Monday, March 2, 2009

Wit

There are many movies out there with palliative themes, as we can attest to with our top 10 movie post, which garnered much comments. One of my all time favorites, also made number 1 on Amber and I's original list; Wit.

I first saw this movie in medical school. In fact, according to the IMDb, this movie is known for being shown at medical schools as an example of how not to practice medicine. Also, the plot deals with dying, so it's all the more relevant to those of us who care for dying patients.

The plot is this: An English lit prof., known for her high expectations and little compassion in the classroom is diagnosed with ovarian cancer. The movie shows her experiences from diagnosis to death. Her last weeks are spent in the hospital, undergoing rigorous treatment. She is alone, except for the nurses, attending and fellow who treat her. Through her reflections and memories there is a definite parallel between her heartless days teaching and the heartless medical system she is now in.

The movie is based on a play by Margaret Edson and this monologue, play-like background is the inspiration for the screenplay, making it unique. The soundtrack is simple with only 4 pieces listed. My favorite piece is "Speigel im speigel" or 'Mirror in a mirror' by Arvo Part. It is played often in the movie, the simplicity of the cello and piano is also melancholy, leaving the viewer with the feeling of being alone, just as the main character is.

I love this movie not just for it's ability to pierce me with its sad realities of the medical world, but also for it's subtle sub theme about death. All through out the movie we are bombarded with a certain text from a John Donne's Holy Sonnet 10. The main character was a John Donne expert and specifically recalls the punctuation differences pointed out at the end of this poem by her mentor.

The last line of the sonnet entitled "Death be not proud" is "And death shall be no more, Death thou shalt die." The version our main character had found was different "And Death shall be no more; Death thou shalt die!"

Here is the discussion with her mentor on the punctuation differences, talking about the version with the comma:
"Nothing but a breath, a comma separates life from life everlasting. Very simple, really. With the original punctuation restored Death is no longer something to act out on a stage with exclamation marks. It is a comma. A pause. In this way, the uncompromising way one learns something from the poem, wouldn't you say? Life, death, soul, God, past present. Not insuperable barriers. Not semi-colons. Just a comma. "

If only the main character's death could have been so simple. Yet of the many ways death is portrayed in films, her portrayal is haunting. No one should have to die like this, without dignity and respect (ignoring her DNR)...alone in a hospital. Yet it is haunting, because of how real this type of death is. It is the antitheses of a palliative care death.

I've included two clips from youtube. (For email subscribers click the title above to go to the web page to view) In the first, our main character (Emma Thompson) is thinking out loud. It's a lovely introspection of what's she's dealing with. The second is a beautiful moment when our character actually gets her one and only visitor, her old hard-nosed mentor. The simplicity of human connection in the clip, with the Arvo Part soundtrack accompanying, makes me tear up every time.





I'd also suggest reading John Donne's Holy Sonnet 10 "Death be not proud" (This version uses a semi-colon and no exclamation!)

8 Responses to “Wit”

Sandi Pniauskas said...
March 17, 2009 at 7:52 AM

When Wit was first introduced it did not receive such a welcome from some medical communities, well understood from those who viewed the play. There were instances where the play was viewed direct to medical communities outside of public forums. What was not understood originally was the overriding message of the human frailties in all. Today, a wider acceptance has been gained except for one. Newly diagnosed ovarian cancer women (and families) or those in treatment are cautioned concerning the extreme emotional impact that the play may have and timing is everything. It takes a strong person to view the play/movie depending on the patients' current set of circumstances. A caution worth noting. Having seen the play many times with ovarian cancer friends and those unaffected and personally 'with' wig it was and remains exceptional.


Cyndi Cramer, BA, RN, OCN, PCRN said...
March 18, 2009 at 3:14 PM

We showed this as our first Palliative Care "Come to the Movies" program at my hospital last year. We had people come out who had not shown any interest in coming to our PC Educational programs and, I think, were able to touch them and make our PC mission a little clearer to them...
We have since showed 2 more movies. Another way to reach people...


Sandi Pniauskas said...
March 18, 2009 at 3:31 PM

Hi Cindi, I am glad that Wit was met with success. I am curious how many newly diagnosed ovarian cancer women/families attended. Were you targeting the audience specific to ovarian cancer women?
Thanks.


Cyndi Cramer said...
April 3, 2009 at 1:00 AM

No--we didn't specifically target one audience. We are doing a series and we call it "Come to the Movies". The movies have EOL themes with discussions. Just another way to reach folks that won't come out to educational programs...
The last one we did was "The Bucket List" We asked people to make their own Bucket Lists afterward and I was recently told by someone that they are now 1/2 way through accomplishing the things on their list...


Amber Wollesen, MD said...
April 3, 2009 at 10:43 AM

I think it's great to use movies like this for educating on end of life. It really grabs the audiences attention. I know my nurses use scenes from Wit in their ELNEC classes. It's a big hit.

I can see how it may be too emotional for someone undergoing treatment for ovarian cancer.

Movies like this are great ways to start discussions, whether you are in the health care field or not. I know watching Million Dollar Baby (hmm, maybe a future post) led to some good discussions between me and my husband (he is not in health care). It can be a good way to bring up otherwise uncomfortable subjects. Like "Hey, what would you want if...?"

Thanks for your comments.


Cyndi Cramer said...
March 16, 2011 at 11:53 PM

No--we didn't specifically target one audience. We are doing a series and we call it "Come to the Movies". The movies have EOL themes with discussions. Just another way to reach folks that won't come out to educational programs...
The last one we did was "The Bucket List" We asked people to make their own Bucket Lists afterward and I was recently told by someone that they are now 1/2 way through accomplishing the things on their list...


Sandi Pniauskas said...
March 16, 2011 at 11:53 PM

Hi Cindi, I am glad that Wit was met with success. I am curious how many newly diagnosed ovarian cancer women/families attended. Were you targeting the audience specific to ovarian cancer women?
Thanks.


Cyndi Cramer, BA, RN, OCN, PCR said...
March 16, 2011 at 11:53 PM

We showed this as our first Palliative Care "Come to the Movies" program at my hospital last year. We had people come out who had not shown any interest in coming to our PC Educational programs and, I think, were able to touch them and make our PC mission a little clearer to them...
We have since showed 2 more movies. Another way to reach people...