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Cockpit crises teach strong lesson
Play attracts attention of professionals

By Roberta Burnett Special for The Republic
Special for The Republic
April 19, 2002

Since Shakespeare's time, English writers have told us that the arts' dual purpose is "to teach and to delight."

Today, if theater intends to teach even a little bit, American puritans call it highbrow (as in "not for us"). If it delights, then it must be extreme, for everything from sunglasses to vodka. In steep thrills lies pleasure.

For the next couple of weeks at the Scottsdale Center for the Arts, we have a chance to see useful theater that has a huge share of inherent excitement.

Charlie Victor Romeo, named after the voice recorder on airplanes, is a play in six scenes. Each scene has a small cast, played in a small space, the airliner cockpit. There isn't much action, but there is plenty of conflict and errors in judgment.

It doesn't remove the suspense to say that most scenes depict last moments of life for crew and passengers in devastating collisions of plane, water and earth. In other towns, the tech-y guys, the ones with button-down collars and pocket protectors (the ones who almost never go to plays), form a hefty segment of the audience. It is they who become obsessed by the play and next time bring their friends.

The reason? Each of the six vignettes is scripted from voice tapes of large airliners about to lose it. There are few and minor changes. Some of these planes deep six, and others don't. But we are there, as if perched on the nose of the airliner, looking in at the crew in what might be their rational-emotional death throes. That is the substance of great and small tragedy, of the sorts we are familiar with. Men and women struggling to right the tippy tide of the events, aware of all the treacherous possibilities and often enough unable to save themselves. Sounds like Sophocles to me.

Developed by three men, two theater people and one English major, Charlie Victor Romeo is fraught with tension. Said Bob Berger, one of the originators of the show, the tapes are a matter of public record when they are entered into official reports. He and his friends read hundreds to make this selection of a very powerful six.

That isn't what got the engineers, the airline pilots and, interestingly, the U.S. Air Force, buzzing. From the third week of its opening in a tiny neighborhood theater in New York City, airline personnel stopped backstage after the show to ask leading questions, like, "What was the theater company doing to get this play made into a video for use in training pilots?" That was amazing to Berger, the English major and an admitted "tech-y idea man."

Six months out from the show's inception, the Air Force, with input from the Pentagon, Berger said, was sending a crew to do those training films. West Point cadets enrolled in engineering psychology courses and studies of human error began to see the play.

It isn't the compelling dialogue data alone that opened the door into the military. It's what the off-duty pilots saw from their perches at the nose tip of the airliner looking in. Charlie Victor Romeo is what all great drama is about, how people behave.

In this case, under life-threatening pressure. We see ordinary mortals strain for control of their plane, and their cohorts, more lowly ranked men and women, react normally. They are afraid to step beyond the bounds of rank, cultural background and gender even when the boss is making mistakes, even when the outcome could save their lives. Audiences discover here that human beings are so conditioned by our culture and its structures that we cannot let them go. In this play, more times than not, that conclusion kills.

So far, "the lessons pilots have learned from the study of the interaction of crews through crises (like these) have a serious impact on aviation safety. Close to 70 percent of aviation accidents are related to human factors," Berger said.

Berger noted that "there's now a science in aviation called crew resource management. It studies people interacting under stress in the cockpit of an airplane, and the ways rank, cultural differences and gender complicate decisionmaking. It turns out these are big factors in aviation safety."

Enter another set of characters from life's playing fields. The physicians and nursing staff in emergency and intensive care units of hospitals. Oh, no, not those who clean up the aftermath of the crashes the play depicts.

Working medical professionals see that Charlie Victor Romeo's players mirror themselves and the psychodynamics of their ER or ICU staffs as they leap into situation after situation trying to save lives. With the play now touring to university medical colleges and organizations like Banner Health Systems in Phoenix, Berger said, "that meant that what we'd created was actually useful art, useful. Imagine that."

Physicians and nurses, Berger said, "can learn from catastrophic failure when the airline crew who die can't. The patient can die. The doctor can still learn. Learning from cockpit failure isn't taught in med schools."

Dr. Jay Kaplan is vice president for emergency services for Banner Health.

He also works with Studer Group, a company that works with 200 hospitals over the United States to create excellence in medical services.

Now, through his enthusiasm and dedication, Banner Health Systems in Phoenix is using Charlie Victor Romeo to introduce to physicians and nursing staff the notion that they can begin to change the hierarchical structure of the high-intensity medical culture.

"Patient safety and incidents of medical error have been on the public mind for several years now," Kaplan said. "There are many processes in medical practice (that) we could be performing better. Physicians aren't trained in medical school or residency to step back from 'doing it, doing it, doing it' to look at examples (of work done) and try to create ways of doing it better," he said.

Kaplan said he believes that Charlie Victor Romeo is the launching pad to change. The medical industry "has many ideas about how to improve practices. The real question is how do we implement the ideas."

Kaplan said Banner is taking its physicians and nursing staff to two performances of the play at the Scottsdale Center's 136-seat Stage 2.

"Performance art can inspire people to recognize a problem and to change," Kaplan said. "Banner is looking at this theatrical event first to increase awareness of the issues pointed out in that play and also to inspire our leadership and our staff to want to make and create better processes that will lead to better outcomes for our patients and our staff."

Originally scheduled to run for five weeks when it opened in New York, Charlie Victor Romeo is now in its third year. It may just be the seed of a peaceful revolution in medical care.

Reach the writer at roburnett@hotmail.com.




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