The role of the returning prisoner in "Ghost in the Cottonwoods" should have been actor Shannon Parr's crowning moment. Walking across the small stage of the Chicago theater, Parr sensed the audience's undivided attention, their mounting excitement. Unfortunately, one jerky movement on his part, and before he knew it, Parr grazed his pupil on the spiky branch of a small artificial tree -- his character's homecoming gift. A seasoned actor, Parr stuck the scene out and finished the play that night, but the damage was done.

"I went home and drugged myself to sleep for three days," he says. It took him a year to recover full use of his left eye.

Actors, both on stage and in films, face the mental and physical stresses of performing: accidents, varying levels of voice strain, grueling stress, unrealistic demands on their private lives, and -- if they do attain fame -- the occasional stalker. National or international acclaim raises the ante: the specter of the pursuing paparazzi can never be far behind.

That's why professional actors have to grapple with the unglamorous side of a life on the stage, whether it's in a theater or on screen. Unfavorable movie or stage reviews, rejection by casting agents and directors, and the constant effort to keep in shape for auditions and screen tests can also erode self-confidence and contribute to a poor self-image. But unlike most of us, actors have to shed all this the moment they step in front of a camera or an audience.

Parr's accident was not unusual for actors. Maneuvering through hazardous sets and uncooperative props clad in unwieldy costumes and heavy makeup while concentrating on your lines is a skill as well as an art.

"In real life, you don't have to worry about keeping up the pace and telling a story," Parr says. "On stage, you're pacing and blocking. You're also staying connected with the story. You throw another element like stairs in there, and inevitably something will happen. Somebody's always falling and hitting their head."

Slips, trips, and falls happen all too easily on stage, concedes Mike McCann, founder and president of the New York Center for Safety in the Arts. Costume shoes can be slippery, especially when worn on angled stages. If an actor hasn't spent enough time rehearsing, she can easily be thrown off-balance. By taking the time to become acquainted with a given stage during rehearsal, (especially if the surface is sloped) you can avoid unnecessary spills. More slips and falls occur when the lights are out and actors have to move around near open trap doors, says McCann. Marking holes in the stage with fluorescent tape, he says, is an easy, foolproof solution.

Like professional sports, acting can be physically demanding, so sprains, strains and other musculoskeletal problems are rampant in the acting industry, says Dr. Alice Brandfonbrener, director and co-founder of the Medical Program for Performing Artists of the Rehabilitation Institute of Chicago. Over a four-year period, 30 percent of her patients -- mostly actors -- were diagnosed with low back pain, and muscle and joint problems, according to a study Brandfonbrener published in a recent issue of the Journal of Medical Problems of Performing Artists.

"Acting is a strenuous business," Brandfonbrener says. "People get a lot of pulled muscles and muscle tension and back problems." In one unusual example, a patient came to Brandfonbrener after fellow actors dropped him unintentionally. "We see actors who do things onstage they may not be trained for. And some people aren't in the best shape, or have the endurance and agility they need."

In addition, staged combat scenes can be a risky business. A fight coordinator usually choreographs most movements in actors' combat scenes, but a certain number of improvised punches, pushes, slaps, scrapes, and cuts are inevitable. "Even though most actors nowadays have combat classes and are taught how to do it," Brandfonbrener says, "accidents do happen."

And if directors aren't careful, in the process of creating a realistic setting, a freak accident can occur. In a famous 1993 case that shook the film industry, actor Brandon Lee was accidentally shot while filming The Crow, a movie about a murdered man who comes back from the dead. State safety and health officials determined that crew members broke safety laws by using live ammunition to create homemade blanks. A piece of one real bullet lodged in the gun, and when an actor later used the same weapon to fire blanks at Lee, it killed him. In another tragic case, actor Vic Morrow and two child actors, Renee Chen, 6, and Myca Dinh Le, 7, were killed on the set of a Twilight Zone episode staged in Vietnam when a helicopter crashed into them in a freak accident.

Actors generally undergo rigorous conditioning to prepare for a new role, but can become injured just saying their lines -- hundreds and hundreds of times. An actor can easily strain his voice from hours of rehearsals and performances. Some thespians must endure as many as eight consecutive shows a week. "We see performers who are using their voices in ways that they can't sustain, or they did something to suddenly increase the use -- like yelling -- without thinking about proper care or support of the voice," Brandfonbrener says. "They get hoarse or they can't talk." She suggests warming up vocal chords before each performance. A professional voice instructor can also provide instruction on how to change your voice level or pitch effectively for a role.

Exposure to artificial smoke and fog used for special effects can also irritate your throat and lungs, says McCann, with the New York Center for Safety in the Arts. Many stage actors complain of respiratory problems, including occupational asthma. Because of these complaints, the Actors’ Equity Association and the League of American Theaters and Producers sponsored a study in 2000 to examine the effects of smoke, haze, and pyrotechnics on actors. While researchers found no hard evidence linking these staged effects using smoke with serious health consequences, they suggest that they may cause increased respiratory, throat, and nasal irritation. The National Institute for Occupational Safety and Health recommends keeping the amount of smoke to a minimum, and using only fog fluids made from food-grade or high-grade glycols because they contain fewer toxic chemicals.

This advice didn't help Pamela Dale, who sings with the San Francisco Opera. While she had been exposed to theatrical fog for years without apparent harm, exposure to a combination of glycol fogs and fumes from propane torches during a dress rehersal in 1998 left her physically ill, according to the San Francisco Chronicle. She was later diagnosed with reactive airway disease, and worries now that her singing career may be over.

A 2000 survey of opera employees by the California Department of Health Services, in fact, found that 24 percent reported respiratory symptoms from exposure to theatrical smoke or fog. In response, the California Occupational Safety and Health Adminstration fined the San Francisco Opera Association $2,340 for workplace safety violations.

Elaborate costumes may look great on stage, but they can challenge the actor who has to get in and out of them quickly between scenes. Heavy period costumes can be stifling under hot lights; hairy animal costumes can become beastly when they have to be pulled on or off in a hurry. Even the most basic stage makeup can cause allergies. Buddy Epson, the actor originally slated for the role of The Tin Man in the film version of The Wizard of Oz suffered a severe reaction to the metallic silver paint used in his costume and had to bow out to actor Jack Haley. Actors have developed rashes from wig glue; others have gotten scratches from wearing too little clothing onstage, Brandfonbrener says.

If your throat becomes irritated or skin rashes erupt, you may be showing the first signs of an allergic reaction. It's best to see a doctor immediately before the symptoms become more severe.

Parr, the Chicago actor, says he recently donned his most memorable costume for a New York production, in which his character suffers from the nerve disorder sciatica and has trouble with his bowels. To simulate feces, an unsavory mixture of baby oil, chocolate pudding, and oatmeal was poured into a diaper and onto his bare skin backstage. "At one point I had to come on stage and change this filthy diaper," he says. He wiped himself off with wet towels -- all in front of a disgusted audience. "It was a gross out, but it's poignant to the character. It was sort of a moment when you understand what this character's going through."

After doing scenes like this, an after-work drink or two might seem an appealing way to get away from the job. Many actors relax after work with their favorite drink or a pack of cigarettes. But the obvious dangers of smoking aside, daily drinking can creep into problem drinking or even alcoholism, in people susceptible to the disease. "By and large, people in theater do not lead a hugely healthy lifestyle," Brandfonbrener says. "Actors are a pretty high-stress group. It's their long hours, their hard work, their intensity, and their personality." And until recently, cocaine and other drugs were a familiar part of film actors' landscape: Even if they weren't using them, drugs were as plentiful and available as candy. It's no wonder that the acting industry is rife with stories about famous stars struggling with their addictions.

Widespread substance abuse among actors is often associated with high stress, which is an inherent part of an actor's life. Unless you happen to belong to an acting dynasty, maintaining a professional acting career is uncertain. Landing a role depends on each audition and your health, and starting out, pay tends to be low. In fact, on average, actors who belong to the Screen Actors Guild and the American Federation of Television and Radio Actors earn less than $5,000 a year from acting.

Taking on a rough role can also be emotionally trying, Parr says. "I try to get personally involved in my role, " he says, and playing a killer or evil character unearths his own fears and insecurities. "Night after night that can take a toll on your life. Sometimes you dig up things you don't normally walk around with."

Brandfonbrener says these anxieties contribute to many actors' ill health. But many actors neglect to see a doctor regularly, often because they lack health benefits. According to a recent study from the National Endowment for the Arts, four out of five artists moonlight to earn money to cover basic expenses, leaving little to pay for medicine, counseling, or health insurance.

This is just what inspired Dr. Barry Kohn to set up free clinics for performers in New York and Los Angeles. Physician Volunteers for the Arts has pulled together grants from many organizations in order to provide a staff of 16 doctors to tend to performers' medical needs.

While not all actors have access to free clinics, there are plenty of things they can do on their own to ward off a visit to the doctor's office. Exercise and activities, such as yoga, can reduce stress and help keep actors in shape without breaking the bank. "Stress has a role in one's immunity to infection, or lack of it," Brandfonbrener says. "Stress also causes muscle tension and [so] has a role in increased incidence of injuries." She adds that actors should also look to each other for support, and seek professional counseling if things get tough.

Why, despite the many downsides, do actors like Parr claim they wouldn't want to do anything else? The physical and mental skills it takes to move an audience to tears and laughter is both the profound challenge and the reward of acting, he says.

"The ability to take this journey takes a lot of courage," Parr says. "So does having the ability to make people think and reflect on humanity."

-- Kristin Kloberdanz, M.A., a former associate editor for Consumer Health Interactive, is an editor at Book magazine in New York City.

Further Resources

Actors' Equity Association (AEA)

This association was founded in 1913 and is the American labor union representing actors and stage managers in the legitimate theatre. There are currently about 40,000 active Equity members. In addition to other services, Equity provides health insurance to its members.

http://www.actorsequity.org

Center for Safety in the Arts (CSA)

The Center for Safety in the Arts was founded in 1977 to gather and disseminate information about health hazards related to arts and crafts materials and facilities, including visual arts, performing arts, educational facilities, and museums.

212/385-2034

National Institute for Occupational Safety and Health (NIOSH)

Established in 1970 by the Occupational Safety and Health Act, NIOSH is a federal research agency that makes recommendations to help employers prevent job-related injuries and illnesses.

800/356-4674

http://www.cdc.gov/niosh

Occupational Safety and Health Administration (OSHA)

Part of the Department of Labor, OSHA develops and enforces safety and health regulations in the workplace.

800/321-6742

http://www.osha.gov

Performing Arts Medicine Association (PAMA)

An organization of physicians and other professionals dedicated to improving the health care and treatment of performing artists through education, research, and teaching.

http://www.artsmed.org

Screen Actors Guild (SAG)

Founded in 1927, this union offers many benefits, including health insurance, to its approximately 135,000 members.

323/954-1600

http://www.sag.com

References

First published September 27, 2000
Last updated March 17, 2008
Copyright © 2000 Consumer Health Interactive