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Chris Aiken: I think people don't understand that you can prepare for improvising, not just by improvising, but also working with discipline, with known things. Like, I have 101 ways to fall down. I have many ways to balance. Many ways to resolve certain situations so that I'm not worried about my safety.

Emily Silverman: This is The Nocturnists: Uncertainty in Medicine. I'm Emily Silverman. Today we're talking to improvisational dance artist Chris Aiken. Although uncertainty is everywhere in medicine, most of us do our best to avoid it. Chris, on the other hand, seeks uncertainty out. He teaches at Smith College in Western Massachusetts, and his life's work is about getting on stage without a plan, responding to the unknown in real time, literally moving through uncertainty.

We rang up Chris to see if he might have any wisdom to impart to the medical community. I learned a lot from this conversation, but before we dive in, I want to hand the mic over to Molly Rose-Williams, our head of story development here at The Nocturnists. Molly is a dancer herself, and first took a class with Chris several years ago. As part of our Uncertainty research, she was lucky enough to be invited backstage to one of his rehearsals at Smith, a sort of uncertainty incubator for dancers. Without further ado, here's Molly.

[music]

Molly Rose-Williams: I just want to start by saying that if you've never seen or done improvisational dance, it's probably not what you think. Yes, you might encounter some meaningful sighs as people twist themselves into odd positions, or a little off-rhythm dancing to absolute silence, but what these tropes don't capture is the potential rigor of the form. This rigor is something I first came across with Chris. When I was 25, I took a three-week intensive with him at the Bates Dance Festival, a training program for professional and pre-professional dancers. His class rocked my world. Not only was the dancing energetic, muscular, full of delight, and truly watching Chris articulate his liquid spine is delightful.

As you'll hear, every one of the physical explorations Chris offers unfolds into a world of philosophical inquiry. Chris and I have stayed in touch since that first workshop and continue to dance together. It was with great pleasure that I visited a rehearsal for one of his most recent creative processes this last November.

Chris Aiken: Let's begin.

Molly: The studio is a big room next door to the basketball court, but once the door is closed, we're surprisingly insulated from the squeaking shoes and shouts from the gym. Three sides of the room are lined with big windows, and the afternoon sun is streaming in, casting square shadows on the gray Marley floor. We start in an opening circle: 11 dancers, Chris, the musical collaborator, Jake, who's also a professor at Smith, and myself. After a check-in, Chris introduces the focus for today's rehearsal.

Chris: Conceptual level, could you bring forth that continual sense of beginning to continually begin again? Begin again.

Molly: Well, at first, Chris says his main work was to get them more comfortable with the unknown. Now, after three months of rehearsals, it's important to make sure they don't get too comfortable, don't get complacent,

Chris: That's going to be really important for this piece because as we rehearse more and more towards the performance, things will start to become more and more familiar. How do you retain a sense of beginning moment to moment? Because almost inevitably, if you keep doing the same thing, even though it worked four times, there's a point at which it stops working.

Molly: Chris gets the group to stand up and offers a prompt for warm-up meant to help them tap into the potential of each moment, as opposed to their patterns or fallbacks.

Chris: Is it possible to work with the quality of being precise without needing to know what that means? That your attention is precise. It's like you have a compass of where's north, and the north is precision. Okay?

Molly: Improvised dance is my favorite kind of dance to watch because it requires such presence from those moving. Every movement is not just a movement of the body, but a moment of decision-making made physical. As the dancers start to warm up, Jake gradually layers in a soundscape of sparse and spacious tones. Dancers move from solos to duets to trios and out again. Upstage left, a cluster coalesces and then breaks apart. The energy in the studio has shifted, as if the dancers are tuning the air with their focus. In two weeks, this group will step on stage without any set steps or choreography, but they won't be entirely without a plan.

Chris, like many professional improvisers, tends to work with scores, sets of rules, guidelines, or guiding questions that offer constraints and inspiration. After about 10 minutes, Chris calls the group back together to start practicing one of the scores from the beginning of the piece, swarming.

Chris: In a swarm, anyone can be at the center. It's not a flock of geese where there is some bird that's in the front. The front could be from the inside.

Molly: The swarming score gives a structured way of exploring how individual choices relate to the group as a whole. The only constraint is that the dancers stay relatively close to one another. This means that every choice one dancer makes directly impacts the others.

Chris: Why don't we just get in a clump and start walking, and then see what happens?

Molly: For this score. Jake hangs back, allowing the group to develop a rhythm of its own without music.

Chris: When it starts speeding up a little bit, stop. Imagine that you're in a rugby match and you're not in a dance. There's a sense of readiness. It's not casual.

Molly: The effect of 11 bodies slipping around one another at speed is remarkably swarm-like. Thrilling, like the best sports game, and inexplicably coherent.

Chris: Sometimes you may have to run to catch up.

Molly: Images emerge like shapes in smoke. A herd of gazelle, a school of fish, an angry mob, a Spaghetti Western showdown, a royal procession.

Chris: Every once in a while, just be still.

Molly: I'm struck, as I so often am when I'm watching improvised dance, how much meaning can arise spontaneously if you just take the time to let it come.

Chris: Okay. Pause and just rest.

[applause]

Chris: All right. We'll come back to this.

Molly: As rehearsal ends, we sit down to debrief.

Chris: Okay, let's come together. Make sure you take some water. What are you noticing for yourself about your own dancing? Your own choice-making?

Molly: The group talks about the challenge of interrupting patterns, doubts around whether choices are good enough, how hard it can be to tell when you've been on too long, and the shock of becoming the accidental center of attention.

Group Member: Am I exiting too soon or too late?

Molly: In his responses, Chris straddles the role of teacher and director, offering tips and tools as well as direction and constructive critique.

Chris: If you feel that sense of I've been on too long, one thing you can ask yourself is, "Am I generating or am I coordinating? Am I adding something?" Then from there, you can say, "Does this thing need me? No, I can exit." That can be a transition off, or to like, "Now I feel I have a sense of purpose."

Molly: The countdown to the performance has begun. The cast has a few more rehearsals, but soon they'll be going on stage in front of hundreds of people, all waiting to see how they'll navigate the unknown. In parting, Chris offers a few final words of encouragement.

Chris: I am not worried. If chaos happens, it's going to happen. It's what's the response to chaos?

[music]

Emily: I am here with Chris Aiken. Chris, thank you so much for being here.

Chris: It's my pleasure to be here. Thank you.

Emily: Chris, we are making this podcast because in healthcare and in medicine, we don't talk very much about uncertainty. Part of the reason why is the topic can cause a lot of fear and anxiety, and even avoidance. Your work takes you toward uncertainty. Tell us a bit about why you choose to work with uncertainty and with improvisation as opposed to set choreography.

Chris: Sure. I've made my career as a dance artist creating evening-length improvised performances that involve dancers, musicians, lighting designers. We work with varying degrees of structures, but the content, both in terms of the movement and the music, is totally improvised. I chose to work this way, I think firstly because, although I did set choreography when I was young and I still do it periodically, when I came across people who were improvising in performance, it had a feel of really living on the edge that appealed to me. Once I got a taste of it, I found that of all the dance forms that I was practicing at the time, that was the one that made me feel most alive.

I like to be able to juggle many balls of awareness, my body, my movement, my sense of relationality. Like, what was I choosing to pay attention to and relate to? That was really stimulating to me. I felt that when it was successful, it was on a community level or a collaborative level, thrilling.

Emily: You were talking about when you're dancing, there's a sort of tone to your attention, and holding that attention, you enter into this process of choice making. You tell your dancers to always be asking themselves these questions. Am I generating or am I coordinating? Does this thing need me? Have I been on too long? It's this kind of inner monologue that's always going, and I think maybe that's what you're saying when you said it's living on the edge. There's just this heightened awareness. It almost reminds me of an ER doctor.

[laughter]

I was wondering if you could speak a bit more to that process of the quality of your attention when you're in improv, and also how that informs the choices that you make.

Chris: I do want to just push back a little bit with the word choice, inner monologue, because when I'm rehearsing and I'm directing, I'm telling them these things, but I don't want them to be in an analytical place when they're performing. The model that I would use is that we're practicing these compositional principles, and we're talking about the sort of balls of awareness that you just delineated, but the idea is we're developing poetic instincts. It's almost like valence is. You feel a sense of like I've been on too long, so I need to make space for someone else, or I see the energy starting to die, and I go forward.

I may not know what I'm going to do to bring energy, but it's like something's calling, and I go. As I begin responding to that feeling or that sensibility, it activates the next set of choice-making. It's a kind of thinking that is just, I guess, lower down in the brain. If it's too cortical, I find it's too slow. As with anything, whether it's sports or music or dance, there are places in the river of tension where things slow down, and you have more time to analyze quickly what's happening. When you're in the most intense parts, you just have to go.

One of the beauties of being in an ensemble is that if, let's say, two or three people are really diving into some material, the assumption is they can't hold all the other balls of awareness, such as the space and the audience. The other people in the ensemble, it's understood that they'll take care of it. If the composition starts to collapse, they'll just do little things to help make it work.

I want to just say something about variation.

Emily: This is Chris back in rehearsal.

Chris: Sometimes, some material starts to develop, and it becomes a motif. That impulsive area is almost always too soon, because we are just barely getting it, and it starts to change, and it collapses just of its own weight, where it's like, "Oh shit, that was just cooking, and now it's gone." If that's happened like 16 times in an improvisation, say, we just never get it. We never get the satisfaction of something actually becoming itself because of the impulse to vary it. Inhibit. Stay with what's happening longer because it takes the audience longer to even know what the hell it is.

You may be like, "Oh, this is so obvious," but it's not obvious to the audience. Their perception is slower than yours, their appetite for variation. The thing with improvisation is you don't need to add a lot of variation. With 11 people, there's a bonanza of variation.

Emily: What you said about variation really struck me and made me think of two things. One is the challenge as a doctor of empathizing with the patient's point of view as we're communicating information to them. A lot of the doctors we've spoken to, they may have seen a disease a million times, but this is the first time that the patient is getting this diagnosis of cancer, let's say. The patient is not going to experience time the same way that the doctor is. The patient may not even hear it the first time or the second time or the third time that it's said, but it also made me think of just the general challenge of waiting.

It reminded me of this saying that we have in medicine sometimes, where if we're in the hospital and there's a patient, and something weird happens, like there's a weird lab value or they look a little different or they look a little funny, the saying is, "Don't just do something, stand there."

Chris: Love it.

Emily: The idea is just to wait, to wait, and see what it is. I was wondering if you could talk a bit about the virtues of waiting.

Chris: Really, what we're talking about is the capacity to empathize. It starts with the perception of looking or listening. Not jumping to "Oh, I know what that thing is," but just continually re-perceiving the people or the thing that's in front of you. What you said made me think of two things. One is the power of observation. By waiting, that you can both change your resonant capacity to take in new information, but also you can wait for the energy inside of you to well up until the time to act becomes clearer than it is at that moment.

To teach yourself that the first reaction, or the impulse to just do something, isn't always the best impulse. Taking note of your habitual tendency to solve something right away if it starts to go awry, or if it becomes uncertain, to use the words of this podcast. I think to go into these realms that we're talking about, you have to have a certain tolerance for uncertainty and a willingness to allow things to be unknown and to not try to solve it right away, because sometimes you just don't have enough information.

Emily: One question we've been asking ourselves as a team is, what's the difference between patients and laziness, for example? If you're a physician and you have a patient and

you're not sure what's going on with them, you don't want to act too soon. Like you said, there's this virtue of waiting for it to build up inside, and then the action comes when it's ready to come. Do we also sometimes run the risk of not acting soon enough? Letting the mystery sit for so long that we're actually being complacent or not generating. I guess you could say we get stuck in coordination. Is the reverse also something to look out for?

Chris: Absolutely. John Dewey, the American philosopher, talks about the process of opening your mind, that it's an active process. It doesn't just happen. There's an orienting towards listening, towards dilating yourself, or changing the shape of your attention. It's not passive at all. I think the more you practice that, the more it becomes part of who you are. One of the reasons that I chose to become a performer is there's a focalizing effect of performing. You welcome pressure, you welcome people's attention, because of its focalizing effect on you.

I can imagine, as a medical profession, you don't go into that profession so you can space out or so you can be thinking about other things. You go into it because of the power of being with a patient or with a team who are working towards a common goal, which is helping this person or helping these people. There's something very powerful when the stakes are high. I always tell the dancers-- if I find them being a little too relaxed or too casual, I'll say to them, "What are you waiting for?" I'll say, "Imagine someone you love just walked into the room, or someone you really respect."

I used to often say, "If Michelle Obama walked in, would you suddenly start changing what you were doing to make it better? Well, why are you waiting like she's here?" To imagine the stakes as high as it can be so that you're practicing as if it really matters, so that when it does matter, you have a history of meeting the moment and doing the work it takes

to attune and act in ways that are creative or healing.

Emily: I think that's really true in medicine as well, the way that high stakes can cause us to focus super intensely. High stakes can also cause us to feel a lot of anxiety and nervousness. I'm wondering, do you get nervous when you perform? If so, how do you deal with those nerves, and how do you tell your students to deal with those nerves?"

Chris: I find that the ability to stay calm when things go awry or when the stakes get really high, it comes with practice. It comes with surviving awkward situations. I put them in situations sometimes that I know will blow their circuits a little bit, but it's controlled. For example, that moment when you walk out of the wings, you feel the audience's vision on your body. At that moment when you turn and you see faces, there's kind of a almost instinctual fight or flight response. I highlight that moment, and I make them practice it over and over and over.

They just keep coming out of the wings, turning, and they walk towards the audience, and they have to look at someone. They can't look over them or look down on the floor. That's the strategy that many dance teachers teach their students. They tell you, "Don't look at anyone particular because you'll forget their choreography." They're not there to eat you or judge you, although that's what you think they are. People go to performances because they want to be inspired. They want to feel connected. When you allow them to see you, by allowing yourself to see them, everyone calms down.

They go through that experience, they realize, "Okay, I did that. It was a little awkward or it failed miserably, but I'm going to keep going." That's what I mean about taking the durational approach. That you get better if you confront these situations, because the more confident you are, the more you have access to your full intelligence and your full listening capacities.

Emily: I'm curious if you could talk a little bit more about that. How do you think about failure when it comes to improv? Have there been times where you have felt like you failed? If so, how have you dealt with that?

Chris: I don't measure my success based on one performance or even one section of a performance. I look at five-year increments. I always look back and I say, "Well, have I grown in that five-year increment?" If I can say yes, then I keep going. If you're going to choose to improvise or work in the unknown, you're going to fail, and that's part of the deal. Yvonne Rainer, who's considered by some to be the godmother of postmodern dance, she said, "All improvisers have to develop a relationship to regret." It's not if it comes, it's when it comes. Failure is just part of the deal. It's not like if that happens, when it happens, how you respond to that.

I tell dancers that it takes stamina to improvise, psychic stamina, because you have to deal with the fact that you might not like what you did, or you might not enjoy how things went. It also means that when it's like magic and it's incredible, everything goes perfectly. I know it's not going to last. I don't live for the magic. I live for the opportunity to be in these situations, and whether I succeed or not, it's being in that situation that's a gift.

[music]

Chris: Sarah and Shavi, intensify. Become the center, even if it's a center of uncertainty.

Molly: Two weeks after we talked to Chris, I went to see the performance. The dancers attacked the work with grace and tenacity, and the piece was beautiful, idiosyncratic, and completely different from the version I'd seen in rehearsal. Chris said he was pleased with how it went. From what I could tell, all their preparation had paid off.

[music]

Chris: The lights are fading.

[music]

Chris: It's dark.

[music]

Emily: Thanks for listening to The Nocturnists: Uncertainty in Medicine. Our core Uncertainty team includes me, Emily Silverman, The Nocturnists' head of story development, Molly Rose-Williams, producer and editor, Sam Osborn, and our Uncertainty correspondent, Alexa Miller of ArtsPractica. Our student producers are Clare Nimura and Selin Everett. Special thanks to Maggie Jackson and Paul Han.

Our executive producer is Ali Block. Our program director is Ashley Pettit. Our original theme music was composed by Ashton Spencer, and additional music came from Blue Dot sessions. Artwork for Uncertainty in Medicine was created by Eleni Debo, who is represented by Folio illustration and animation agency.

The Nocturnists: Uncertainty in Medicine was made possible by generous support from the ABIM Foundation, the Gordon and Betty Moore Foundation, and the Josiah Macy Jr. Foundation. The Nocturnists' title sponsor is the California Medical Association, a physician-led organization that works to keep the doctor-patient relationship at the heart of medicine. To learn more, visit cmadocs.org.

The Nocturnists is also made possible by support from listeners like you. In fact, we recently moved over to Substack, which makes it easier than ever to support our work directly. By joining us for a monthly or annual membership, you'll become an essential part of our creative community. If you enjoy the show, consider signing up today at the nocturnists.substack.com. If you enjoy this episode, please share with a friend or colleague. Post on social media and help others find us by giving us a rating and review in your favorite podcast app.

I'm your host, Emily Silverman. See you next week.