Bain Butcher, a conceptual figurative artist and physician who has a co-appointment at the University of Cincinnati School of Art and College of Medicine, spoke with UF Center for Arts in Medicine’s Operations Manager Kimberlee Campbell-Smith after the Creating Healthy Communities: Arts + Public Health in America convening in Cincinnati, Ohio. The convening was hosted by the University of Cincinnati at the Health Collaborative where public health through placemaking, wellbeing and creative environments was the focus throughout the day.

Q.   What was the issue at the heart of your provocation?

A.  I spoke primarily about improvisation, playing off that idea as a keyword. Often when you're working in transdisciplinary groups or arts integrated research projects involving collaboration, or when working in innovative spaces characterized by uncertainty --- improvisation becomes an essential ingredient for success. I also spoke a bit about improvisation as an idea for developing a group mind especially in the sense of helping a group of collaborators to have common thematic purpose.

I quoted comedian Maya Rudolph. What she said in this quote is, "In improvisation there is one hard and fast rule, and that rule is known as "Yes And." To say yes and not just to say yes, but to add information. In the adding of information you don't negate the other person's idea, but you build on it".   You have to have the flexibility and adaptability to take what artists contribute to a process and then build on it, but keep everything moving in the direction of a theme.

Improvisation is key in painting as well, you make a mark in painting and you make it with intention. You make it in the context of a larger idea but you don't always know exactly what it is going to look like until you've made the mark. Now you are in a conversation with the work -- a sequence of assertion and negation.  It means now you have to make all these dynamic moment by moment decisions.   This is also characteristic of patient interactions.  Being both a physician and artist, I notice the importance of structured improvisation in everything I do.  I also think it's a really important quality to cultivate especially for arts integrated research. It is something that the arts can really contribute to STEM disciplines in terms of learning how to build dynamic, iterative, and improvisational thinking into research processes. 

Q.   What question or challenge did you pose to the group?

A.   Since all of us at the convening were working in our own way trying to push the edge of how to integrate arts methods into a wide range of well-being and health-related goals, the question that I posed the group is, how do we maintain thematic purpose and allow for the greatest range of individual and group improvisation? 

Another way to say it would be that in an improvisational creative environment, how can the original intents be reframed along the way without ever losing the center? or without losing the main reason for the project in the first place?

Improvisation can kind of spin things out of control as well. How you harness all that energy but direct it purposefully is key, because if you can do both of those things (maintain structure and improvise in real time) then you can have a really great outcome and a high degree of efficiency. If one or the other impulse (too much rigidity or too much improvisation) overcomes the process then it can fly apart. I think that from the leadership standpoint learning how to facilitate that mindset and encourage it without losing direction is critical.

Q.   Why is it important to understand improvisation at this time?

A.   When it comes to these kinds of projects in large organizations, we're living in an era of rapidly increasing automation and greater emphasis on optimization, economic efficiency and return on investment. Creative activities and human processes, which are naturally improvisational, are not often valued based on their economic returns, because human processes can be inefficient in the short-term.

What I think is important to keep in mind is that over a longer period of time, allowing human improvisational and adaptive qualities to work their way into processes usually ends up yielding better long-term outcomes. It's just that we live in an era of short-term gratification and discussions about economic optimization on a quarter by quarter basis rather than a year by year or decade by decade basis.

When we think about sustainability and we think about solutions to large-scale problems, ones that could really benefit a wide range of stakeholders, then improvisation and adaptibility become critical. A human approach to things that provides room for improvisation in individual creativity really yields a more sustainable longer term outcome and ultimately saves money.

Q.   If you are to offer a call to action, what would it be? To whom?

A.   I can think of lots of calls to action, but one would really be directed towards the artists and the researchers to encourage them to have confidence to build creative processes into their protocols and budgets and to plan the necessary room for these improvisational processes and not to shy away from it. In other words, to lead by example and also be an advocate for the important contributions that arts integration offers.  So that when researchers are planning and talking with the administrators, policymakers or leaders about the outcomes of their projects being upfront about that room for error and that room for choice making and creativity is key.

Through this discourse, the administrators and policymakers can begin to understand how arts integration works. Unless they're already accustomed to it in which case, it's not as difficult to advocate for it. I think as the arts integration processes mature and more fields begin to use approaches like design thinking and other varieties of different creative tools to inform their research, it's very important for the researchers and the artists involved to be able to articulate the importance of the creative parts of the process.