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When Christopher Stott-Rigsbee was attacked by assailants in November 2010, he got a concussion, bruised ribs, gravel embedded in his gums, cuts all over his face, and he lost three teeth. But the real pain came later. The lead singer and songwriter for the Plattsburgh, New York-based band Adrian Aardvark, Stott-Rigsbee started having panic attacks and anxiety; after four years, he finally began seeing a psychiatrist, who diagnosed him with PTSD and depression.

鈥淚t has taken years for me to start the recovery process, and I will be working to recover my self-worth, masculinity, and my faith in humanity and society for a long time,鈥� Stott-Rigsbee said. 鈥淚t鈥檚 become so important to write songs and finally begin to feel connected with other disconnected people who are trying to find their way through the maze of depression and anxiety.鈥�

The therapeutic benefits of creative expression aside, managing his health remains a challenge for Stott-Rigsbee. Like many working musicians, he does not have health insurance, and seeking medical treatment is 鈥渇inancially horrific,鈥� he said. He needed a second job so he could afford therapy. That鈥檚 one reason why this year, he and Adrian Aardvark played the O+ Festival in Kingston, New York.

O+ (鈥淥 Positive鈥�) was created in 2010 to address a systemic problem鈥攖he affordability of health care for people outside traditional employment structures鈥攚ith a quietly radical mission: Allow musicians and artists to exchange art and performance for health care services donated by doctors, dentists, and other providers.

During the 2018 annual festival, which took place Oct. 5-7 across multiple venues, Stott-Rigsbee was one of 173 musicians, artists, and festival volunteers, most of them locally based, who made a combined 465 clinic visits covering a wide array of services, including primary care, nursing, acupuncture, massage, homeopathy, mental health sessions, reflexology, videostroboscopy (testing for vocal cord abnormalities), and more. In addition, two dentists鈥� offices saw 70 patients for cleanings, fillings, and other work, and a third dentist donated 10 postfestival appointments.

There also were classes for yoga, meditation, dance, and sound healing. For any follow-ups, performers made appointments at places such as the Institute for Family Health, which offers sliding-scale treatment at locations throughout the Hudson Valley and New York City, or other affordable local providers for those coming from farther afield.

鈥淭his has a place in where our health care system is right now,鈥� said Dr. Mark Josefski, who helps run the pop-up clinic at the festival. 鈥淚t鈥檚 a small place, but it鈥檚 meaningful. Artists and musicians are a subset of the population who traditionally have a harder time accessing health and dental care because most of them do not work for large employers.鈥�

In 2018, Stott-Rigsbee got his first medical check-up in more than two years, and also had Reiki and massage sessions. Treya Lam, a multi-instrumentalist from Brooklyn, also got a massage, Reiki, and a general practitioner visit, plus she saw a dentist for the first time in 12 years. 鈥淭he health care exchange was paramount to my desire to be a part of the festival,鈥� she said. 鈥淚 personally have not sought out preventative medical care in over a decade.鈥�

Everyone sees a nurse, a doctor, and a stress-management professional upon check-in, and also can choose three more services, all free of charge.

The Duane Mark Trio traveled from Texas and North Carolina specifically to play in exchange for care they otherwise would struggle to afford. 鈥淭here are basic maintenance things you can鈥檛 keep up with when you鈥檙e uninsured,鈥� said Duane Mark, the group鈥檚 guitarist and vocalist. But there鈥檚 a double bind for a working musician, because 鈥渟urgery on something you鈥檝e delayed can put you out of work for weeks or months, and there鈥檚 no unemployment. We either save money, go in debt, or crowdfund.鈥�

Over O+鈥檚 nine-year run, its clinic planning committee has tweaked services (adding more massage sessions, for example) in response to feedback they鈥檝e received from participants. 鈥淥ne thing we learned is that people felt like they had to choose between a primary care visit or a mental health visit and a massage visit,鈥� said Cynthia Kim, the director of behavioral science at the Institute for Family Health and a member of the clinic committee.

Now, everyone sees a nurse, a doctor, and a stress-management professional upon check-in, and also can choose three more services, all free of charge. This year, Kim helped recruit six doctors from the institute to come to O+.

The clinic, which is run out of the Old Dutch Church in Kingston, is overseen by Shannon Light, a resident nurse who works in the ICU at a local hospital. Light has worked to expand O+鈥檚 impact year-round through a series of panel discussions, wellness forums, community dinners, CPR and Narcan training, and other events with local community leaders and residents.

O+ is a nonprofit and, until recently, everyone involved was a volunteer. It has grown enough that the team is now able to pay its seven members full-time or part-time salaries, but organizing and putting on the festival still relies heavily on grassroots efforts. 鈥淭he magic sauce is that we value each other equally,鈥� said Joe Concra, a painter and the co-founder and executive director of O+.

The festival apparatus has become a well-oiled machine in Kingston, where many of the same health care providers donate services each year. One of them is Tom Cingel, a dentist who helped start O+ by offering free teeth cleanings to entice a favorite bands from Brooklyn to come play in Kingston. Every year since then, his office is booked on the festival weekends, often with 25 new patients coming in to supplement the handful of returnees from previous years.

鈥淧eople are just so happy to get free care,鈥� Cingel said. 鈥淚t鈥檚 personally rewarding to see someone lose a bit of anxiety when you tell them good news or provide a reasonable solution that isn鈥檛 tens of thousands of dollars, and professionally you feel like you鈥檙e doing something with the skills you鈥檝e acquired.鈥�

鈥淚f we were to talk about revolution, in our mind we think it’ll be pitchforks, but in reality it’s more like: what can you bring to the table?鈥�

The larger goal of O+, alluded to in its slogan, 鈥淎pply Pressure and Elevate,鈥� is to create a better community by 鈥渃reating the space for something radical to happen,鈥� Concra said. 鈥淚 think of it as a boat. The bow of it is art and music for health care and wellness services, but what we leave in our wake is art, connectedness, doctors who now know patients, patients who know dentists, massage therapists who know bands, bands that know other bands and artists. 鈥� It does a lot more than I thought it could do. It really is about communities taking care of themselves.鈥�

O+ also has had a positive effect on Kingston, a postindustrial city that looks and feels radically different now from a decade ago. Multiple music venues have opened in the past few years to support the musicians who鈥檝e moved in, and 35 commissioned murals now adorn walls throughout the city.

The next step is to replicate that impact elsewhere. O+ has mounted one-off festivals in other cities before, but for 2019 they are formalizing the process with a standardized starter kit that details all of the production needs and an assessment tool for determining a city鈥檚 viability for hosting the festival.

Two other festivals are now planned for 2019 in Poughkeepsie, New York, and North Adams, Massachusetts. Poughkeepsie held a festival earlier in 2018, but North Adams was a new market, and will be a proving ground for O+鈥檚 ambition to expand sustainably.

North Adams was chosen for a number of reasons: The mayor was supportive, the local team was able to raise two-thirds of the funding early, and Berkshire Health Systems had agreed to send doctors and other health care providers. And, like Kingston, North Adams is a small city in an economically depressed region, but one with a number of creative people and strong local arts institutions, such as the Massachusetts Museum of Contemporary Art.

As the festival leaders and local teams planned the expansion one afternoon at the O+ headquarters in Kingston, a mood of optimism mixed with exhaustion prevailed, with the knowledge that there was a lot of work to do.

鈥淚f we were to talk about revolution, in our mind we think it鈥檒l be pitchforks, but in reality it鈥檚 more like: What can you bring to the table?鈥� co-founder Joe Concra said. 鈥淭hen one day you wake up, you realize your community鈥檚 healthier, there鈥檚 art on the walls,” and the town has venues.

鈥淲e鈥檙e not going to be, but I wish we were obsolete in five years. Or that there are numerous organizations like O+ that operate in different fields鈥攕ocial justice, bikeable cities, providing clean water鈥攅nough new, radical ideas that build small, local economies that make these pockets of places you want to be,鈥� he said.

鈥淵ou don鈥檛 take down Goliath with one stone. That鈥檚 really the deal. You want to just make things better,鈥� Concra said.

Support for this article was provided by RiseLocal, a project of the New America National Network.