Dramatic Difference

By Susan Murley

Unsure of whether his research was reaching all the audiences it should, Dr. Ross Gray made a decision that would dramatically affect his work – quite literally. Instead of only publishing in an academic journal, he decided to turn his results into drama, and take his research on the road.

Gray, Co-director of the Psychosocial & Behavioural Research Unit at Odette Cancer Centre, performs qualitative research – research that is not based on numbers or statistics but that examines issues in their social context through techniques such as observation and interviews. In the mid-1990’s, Gray conducted focus groups in collaboration with the Ontario Breast Cancer Information Exchange Partnership to determine what information women with metastatic breast cancer were lacking, and how to best fill this need.

The results of the research were extremely interesting, but publishing them in academic journals reached only a small segment of the people who might benefit from the information. So spurred on by a debate within the qualitative research community about new ways to disseminate research findings, and by a personal interest in scriptwriting, Gray began the long process of taking academic information and morphing it into a play. The Canadian Breast Cancer Foundation decided to sponsor this innovative venture.

With the help of the Act II Studio, a theatre group for older adults at Ryerson University in Toronto, and its director/scriptwriter, Vrenia Ivonoffski, Gray gathered together actors, women with metastatic breast cancer, and researchers to take a leap into the unknown by developing a script together. “It was quite a terrifying process in some ways, because for a long time I didn’t know if we would be able to deliver something that was compelling and useful.”

The result was Handle with Care?, an engaging and informative drama on metastatic breast cancer that was very well received by patients, their families and health-care professionals. With some understandable nervousness, Gray took the drama to “grand rounds” – academic seminars held for clinicians in a hospital setting. He was astonished at the reaction.

“They were surprisingly accepting of it as a legitimate means of communicating research,” he says. “I expected criticism but it never materialized ... We got a standing ovation after rounds. It is almost as if it bypasses people’s usual critical approaches, because it engages them at a different level.” He remembers one young oncologist that remarked “I’ve never really thought about the impact of certain things on the family, and I’ll ask different questions in clinic now.”

Clinicians, patients and their families were not the only ones learning as a result of this novel way of disseminating research results. Gray discovered that the creation of the play was itself a type of research, albeit one that was a little “messier” than the usual qualitative research process. “We tried to mess up the idea of research a little bit. What I mean by messy is that we continued to learn outside the formal research process. We had women with metastatic breast cancer, who added their voices and responded to the original voices in the focus groups. We had the volunteer actors, who didn’t have a clue about breast cancer, who added to the knowledge by not having a clue about it, and saying, ‘Well, why don’t you just “will” yourself to get better?’ The building of the script was not just a translation.”

Gray also learned a different way of seeing ill people and the contribution they can make. “A lot of our thinking about people who are ill is about how health care professionals can help them cope. What we did is to work with people who are ill as expert consultants.”

With the success of Handle with Care?, two more plays followed, one on prostate cancer and another addressing issues faced by breast cancer survivors. Gray published also Prostate Tales: Men’s Experiences with Prostate Cancer in early 2003. The book of stories stems from a Canadian Institutes of Health Research-funded study of masculinity and prostate cancer. Using interviews with men who have prostate cancer, Gray took the story of their lives and put them into a narrative.

In addition to his more traditional qualitative research, Gray continues to explore other innovative vehicles for communicating research results. Recently, he has begun public storytelling as a way of achieving similar impact with less work than creating and performing a play entails. All in all, Gray’s foray into drama also confirmed the importance of the more “traditional” research he conducts. “I discovered that the type of research that I do was really valuable to a lot of different audiences, and that qualitative research does have a place in the health care system.”