Anna Deavere Smith's "Let Me Down Easy' (1st review)

In any given situation the world can be divided into two groups: doctors and patients. The doctors— that is, the experts— may know how to solve the problem at hand, but only the patients know firsthand the suffering caused by the problem. Holocaust survivors may be clueless about how to prevent another Hitler, but they appreciate the urgent need to do so more keenly than any State Department diplomat. That's why it's essential for patients and doctors to listen to each other.

The suis generis actor/playwright/journalist Anna Deavere Smith has made her reputation by listening to figurative doctors and patients in a wide variety of situations, among them race riots, choreography and the American presidency.

Smith's m.o. is to interview hundreds of people in all walks of life and then, on stage, assume their personas in one-woman shows. This process forces Smith (and her audience) to feel and empathize with the pain of her subjects— experts and victims alike. Let Me Down Easy, her extraordinary meditation on health care, illness and death, finds Smith literally interviewing and portraying doctors and patients, with a few ministers and even a Buddhist monk thrown in for good measure.

One-person plays usually suggest a theater company trying to cut costs. Smith's shows, by contrast, reflect far more exhaustive research (in this case, interviews with 320 potential subjects) than any theatergoer can reasonably expect, even at today's inflated ticket prices.

Smith understands what every good journalist knows instinctively: that most people are so starved for attention that if you're willing to listen to them, they will tell you the deepest secrets that they'd never share even with their best friends and closest relatives. The result is a 90-minute sequence of 20 interviews that often surprise us, rarely overlap and build gradually to a climax whose roots, in Smith's skilful hands, are equal parts emotional and intellectual.

Rich patient, poor patient

Thus we have a choreographer, hungry for real-life experience, who remarks, "I'd like to know what it's like to be shot." The feminist writer Eve Ensler wonders, "Why is everyone so terrified to see women age?" A palliative care physician asserts, "It's not possible to turn dying into a picnic."

The not-so-subtle undertone of Let Me Down Easy is the correlation between quality health care and economic class. An intern at a charity hospital in New Orleans yearns to treat every patient "like a Saudi Arabian princess coming to the Mayo Clinic," only to find herself beaten down by the sheer lack of resources and the cynicism of her colleagues. A cancer patient at Yale New Haven Hospital relates the time she was cavalierly informed that the hospital lost her records— until she revealed that she was the vice-dean of Yale's medical school, whereupon her records were located within a half-hour.

Life as an act

Smith's method inevitably suffers from a few weaknesses. Some of her subjects (like the biker Lance Armstrong and the Texas Governor Ann Richards, both cancer patients) are public figures themselves, well schooled in the facile art of telling interviewers what the interviewers want to hear. (Another cancer patient— Joel Siegel, the movie critic for ABC News— readily acknowledges that his whole life is an act; chemotherapy, he quips, is "like beating up your dog with a stick to kill the fleas.")

Similarly, Smith's empathy for her subjects appears to have left her unwilling to challenge their assumptions; as an interviewer she is more Larry King than Oriana Fallaci or Jon Stewart. Nor do we find much in the way of disagreement among the 20 subjects she has chosen to portray.

The supermodel Lauren Hutton, for example, goes unquestioned when she maintains that the biggest benefit she got from her work for Revlon was access to superior medical care; as Hutton puts it, "The best doctors all know each other, and they pass you around."

Thousands for reputation

This widely held myth remains to be proven. To be sure, doctors develop some sense of each other's capabilities when they refer their patients to other specialists. But otherwise most doctors know each other's work only by reputation; the best doctors are actually too busy to spend time evaluating each other or conducting patient satisfaction surveys.

Walk into almost any doctor's office these days and you will find the waiting room littered with glossy brochures and newsletters from hospitals and medical schools in distant parts of the country. When I asked one of my Philadelphia doctors why he received the Cleveland Clinic's in-house magazine, he rolled his eyes.

"These hospitals spend thousands of dollars to promote their reputations," he replied. "They want to keep their name in front of doctors in case U.S. News & World Report polls us for its "'best hospitals' ratings."

His waiting room was empty

I wish Lauren Hutton had known my late ophthalmologist father-in-law, I. Edward Rubin, who practiced medicine in Philadelphia for 61 years. Ed never promoted himself, never played medical politics, never made Philadelphia Magazine's "Best Doctors" list (and couldn't have cared less). Yet his patients venerated him for one strange reason: He was the only competent doctor I ever met who treated his patients as if he needed them more than they needed him.

As far as Ed was concerned, his patients put food on his table and validated his right to exist, and so he was always grateful when they walked in his door. His waiting room was usually empty— not because he lacked patients, but because he hated to keep them waiting. He refused to delegate authority to nurses, receptionists or bookkeepers; his patients dealt directly with him or (his only intermediary) his wife.

He prepared for his patients the night before appointments by reviewing not only their records but also those of their parents and other relatives, in order to spot potential hereditary diseases. He faithfully attended the early-morning lectures at Wills Eye Hospital to keep abreast of new developments.

Less than Medicare

He resisted raising his fees because, he said, it would cause a hardship for his patients. (His standard fee was actually less than the amount allowed by Medicare.) When he had to refer a patient to an expensive specialist, he reduced his own fee in order to ease the patient's burden.

Lauren Hutton, in her glitzy celebrity/corporate milieu, would never have been exposed to such a meticulous, dedicated and humble doctor.

Do such doctors still exist in our age of impersonal "team medicine"? I don't know. But if they do, I suspect Anna Deavere Smith will find them and define their place in the cosmos, however obscure. For her unique combination of industry, intelligence and dramatic talent, Lord, make us truly grateful.♦


To read another review by Steve Cohen, click here.
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