The woman, Judy, says with soft, upturned eyes to the doctor, “My daughter wanted me to come in... she says I’m a little forgetful.” Judy is older, she has brown hair that hovers above her peach cardigan. She laughs sweetly at her own absentmindedness. Sometimes she gets lost, and admits to having left the stove on for too long, but “only once,” she insists. Though it will eventually become obvious why, it’s hard not to become irritated that Judy’s daughter sent her unaccompanied to the doctor. Judy’s initial curiosity fades into concern as the evaluation persists. The doctor asks Judy to spell the word “world” backwards. Judy, cautious and seemingly unsuspecting, complies: “D-R-L-W.”
Medicine and science, to the extent that they concern themselves with the individual, tend to do so from on high. They tend to analyze, to treat the phenomenon, to explain. Judy’s doctor falls into this trap — one that Judy has, in fact, expertly set.
Standardized Patient tracks doctors-in-training interacting with "standardized patients": actors portraying characters with specific motivations, family backgrounds, personalities, and sets of symptoms. The camera follows the doctors as they discern the actor-patients’ ailments and communicate a treatment plan. After Judy’s misspelling, her doctor, as if ordering a cheeseburger from the drive-thru window, flatly states: “So Judy, some of these signs and symptoms could be consistent with the initial stages of Alzheimer’s or dementia.”
Judy cuts her off: “Alzheimer’s? You think I could have Alzheimer’s?”
The doctor realizes her mistake. She vigorously shakes her head, backtracking on her indifferent delivery, “Oh n–no. I’m not saying you do have, at the moment -- at all. I’m just saying...”
Judy goes in for the kill. She stares back and quotes the doctor: “at the moment?”
Tribe's video is a two-channel installation. On one channel, viewers watch a straightforward narrative of these doctors-to-be either succeed or, in some cases, fail miserably (like Judy’s practitioner). Other doctors rise to the occasion, like one who stays with a distraught teenager through a herpes diagnosis: “I can be there to talk to him with you. Or if you want to tell someone else, I can be there with you if you need that. My job is just to be here for you.”
The second channel projects onto the backside of the same screen. It consists of an assemblage of documentation, charts, transcripts, and closed circuit video footage of the interactions between the doctors and standardized patients. Every utterance and action by the medical student and standardized patient is described, recorded, and cataloged. This parallel video gives the viewer a peek behind the curtain at the abstracted and mechanical nature of medical bureaucracy and efficiencies. Indeed, the collage of roles, scripts and documentation escalates into an exciting confusion. Who is actually acting and from where is the direction coming?
Tribe’s Standardized Patient represents her most recent entry into an ongoing study of various medical worlds and their characters. That work includes 2009’s H.M., about “Patient H.M.,” a famous amnesiac who had only 20 seconds of memory recall, and a 2015 collaboration with a group afflicted with aphasia that led to the redoubtable video, The Aphasia Poetry Club.
Standardized Patient is that rare artwork that is unconcerned with itself, an installation that transcends the status of mere gesture among an art world in-crowd. Instead, it demonstrates how medical technologies have organized us -- doctors and patients alike -- into what the scientist and novelist C.P. Snow famously described as the “two cultures,” humanities and science. Viewers of Standardized Patient see directly into that chasm: again and again, the actors draw out a painful realism, while many medical students choose to be right without being considerate.
Recently, artist and writer Bean Gilsdorf wrote powerfully of her own experience with the medical world. At one point, deep into the onerous journey of her mother’s acute myeloid leukemia, an attending physician condescendingly said to her mother, “Now, I know that’s a big word...” Gilsdorf remembers at that moment it was “as though my mother’s physical wasting was an outward sign of mental incapacity,” an arrogant misdiagnosis by the attending.
A medical student in Standardized Patient employs a similar eminence and absence of self-awareness. When speaking to an actor ostensibly near death, the student begins evangelizing, “I believe in heaven and hell and I believe in God and that Jesus died on the cross for me. I plan to go to heaven and live my life the best that I can.” The observing faculty member gently intervenes before the medical student can go on.
Medical education requires doctors to spend years looking at human beings as matter and mechanism. It shouldn’t be a surprise when they articulate this perspective out loud. And, unfortunately, their job is not always to “just be here for you,” as one student in the video reassuringly says. Yet, it doesn’t have to be this way.
By dint of its very existence, Standardized Patient epitomizes art’s necessity in a society that prioritizes the STEM fields. The medical students in the videos will eventually become doctors somewhere. Some will be extremely fluent in specific deductive strategies. They will summon the pertinent swaths of medical knowledge. But when examining an anxious patient, will they also summon a capacity for patience and compassion? Will they push back against the structural forces that privilege efficiency over empathy? And will they recognize the need to be with their patients, rather than knowingly explain the patient’s world to them?
'New Work: Kerry Tribe' featuring the video piece 'Standardized Patient' is on view at the San Francisco Museum of Modern Art through Feb. 25, 2018. For more information, click here.
Funding for KQED Arts is provided by The William and Flora Hewlett Foundation.
Support is also provided by Yogen and Peggy Dalal, Diane B. Wilsey, the Kenneth Rainin Foundation, the John S. and James L. Knight Foundation, Helen Sarah Steyer, the William and Gretchen Kimball Fund, and the members of KQED