Journal

By Reko Lundan

8.2.05
I’m writing a play with the working title Prioritisations. It takes place in a hospital environment and deals with what people perceive as being of primary importance – in their lives as well as in health-care. I’ve rewritten the first part once and got positive feedback from the Theatre Manager and the Composer (it’s a musical play); they used words like „inspiring“ and „impressive“. There are problems too, to be sure – the play contains too much suffering.
Prioritisation of costs within health-care, on one hand, and increasing demands on the other (medicalisation) is one of the severest problems of the welfare state in Finland, as in the other Nordic countries. I want to take on this difficult subject, and do so using artistic means. I’ve previously taken up social subjects and woven a fictional web around them, for example in my novel Rinnakkain (Side by Side), in which a group of neighbours protest because there is a plan to set up a home for alcoholics close to their residential area (the Nimby syndrome). The main characters in „Prioritisations“ are both doctors and patients, people who care and people who are being cared for – the roles are mixed, of course.
In Finland a law implementing a so-called ‘Guarantee of Care’ is coming into force this year, which involves defining a time-limit within which the patient must receive care. This adds a further load to the health-care sector, a sector that of course at the same time has to be made more effective. One of the characters in my play, Veli-Matti, a senior doctor, is one of the people involved in making these decisions. In the first act he has to put forward a suggestion that involves closing the hospital’s x-ray department. Veli-Matti has a religious conviction, and feels uncomfortable working in what he calls the „modern-day executioner’s service“. Veli-Matti’s decision is not made any easier by the fact that his ex-wife Mia works in the department that is threatened with closure, and she too is at a turning point in her life ...
In this way, I mix the current situation within health-care in Finland with fictional material. At the same time, I’m trying to pose two questions:
1. When we assign points to illnesses in order to establish a waiting list of patients, do we also assign points to the people and their life-styles? Is the determining factor in whether one receives care, the expectations of productivity that society has of its ailing citizen?
2. „Do I exist and, likewise, can I die?“ (Osip Mandelstam) What should one do with one’s life? Aim for one’s own profit and pleasure? Or to serve one’s nearest? And what to do when one is forced to make „painful cutbacks“?
A good example of the latter question is the 60-year-old businessman Kimble, who at the start of the play is running off with a young woman to spend a weekend in London. When Kimble comes to the hospital to visit his wife (who is in for a routine operation), he comes across the hysterical Mari, whose husband has been in a car-accident. Kimble never makes it to the London plane, but is forced to sacrifice his craving for pleasure in order to help a fellow-being in need. Later, Kimble experiences „a miracle“ and in the second act becomes a kind of benefactor.

16.2.05
I always create a work from outside its structure. I never plan the plot, in fact I can’t even describe the plot of my finished works. On the contrary, I accumulate scenes (or fragments of scenes), encounters between different people, lines.
It now looks as if the play is going to consist of three acts, with the first one taking up the first half. It takes place one afternoon and evening in November at the Central Hospital. The second and third acts take place the following summer during a weekend just before midsummer. We find ourselves at Kimble’s magnificent country estate, where people have assembled to set up a charitable foundation using Kimble’s money (and nearly everybody is wondering, a. Why have they of all people been invited to attend? (they were present when Kimble experienced the „miracle“); b. Why have they agreed to come? (curiosity, own profit ...) The third act is Chekhovian, and the others leave Kimble after a night that turned out to be quite different from what anyone had imagined.

19.2.05 (Helsinki-Vantaa Airport, on the way to Lapland with my daughter Lisa, aged 4)
My first idea was that in the first act Veli-Matti should decide which x-ray department should be closed, but today’s Helsingin Sanomat contained a report that the Ear and Throat Clinic for the Helsinki and Uusimaa province health district was to be moved to Helsinki, and the clinic in Espoo closed down. This gave me an idea for Veli-Matti’s dilemma. Should the Ear Clinic be moved to the first district or the second? His ex-wife, Mia, works in the first district, and she is positively blackmailing Veli-Matti to keep her own clinic open. I now have seven characters:
• Veli-Matti
• Mia, his ex-wife, who learns that she has breast cancer.
• Netta, Mia’s young colleague at the ear clinic, who is thinking of going to Africa as an aid-worker in an AIDS clinic.
• A hospital porter by the name of Petteri, who is both unrequitedly in love with Netta and a wannabe poet.
• Kimble, a libertine and businessman, around 65 years old.
• Jouni, who works for a major company streamlining and rationalising businesses and has been in a car accident; he is being operated on during the whole of the first act.
• Jouni’s wife Mari, who is hysterically waiting outside the hospital for information about the operation, and latches on to Kimble, whose share portfolio Mari looks after in her job.
(With a start, I hear an airport announcement that four-year-old Lisa is waiting for her father at Gate 20. I had got out my laptop computer for a while and hadn’t noticed that there were two doors to the play area ... We still make it to the plane though.)

22.02.05
I must make the tone of the play warmer. At first you always make the same beginner’s mistake, it’s all arguments, problems, suffering – because that’s what’s dramatic. But it’s through the contrasts, the changes of mood and rhythm that a play becomes a whole, as with life in general. The friendship between Kimble and Petteri in the second act gives the piece more warmth. Kimble has taken Petteri, who had tried to commit suicide, under his wing. I want to portray friends who have an age-difference of around thirty years.
The scene in the sauna in the early hours of the morning is beautiful: the old sybarite Kimble and the one-breasted, middle-aged woman Mia fall in love with each other. The morning that follows the night that has gone wrong in many ways (Jouni and Petteri have drunk themselves into a stupor and fallen asleep next to each other like a pair of small kittens) brings with it humour and a message that life goes on.
Prioritisation within health-care is not forgotten in the second act either. Veli-Matti sits on a committee assigning points to illnesses. Veli-Matti: „We’d save a huge amount of money if patients’ lives weren’t artificially lengthened by one last week, one last month, one last year ...“
The second and third acts also deal with sexuality and ageing bodies. Kimble has fought against growing old by picking up young girls with silicone breasts. Now he falls in love with Mia, who doubts her own femininity. Jouni wonders if he is man enough for Mari, because as a result of the car collision he now suffers from epilepsy, which amongst other things means that he is now forbidden to drive a car. Here too room is left for musings on what really is important in life. And finally, Petteri and Jouni sing a duet about the prioritisation of life-choices.
The structure is nearing completion, the lists of scenes in both acts are already well advanced. I must finish writing the first version and at the same time send the Composer the lyrics.

1.3.05
The law implementing the Guarantee of Care comes into force in Finland today. Health-care centres have to evaluate the need for care within three days, even for less urgent illnesses, and the patient must be given care within three months. Helsingin Sanomat: „All care cannot even be bought in Finland within the times laid out. For example, the waiting time for operations following a breast removal is measured in years.“ In the second act, Mia is in that very queue. And she is afraid of undressing in Kimble’s presence: „Am I a desirable woman?“ Someone says that at some swimming-baths they saw a woman who had had a breast removed and had a beautiful tattoo over the scar. Should Mia have had one of those done? Kimble says she is beautiful: „I have never seen more personal breasts, and I can honestly say I’ve seen thousands.“
Now I’m concentrating on directing King Lear. My own play will have to lie down and rest until I return to it in April. I have promised the Theatre Manager a first version before the end of May.

Reko Lundán is a writer

Translated by Roy Hodson