The neurologist choreographing joy

In 2022, 13 adults with multiple sclerosis (MS) logged onto Zoom for a modern dance class at Penn Medicine. Meeting virtually due to COVID, the participants focused on their breath to settle into their bodies and imagined themselves moving through water as they pushed their arms forward. They learned short “phrases” of movements that evolved into a longer piece of choreography.

Every movement could be performed from a seated position, as MS touched the dancers in different ways: mobility, balance, strength, vision.

Even though the class was part of a research study, the point wasn’t improving symptoms or physical functions. Alex Pfister, MD, a neurology resident at the time and also a modern dancer, wanted the group to experience a real dance class, not a “medicalized version of dance, focused on some endpoint of medical improvement.”

The dancers were moving their bodies, expressing themselves, and finding joy in new ways. One person said she felt “somewhat free of MS” while she was dancing. Another said dancing gave her some trust in her body.

Pfister, now a neurohospitalist at the Hospital of the University of Pennsylvania, witnessed firsthand how, for people with neurologic conditions, an adaptive dance class could offer benefits that medical care or exercise could not. Over time, she would discover a larger community of artists and clinicians working separately toward similar goals. What she had explored in one dance class would become part of a movement to connect the neurology, arts, and patient communities.

Creativity has been a source of comfort for Pfister since she was a young child. She learned to knit and sew before she could read.

In college, she fell in love with modern dance as well as taiko, the Japanese tradition of performance drumming. Using her body as a tool for art—and understanding the alignment and anatomy that made that possible—intrigued her.

At the same time, Pfister was drawn to biology and neuroscience. Looking back, both passions were rooted in her fascination with how the body worked.

After graduating with degrees in modern dance and biology, Pfister continued to explore both, unsure how, or whether her interests might fit together. She trained and performed with taiko groups in Hawaii and New York and danced with the Sokolow Theater Dance Ensemble while working at the American Museum of Natural History cataloging bees and insects.

While in New York, Pfister discovered the nonprofit Dance for Parkinson’s, which offers research-backed dance classes for people with Parkinson's disease around the world. The program tapped into the things Pfister loved about dance—movement, creative expression, community, and an understanding of the body—in service of people living with a neurologic condition.

As she began medical school, the concept stayed with her.

In 2019, Pfister moved to Philadelphia for her neurology residency at Penn, while she and her husband started Casual Fifth, a taiko and dance ensemble in South Philly.

In her third year of residency, Pfister found a chance to bring her two interests together. Inspired by programs like Dance for Parkinson's and a growing body of research suggesting dance can benefit people with neurologic conditions, she designed a virtual class for people with multiple sclerosis.

The class, which is now called MS DanceMovement, proved safe, feasible, and enjoyable—and participants reported improvements in mood and pain.

When Pfister presented the results to the Neurology faculty, she caught the attention of Rebecca Ichord, MD, then a pediatric neurologist at Children’s Hospital of Philadelphia, who shared Pfister’s interest in adaptive arts programs for people with neurologic conditions.

Outside of medicine, Ichord was helping lead the Tango Therapy Project, an adapted tango program for people with Parkinson’s. She recruited Pfister to help develop a training program for the tango dance teachers and volunteer partners. Partners hold the dancers’ forearms in an adapted embrace that provides more stability and incorporate other small modifications to make the dance more accessible, like replacing a pivot or turn with a series of tiny steps.

The tango program, which has expanded to serve people affected by other motor challenges and neurological conditions, reinforced Pfister’s belief that adaptive arts programs are strongest when artists and medical professionals work closely.

“You need to have this interdisciplinary team—people who have both really wonderful dance and creative movement expertise, and also people who have medical expertise—and fuse those things together,” Pfister said, “so that you're designing classes that are accessible but also getting at the meat of what the art is.”

Ichord saw the same combination in Pfister herself.

“I've met many very talented clinicians who are also very talented artists. But very few had the opportunity to bring those interests together for the benefit of patients,” Ichord said. “She is one of those people.”

“The arts are one of the ways humans have always explored understanding themselves,” Pfister said. “People living with neurologic conditions are often seeking that, and people who work with those conditions recognize that the arts offer something beyond standard medical treatment. The two approaches can make people’s lives much fuller.”

Pfister also created the Philly NeuroArts Network, an online hub for adaptive arts programs. In particular, she wanted to help neurologists and other clinicians—not only at Penn Medicine, but across the city—to access arts resources for their patients.

“Alex is embodying this broadened perspective of what it means to bring these two things together—to make the arts part of health care and well-being,” said Carolyn Merritt, the co-director of the Tango Therapy Project. “What is the point of living longer if not to have the best quality of life while you’re still here? And the arts can help you find that.”

For Pfister, the work goes beyond creating adaptive arts programs or events. It’s challenging the notion that medicine and the arts belong in separate worlds. As a neurologist, dancer, and drummer, she has never seen the divisions that others do.

“We’re often taught that these things are separate. The systems don’t really support bringing them together in a straightforward way,” Pfister said. “Part of why I’ve kept doing this is to encourage other people who might have a similar interest to see that there is an option to try this.”