Developing a Story about Triage - an essay on playwriting

The following is an excerpt from a play I wrote inspired by the true story of Memorial Medical Center and the struggle during hurricane Katrina. It was a difficult piece to write and after the excerpt, I've detailed my process that motivated my writing. I should note what transpires is not what happened, but it did nearly come to be.

TRIAGE

August 31st, 2005 - New Orleans, Memorial Medical Center. 7th floor lobby. It’s pitch black. A radio plays. RADIO -under martial law. There have been reports of looting in the downtown area. Relief efforts are being made but at this time it’s not clear how much the coast guard are capable of. We have even had reports of shark fins spotted in the floods. The storm has appeared to dissipate but the destruction in its wake has not. Light fades in. Beams of light coming from doctors and nurses using flashlights move across the stage in direct but tired paths. Morning light from the hospital windows stream in. There are many patients in the lobby. They’re on beds that have been wheeled out of their rooms so staff can keep an eye on them. These patients have notes with the number ‘3’ on their gowns. One of them keeps wailing but everyone’s tuned it out. Most have given up and lie motionless under their sheets, apart from SAM who tries to stay active and positive even in the darkness. Nurse JULIE is hand pumping a ventilator on a patient; MARCUS WHITELY. He seems comatose.

SAM Good morning Julie. JULIE Good morning. SAM Christ it’s hot. JULIE Mmhmm. SAM How’s Marcus doing? JULIE He’s breathing. SAM Yeah? JULIE Mmhmm. SAM You hear the radio? JULIE Mmhmm. SAM You think they’re sharks in the waters? JULIE I don’t know. SAM I don’t know either. My sister’s scared of sharks. Never seen one but always been scared. JULIE wipes her brow and swaps her hands on the ventilator. They’re both numb. SAM When’s the next rescue coming? JULIE I don’t know. SAM Sorry Julie. JULIE …sorry Sam, I’m just tired. DR. ROBERTS enters and goes straight to SAM. ROBERTS Sam, how we doing? SAM Good! Ready to rock and roll out of here. ROBERTS starts checking over SAM. ROBERTS Nice to see someone in good spirits! Julie how long you been on Marcus? JULIE Few hours. ROBERTS Okay hold on. Amanda! NURSE AMANDA comes out of the darkness to ROBERTS. AMANDA Yes? ROBERTS You just had a rest didn’t you? AMANDA Sure if you wanna call it that. ROBERTS Take over would you? AMANDA Get yourself something to eat Julie. AMANDA takes hold of the ventilator and pumps it. JULIE backs off. JULIE Thank you…Sam you hot? SAM Ain’t we all? JULIE Here. JULIE picks up a clipboard and fans it at SAM. AMANDA Julie? JULIE I’ll cool him down then I’ll have my break. ROBERTS Take care of her Sam. ROBERTS walks to the end of the lobby and DR. WELLS enters and stops him. They begin talking but we don’t hear what they’re talking about. SAM I’ll do my best. JULIE How old’s your sister? SAM She’s at university in Austin. JULIE And she’s scared of sharks? SAM Yeah. I don’t know where she got it from. We were at a museum when we were kids and there was this exhibit for understanding your fears. Part of it was this booth which would show you pictures of things that might be scary to you. The dark, spiders and at some point a picture of this big great white shark comes up. Like Jaws, mouth open and everything. And she screams crying. My mom goes to hold her, and we get her ice cream and it’s all fine. We go home, and everyone’s gone to bed. She was 11 at the time, and I here her knock on my door. JULIE How old were you? SAM About 16. Anyway, it’s late. I’m in my room, I hear a knock at the door, and the door opens and it’s her, she says she’s scared, and she doesn’t wanna go to bed. So, I tell her it’s fine go to bed. And she stands there, and I say “fine.” Throw off my covers and take her to bed. I told her there ain’t no sharks coming to her room, especially when I’m there. She went out like a light after ten minutes or so. JULIE Sounds like a nice girl. SAM She is. Hey Julie when the rescues come, if they do, don’t leave me behind. Please don’t leave me behind. JULIE Sam. SAM You don’t have to say anything. Just don’t please. Please. JULIE puts down the clipboard and walks to the end of the lobby away from the patients, towards DR. ROBERTS and DR. WELLS. She sits on the floor and rests her head on the wall behind her. WELLS -five gone as soon as the power went Harry. ROBERTS I know. WELLS We have four nurses working on Sitwell on the 8th floor. He’s what? 400lbs? And his tumour hasn’t receded. We don’t have enough to get him down here for resc- ROBERTS -I know. WELLS I’m not trying to make this difficult. ROBERTS You’re not making it easy. WELLS *scoffs* easy. ROBERTS …I don’t know. And I don’t have to know. How is Mr. Sitwell? WELLS He needs a working hospital with working equipment, clean bathrooms, more staff. Surgery! He needs surgery… ROBERTS Yes, but how is he? WELLS He’s not doing well. Amanda thinks he’s given up. ROBERTS Rescue should be coming soon.

WELLS There’s 200 patients here. I’m sorry Harry but this is – I can’t keep at it like this. This is getting cruel. Pause. WELLS Upstairs in the store room we still have morphine, Versed and Lorazepam. ROBERTS exits, not making eye contact with WELLS. WELLS Don’t have any cigarettes do you? JULIE …no. WELLS How’s Marcus doing? JULIE He can’t breathe without someone hand pumping his ventilator. But he is breathing. WELLS He’s not breathing, you're doing it for him. How many do we have rotating on him? JULIE I don’t know. Every few hours we swap. WELLS What were you talking to Sam about? JULIE Nothing. His sister. I think he’s trying to hide how sick he is. WELLS Can’t blame him. JULIE Yup. I thought he was a two when we first-you know. WELLS He’s a three. JULIE If you say so. WELLS So Marcus needs oxygen and he’s weighed down by fluid? JULIE Something like that. WELLS Then he won’t be able to go via helicopter. To evacuate him we’d have to get him to the 2nd floor. Down five flights of stairs. You know we need oxygen and we don’t have oxygen. Pause. WELLS It might be best to let him go. JULIE stares at WELLS. WELLS Come on. WELLS and JULIE go to AMANDA. WELLS I’ll take over. Julie would you…? WELLS directs her to the ventilator, but JULIE won’t take over it. WELLS dismisses AMANDA and handles the ventilator. AMANDA Are you sure? I’m happy to- WELLS Yes I’m sure. Julie, come on. WELLS and JULIE wheel MARCUS out of the lobby. AMANDA starts doing the rounds checking on the other patients. SAM sits up and watches MARCUS go. ROBERTS enters the lobby with a handful of syringes. He goes from bed to bed. The first bed he goes to is the wailing patient. ROBERTS I’m gonna give you something to make you feel better. ROBERTS begins administering injections on the patients with ‘3’s on their gowns. The wailing stops. AMANDA Harry what are you doing? ROBERTS Don’t worry, this’ll help, this’ll help. AMANDA What are you-what is that? ROBERTS Morphine. AMANDA Morphine? ROBERTS I don’t need your help. AMANDA Harry. ROBERTS grabs AMANDA by the arm and drags her away from the patients, grinding his teeth. AMANDA Harry! ROBERTS What do you want? It’s 100 fucking degrees in here. You can smell the shit right? This is morphine. And I am going to help those people because this is fucking misery. Are you going to help me? AMANDA shakes her head in disbelief. ROBERTS No. Well, I’m sure you’re needed elsewhere. AMANDA wants to hit him, and it takes everything in her not to. AMANDA retreats upstairs. ROBERTS composes himself and walks towards SAM’s bed. ROBERTS Hello again Sam, how are you? SAM I’m good. Where have they taken Marcus? ROBERTS I’m not sure. Sam I have this here and it will help you feel better. SAM What is it? ROBERTS injects SAM with one of the many syringes. ROBERTS …morphine. SAM When’s the next rescue coming? ROBERTS It’s coming. SAM Okay. At this point I’d be happy just to go. Walk out the door or swim I should say. ROBERTS smiles a tired smile. SAM taps on the stapled note on his gown. The note reads ‘3’. SAM What do these mean again? ROBERTS It means in the current circumstance you’re the last round of patients to be rescued because your condition is either terminal or borders on terminal. SAM Right. I don’t remember it being put-being put that way. ROBERTS I’m sorry Sam, it’s what should-what we do. SAM So is two the second round of patients to go? ROBERTS Yes. SAM Okay. Julie marked me as a two. ROBERTS She did? SAM Yeah, then the other guy made me a three. ROBERTS goes to leave. SAM Could you make me a two? I was a two. I am a two. ROBERTS stops and turns back to SAM and takes the note off. And writes on his gown ‘1’. SAM Thanks man! There’s this bar on Roosevelt you’d love and when we’re out of here - I’m buying you a drink! ROBERT leaves. SAM falls back into bed, beaming. The lights from the windows fades away and lights from the doctors and nurses’ flashlights get brighter. RADIO …Only yesterday were the staff of Memorial Hospital flying out infants in incubators via helicopter two at a time. We can now confirm rescue efforts are being focused on Memorial Medical Center. Over 200 patients are awaiting transport having suffered a power outage Wednesday morning. I can see the helicopters flying over now. The lights from the flashlights go out one by one. WRITING TRIAGE PLOT SYNOPSIS When Hurricane Katrina hits Memorial Medical Center, hell breaks loose. The nurses and doctors run to protect patients but in the following days each of them are tested in more ways than one. An end of life doctor - Dr. Wells resents that he must stay during the storm even for the dying. Nurse Julie is forcing herself to help no matter what. Dr. Roberts is exhausting himself keeping everything afloat, and his wife, nurse Amanda see’s him become less and less concerned with the wellbeing of the patients. Slowly Dr. Wells tries to convince the staff that allowing the patients to die with dignity might be the best way to help. Julie becomes dronelike from tiredness and comes to the conclusion that Dr. Wells is right. Dr. Roberts wishes he could ignore Dr. Wells but eventually succumbs to this mindset and begins dosing patients with a lethal concoction. Amanda see’s Dr. Roberts do this and she can’t begin to understand and she can’t stop him but she won’t help him. The play ends with the staff being interviewed about their heroism during the hurricane and Amanda forces herself to admit the courage that her colleagues showed. STRUCTURE The story structure for Triage is framed as a five-act play that takes place over five days. The circumstance dictates the action as each act presents new challenges for the same characters which causes them to adapt. Specifically, day one the storm hits. Day two the floods hit and patients are triaged. Day three, the power goes out. Day four, patients are euthanised. Day five, everyone is rescued. For this story, I am interested in asking moral questions of the audience as Bertolt Brecht did; “Brecht wrote in the present tense because he wanted us to ask, moment by moment whether his characters could have behaved differently” (Edgar 2009: 31). And as this story is based on real events, I think those questions become more engaging. I also want to note the structure of the character arcs in the overall story, which is as follows: 1. Sam wants to leave the hospital but he can’t or he’ll die. He is then killed in the hospital. 2. Dr. Roberts wants to help his patients but he’s not sure he has it in him to help. He then helps his patient’s but he helps them die. 3. Julie wants to be the hardest working person in the hospital but she isn’t sure if she can meet the demands this emergency has asked of her. She then succumbs to her exhaustion and lets those who need her most, die. 4. Dr. Wells wants to let the dying die but his colleagues won’t allow it. 5. Amanda wants to support and care for her husband but her husband won’t allow himself any rest or support. In order to meet Aristotle’s rule of ‘Reversal of the Situation’ wherein “the action veers round to its opposite” (Aristotle 2015: 11) there are other characters in this piece who cannot meet such an ironic end. Dr. Wells and Amanda serve to force opposition on the other characters. I decided this with Aristotle’s reasoning that reversal of the situation is “subject always to our rule of probability or necessity” (Aristotle 2015: 11). So Dr. Wells and Amanda have the intention and obstacle the other characters have, but not the poetic reversal that Sam, Julie and Dr. Roberts have. DRAMATIC ACTION I tried to form my actions following the format David Edgar suggests in How Plays Work: “A dramatic action consists of a project, followed by a contradiction or reversal.” (Edgar 2009: 25). The actions for Triage were as follows: ACTION OF THE PLAY: These doctors and nurses are doing everything they can to keep their patients alive. But are any of them really living? ACTION OF THE SCENE: For the first time in her career, nurse Amanda refuses to assist a Doctor. Dr. Wells meets the call of an end of life Doctor. And nurse Julie and Dr. Roberts help their patients die. PROCESS The initial script, was motivated by dystopian triage. And to build on that scene, I started experimenting with other characters who could exist in this world. I wrote four different scenes: One: an emotional scene where nurse Julie told the dying patient Sam about a euthanasia she assisted. Two: a scene where Overseer Roberts meekly debated an intimidating Overseer Wells on the value for care of life versus ruthless operation. Three: a scene where Overseer Wells interrogates Sam. Four: a scene where Overseer Roberts dismisses Overseer Wells that reveals a ruthlessness Wells has instilled in all the characters in the play. I chose to pursue the interrogation scene as I thought the protagonist/antagonist relationship would be the most effective and at some point while working on the interrogation scene, I made Sam passive at the crisis point of the story. Which does not work for a protagonist who must pursue an objective in every scene (Edgar 2009: 48). And in this early draft of the scene, there was an interrogation sequence. But I was unsure if it was dramatically exciting. When I shared the scene before the formal reading, the feedback I received from my fellow students on the course was that they liked it and enjoyed the interrogation. So, I kept it but still unsure of it’s effectiveness. However, the feedback I got after the formal reading helped me course-correct. I was informed my world building and dialog was good, but my dramatic action was too open. In my opinion, the best feedback I got was during the actual reading for my scene. During the interrogation sequence, in the audience I heard someone yawn. I returned to the scene deciding I needed to make a strong choice to focus the scene and make it more exciting. I emulated the spirit of Caryl Churchill’s A Number and committed to the concept of a bleak sci-fi dystopia in all it’s absurdity (Churchill 2002). I decided I would make an effort to not influence the staging or line delivery and leave it to interpretation. I also used a technique I learned when I studied with the National Youth Theatre. It’s a common performance exercise called ‘view pointing’ and an aspect of it is you perform whatever comes to you and range it from 1 to 10. 1 being incredibly reduced and 10 being absurdly big. I felt initially I wrote the scene around a 1 to 5, so what would happen if I turned it all up to 10? I enjoyed the change and felt it captured the essence of my interest in bleak dystopia. But my feedback from my tutor was to commit to the story in the opposite direction and make it more conventional and real. Also consider the setting more and build a stronger sense of place. Which led me back to the impetus for the story, a Radiolab podcast titled Playing God. Where a reporter talks about her work as a Triage nurse at war, and a story about triage which occurred at Memorial Medical Center after Hurricane Katrina hit (Radiolab 2016). And so, the current state of the script is loyal to that story. Some of the characters lines are real quotes from the people who were in that hospital during those five days: SAM Ready to rock and roll WELLS It might be best to let him go. ROBERTS I’m gonna give you something to make you feel better. (Radiolab 2016) I attempted to write genuine characters with natural conflicts like those in Mike Bartlett’s Love, Love, Love (Bartlett 2010), but I kept struggling with how you take moral characters and drag them through a narrative that makes them do something immoral. To conclude, I think the scene still needs development. Personally, I would have preferred to write with a lot of research to work with. However, that wasn’t possible given the time and budgetary constraints. I believe the piece would have been more effective if it was as well researched as Arthur Miller’s The Crucible. It is evident Miller extensively researched Salem and has shown great care for dramatic action (Miller 2000). And in my opinion, I think the play would be more engaging if it was more absurd. I think there’s a lot of power in removing contextual detail and allowing the emotion of a piece to be the driving force of the play; similar to debbie tucker green’s active lack of stage direction or staging in random. As green’s devotion to performance in random gives the play a lot of emotional resonance (green 2008) it would not otherwise have if made more realistic. If I were to develop the scene further, I would attempt a draft that was less realistic and more absurd – not necessarily an absurd piece but in the middle of the spectrum between realism and absurdism. As in my adherence to realism I think I have made an error. An error which Phyllis Nagy notes in her essay Hold Your Nerve: Notes for a Young Playwright: “plays are not journalism.” (Nagy 1999: 125). Nagy suggests that you have to balance the want to write something intellectual and prescient with something emotionally curious and evocative. To achieve this, Nagy suggests that one must be bold enough to fail their attempt at playwriting in order to succeed at playwriting (Nagy 1999: 132). I could discover the realism makes this play effective after attempting such a rewrite, but what I think most is I need to risk failing a few more attempts at this play before it becomes something worth staging in a theatre and charging patrons to see. BIBLIOGRAPHY Aristotle (2015) Poetics. Tustin, CA: Xist Classics (Xist Classics). Available at: https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=nlebk&AN= 1096729&site=ehost-live&scope=site&custid=s1123049 (Accessed: 15 January 2019). Bartlett, Mike (2010 [1]) Love, Love, Love. London: Bloomsbury Publishing UK. Churchilll, Carly (2002) A Number. London: Nick Hern Books Ltd. Edgar, David (2009) How Plays Work. London: Nick Hern Books Ltd. green, debbie tucker (2008) random. London: Nick Hern Books Ltd. Kelly, Dennis (2009) Orphans. London: Oberon Books Ltd. Miller, Arthur (2000) The Crucible. London: Penguin Books Ltd. Nagy, Phyllis (1999) ‘Hold Your Nerve: Notes for a Young Playwright,’ in Edgar, David (ed.), State of Play. London: Faber and Faber Ltd, 121-132. Radiolab (2016) Playing God [Podcast]. August 22. Available at: https://www.wnycstudios.org/story/playing-god (Accessed 13 January 2019)