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Emily Silverman

You're listening to The Nocturnists: Stories From the World of Medicine. I'm Emily Silverman.

Today's episode features a very good friend of mine, Alessa Colaianni who I've had the privilege of knowing since medical school. Alessa is an actor-turned-otolaryngologist who tells a story today of losing and then regaining access to her emotional landscape. Alessa is a head and neck surgeon at Oregon Health and Science University in Portland, Oregon, and she's also a writer whose work has appeared in The New York Times, The New Yorker Guernica, The New England Journal of Medicine and other venues. In the conversation that follows her story, Alessa and I talk about what it means to be a performer-type, her decision to pivot from the theater to a career in surgery, and all of the interesting ways in which theater makes its way into our lives as physicians.

But before we get there, let's take a listen to Alessa’s story, which she told live at The Nocturnists in San Francisco in June of 2022. Here's Alessa.

Alessa Colaianni

I was never supposed to become a surgeon. Surgeons are serious. Surgeons are stoic. Surgeons are unflappable. I am flappable. Before medical school, I thought I was going to become an actor. In my childhood bedroom, before sleep but after bedtime, I would practice scenes from movies that I had seen. I would practice fainting onto my bed from different heights to get it right. I would steel my gaze against imagined intruders at the window. I practiced delivering breezy anecdotes from the imagined couch of a non-existent talk show. I would host science shows from the bathtub. "See kids, that light on the bubbles–it's called prismatic effect." And I would answer our childhood telephone, when telemarketers would call, as different people every time. "Well, of course, we'd love for you to come and wash our windows." When I cried, which I did easily and often, I would run to a mirror to watch myself cry. I'm aware of how psychopathic that sounds now, but at the time it was discovery. What do I look like when I'm really grieving? How does my face contort? When I'm really scared, what does my voice sound like? I didn't know what I was practicing for. It was just like playing an instrument. And I figured it would come in handy if I got, you know, discovered at the mall.

I thought long and hard about going to Chicago to Second City after college to pursue an acting career. But I went to medical school instead. I rationalized it. I figured it was easier to do some theater on the side of medicine than it was to do medicine on the side of theater. What would that look like? But perhaps it shouldn't have surprised me so much that I was gravitating towards the operating room–the operating theatre. Bright Lights, cold room, blue drapes, “Doctor, surgeon, suction, scalpel!” plenty of drama–plenty of drama. So instead of an actor, there I was: a surgical resident. Cheerful, chipper, upbeat, happy to help, always ready. I knew exactly what this new role was demanding of me, and I was determined to play it perfectly.

Now I'm in the operating room with a trusted mentor. Case is going fine. Suddenly, the anesthesiologist says, "Hey, what's going on up there? We lost our EKG tracing." I'm looking at the carotid arteries. So I put my finger on it to see if there's a pulse. There isn't. I hear myself say, "I'm starting compressions," and then I'm pounding on the patient's chest. The room is full of people. It's chaos. There's lights. It's hot. I'm sweating. I'm so scared. This is not supposed to happen in the controlled environment of the operating room. I'm panicking. I'm nervous. I'm nauseous. And I feel like I'm in a movie. At the end of the day, my mentor calls me up to his office, sits me down, "Thanks for doing what needed to be done today. You're always so even-keeled."

"Yes, I am." I was flabbergasted. I was sure that my face was showing all of the emotions I've been going through in that room. If I'd gone to the mirror like I did when I was a kid, would I have seen anything at all? I was proud. But I felt like I'd lost something.

A few years later, I'm in a Broadway theater in New York. I'm there to watch a high school friend make her Broadway debut. The last time I saw her we were sharing a stage–Oliver! The Musical. Our paths have diverged. Now I'm in the audience. The lights go down. The show starts and I'm transported...for about 30 seconds and then I'm like, "What would it be like if I were up there?" The actors are transcendent. They are inhabiting their bodies. They're exploring the boundaries of human emotion right in front of me. They're flying. And I'm stuck in this fucking role. "Thank you for this interesting consult." "Of course, I'm happy to write that Tylenol order at 2am." "Totally makes sense for you to take over the case at this point, thank you." "Yes, I will write that discharge summary." "Don't mind taking extra call." "I'm here for you." "I exist for you."

I'm watching those actors. Who would I be if I hadn't gone to medical school? Did I fuck up my whole life? In the alternate universe where I chose theater instead of medicine, am I happier? Freer? More me? I have this fantasy. I'm on a stage and in the audience is every attending I ever assisted, nurse I ever scrubbed with, patient, co-resident, consulting physician. And they're sitting there and the doors are locked. And they just have to watch me emote. Anything but chipper. I can be angry. I can be jealous. I can be sad. I can be joyful.

In fellowship, I worked with this titan of surgery–35 years into a beautiful career. We were doing this case, and it was going fine. Nothing out of the ordinary. At the end of the case, he pulled me aside, “I'm so sorry. I was so nervous today." "You could have fooled me. I didn't see a thing." "I had a case just like this," he goes on, "a few years ago and it didn't go well and it's really weighing on me today. I thought I would drop the scissors. I think I'll talk to my therapist about it later."

Now I'm the attending. I try to be honest about the emotions that I'm feeling–within reason. I try to bring my whole self to the operating room. If I'm nervous about a particular portion of the case, I'll tell the resident why. I'm joyful that something turned out to not be cancer, I let myself feel that in the operating room. Sometimes I make up silly songs to get myself through particularly stressful parts of the case. "You're a big bad tumor, but we're gonna get you out, without hurting anything we cannot live without."

Recently, a new scrub nurse that I'd never worked with before looked at me across the table. "Hey," she said, "You're really weird." “Me? I'm not weird.” "But it's like a joyful-weird." Joyful-weird. Now that's a role I want to play.

Emily Silverman

I am sitting here with Dr. Alessa Colaianni. Alessa or Alessandra, whichever you prefer, thank you for being here today.

Alessa Colaianni

Thank you for having me.

Emily Silverman

So for the audience, Alessa performed her amazing story at The Nocturnists on June 10, and as you heard in the intro, is a surgeon working up in Portland. But, we are also very good friends from med school and don't get to see each other very much. So, it's just a great moment to sit down and be able to see your face and chat and catch up a bit.

Alessa Colaianni

I know. This is a nice Sunday morning FaceTime with a very fancy microphone.

Emily Silverman

So at the beginning of your story, you talk about growing up and being a child–being a tween, even maybe a teen–and this impulse that you had to act. You talk about practicing fainting onto a couch, telling fake anecdotes for a talk show, answering the phone as a telemarketer. When you would feel emotional and cry, you would run to the mirror–you would watch yourself cry. And in the story, you say that it felt like a form of discovery. I was wondering if you could expand on that a bit. Discovery of what?

Alessa Colaianni

You know, I did theater like starting pretty early. We were constantly in like, you know, theater camps over the summer, doing children's theater from a pretty young age–from I don't know–I'd say like six or seven. And we were always in choir and always kind of performing. And I imagine that was something that we like–my sister and I when I say we, that's who I'm referring to–we did all this together. The idea of like putting on a new identity, or kind of exploring a feeling, or like what would it feel like to be in this situation, was just always a part of what we did. Like, any games that we played were very imaginary. We weren't necessarily playing with dolls. We were like, becoming different people, and like living outside in the backyard, and pretending that one of us lived in the house and one of us lived outside the house, and like developing these characters. And so I think it was just like discovery of additional states of being, of ways to be.

Emily Silverman

You brought up your sister, and I've met your sister.

Alessa Colaianni

Yeah, you have.

Emily Silverman

And the two of you when you're together are just like hilarious. So I was wondering if you could talk a bit about what it was like playing these games with another person–with your sister. Because I was an only child and I think there...we have a lot in common, you and I. But I was sort of all by myself growing up. And so I'm just curious, like, what is it like to have a partner in crime, so to speak? To have that other person who your energy can kind of bounce off and you can like, sort of toss the baton back and forth?

Alessa Colaianni

So you know, she's two years younger than I. And especially as a child, I could be a pretty bossy individual. I think that's a little bit dissipated as I've gotten older, but maybe not. That might not be true. But I kind of would like co-opt her into playing these games with me, initially. And then we ended up going to college at the same institution and being in the same sketch comedy group together. And it was really in college that we started to like play off of each other more, as opposed to me kind of browbeating her into like, "No, you're the princess. You chase me." Yeah, so. But now, like anytime we're together, anytime we're with our family, we're like constantly doing voices or riffing and being ridiculous.

There are a couple other people in my life that I have that kind of relationship with where like, the imaginary just takes over immediately. And one of them is my best friend here who I've known since high school. And we like, lived together during med school, lived very close to one another during residency, and she's an OBGYN here at OHSU–Shaalini. And she and I will have that same kind of like ridiculous, imaginary, flight of ideas almost anytime we're together. And we joke that, like, we think we're hilarious. But everybody around us...It's like, you know, the scene in the movie where you're seeing what the characters think they look like, and then the camera pans around, and actually they're just really sweaty, and look terrible, and can't dance, and everyone's horrified. That's kind of what we assume is happening at any dinner party that we're together at. Because we're like, "Yeah, and then the raccoon is wearing a top hat. And he's dancing around like boop, boop, boop, boop, boop." And everyone's like, "What are you guys talking about?" Anyway, all to say, that having a partner in crime is lovely and enabling and also probably annoying to most people who are watching.

Emily Silverman

I was scrolling through Instagram the other day, and I stumbled across this account. And it was this very, very woo-woo guy who serves as a spiritual adviser to people like Oprah, you know, sort of like a pop culture, celebrity spiritual guru. And he thinks and talks and writes a lot about like past lives, which again, I don't know if that's really a thing or not. But I just stumbled onto his website. And he talks a lot about these different soul types, and how the soul type is sort of like why we're here. We're incarnated on this earth with these aptitudes, I guess, that may or may not stem from past experience that we've had in past lives. And there were different types: there was The Thinker, The Leader, The Hunter, The Helper, The Educator, The Spiritualist–and of course, we all have aspects of all of these, but you know, often one of them will step forward in our personality. And I noticed one of them was called The Performer. And I saw a lot of myself in it, and I was thinking about you, and just reading the description of like, what is The Performer soul type. And he described it as you know, a people person–which doesn't necessarily mean you're an extrovert, can be an introvert–but people person: very fun and playful, excellent communicator, great storyteller, a penchant for the dramatic, maybe has a dramatic flair. And the gift that they have to give the world is this self-expression and understanding the range and nuance of human experience. And it reminded me of what you said in your story; it was that it was like playing an instrument. It was like the emotional apparatus–or even the physical body to an extent–was your instrument, and you were kind of playing that instrument as a child, like doing scales. Does this soul type idea of The Performer resonate with you at all? And if so, what does it mean to be a performer?

Alessa Colaianni

That's super interesting. And I like the framing of that as like the gift that you can give to the world because I think that, particularly like in the past I don't know 10 years or so, I've sort of been embarrassed about that part of myself. You know? Like, I do love being on stage. And I do love performing. And I love being in plays. And I love singing. And I just–I love interacting with an audience in that way. But it's been a really long time since I've done that. Like, the last professional show that I did was right before medical school, and then a couple you know, skits or like MC jobs or things like that since then. And then really like The Nocturnists was the first time that I had been in that environment in a really long time.

And it was weird to be back on that. I totally loved it. But I was like scared in a way that I hadn't been prior to, I would say, going to medical school and kind of changing my whole life. And I think I've been like really apologetic about that part of myself, because like doctors aren't necessarily supposed to be performers, right? Like we're sort of supposed to like...well, we can talk about medical culture and like how messed up it is. But you know, the doctor character is like not a full person, typically. Like, it is a person that you interact with for a specific purpose. They're supposed to set aside any bias or their own personal feelings, you know–really emotion in any capacity–at least theoretically. And that's kind of like what you're taught initially. It's like you are really...it's not about you–which I think is true. Like, it is not about you. However, you are there. And you are a full person. And I think that patients can appreciate when you're being real with them. And I'll get into more on that later. It's kind of, at least theoretically, diametrically opposed to the performer. Because the doctor is not a performer. So yeah, I think I was kind of apologizing for that part of myself. So I really appreciate that you, or that this guru, frames it as a gift, or like a thing that you can give, and that like, is appreciated by people. Because I think that is not how I have felt about it. I have just been like ashamed of it, or like embarrassed by it, or like, "Yeah, yeah, yeah, I used to do theater."

Emily Silverman

You know, I've dealt with that, too. That feeling of shame of like this part of myself maybe that is more creative or artistic or wanting to explore and express and even wanting to have an audience. And I was also reassured by this weird guru guy because he was talking about how each soul type, you know, that there's conditions under which they thrive, like a flower turning toward the sun. And then there's other conditions where it just sort of shrinks and turns gray and dies. And how with the performer, like they really–they need an audience. And how that doesn't have to be, you know, a negative thing or a narcissistic thing or a, you know, self-absorption and blah, blah, blah. Like, obviously, there's a grain of truth in that. And probably there is a way in which like, if you just look at actors as a population, there's a little bit of that there, the same way where if you look at doctors as a population, there's probably some other stuff you can dig up. But why should people, performers, actors, be ashamed of, I don't know, this talent, or this skill, or this interest and the need, or the want, or the desire, or the longing, to share that with an audience?

Alessa Colaianni

I don't think you should be ashamed of it. I think it's more just like recognizing it as a part of yourself and not necessarily as a negative. I think we're also not set up to just be one thing forever. And what you reminded me of is that I just read about–I don't know why I was reading about Tilda Swinton, but I was reading about Tilda Swinton. And recently, she decided to become a hospice and palliative care–like get training in hospice and palliative care–which I think is super interesting for somebody who's made it as an actor. You know, every actor who talks about acting is like, "I can't believe I get to do the thing that I like love to do the most, and I get paid for it," yada yada. She has achieved that, and now is like seeking something more direct, or like more tangible, or more externally focused. And so I think that that's partially why I went into medicine.

I was talking actually to a friend of mine–actually the friend that I mentioned in the story–she's an actor, right? So she, like, did this thing. She went to Yale School of Drama, she has been in movies, she's been in plays, she was on Broadway, she's successful. And we were talking after that show and I was like, "Gosh, you know, it's so crazy, because I really love what I do, but I really miss acting. I really miss doing this stuff. And I kind of wonder what it would have been like the other way." And she was like, "You know, listen. Sometimes I don't want to go to work either. Like, sometimes I just don't want to go to work." And I was like, "But your work is acting." And she was like, "Yeah, I know."

I think burnout is just maybe like the result of doing the same thing over and over and having to do it as opposed to like deciding to do it. I don't know who gets to just decide what they want to do every day, other than like the extremely, independently wealthy. And this kind of is going on a little bit of a tangent, but you know, people will say like, "God, your job is so hard." Like, man, every job is hard. If I had to do half the jobs that I interact with on a daily basis, I would be burned out. I would be tired. I think it's just–you're not supposed to be doing one thing for your entire life.

Emily Silverman

I love that. And I am curious about this moment though, this fork in the road. So it was really this fork between theater and med school. And it's these moments in life, right, where you almost like see the quantum flickering of like, "My life could be this or that and I have to decide." And it's, I don't know, it can be really a lot of pressure. Were you already grieving the loss of the path not taken? Or did you feel pretty confident in that decision? Or what was that moment, that fork-in-the-road moment?

Alessa Colaianni

There's no like moral clarity about anything that we do, I don't think. Like I'm not a moral relativist, particularly, but I don't think that it was as simple–I know now that it was not as simple–as like, go be a doctor and like you will, by default, do something good for someone. Because I do think that medicine has the potential for extreme harm. Surgery in particular has the potential for extreme and direct and immediate harm. And so it is more of a moral...like, you don't always feel good as a doctor. And that's, even when you're interacting with patients, even when you're helping someone. Sometimes, like you're working in a system that's broken. So like, the help that you're offering isn't the help that you were told was the right kind of help. Or you have complicated interactions with people. Or like, you know, people's expectations of what medicine can do and can't do…

Like, I think it ultimately ends up being a much more morally perilous journey than I had initially thought as a very naive 23-year-old, even with the benefit of several medical ethics classes. So like, I knew that it wasn't going to be a piece of cake, but I was like, "But on the balance, we're gonna be doing the right thing for people." It's like, sometimes you are and sometimes you aren't. Like I have a–and we can, I can talk for a long time about how terrible insurance is but–I have a patient who needs a neck operation. She has a mass in her neck, okay. And she has the Oregon Health Plan. And they've decided that this is an elective procedure. And she's a smoker, and so they won't do it. They won't pay for it. I'm like, "This is ridiculous. This is not the right thing." You know, like, yeah, sure, it would be better for her healing from surgery, etcetera, if she didn't smoke. But to deny somebody that because they're making a judgment...Anyway, all to say is that it turns out to be more daily, ethically fraught than I thought it would be.

Emily Silverman

So you arrive at medical school, and this is where we meet. And I still remember this.

Alessa Colaianni

The first week.

Emily Silverman

The year was 2010.

Alessa Colaianni

The city was Baltimore.

Emily Silverman

Baltimore, Maryland. We're sitting around a picnic table, eating crab. I don't know if we really are, I just kind of made that up. But I'm sure we did that at some point.

Alessa Colaianni

I'm sure we did.

Emily Silverman

And you talk about, you know, not surprisingly, being drawn to the operating room or the operating theater. You talk about the inherent sense of drama in the operating room. You talk about this moment where there's a code and you're kind of moving through the motions of the code, but it feels like you're in a movie. If–let's just say that your soul type is Performer. I don't know if you identify as such, but let's just take that for granted in this moment. You can take the performer out of the theater I guess, but in a way, you can't take the theater out of the performer. And so you gravitate maybe in certain directions and you experience the world, maybe through this lens. And I don't think this is unique to you, though. Like, a lot of people that I've spoken to do feel this thing of like medicine as performance.

Alessa Colaianni

Oh, yeah. No, I can definitely speak to that. And you wonder where it comes from, like, if it's a chicken and the egg kind of thing. Like obviously medical dramas are like–we've all grown up with ER and Grey's Anatomy and like all these things where you're seeing medical drama played out on the television. I mean, like, the number of medical dramas out there is like just astronomical. So there's clearly something that's heightened dramatically about the hospital that has spawned all of these dramas that we like to watch. But you wonder if it comes from there or if it's the other way around. Is it that I feel like I'm in a movie because I've seen Grey's Anatomy and I know what's going to happen here? Or is it because there's something inherently very dramatic about what happens in the hospital, that naturally feels surreal, and therefore spawns art of varying qualities?

I remember very clearly, in college, visiting a friend of mine who had had an inexplicable paralysis happen–like just was very ill. She was hospitalized in Chicago, and I went and visited her. And I wrote a short story about it later because it just felt so meaningful. Like, it was just everything about the hospital, everything about...And this was before I had seen any medical dramas, like I think I'd seen maybe like House MD, a couple episodes or something. But Grey's Anatomy wasn't out. I wasn't an ER fan. This was not something that I had internalized yet. There's something about that interaction–something about the whole setting–felt laden with meaning that I then wrote it into a fictional short story. And similarly, my grandfather got very ill when I was in college. And like, we flew out to visit him when he was kind of dying in a long-term acute care facility, my dad and I. And that later became a short story as well. And this is well before I was entertaining any ideas of going to medical school.

So I think there is something very dramatic about and very, like, meaningful, and some people will translate that into art, some people will translate that into like, memories that they hold with them, some people will avoid it altogether. But I do think that there's a heightened level of humanity when there's the specter of illness or kind of the unknown about the body.

Emily Silverman

I'm imagining there's probably some amount of, you know, second thoughts or, you know, how do you think about regret? I know that you don't regret the choices that you've made because you love what you do. But how do you think about the path not taken when you go to see your friend in her show? And what was that experience like? Because I think in the story, you said, you were totally immersed for the first, 30 minutes, or maybe you said 30 seconds, I can't remember. And then immediately the thought comes to you of like, "That could have been me." And so as you're sitting in the audience at your friend's show, and sort of like, maybe grieving that path not taken.

Alessa Colaianni

Yeah, well, in that moment I was like definitely grieving the path not taken. But I also remember doing that when I was like eight years old, watching Annie with my grandfather and being like, "Who's this redheaded bitch that gets to do the show? I should be up there." So that's not a new feeling. Like anytime I see anybody performing anything, I'm like, "Why is that not me?" That I think may be–that's a little embarrassing to admit, but it's totally true.

Emily Silverman

No, no. To lessen your embarrassment I'll confess so that you're not alone here. My parents took me to see Annie on Broadway when I was a little girl, and when the show ended, there was a standing ovation. And I stayed in my chair seated with my arms crossed pouting because I was so angry that I wasn't the–

Alessa Colaianni

That it wasn't you?

Emily Silverman

–kid on stage. And then the woman who played Miss Hannigan–her name was Nell Carter. Amazing actress; I think she has since died. She walked up to the front of the stage, and she looked at me and she saw that I wasn't happy. She told me to smile.

Alessa Colaianni

Oh, man.

Emily Silverman

So I don't know. There's probably some pathology there for sure. But I definitely have had that feeling of like, you know...I'm not as much of an actor as you. I may be more behind the scenes. But anyway.

Alessa Colaianni

I don't know. You told me you sang like a lark at your bat mitzvah. So I think there's a performer in you.

Emily Silverman

I have two more questions. Do you have a couple more minutes?

Alessa Colaianni

For you? I've got five. Yeah, of course.

Emily Silverman

Okay, so first question is kind of out of left field, but it's something I've been thinking about. And it's this question of like self, okay? And so, as you know, when I was in my medical residency, I developed an obsession with SNL actress Kate McKinnon. She, I think, shares a lot of what you're talking about in your story, which is like wanting to do different voices and different accents and try on these different characters and like, that's sort of where she's at home and that's the gift she has to give. And I've seen her in interviews and she really struggles to take off that mask. Like she's sort of always being a character. And I wrote an essay about her, which I think you've read. And in the essay, I sort of wonder aloud, like, "Who is the real Kate McKinnon?" And I was also thinking the other day–I walked into an ice cream shop–and I walked in, and I was like, you know, "I'd like a chocolate ice cream cone." And they said, "Okay,” you know, “Here you go." And they gave it to me. And I said, "Thank you so much." They said, "That'll be $4." I said, "Here you go." And they said, "Thanks." I said, "Thank you, have a wonderful day." They said, "You as well. Have a great day." And I walked outside with my ice cream cone. And I had this feeling of being like so proud of myself for having just like a normal interaction.

Alessa Colaianni

Successful interaction achieved.

Emily Silverman

Successful normal human interaction achieved. And, then it kind of made me wonder like, was that a performance? Was I performing normal? Or so like, how do you know what's performance? And what's normal? And what is the self? And what is an act? And I don't know, this is a philosophical question. But since you're such an amazing actor, I thought maybe I'd ask you.

Alessa Colaianni

Well, I imagine that there's a lot of like, philosophy of art and philosophy of theater that like deals specifically with this question. And I actually imagine there's just a lot of philosophy that deals with this question, not necessarily like aesthetics. And I think it is the question because I do think that there are elements of performance in our everyday lives. And it's, it's nice to hear you say that you've experienced that because I've also experienced that–have like a fun little bantery interaction with the person at Starbucks. Or like these kind of, you know, perfunctory, non-deep interactions with people who are themselves playing a role. Like I am expecting something of them, they are expecting something of me, we're not interacting at the deepest levels of our human consciousness. It's very superficial.

And so maybe that role-playing is superficial, and maybe why that ends up being less fulfilling, if you do it for a long time, even if you're playing different roles, and even if you're like being an actor and exploring different things, and turning on or playing with different selves or versions of self. But like, is there something that's more meaningful underneath all of that? Like, is there something that is the real Emily Silverman underneath the person that interacts with people on a daily basis? Like, is there something more profound or more deep, or more real? Some people, I think, think, “Yes.” I think some people think that there's like an essential self that you can't get away from. And I think some people think that that is malleable.

And I was reading a New Yorker article recently about a writer–but basically this author, like wrote memoir. But she wrote memoir as different people essentially, like she had multiple versions of herself. And like the idea that you would be describing one person over the course of multiple memoirs or short stories that were like autobiographical was like anathema. She was like, "No, of course not. That's crazy. Like, of course, I've changed, of course. Like now I think this thing and I thought that thing beforehand. Like, we are all malleable." So like is there some deeper self that she was ultimately expressing? Or is like that thought the deeper self that she was ultimately expressing? We can really go down a rabbit hole here. But that's been my issue. That's like, I feel unmoored because I'm like, "Who is, who is, who is Alessa? What does she like?" Yep, back to narcissism. Okay, so what we've concluded is that I am a narcissist and that my soul type is Performer all the way down, turtles. No helper. Zero helper.

Emily Silverman

Okay, last question.

Alessa Colaianni

That last one was a doozy, Emily.

Emily Silverman

I know. I know. Thank you though for humoring me. I guess the last question is like, your story was about losing touch with that side of yourself. And then you found yourself standing on stage in front of an audience getting to tap back into that side of yourself. And you say in the story, that you have this fantasy where you gather everyone in your medical life, you know, doctors, nurses, patients, techs, whoever, into an audience, and you lock the doors and they are forced to watch you emote, which in a way is what was happening that night.

Alessa Colaianni

Yep. The doors were unlocked. But that's exactly right.

Emily Silverman

So I guess the question is, what was that like? And then follow-up question: Is there a possibility of a one-woman show in the future? Or maybe like a long-form exploration of the Tilda Swinton in reverse? The I've been concrete for 10 years and now I'm going to take attack and now I'm going to, you know, try something a little different?

Alessa Colaianni

You know, so, it felt weird and great to be up on stage again. It was really, really fun, and like, very invigorating and scary in a way that I haven't been scared in a long time. And so that like, in the initial weeks after that event, I was thinking about how do I like make that a part of me again? Or like, how could I? Like, is there an improv class that I could take here in Portland? Or like do something creative other than writing, which I do, but which is a very different process. As a writer, you very rarely interact with your audience unless they're emailing you asking if you really like the job that you want to like….

Yeah, so as a writer, you really like don't interact with your audience very much. But as an actor, like you're constantly interacting with your audience, I guess, in like a live theater kind of situation, which is the kind of acting that I like. So I don't know. I'd like to do some more of it. I'm also now like predisposed to recognize elements of performance in my daily work. And so you know, the timeout at the beginning of surgery, like the curtains, the lights…like I do, I'm kind of primed to like experience those as theatrical in a way. Not that they don't, not that they're fictional, or not that they're not real, or not that they're not important, but just like, appreciate them for what they are and like think of them as like elements of something that I have known in many different contexts, I guess.

I don't know about a one-woman show. I think it would be fun to perform somebody else's words again. I really miss that, picking up a script and memorizing it, and working it out with your scene partner. I have a friend, who's actually another OBGYN here, whose husband used to do a lot of theater. And at some point, we were like, bantering back and forth across the dinner table. And he was like, "Do you wanna, should we, like, maybe do like a one-act or something?" And I was like, "Yes!" But then I was like, "Oh, sorry. Did I sound too eager?" Like, "Yes. Yeah. Cool. Yeah, that's a great idea, Adam. Let's totally do that." Yeah, no, I was like, super excited about it. So yeah, we might, we might just dip our toes in again.

Emily Silverman

Well, that sounds fun. I will buy a plane ticket to Portland to come see you and your one-act with your friend. Thank you so much for sharing your story with The Nocturnists audience and for coming on to chat with me today about all of this and for humoring all of my just disproportionately philosophical questions.

Alessa Colaianni

I mean, you know, I was a philosophy major and I love philosophy. It's just, it's frustrating now to like, consider these questions because I don't have answers to them. And in my daily life, I usually have answers to like, like pretty concrete answers to the questions that people ask me. Right? But that was a–that was a gift. That was a gift of a question.

Emily Silverman

That's the gift that medicine gives, sometimes. Anyway, this was fun. I love you. I love being with you, chatting with you, talking with you. Maybe sometime we should go see Annie together and give it a standing ovation.

I have been speaking with Dr. Alessa Colaianni, and check her out. We'll drop some info in the show notes. You can find more about her, her website, her writing, and potentially more theater work in the future. So thank you, Alessa, for being here.

Alessa Colaianni

Thank you so much for having me.