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‘Hospital’ Looks at the ‘Mystery’ of Our Health Care System

  • The show "Hospital," a collaboration between Los Angeles Poverty Department and Wunderbaum theaters, is to be performed Jan. 17-18, 2014, at Dartmouth College's Moore Theater. (Courtesy photograph)

    The show "Hospital," a collaboration between Los Angeles Poverty Department and Wunderbaum theaters, is to be performed Jan. 17-18, 2014, at Dartmouth College's Moore Theater. (Courtesy photograph)

  • The show "Hospital," a collaboration between Los Angeles Poverty Department and Wunderbaum theaters, is to be performed Jan. 17-18, 2014, at Dartmouth College's Moore Theater. (Courtesy photograph)

    The show "Hospital," a collaboration between Los Angeles Poverty Department and Wunderbaum theaters, is to be performed Jan. 17-18, 2014, at Dartmouth College's Moore Theater. (Courtesy photograph)

  • The show "Hospital," a collaboration between Los Angeles Poverty Department and Wunderbaum theaters, is to be performed Jan. 17-18, 2014, at Dartmouth College's Moore Theater. (Courtesy photograph)
  • The show "Hospital," a collaboration between Los Angeles Poverty Department and Wunderbaum theaters, is to be performed Jan. 17-18, 2014, at Dartmouth College's Moore Theater. (Courtesy photograph)

Skid Row in downtown Los Angeles takes up 50 square blocks of real estate, with a population of some 8,000 who live in low-income housing or hotels, and 4,000 who are transient. It’s the single largest concentration of homeless people in the country, just blocks from the city’s high-rise business district with its familiar, gleaming skyline.

Within Skid Row there are missions, housing and services that provide for the homeless, many of whom have addictions to drugs and alcohol, a mental or physical illness, or, often, a combination of some or all of the above.

In 1985 the LAPD set up shop on Skid Row to work with the transient population, but in this case LAPD doesn’t mean the Los Angeles Police Department, but the Los Angeles Poverty Department, a theater group that has given a face and voice to people who are often lumped into the category of better-not-seen and better-not-heard. The people who live and work on Skid Row also happen to be LAPD’s actors and writers.

Given the checkered reputation, until the last 10 years, of the Los Angeles Police Department, the name of the group was intended to be ironic, said its founder John Malpede. It was either that, or, as someone else suggested, Attack of the Killer Tomatoes, the name of the cult D-movie. LAPD stuck.

In the past the LAPD has performed works about the high level of incarceration in the U.S., how the recovery community in Skid Row encourages addicts to seek treatment and the meaning of Utopia and Dystopia as viewed against the history of urban policy in the U.S.

LAPD will give two performances of its most recent project Hospital, created in collaboration with the Dutch theater collective Wunderbaum, at 8 p.m. next Friday and Saturday, Jan. 17 and Jan. 18, in the Moore Theater at Dartmouth’s Hopkins Center.

There will also be a panel discussion at Dartmouth College on the issue of health care access at 4:30 p.m. on Tuesday in Rockefeller 003. On Wednesday, members of the troupe will attend a Listen Community Dinner in White River Junction to perform a 10-minute segment from the show, as well as talk to diners about their experiences with the health care system.

Given the popularity of medical dramas on television, said Malpede, interviewed by phone from Los Angeles, Hospital began as a riff on some of their standard cliches, “but as it evolved it was more about experiences with the medical system.”

Although patients, doctors and politicians disagree on how best to improve an unwieldy, convoluted and expensive system, said Malpede, in his experience talking to people, “I think pretty much everybody is interested in the mystery of it all.”

While researching the issue, Malpede and LAPD associate director and producer Henriette Brouwers spent time last summer in the Upper Valley speaking to doctors at Dartmouth-Hitchcock Medical Center and community service providers at The Haven and the Good Neighbor Health Clinic.

Why the health care system became as unmanageable and unsustainable as it did is one of the questions Hospital attempts to unravel, and one of the characters in it is loosely based on Malpede himself.

“As someone who’s been an artist and self-employed a lot of time, I’ve ... hit most of the pot holes in the road that we’ve managed to have over the last 40 or 50 years. I managed to be a kind of Everyman,” he said.

After dealing with what he calls “major medical stuff” that wasn’t life-threatening but which still managed to cost far more than he could afford, even with health insurance, Malpede had to “contest the willingness of the insurance company to pay.

“As it turned out I was able to find the numerous mistakes they’d made and get out of the whole thing, but most people aren’t able to do that,” he said. So what do people with low to no incomes do when confronted with medical issues?

“One of the things we really know about people in poverty is that they’re confronted with the social determinants of health,” said Sara Kobylenski, executive director of The Haven in White River Junction. She ticks off such culprits as lead paint, mold and heating systems that are not clean or have pollutants that affect the lungs.

There is also a higher rate of smoking among people in poverty, and nutrition is a chronic challenge, Kobylenski said. “It’s well documented in the health literature that more money needs to be spent on health conditions caused by these social conditions.” And access to health care, she said, doesn’t depend only on whether someone has insurance, but on such intangibles as time, coordination, transportation and follow-through.

What a theater piece like Hospital does, Kobylenski said, is to hold up a mirror to society.

Since Hospital’s premiere last September in Los Angeles, it’s been met with nods of recognition from audiences, Malpede said. “It’s touched a lot of people because it resonates so much out of experiences people have had.”

After its engagement at the Hopkins Center, Hospital will travel to the Fusebox Festival in Austin, Texas. And LAPD itself is the subject of a gallery retrospective at the Queens Museum in New York, which runs until May 11 this year.

Malpede regards this as all in a day’s work. LAPD’s first obligation, he said, is “to create community on Skid Row.” Its second task is to “get the perspective of people living on Skid Row and get that out to a broader segment of society, so if people do listen we can inform the public debate in that way.”

For more information on “Hospital,” call the Hopkins Center Box Office at 603-646-2422 or go to hop.dartmouth.edu/Online. For information on LAPD, go to www.lapovertydept.org.

Nicola Smith can be reached at nsmith@vnews.com