| Is There a Doctor in the House? 
				In the picture-perfect world of theatrical dance, spectators 
				don't expect to hear that question called out from the stage. 
				Imagine the surprise of performers and audience alike when a 
				principal dancer collapsed onstage two-and-one-half-hours into a 
				performance of Pacific Northwest Ballet's Cinderella in March of 
				2002. Two physicians and a nurse in the audience responded, 
				hurrying backstage to check on the fallen dancer. Also found was 
				a prince to finish the performance. While a CPR-certified 
				physical therapist administered first aid backstage, the new 
				lead couple quickly discussed their impending unrehearsed 
				performance. The company continued, repeating the final pas de 
				deux. Says Olivier Wevers, the prince 
				who came to the rescue, "It was ah amazing moment. We were all 
				nervous but we knew what to do: 'The show must go on.'" 
				Emergencies are an ever-present, if uncommon, 
				risk in dance. The types of emergencies range from ah accident 
				on the stage to ah acute episode of a pre-existing medical 
				condition to the rupture of ah Achilles tendon. 
				Dancer choreographer Dan Wagoner, who teaches 
				at Connecticut College, recalls ripping his foot on a protruding 
				iron nail in the floor when dancing with the Martha Graham Dance 
				Company in Samson Agonistes in 1961. Paul Taylor and Martha 
				Graham proceeded to dance around the pool of blood, carefully 
				avoiding the nail. (Then they got him to a hospital in a cab.) 
				In a recent interview, choreographer David 
				Parsons talked about "doing the pit"--when a dancer somehow 
				falls into the orchestra pit, as he himself had done while 
				directing a rehearsal of his signature piece Caught. The solo is 
				danced with a strobe light in a completely dark theater. Parsons 
				dove, head first, ten feet into a concrete pit. He went into 
				shock, was immediately taken to the hospital, and was told that 
				if he hadn't been in good shape and warmed up, he would have 
				suffered serious injury. 
				"My performers are adept at improvisation," 
				says Parsons. "It's not like we're dancing Serenade of Swan 
				Lake. We can improvise through the unexpected injury of 
				emergency--even in front of thousands of people. The show only 
				stops when the lights go out." 
				PNB co-artistic director Francia Russell says, 
				"In my career, I've seen many injuries. Yet out of thousands of 
				performances during our tenure as artistic directors, the dancer 
				collapsing onstage was a first. Still, it was enough to make us 
				think carefully and critically and see how we could strengthen 
				our response." 
				At New York City Ballet, Marika Molnar, 
				physiotherapist for the company, notes that it helps for the 
				theater and studios to be located only several blocks from the 
				hospital. Says Molnar, "I can remember a rehearsal on stage when 
				one of the dancers was leaning over a second-story balcony and 
				fell onto a fence. Ah emergency response team was on the set 
				within eight minutes. Even now, if someone needs to go to an 
				emergency room, a physician whom the dancer knows, who is 
				familiar with ballet, is already at the hospital by the time the 
				dancer arrives." 
				Molnar says that part of the company's 
				emergency-response protocol involves educating the dancers to 
				take care of themselves and others if something serious happens. 
				"The dancers feel that there are many safety nets in place For 
				their protection," she says. "We have emergency procedures that 
				everyone knows--from stage hands to dancers to administrators. 
				This includes having everyone's cell phone number." 
				Says PNB's Francia Russell, "'The show must go 
				on'--but not at a dancer's expense. The dancer needs to take 
				precedence. This is also true for smaller companies. There are 
				usually many health professionals in the community who are 
				willing to help out, who are interested in dancers and volunteer 
				their services. It's not necessarily expensive." 
				Cher Carnell, a former principal with 
				BalletMet and Louisville Ballet who now teaches in Bellingham, 
				WA, agrees. Companies she has worked with have had a dedicated 
				volunteer doctor on hand during performances. She acknowledges 
				the need for such support, recalling a time when a partner 
				snapped his knee ligaments, sending him into shock. "We covered 
				him with a blanket and talked to him," says Carnell. 
				Companies that perform strenuous and 
				potentially dangerous work might need to be especially alert. A 
				case in point is Elizabeth Streb's high-impact movement. "With 
				Streb work, the risk is higher since the physical intensity is 
				higher," says Streb. "The trust element is critical, so I need 
				to know about preexisting conditions, It's hard for dancers to 
				talk about this because we are so vulnerable, especially in the 
				fragile dance economy we're in. But we depend on each other in 
				performance to be OK. If someone gets hurt, it won't be just him 
				or her--it will be other dancers as well." 
				At the Boston Ballet, emergency-preparedness 
				is a priority. According to Dr. Lyle Micheli, Director and Ruth 
				Solomon, Coordinator of Dance Medicine Research in the Division 
				of Sports Medicine, Children's Hospital, Harvard Medical School, 
				the Boston Ballet reserves two seats near the stage for the 
				physician providing medical coverage and two seats for a 
				physical therapist at every performance. An up-to-date doctor's 
				bag and physical therapy equipment are kept in the physical 
				therapy room at the theater. 
				According to Molnar, NYCB's physical 
				therapists are backstage for every performance until the end of 
				the first intermission, The New York State Theater provides a 
				physician at each performance, and NYCB's orthopedic consultant, 
				Dr. William Hamilton, or an associate, is usually in attendance. 
				Backstage, there is a defibrillator and at least two people, 
				certified in CPR, who can use it. A backstage therapy room has 
				crutches, aircasts, bandages, etc., as well as a fully equipped 
				doctor's bag. 
				Preparing for the unexpected--within 
				reason--makes good sense. Says PNB's Russell, "It's not just the 
				legal thing to do, it's the humane thing to do. We supply first 
				aid kits, a physical therapist, and ice buckets backstage--as 
				well as maintain a well-supplied doctor's bag. What we learned 
				from our experience two years ago is that, although there may be 
				ah available doctor in the house to administer during an 
				emergency, often he or she does not have a completely equipped 
				bag--they don't bring them into the theater." PNB now maintains 
				a fully equipped kit, which is periodically checked in both 
				their studios as well as the theater. "The dancers know that we 
				have such equipment," says Russell. "The more secure the dancer 
				is, the better the performance." 
				The story of the 28-year-old dancer who 
				collapsed during Cinderella indeed has a happy ending. At the 
				hospital, he was diagnosed with a form of irregular heartbeat. A 
				short two weeks later, the company applauded his return to class 
				and rehearsal. 
				For the rare serious medical emergency, it is 
				not enough to have a doctor in the house. Dance companies need 
				to have a fully equipped medical bag and staffers certified in 
				CPR and qualified to treat shock. Dancers need to mentally 
				rehearse for such events--so that a new prince of princess can 
				be found, a partner can be reassured, and the dance can go on. 
				Be prepared 
				How can dance companies (and theater 
				management) prepare for the odd emergency? In addition to the 
				physical and medical aspects of safety procedures, the 
				psychological and emotional aspects are also important. 
				Preparation for emergencies helps maintain dancers' trust and 
				enthusiasm, and good employer-employee relations. Dr. Richard 
				Gibbs, a former ballet dancer who is now the head physician at 
				San Francisco Ballet, notes that, "It's rare to see a dancer 
				collapse on stage. It's more likely that someone will drop in 
				the audience, not on stage if for no other reason than the 
				younger age of the performers." He believes that no company is 
				too small to be prepared for a first response. The Following are 
				Dr. Gibbs' recommendations for emergency preparedness. 
				* Ice buckets backstage 
				* A physical therapist at each performance 
				* A medical office on site 
				* Emergency medical supplies, complete and 
				updated, ready for any doctor to use 
				* Planned response with dancers and production 
				personnel--as with an earthquake or fire drill 
				* Staff certified in CPR  |