We were sitting in the Dacha, a whimsical Russian-inspired cedar building, participating in a healthcare design workshop. When it became time to share our projects, we, Melanie and Mollie, simultaneously revealed papers bisected into regions of “theory” and “practice.” This was the beginning of our “soul sisterhood,” which has been a mess of ideas, organizing, and true, deep friendship within the community of the Gesundheit! Institute.
We are best friends and organizers—Melanie is both a philosopher and teacher, and Mollie is a cook and medical student. As young, zany intellectuals and communitarians, we find ourselves experimenting with age-old community questions like: “How do we make sure all voices are heard?” “How do we quickly facilitate temporary community?” “How do we maintain the whimsy in long-term communities?”
The Gesundheit! Institute is a project seeking to reclaim the idea of what hospitals and healthcare are. The project began as a group of activist doctors who opened a clinic in their home, experimenting with the coalescence of communal living and radical medicine. After 10 years, the group realized that they needed a larger site to address the need they saw in the community.
That larger site is the place we now hold educational programs on topics ranging from humanism to designing healthcare systems. As a process-oriented project, we have realized that, in order to be a model for ideal care, we also have to educate care providers toward constructing their own radical healthcare practices. We currently lack the funding necessary to support the project of providing clinical care, so we have chosen to focus our energies on this educational component of the mission.
We host seven annual education programs on 320 picturesque acres in West Virginia boasting a waterfall, a lake, and innovative, intellectually designed architecture. Like many of the concepts we teach, community is something that we are teaching and learning simultaneously. We experience the unique phenomena of “temporary communities” with long-term staff and community members facilitating oscillating groups of educational participants.
Community concerns such as quiet and loud, dirty and clean, inclusion and exclusion arise in temporary communities just as they do with more traditional forms. We utilize meta-conversation sessions (or, conversation about conversation) as a “living laboratory” to reflect upon and experiment with group dynamics.
Meta-conversation is a tool to explore the ways we are designing community while living in it. The traditional format of meta-conversation is a daily one-hour group session with participants seated in a circle on the floor. One teacher “passively” facilitates (very little prompting, more focused on making sure people are being heard) and the group begins with a social sweep (eye contact with each participant around the circle) and ends with a communal “hum.”
The problem with this structure, however, is that we are often confronted with groups stuck in silence or meaningless, surface-level commentary. During a recent educational program for medical students on “constructing humanism,” we ran into just this problem—in the Dacha, in a room full of emotional, broiling people sitting silently and politely in a circle. As young, excited, brainy, and frankly, weird, facilitators, we had the opportunity to experiment with the way we structured meta-conversation to solve this often-present community issue.
First, we rotated facilitation duties. By Melanie, the primary teacher, stepping down, and Mollie, whose primary role was cooking, stepping up to facilitate, we disrupted some traditional hierarchies of community conversations. Now that Melanie was able to function as a “normal” group member, she had the ability to perturb the system, to stir the pot, by bringing up hot topics in a way that might have compromised her objectivity as a facilitator. She, for example, delivered a beautiful, highly dramatized “complaint” about couples forming and disrupting the community—which spurred one of the most emotional and productive conversations of the month.
After switching facilitators, we introduced an extended metaphor connecting issues of group dynamic to ripening fruit. Some issues, or fruit, are just budding and might not be ready to be “picked” or discussed by the group quite yet. Some others, however, are overripe and beginning to stink—needing badly to be discussed.
Passing around notecards, we invited participants to take five minutes of silence to articulate a “fruit” or an aspect of group dynamic that needed to be discussed. Notecards were then to be passed to Mollie anonymously and sorted into piles of “unripe” and “ripe.”
Mollie then reformulated the “fruit” into yes or no questions to pose to the group in a “general feelings” style recognizable from most consensus processes. By answering these questions with hand signals, group members were able to tap into their own opinions and see the climate of the entire group. Conversation easily flowed once topics were introduced in this way.
A particularly interesting moment arose when five group members answered negatively to the question “Do you always feel safe here?” Again, we took the chance to change the format of the conversation, suggesting that these people start a separate conversation outside on the Dacha porch, to discuss the ways in which we had been made to feel unsafe. This group, which incidentally included both of us staff members, morphed into a kind of solidarity group and spurred a social experiment that addressed our concerns about alcohol and consent, using one of our favorite social change tools, whimsy. We formulated an experiment dictating that when community members were consuming alcohol, they had to wear gloves and were forbidden to make physical contact with anyone. This experiment did not solve but certainly helped us begin to address the concerns of the solidarity group.
Moving forward from this particular educational program, we continue to open up experimental spaces at Gesundheit!, and look forward to more methods of quickly building intimacy and trust in temporary communities. Just the other day on our post-lunch “constitutional” stroll, we found ourselves in a discussion of the most satisfyingly deep and challenging conversations we’ve had—discovering that they all occurred either lying in bed or on a walk. We simply can’t wait to apply those formats to our next meta-conversation…perhaps at bedtime?
Melanie Meltzer is a radical theorist, teacher, and organizer. Her first experience of communal living was at circus and performing arts camp with the Hog Farm Commune. She is the Education Director of the Gesundheit! Institute (patchadams.org) and a Project Coordinator at the School for Designing a Society.
Mollie Nisen is a medical student and intermittent kitchen coordinator at the Gesundheit! Institute. She is a “graduate” of the Oberlin Student Cooperative Organization and plans to practice medicine in a cooperative structure in the future.