Stories Embrace: Readers’ Theatre for Cancer Education in Alaska

by Melany Cueva, R.N., Ed.D.

The intent of the Readers’ Theatre, created for my doctoral dissertation, was to open hearts and minds of Alaskan residents to address cancer issues through the reading aloud of, and simultaneous listening to, a scripted conversation. As story, Readers’ Theatre embraces a holistic, interconnected process of living and learning as participants engage in creating meaning both individually and collectively through reflection and conversation.

“Readers’ Theatre is like a circle because everyone is connected in some way, either by reading or listening, a circle of information.”

“Each person’s words were like points of light, jewels of beauty connecting each of us to one another.”

“Readers’ Theatre touches a taproot inside us. It nourishes something inside. You see people flower right away in the post- reading discussion. They blossom right in front of your eyes, like places that haven’t received water in awhile.”

– Readers’ Theatre participants

To engage in a Readers’ Theatre experience, all that is needed are people willing to read a character aloud. Participants are invited to choose any part. For example, a man may read a woman’s role, a woman may read a man’s character, an elder may read the words of a youth, or a youth may read those of an elder. Choosing the dialog of a character that differs from the reader’s gender or age may provide different insight. Listeners are provided scripts to follow along with or they may choose to listen without reading as their imagination creates meaning. Doing this allows the focus to shift from performance to engagement.
In his book Yuuyaraq: The Way of the Human Being, Harold Napoleon (1996) discussed the ‘Talking Circle’ as a place where the “…truth can be spoken about all things… to share oneself, and one’s experiences, feelings and thoughts” (p. 28). With Readers’ Theatre, the readers gather among the listeners in a circle of connection. As expressed in the following participant comments, both readers and listeners embraced the experience!

“As a reader, besides hearing it, you are also experiencing it.”

“I was a listener, so for me it was an opportunity to just be present for each other. Doesn’t happen much in a person’s day. It allowed an opportunity to reflect, to be introspective, to just be.”

“It was kind of a meditative experience. There is something very ancient about the process of reading together, it creates a spiritual dynamic, where we engage and in this case we become and we are able to work through. As a result, emotions can flow and you can actually feel what the characters were feeling and then identifying together as a group and to me that process in and of itself was very powerful.”

–Readers’ Theatre participants

The opportunity for reflection and dialogue are important dimensions of the Readers’ Theatre  experience. After reading the script, participants are invited to engage in a post- reading conversation. Exploring meaning in community with other people is an important part of the experience. It invites both readers, who are also simultaneous listeners, and listeners, who may have silently read along, to participate in a discussion about the content presented, to share their experiences, and together move beyond the limits of existing perceptions to create new understandings. The script serves as the catalyst from which new meaning can emerge as participants engage in dialogue.

Cajete shared in Look to the Mountain: An ecology of indigenous education, “Through story we explain and come to understand ourselves. Story in creative combination with encounters, experiences, image making, ritual, play, imagination, dream and modeling, forms the basic foundation of all human learning and teaching” (p. 68). Readers’ Theatre built upon people’s stories beginning at that place of knowing and freed imagination to invite other possibilities to emerge.

“Within our culture stories are handed down orally and by telling family and friends, that is how it is preserved. I really respect stories and storytelling. I remember growing up at home, one person would tell a story and maybe it jogs someone else’s memory, and they would tell their story. I appreciate hearing people’s stories.”

“I value spoken word and that process. Strong oral traditions resonate with our community, the community I grew up in, and that’s very typical of Alaska communities but that is also cross-cultural.”

“Readers’ Theatre is natural. It allows everyone in the room to participate. Everyone is invited, everyone knows someone who can tell a story, everyone has stories to tell. Stories are living processes, a story that was told three generations ago can be told again. Some of the lessons will be the same but other lessons could not have been anticipated. Story is open to everyone regardless of different cultures, literacy levels. It feels really natural and comfortable.”

-Readers’ Theatre participants

Could Readers’ Theatre serve as a culturally respectful way to bridge the often-difficult conversation of cancer? Might Readers’ Theatre as scripted stories, serve as a springboard for cross-cultural dialogue, freeing imagination for the hopeful discovery of possibilities?

“We don’t talk about it (cancer) – the Big C –  That’s how we walked around our family – oh she’s got the Big C. But you know we whispered it and stuff.”

– Readers’ Theatre participant

Cancer among Alaska Native people is often not talked about, keeping a shroud of silence intact, reinforcing the ways in which health disparities remain invisible. Cancer, considered a rare disease among Alaska Native people as recently as the 1950s (Brown et al.,1952), is currently the leading cause of mortality. Cancer death rates for Alaska Native people are 34% higher, while cancer survival rates are 17% lower, than for U.S. Whites. Cancer incidence rates among Alaska Native people are among the highest of any ethnic group in the U.S. and are increasing (Lanier et al., 2006).

Understanding, the 45-minute cancer education script used as the basis for the Readers’ Theatre experience, was written as a collaborative effort and incorporates the stories generously shared by people living in Alaska. The script explores many challenging and sensitive themes including emotions associated with a cancer diagnosis, treatment, pain, loss and grief, and end-of-life. Healthy lifestyle choices and recommended cancer screening exams are voiced. We hear Alaska Native people’s stories of hope and resilience and learn ways to keep our communities strong and healthy. People’s experiences, stories, common questions, and concerns related to cancer are woven into the lives of five characters: Earnest, a widower in his 50’s whose wife died of breast cancer; Vera, a young woman whose Papa died of colon cancer; Margie, a woman in her 40’s who is a breast cancer survivor; Nellie, a woman in her 60’s who is being treated for lung cancer; and Phillip, a young man in his 20’s who is a testicular cancer survivor.

This article shares how 24 diverse adult learners in Alaska described their experience with Readers’ Theatre as cancer education. Understanding emerged from two Readers’ Theatre workshops with a post-reading written reflection and discussion and a follow-up interview conversation two to three months later. The first three-hour Readers’ Theatre workshop was held in Fairbanks, Alaska, for Community Health Practitioners, who are the village-based primary providers of health care in rural Alaska. Five Athabascan women and one Caucasian woman from small, remote villages participated. The second two and one- half hour workshop was held in Anchorage as part of the annual statewide Alaska Health Summit. There were 18 participants, 6 women and two men. Ethnicity varied among participants: six people were Alaska Native including, Tlingit, Inupiat, Yupik, and Aleut; one person was Chippewa; one person was Asian; one person was Hispanic; and nine people were Caucasian. Participants were 25 to 63 years old. A semi-structured interview conversation ranging from 30 minutes to 2-1/2 hours was conducted two to three months after the Readers’ Theatre workshops; 4 by telephone, due to Alaska’s vastness, and 9 in person. One participant was unable to be reached for an interview.

As participants described how Readers’ Theatre supported their learning, seven expressive threads emerged: feelings, learning, laughter, story, communication, power, and transformation. To continue to honor the words and experiences of the 24 diverse adult learners who generously shared their response to being engaged in cancer education as Readers’ Theatre, a new script was developed. Within these scripts, characters embodied as themes were arranged in a dynamic Readers’ Theatre conversation.

The Readers’ Theatre becomes a living fabric as you, the reader, connect and embody participants’ words, weaving them into your life pathway. The introduction to the new 20- minute script, A Story of Possibility, is below.

Narrator: The Setting: The Present. Read, hear, feel, absorb, and experience Readers’ Theatre participants’ stories and words. It honors their voices. As you, the reader, breathe audible life into their words, they live on in a dynamic process, freed from the silence of the page. It is the heartbeat of a vibrant journey, awakening with possibility, eagerly awaiting the magic you bring to the living spiral of understanding.

ALL: We emerged from the words and experiences of the 24 diverse adult learners engaged in a cancer education Readers’ Theatre workshop. Our stories are heard in the telling and the retelling… woven into a vibrant tapestry of meaning.

Story: I am story. I honor the oral tradition of Alaska Native peoples. I honor our Elders who share their wisdom in a living spiral of understanding.

Laughter: I am laughter. I bubble up from within, bursting with energy; the energy that flows into healing and insight.

Power: I am power. My presence fills the room. I am felt in what is spoken and what is not spoken. I add emphasis to feelings and ideas to facilitate learning. I search for moments of harmonious balance shared between people. I am the constant dance as people lead and follow, listen and talk, yielding to the importance of we. My strength is manifest as interconnected balance.

Learning: I am learning.

Feelings: I am feelings.

Feelings and Learning: We step together.

Learning: and separate.

Feelings: Feelings

Learning: dancing with learning.

Learning and Feelings: Together, we weave a thread of invisible tension.

Learning: Tension vital to deeper knowing.

Communication: I am communication. I weave connections as

ALL: we dance together.

Transformation: I am transformation. I resonate as an affirmation of renewal … as a settling expressed with a deep “ahhh” … as a sudden spark ignited as an “ah-ha” … I am the shift from which new insight emerges.

ALL: We are …

Story: A Story of Possibility …

ALL: Our words await new meaning as you add your fresh insight to the experience Readers’ Theatre.

The Readers’ Theatre experience held a place for people to experience different perspectives, learn new information, create fresh understandings, and feel and express in a variety of ways. Participants also expressed a sense of renewal and affirmation. Laughter was experienced as a natural response to conversation and was described as a source of nourishment, strength, and healing that supported learning and enhanced memory retention. In the words of a participant, “If you don’t have fun while you are learning, then everything you are learning Is just not going to stick.”

Through story, participants engaged in a multi-sensory learning journey, which invited interconnected ways of knowing and understanding. Listeners and readers alike became time travelers, reliving past memories as well as considering future options, the vicarious trying on of another’s garments of experiences and perceptions. Thus the Readers’ Theatre script became woven into the life of each participant—tugging, challenging, and affirming. Readers’ Theatre connected with participants    affectively to discover deeper understanding.

“I felt it really speaks to people inside. I saw or sensed much more internalization of messages because it touches people’s feelings. It bypasses the whole cognitive rational mindset and goes straight to people’s hearts where our wisdom really lies.”
-Readers’ Theatre participant

Participants described shifts in meaning perspectives as they gained new insight in conversation with others. Readers’ Theatre provided an opportunity for people to become immersed in another way of being in the world, to perhaps read the voice and feel the emotion of a different gender, age, or life experience.

“It allowed me to be someone else for awhile. If only you could walk in my shoes. I personally practice this as much as I can. What would it be like if I lived in this neighborhood and I didn’t have a car? Perspective allows you to imagine a different possibility.”
– Readers’ Theatre participant

In Variations on a Blue Guitar, Greene (2001) described imagination as “the capacity to see new possibilities in things, to perceive alternative realities, to open windows in the actual and discover what might be” (p. 30). It is there on the edge where dreams give way to reality and imagination is translated into possibility that we begin to create new meaning.

The script also provided a way for culturally diverse participants to discuss difficult topics at a distance, through the lives of the characters, or if they so chose, to relate their own experiences. The characters became the conduit for participants to speak freely in direct or indirect ways. The locus of control was with each participant.

“It helps open a place for discussion to have difficult conversations, maybe to talk about things we don’t talk about. After this, over Christmas I went home. I went home and was talking about this workshop. It is not talked about. Nobody talks about my Aunt’s cancer and we don’t talk about my Uncle’s death. Nobody talks about it and I think you should. It is really important It can help us begin to heal.”
-Reader’ Theatre participant

Readers’ Theatre was described as a culturally respectful pathway for learning. Everyone was invited to enter into the conversation through story, facilitating participants’ active engagement in their learning journey. By giving voice through scripted conversations, topics often difficult to discuss were made audible, no longer destined to remain at the fringe of our subconscious or haunting the depths of our conscious unable to filter into accepted conversations. The strength of Readers’ Theatre lies in the transformational journey of each participant as she or he engages in conversation, reflection, and action in community with others.

Readers’ Theatre created a place for participants to courageously enter the challenging conversation of cancer.

“There are always difficult conversations and this to me is like the ultimate ice breaker.”
Readers’ Theatre participant

The script also provided words for participants to begin to talk.

“For me, Readers’ Theatre has helped out a lot, just reading the words of Margie (a character in the play). I can tell people now that I have had breast cancer and I don’t cry. Reading that part made me realize that cancer is not something you should deal with on your own but it is something you should share and get out, instead of holding it in.”
-Readers’ Theatre participant

Readers’ Theatre entered the silence of cancer, reflecting hope -hope grounded in knowledge as a catalyst for fresh beginnings.

“It was cathartic. Catharsis to me means… it’s a healing process, it’s a renewal, ike the ocean, it’s healing, it’s rejuvenating, it’s bringing, it gives hope. I think hearing other people opening up and speaking about their experiences is cathartic, it is healing, it helps the wounds to close.”

“Well, what I walked away with was a release, a letting go, a settling, visceral peace … it is a deep seated quietness or calm that comes to the center of your chest or your heart, kind of like a settling or grounding of sorts. To where you feel calm, you feel at peace, you have perspective. It is the settling of the spirit so you can make the most of the life that you have, it is about being in the momemt.”

“I left with a renewal of energy • I just couldn’t stop talking about it, the excitement followed me home.”

-Readers’ Theatre participants

Participants were very supportive of Readers’ Theatre and encouraged me to share what I learned to connect with a broader audience. The participants offered the following future possibilities for Readers’ Theatre.

“I think it’s a great tool that you’ll be giving people so I just encourage you to run with this possibility. I really think this Readers’ Theatre has a lot of usefulness and power not just in a healing medical format but also in social work and other formats.”

“I hope this will expan,d and be something that will be utilized in the future in other places. We have all kinds of ways of educating folks, sometimes a clever and unique approach like this can be very useful and very therapeutic.”

“I would like to see more scripts available on a variety of topics. A library of them.”

“I was thinking how easy it would be to apply this to other fields and other cultures.”

“I think this would be a great way to break the ice— because a lot of the villages I grew up in— we did not talk about sex and we did not talk about death, so this would be a good way to try to address HIV/AIDS.”

“I think this would be a great community interactive tool Also a therapy tool with adults.”

-Readers’ Theatre participants

The dance of life is the ability to weave together, giving space and sharing a place. Angles of perception merge and yield. The power of the spoken word is not limited to knowledge acquisition but roots people in cultural values and traditions providing anchorage from which to soar. The stories shared through Readers’ Theatre brought adult learners together in a community where people laughed, cried, expressed, and discussed meaningful topics. Readers’ Theatre fostered a respectful environment for adult learners from diverse ethnic and cultural backgrounds in Alaska to engage in meaningful conversations that awakened possibilities in a living spiral of understanding.

Thank you to the 24 adult learners who participated in these two Readers’ Theatre workshops and generously shared the gift of their stories and experiences. Their courageous voices entered the silence of cancer, making audible new dimensions of understanding.

Shifting Bits and Pieces Resembling a Whole A Living Spiral of Understanding

There once was a story awaiting birth.
Would it be written in the hearts of people or told by the scribe on paper?
Who would experience the gift of the senses?
Was it to be written in the snow with a story knife or
Created from grains of sand to be blown back to the land and its people?
Where to begin?
AH … the journey is already in motion …
embracing the present, remembering the past,
anticipating the future
the paper rustles … hearts quicken
Everywhere makers of wisdom
weaving in … weaving out… a living fabric
no color line
no lines of confinement dictating the
boundaries
only paper— no not paper
people … diverse peoples
But whose story?
The paper was powerless, it could not write
alone, it needed others.
It needed a community
Realms of possibility
the natural, the human, the spiritual
a community of harmony joined through
diversity
colors to texture a picture
A story could be told,
Heard
Read
Felt
Absorbed
Embodied
Shared
A living story of wholeness
Journeying together
As unique vibrant threads
One word joined with another word,
singing inspiration
coloring hope
dancing a song
weaving a story … A Story of Possibility

References

Brown, G.M., Cronk, L.B., and Bang, T.J. (1952) “The occurrence of cancer in an Eskimo.”  Cancer, (5) 2-143.

Cajete, G. {1994) Look to the mountain: An ecology of indigenous education. Skyland, NC: Kivala.

Greene, M.(1995) Releasing the imagination. San Francisco: Jossey-Bass.

Greene, M. (2001) Variations on a blue guitar. Columbia University, NY: Teachers College.

Kawagley, A. O. (2006) A Yupiaq worldview. Long Grove, IL: Waveland.

Lanier, A.P., Kelly, J.J” Maxwell, J” et al. (2006) Cancer among Alaska Natives thirty- five year report 1969-2003. Alaska Native Tribal Health Consortium. Division of Community Health Services. Office of Alaska Native Research, Epidemiology

Lawrence, R. (2005b) Knowledge construction as contested terrain: Adult learning through artistic expression. In R. Lawrence (Ed.), New Directions for Adult and Continuing Education, No. 107. (pp. 3-11). San Francisco: Jossey-Bass.

Napoleon, H.(1996) Yuuyaraq: The way of the human being. Fairbanks, AK: Alaska Native Knowledge Network.

Oleksa, M. (2005) Another culture/another world. Juneau, AK: Association of Alaska School Boards.


This article appeared in the Diving in the Moon Journal, Issue 5, Summer 2008.

Grateful for the many people whose paths are interwoven with hers, Melany Cueva is a nurse, health educator, researcher, mother, wife, life-long learner and someone who loves to splash in puddles, go on long walks, and laugh joyously. Since 1998, she has worked with Alaska’s village-based primary providers of health care, Community Health Aides and Community Health Practitioners, to make a difference in the story of cancer. To increase her formal knowledge as well as understand of how people create meaning, Melany earned a doctorate in adult education in 2007.

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