now medicine doesn't have any answers really. You know, you go to the doctor, and you say, "How can I drop some weight?" and they say, "Calories in and calories out, you know; eat less move more." What else do they say? You know, now whoever invents that pill is going to be very wealthy. But until that time, medicine doesn't really have a whole lot to offer other than to say, "You have to watch out." But there are other collaborators who could be brought into that discussion, namely I think [the] people who help us move. And I get to have a trainer because I think that is a financial priority for me.
Steve: Right, it's an investment.
Smith: It's an investment for me [and] my health and I am very motivated to make that investment, but I know that a lot of people can't do that, and they don't live in places where they can move freely or feel safe moving.
Steve: Yeah, that's a really good point too; there are lot of people who won't go out for a walk because it's dangerous.
Steve: I could be completely wrong about this, but I think that part of our problem is that there are large numbers of people, some of whom have political power, who believe that suffering is good for you.
Smith: Well, the problem is that when people suffer either because of their political circumstances, or their physical circumstances, or out of the inability to have education and therefore ability to make choices that would help them get out of what is causing them suffering—what I don't understand about that kind of an argument is that it's an argument that assumes that we can afford to lose people, that people are disposable. I mean, I think a healthy country is a country where people are healthy physically, and a smart country is a country where people are educated. So, the notion of suffering being for some learning experience is ridiculous, because the suffering can also win—it could defeat you.
Steve: You do talk about the—not to try to find the value in suffering that is unnecessary—but when someone has experienced pain they might be the best healers. The wounded healer [was] something that you talk[ed] about.
Smith: Right, well that's the idea, I guess Carl Jung talked a lot about the wounded healer. And then I think there we're really talking about compassion an[d] empathy. Sometimes the people who've had hardest road come out of it with a real generosity of spirit and an understanding to help others; it's not odd to find that phenomenon; somebody who went through something and knows that you can come out on the other side. Look at the people who, in response to what happened at Rutgers when this young man, Dharun Ravi, turned his web cam on his roommate who was, you know, having an intimate relationship with another man; and, you know, when he found out what happened, jumped off the George Washington Bridge. And a lot of people who came forward with this whole It Gets Better campaign; these are people who want to share the fact that there is light at the end of the tunnel. And so, often we find people who came from vulnerable communities, for example, coming out of it, doing work to help people in that situation. So, in that way is suffering good? I don't know, because if you don't come out the other side you can['t] really be of use. And then too, the[re are] people who are living in spaces where they are not healthy and they are not taken care of, and they develop alternative communities, alternative rules, alternative social systems like gangs. And then what we have is behavior that isn't good for anybody. And I met a young man talking about that kind of life who [luckily] went to a school that got of hold of him and is giving him an alternative, and he talked about how that life is full of, you know, rushes. Like the rush of robbing somebody, getting addicted to that type of rush, the rush of danger because your life doesn't otherwise have things that give you joy and give you excitement. You know, at a certain level, I think [that as] humans, there's many good reasons to want to promote joy and fulfillment and not this idea of suffering. And of course, that idea may have some religious roots.
Smith: But there are other religions that talk about the goodness of human beings and the use of happiness and joy.
Steve: I am fascinated with—[this is] something I asked Alan Alda about also—you have the text written for you extemporaneously by the people that you talk to. But still, when you're working, do you work with [a] director?
Smith: Yeah, I do.
Steve: Okay. So how do you know as an artist when it's right?
Smith: Well, the directors don't work with me on my character work. For my character work, I work [in] a three pronged way: one with [a] person who works on the text with me, learning it; one who works with me physically, looking at videos; and one who works with me with diction and dialect. And those three people are the ones who tell me things about how close or how far away I am. And then part of it beyond that, going back to this word kinetic, is my own kinetic feel of if I am getting it right. And usually if I have that feel, if it clicks in, the audience responds and that also indicates me that I have got it right.
Steve: We just heard, the science advisor to the sitcom The Big Bang Theory spoke here in New York. And he talked about how fascinating it was to him as a scientist, to watch the rehearsal process and then the actual filming, because he realized that comedy was scientific; that it was experimental, and the feedback was immediate—the joke either works or it doesn't work. And if doesn't work, they [have] to fix it. And so in that way, to him, it was much like a scientific experiment with changing the parameters to get where you want to go. And so that's one way where you'll know that something is right by the, you know, the laughter of the audience. But there's something, actually you feel it in inside that, that's it now, that's correct.
Smith: Right. And once I've had that feeling of, I would say a feeling of unity—it may not be exactly what a person did or exactly how they said it, but there['s] a unity between me and them where, again when we were talking, like we were talking about the cowboy, that I don't feel like myself anymore. And so it isn't that I feel like them because I could never know what that is, but I am in an in between place; what my colleague Richard Schechner here [at N.Y.U.] would call a "not not": I am not me, and I am not them. I am a not-not, I am another positive.
Steve: Right, you're some kind of a synthesis.
Smith: So it's that sort of midway space. So I guess what that means when you say the word synthesis is, that's when I know I've created something right. That's when I know there's a third thing and that third thing is the character that I've created by studying that real person and by giving up some of my own habits to be them. Now if I start to feel those habits of my own then I am not in that third place, I am not in that dress, metaphoric dress, or a pair of pants that are created; I'm in my own clothes. And it's a very clear difference.
Steve: What do people who you do say to you after they've seen it?
Smith: Well, I do invite everyone who I do to come and see themselves [performed], and because I've been doing this for many many years now, my goal at this point is to exactly find people who would go to a mountain top and scream what they [have] to say, and I would just happen to be there; it [isn't] really about me. And so in this play, almost everyone has seen it. One of them is actually Ruth Katz, who was a dean, associate dean, at Yale. She is now working in Washington [on the Hill] on health care. The cowboy has seen himself many times. And so I would like to think that them coming to see this photograph of them, gives another dimension to our relationship. As I have with, for example, Mary Ellen Mark who's a great photographer, who's taken my picture many times. As I have with my hairdresser, who cut my hair for this show so that I could, you know, have the hair of a man or a woman—you know, a man with long hair. You know, when somebody creates something about you or for you or if you had an architect and you're happy with their work, there's another dimension to that relationship. Now, of course, it could be unhappy, too, but I like that. Ann Richards, the late Ann Richards, loved watching me perform her, and when I say that it's certainly sounds like I am praising or bragging myself, or maybe trying to get off the hook for your listeners who would think, "Boy, you know, that would be awful, to be done." You know, but it is a specific sort of relationship to a person and their story, and I am well aware that a person could tell their own story without my help, so it must be that when they come back what they're really interested in is that third thing that I just talked about—that thing I created: it's not them, it's not me—but that they enjoy seeing that thing.
Steve: I mean it's completely different from an impressionist, a Rich Little, that's…
Smith: Well that's…
Steve: That's a caricature…
Smith: That's a caricature and that is about power. I think [a]n impersonator, even if it's, like, a drag [queen], an impersonator is the author of a different version of that person. In this case, I see it as, I am really borrowing their words in order to tell a bigger story. There's also that, that it could be [that] the impersonator—say if somebody impersonates President Obama or President Bush—they are doing a kind of a satire to cause us to question something about the president's power. I am not asking, I don't want the audience to question anything about; I could even in what I do, but I am not as interested in having the audience question something, and a lot of people assume I am doing that. You know, I am not asking the audience to question something about the power of Dean Pizzo or the truth of Dean Pizzo. I am asking the audience to watch this sort of rail, you know, bunch of cars on a train that are all unwittingly going in one direction, right; so that each character is telling a part of a big story. And I am trying to get the audience to see how big the story is and that the story can only even come close to the truth if it is big and if it has opposing points of view. People confuse opinions with beliefs and they confuse opinions with facts and especially now in America. So, I don't really know how to tell a story, and I would not dare to think I had the whole story, in such [a] diverse community of opinion and a diverse community of experiences. I think the only way you can bring the whole picture is to have fragments of pictures. And so I think when somebody like Ruth Katz or Sally Jenkins, a great sports writer; you know, Elizabeth Streb, a choreographer; I think when—Peter Gomes, a preacher—I think when they come to see it, they see, I hope, their value, their own value; how important they are in helping the audience see the big picture.
Steve: So it's almost like a prism—all these colors go into the prism, and you get the white light that comes out of the other side.
Smith: Right. That's right. And so if I were the color pink, I would be proud to see that I were in the prism, right. So that's what I want the "real people" to experience when they come—that they are part of this larger American quilt and that they, they've been of service.
Steve: We're pretty much out of time. I just wanted to ask you, not asking you to do a character, but you perform this South African woman. And she said the most amazing thing when this child who only had days to live told her that the child had seen her dead mother the night before. Could you just say what the woman's response was, because it just….
Smith: Right. It was Trudy Hall, and so she said that this little girl knew that she was, you know, going to die and she came to see me (in character) on the Friday afternoon, and she said that her mother had visited her the night before, and that I knew that Norms' mother had passed away six years prior to that. So I sat her down and I said, ["Well,] what time did your mother visit you?" She said, "No, it [was] late at night." I said, "Well, if you see your mother tonight again and if your mother comes to visit you tonight again, you must tell her that I said thank you very, very much that I could look after you for so long."
Steve: Anna Deavere Smith's Let Me Down Easy opens at the Arena Stage in Washington, D.C., on December 31st and plays through February 13th, 2011. The series of seminars featuring the actual people Smith plays are also scheduled. For more information go to www.arenastage.org and to see clips of Smith performing some of the characters from Let Me Down Easy during an interview with Bill Moyers, just google Anna Deavere Smith and Bill Moyers. We will be back very soon with another look at health care in America from a corner that doesn't get a whole lot of attention—the nurses. 'Till then get your science news at www.ScientificAmerican.com. For Science Talk, the podcast of Scientific American, I am Steve Mirsky, thanks for clicking on us.