Wednesday, February 07, 2007

Death Be Not Proud

I watched Wit tonight, the HBO movie adaptation of the Pulitzer Prize winning play by Margaret Edson. For a long time I have wanted to hear Emma Thompson recite John Donne on her death bed. But I had heard the film was intense and bleak and disturbing, and that I shouldn't watch it while I was still vulnerable, still in treatment, especially while my prognosis was still up in the air.

But tonight, after spending my first full day of reveling in my official Postponement of the Inevitable, I felt strong and it seemed like the timing might be ok. Still, I knew it was going to be rough.

And it was. Very rough. Scene after scene was shockingly realistic, more than any cancer movie I've seen. This film captured the pain, the fear, the indignity, the dehumanization, with a brutally stark beauty that was breathtaking. The unflinching camera doesn't miss a single grim detail as Emma Thompson slowly disintegrates from stage IV ovarian cancer. "There is no stage V," she tells us wryly.

I did ok until a scene near the end. It's the middle of the night and she's lying alone in her hospital bed, bald and emaciated, aware that the treatment hasn't worked and the cancer is spreading. She can't sleep so she pinches the tubing from her IV, causing the pump to beep an alarm and summon a nurse. The kind perceptive nurse quickly understands that the tubing isn't actually occluded, that the patient was lonely and afraid, and she ends up pulling up a chair and sitting beside the bed in the dark. They share a popsicle and talk about Thompson's impending death, matter of factly discussing whether she wants to be a full code or a DNR.

And you know, it wasn't the death talk that upset me, oddly enough. What set me off was that distinct three-toned beep, the boo-BEE-boop that sounded when she pinched the tubing. It was the exact same beep my own IV pumps made during my chemo sessions if something went wrong, whenever my blood pressure dropped too low or the pump needed to be reset. It was that quick familiar little sound that brought it all back, triggering a full-blown anxiety attack.

My reaction was immediate, visceral, Pavlovian. It was an instant flashback I guess, or maybe more like a flash flood of sensations. Suddenly I felt like I was about to be knocked down by waves of intense nausea. I was sweating yet shivering with icy cold chills, dizzy and disoriented, struggling against the dreaded inner darkness that rose up from my gut and tried to pull me under. God, it was awful, the way that one little beeping sound from my tv screen had the power to trigger Hell all over again.

I don't think I've blogged much about what it was like during the chemo sessions. It's an odd little irony that although the rest of Our Lady of the Damned is a disgraceful dump, the chemo ward is a five-star luxury hotel. Instead of sitting in the typical ugly brown naugahyde reclining chair in a crowded infusion room, outpatients receiving chemo at Damned General are each assigned a private room for the day, with a one on one nurse. They have a window with a view, their own tv, a fancy adjustable hospital bed with crisp white sheets, and best of all, a private bathroom just a few easy steps from the bed. The down side of this is that, deprived of the camaraderie of other cancer patients, the experience can feel almost unbearably isolated and lonely.

One of my chemo drugs, Rituxan, had to be dripped slowly, and the process took about five hours. Then a nurse would come in and push three other drugs through my chemo port, which took another 45 minutes. That's a long boring miserable day, no fun for anybody. And each chemo session was progressively harder on me, physically and emotionally, than the last.

I remember lying on the bed, gagging but fighting with all my will to swallow the rising nausea. I would be cold, horribly cold, but I couldn't wear a sweater because of the blood pressure cuff. They gave me a major hit of Benadryl to ward off allergic reactions to the chemo, and once that kicked in the room would be spinning, my brain blurry and my speech slurred, with an awful metallic taste burning in my mouth. It was so horrible, so miserable, so scary, so lonely, and yet I was so determined not to break down and cry.

I remember the deep vortex of dread I always felt when the nurse came in my room to "access" me: that's what they call it when he jabs the big Huber needle through the septum of the port that's implanted in my chest. It hurts like hell, but only for a minute. I was usually assigned a chemo nurse named Mike, a friendly knowledgeable talkative guy. I liked him, but for some reason it never seemed to be me he wanted to talk to. He would stand by the bed as he worked on my drips, ignoring me and happily chatting with the designated driver.

They would engage in long talks about football, or about their jobs, or about water skiing and favorite spots to go boating. Their conversations excluded me. I would lie there on the bed, silent and sick and totally irrelevant. They often got so caught up in their football talk they wouldn't even notice if my teeth chattered or if tears ran down my face. If I asked for a blanket or an emesis basin, the nurse would hand me what I needed without missing a word of their conversation.

I would try not to interrupt unless it was absolutely necessary though, because I didn't want to be an annoying demanding prima donna cancer patient from hell who always needed to be the center of attention. Does that sound stupid? Maybe it's hard to understand unless you're the one lying on that bed with the tube going into your chest. I was so helpless, I was so so totally dependent on them, especially the driver. And he already had so much anger and hostility about the whole experience, I felt like I couldn't afford to alienate him further by asking for more.

So I would lie there quietly trying not to bother them while they talked and laughed and did their Monday morning quarterback male bonding thing. I was so quiet I think sometimes they actually forgot that I was there, and it might have been a relief for them to forget about me, in a way. It's got to be hard to stand around watching so much abject misery without desperately needing to take a break. Hell, I would have taken a break from myself too, if I could have. Whenever Mike left the room, the driver would turn towards the window and read his book, and as long as I didn't sniffle the only sound in the room would be the pump chugging away on the IV.

But you know, this is all part of something so common, so ubiquitous, a phenomenon that was portrayed with understated but excruciating brilliance in Wit: the dehumanization and objectification of the cancer patient. You watch in horror as Emma Thompson goes from being the famous dignified English professor to a helpless passive lump of diseased flesh that gets poked and prodded, examined and treated, talked about but seldom spoken to. "I'm nothing but a specimen jar to them," she says at one point. And she tries desperately to hang on to her humanity, her dignity, her selfhood, but strong as she is, slowly they slip away.

I'll tell you the truth: I hated lying on that hospital bed more than anything on earth. I loathed being an invisible object. I hated the sickness too, and the fear, the nausea, the pain, the cold, all of it, I hated every fucking second if it. But mostly I hated the deep incurable loneliness of being the silent thing on the bed that nobody wanted to talk to. Sometimes I've hated myself for letting it happen, but this movie reminds me that it can happen to anyone.

"Ms. Thompson has known many cancer victims," according to the New York Times review, "including, in a cruel twist, a friend who died of ovarian cancer as "Wit" was being filmed. And she said she can understand Vivian's strong inclination to die alone, without help — even if much of her intellectually rigorous solitude seems to fall away by the end of the film."

As much as I hated the loneliness, I can understand this strong inclination too. Because in the end, that aloneness is really all you have, it's the one thing they can't take away and it's all yours.

(Jeanne has been reviewing cancer movies over at The Assertive Cancer Patient. Check it out!)


Blogger Bonnie said...

I see you. I hear you.

Thank you for making that possible.


Bonnie in Houston

11:00 PM  
Blogger Meredith Jones said...

I admire the way you tackle these emotions so directly. Reading your last few posts I wondered when, and if, the post-treatment crash would come for you. I've written a little about it at -
and I'm still struggling, but it is slowly improving.

11:34 PM  
Blogger Ya Looblue said...

i had a friend that couldn't eat that sweet and sour sauce from chinese restraunts because it had the same color as one of her chemo drugs.
emma thomson is awesome. i've seen Wit on stage before...but i haven't seen her movie version.

11:37 PM  
Blogger Sassy Pants said...

That movie is absolutely amazing. The part that makes me tear up even thinking about it is when her mentor reads to her. *Sniff*

I think it should be required viewing for all med students.

9:06 AM  
Blogger Mrs Pretzel said...

Wow. That's all I can say. Wow. Thank you. Somehow, I feel like I understand.


11:20 AM  
Anonymous Anonymous said...

Yeah, it's interesting that you mention that you felt isolated with that set-up. Sounds like a dream to me -- you know, in context.

My oncologist's office is set up so that nearly everything except consultation happens in front of other people. Many of his patients are elderly. All of us live in New England, where privacy is king. It is very disturbing not to have a choice, for the default to be to experience all of this, starting with weighing and blood tests, completely publicly. It kind of enraged me the first time I went there, and the second, and the third...and finally I told them about it, and they looked at me like I'd grown a second head.

Wit is a creepy movie, but a great one. It's nice to see cancer and the experience of being a patient portrayed realistically, as opposed to, say, Bette Davis in Dark Victory or pretty Debra Winger in Terms of Endearment where I seem to remember her terminal state was indicated by a little paleness and some writhing. People need to know that it's not pretty and also that the patient is not a specimen, a lump in the bed.

9:05 AM  
Blogger Carny Asada said...

I saw my oncologist Monday for a follow-up. He said the word "adriamycin" and I had a wave of nausea and despair.

So, yeah. I feel you.

12:55 PM  
Blogger The Fog is Finally Lifting.. said...

Dare one ask? Is Mr. DD still around? The idea of him talking over you as if you didn't exist is heart-wrenching... how do you accept that as the norm?

Back in 2000, my best friend from 1st grade on died of lymphoma of the spine. I visited her 1 or 2 or even 3 times a week for 8 months. Granted, I was not allowed to be with her during her chemo, but I was there for her, not for me or anything else. Maybe it is a guy thing that he couldn't be there just for you.

Oh, Liz, you are **special** I hope we can all make you believe that you are!

Your courage and humor, your sheer zest for life, your feistiness and your love of beauty and nature make you a person of great personal magnetism. I know you will find a place where you will surround yourself with color, beauty and warmth. People will always be drawn to you.

I am sending you good wishes and hoping that you continue to be Unremarkable!

4:13 AM  
Blogger Lymphopo said...

Thank you, wandering. Thank you.

11:10 AM  
Blogger Miss Melanoma said...

When her mentor comes into the room and reads that damn kids book to her, I actually started sobbing, to the point of the crying hiccups. Thank GOD I decided to watch it at 4 a.m. and was alone! And the scene with the bee-Boo-beep? Get this- I broke out in hives.

So, I feel you, sister.
Love the blog. Love the review. Love you! Will you marry me?

3:15 AM  
Blogger betsyl said...

my dad was in a coma for a few weeks (is now fine, all is well) and when his monitors went off, they made the same noise as the french fry timer at mcdonalds. it was *months* before i could go to mcdonalds without jumping and panicking everytime they finished a set of fries.

2:30 AM  

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