Film: Wit

[liv]

Reason for watching it: We screened it for the second year students, who are getting to the point where they're spending enough time in clinical environments that there's a good chance they will see someone die in the coming months. The idea is that they get a supportive environment in which to do at least some of the emotional work ahead of dealing with this for real, and hopefully they then won't completely fall apart when that happens. (There's a ton of research about the detrimental effects of medical students and trainee doctors not being adequately prepared to deal with death, but nobody quite knows what "adequately prepared" looks like. So we're working on it.)

Circumstances of watching it: Ugh, this term! I've had a solid six weeks with a heavy enough teaching and marking load that I feel I've been running a Red Queen's race since the new year, I haven't had time to do anything at all non-urgent, and it's making me really anxious. In theory things were supposed to slow down by the end of February; in practice everybody's kind of scrabbling, and the school were short of staff for running a bunch of sessions through March, so I've ended up roped into more teaching in the coming weeks. And because it's all last minute cover it's all in bits of the curriculum well outside my expertise. I really didn't want to be a facilitator for this session where we get the students to talk about death, but needs must. I kind of feel like this is one of the times where it's more important than usual to have a clinician leading, cos it's not just factual knowledge, it's being able to speak from experience of dealing with death as a doctor. But I suppose I was better than no-one.

Verdict: Wit is thought-provoking if at times over-dramatic.

So, look, the whole point of this film is that it's 90 minutes of the protagonist dying of cancer. Not in real time, it covers several months from diagnosis to the end, but the whole film, and therefore my review, is about illness and dying within the medical system.

Wit is basically Emma Thompson doing a TV version of a srs intellectual play, which had won the Pulitzer prize a couple of years before this film was made. And it's not bad for getting the medical students thinking, because it contrasts the personal, emotional experiences of the protag, with the rather unfeeling medical machine that just treats her as a problem to be fixed or a research topic to be studied. There's a bunch of doctors with basically no bedside manner (why are the research oncologists always the evil ones?) and a very sweet, sympathetic African-American nurse who is the only person who actually cares for Prof Bearing as a person.

Thompson's character, Prof Bearing, spends most of the film quoting Donne a lot, and making snarky, slightly fourth-wall breaking quips to the camera about how a drama falls short of representing the horror that is dying of metastatic cancer. The film certainly took a step further towards realism than most Hollywood representations of hospitals and terminal illness, but it wasn't more realism than you could bear to watch, it's still prettied up quite a lot. There's a little bit of throwing up, but it's fairly symbolic. Even right at the end Thompson looks like, well, a beautiful actress with a shaved head, who hasn't had a good night's sleep and has a bit of a cold sore, and not very much like someone dying of cancer.

The emotional stuff was handled well, you got this whole arc where Bearing has this self-image as a competent intellectual, and she desperately tries to carry on being brisk and sarcastic and clever when actually she's terrified and in pain and and falling apart physically and emotionally. I've always liked Thompson as an actor, and the character of Prof Bearing is not very much like me but is somewhat like the person I thought I might become, when I was a teenager, a respected academic who doesn't really do interpersonal stuff more than she has to. So on some level I could relate to her. I'm not hugely fond of the way that Hollywood portrays academics; there's a lot of reciting poetry in a dramatic voice, particularly Death be not proud, and pontificating about the importance of the commas for understanding Donne's poetry, but hey. I didn't like the very end of the film where she sort of falls back on the classic tropes for conveying suffering, which are not representative of how most people in pain actually act, but I suppose that was necessary to convey the emotional point.

Anyway, it's not a film I particularly recommend unless you're trying to help some students to think about death, but it's not a terrible film for what it is.

It seems possible that I'm somewhat emotionally affected by this; the film is genuinely harrowing in places as well as a bit over-dramatic. And running the discussion where I had to manage a lot of the medical students' emotions was pretty draining, I think, especially coming on top of generally stressful stuff. So lots of things that should be fine are feeling daunting, just now. Send hugs pls?

Comments

[merrythebard]

*many hugs*

[liv]

Thank you, it was really nice of you to comment affectionately.

[cjwatson]

I'm sorry this is stressful, it sounds pretty tough. Looking forward to talking this evening. *hugs*

[liv]

Thanks for sympathy, and for making plans to talk, I'm looking forward too.

[chickenfeet]

This is giving me flashbacks to some focus groups I did with terminally ill cancer patients. They were extraordinary and I was a wreck afterwards. I've found academic oncologists' bedside manner is very bimodal. Some are great, others are terrible. I wonder whether not getting involved with the patients' emotions is a coping mechanism. Not defending that, just wondering.

[liv]

Yeah, people who are willing to do focus groups while in the middle of dying are pretty special! And I can imagine that was much more seriously harrowing than watching a dramatic film about terminal illness.

And yes, I did raise with the students the idea that the particularly dreadful doctor in the film was doing emotional disconnection as a coping or defence mechanism. Cos they're all 20 and idealistic and they were very very sure they would never ever speak to a patient like this character is portrayed as speaking to Prof Bearing, and I wanted to get at a bit more self-awareness than that.

[atreic]

*hugs*

We did W;t as a readthrough for Matthew's birthday once, and it was really powerful. And I'm obviously a bit of a Donne fan (see username). But I haven't seen the film.

I love the phrase 'I feel I've been running a Red Queen's race', which I hadn't come across in that form before. Me too :-/

[liv]

I'm sorry you've got more going on than you can stay on top of, too. Thank you for commenting to this post, talking about the film as a piece of media is definitely helpful to me.

[hatam_soferet]

Hugs.

UD, being a research oncology type himself, has found the academic-bedside-manner mode of interaction somewhat reassuring at times; I suppose it's about knowing your audience.

[liv]

Yes, it was definitely part of the discussion I had with students, that there isn't one simple recipe for good communication, and not all patients would want the style of the nurse who's so positively portrayed in the film, with lots of hand-stroking and "there, there, honey, don't you worry, it'll all be ok".

But the film was really playing up bad communication to stoke the drama; it's not that the medics were taking a detached academic tone rather than a sympathetic one, it's that they were outright callous or even brutal. Like there's a horrible intimate examination scene which was nastier than most onscreen rapes, and a whole bunch of scenes where they basically steamrollered the patient into procedures she either didn't understand or actively didn't want, or kept going with whatever medical stuff they were doing with no acknowledgement it was hurting her.

There was a bit where the senior consultant in the film was doing Grand Round teaching, where he had half a dozen students gawping at the patient and discussing her without ever actually interacting directly, and that scene winds up with the students not knowing some of what they're supposed to know, and the consultant finally turns to Prof B and says, students, eh! They never do their homework properly! So he's sort of acknowledging her as a fellow academic, but not as someone who's in pain and finds it kind of humiliating to have a bunch of medical students standing around her bed discussing her ovaries. So I referred to some research that this a thing that some doctors do, they try to artificially team with the patient against the students, and patients generally don't in fact feel included when doctors do that.

[forestofglory]

*hugs*

[liv]

Thank you! I hope this post wasn't upsetting to you, but with luck I labelled it enough that you knew what you were getting into when you read it.

[forestofglory]

No, I felt I knew what I was getting into. (But I don't think I could watch the movie.)

[liv]

Fair call. And thank you again for commenting sympathetically.

[alexseanchai]

*hugs*

[liv]

Thanks for commenting with hugs, it helps to know that my readers care.

[sfred]

*hugs*

[liv]

Thank you for responding to my hugs request, reading the comments here has made me feel lots better.

[andrewducker]

*hugs*

How did the students take it?

[liv]

Thank you. Student reactions were pretty mixed; a lot of them were angry at the dreadful doctors portrayed in the film, which is probably healthy. Some were a bit upset, some, with a bit of prompting, were thinking seriously about the kinds of topics we wanted them to be reflecting on. About half seemed to be just shell-shocked, not really able to formulate a reaction suitable for a group discussion. Which is perfectly normal, and hopefully they will get some benefit from getting through that reaction in a fictional setting before it happens for real.

[ceb]

*hugs*

You are awesome and this is an excellent thing to be doing; thank you for doing the harrowing stuff so that other people can be better at what they do.

[liv]

Yay hugs! And this is most helpful thing you could possibly have said, because yes, the reason I did this is to make better doctors, not just because we were short-staffed on this particular day, and that's really comforting.

[ephemera]

*hand squeezes* That sounds like a pretty tough assignment, but an important one, so go you for carrying it forward.

[liv]

Thank you, that's a really nice thing comment for you to make. And thank you for translating from literal hugs to supportive gestures in general, I didn't want to feel like I was demanding hugs from people I don't know well.

[siderea]

1) *hugs*

2) Right now, Pesi.com, which offers continuing ed for therapists among others, is offering a free online webinar (well, video), "Compassion Fatigue Prevention & Resiliency: Fitness for the Frontline". Not just for therapists, but anybody who works with traumatized people in oftimes exploitative professional environments. It was quite good. While I have a few thoughts and quibbles and reservations, mostly it was very good. Recommended. An hour and a half.

[liv]

Yay, not only hugs but resources to help me be a better teacher. You're an absolute star, thank you so much for this.

[azurelunatic]

*internet hugs and a cup of comforting beverage*

[liv]

Aww, thanks Azz! And yes, tea, tea helps. Feeling a lot better by today.

[(Anonymous)]

You poor thing.

You seem to have coped extraordinarily well.

Could you have got any help from Macmillan Nurses or the Hospice Movement?

Lots of Love

Southernwood

[liv]

Oh yes, for the more in-depth teaching later on in the course we use a lot of palliative care specialists, nurses and hospice people as well as doctors. This was just an intro activity, they wanted four tutors and a video player!