Emma Thomp­son deliv­ers the per­for­mance of her life in Wit, a film released in 2001.

Although the story line goes to dra­matic extremes, Emma’s per­for­mance rings painfully true, with lines that are painful but com­i­cally bril­liant…

Emma’s char­ac­ter lies in a hos­pi­tal bed while under­go­ing chemother­apy. She deliv­ers an affect­ing mono­logue as a stage 4 can­cer vic­tim, star­ing death in the face. Com­pletely bald, with sickly make-up and an ugly hos­pi­tal gown, she reflects on her career, the val­ues she lived by, and how she chose to inter­act with other peo­ple in her life. Has she made the right choices?

Emma plays a demand­ing Eng­lish pro­fes­sor who spe­cial­izes in 17th cen­tury meta­phys­i­cal poetry. She recites pas­sages from John Donne (“Death be not proud”) while mus­ing on life, inter­ac­tions with stu­dents, and how to pre­pare her own end-of-life story.

Her deliv­ery of Don­ne’s poetry is del­i­cate, highly nuanced and affect­ing. Her analy­sis of his work assumes a well-edu­cated audi­ence with an exten­sive vocab­u­lary. (This film is so unlike Hol­ly­wood-style, low­est-com­mon-denom­i­na­tor deriv­a­tive plots!)

Learning How to Suffer

Emma’s char­ac­ter has been a noted scholar, a teacher whose uncom­pro­mis­ing stan­dards far exceed most col­lege stu­dents’ abil­i­ties or moti­va­tions. She prizes intel­lec­tual rigor and hard work, with no sym­pa­thy for stu­dents who do not under­stand the sub­ject mat­ter, or who fail to deliver assign­ments on time. There’s a painful scene where she humil­i­ates a foot­ball player who has no clue what this poetry is all about…

As the film unfolds, the shoe is now on the other foot: Emma’s char­ac­ter must con­front what it feels like to be depen­dent upon dri­ven, demand­ing researchers with no com­pas­sion for their human sub­jects. To dra­ma­tize this role-rever­sal theme, one of her for­mer stu­dents will play a key role in her treat­ment.

The film opens with the heart-rend­ing scene when she learns that she has stage 4 ovar­ian can­cer. The doc­tor informs her while using dense, incom­pre­hen­si­ble med­ical jar­gon. She tries to parse his mean­ing, trans­lat­ing from the Latin roots of words that she knows… (The doc­tor’s deliv­ery sig­nals the audi­ence to expect that research demands will trump patient care/caring, a theme that con­tin­ues through­out Wit.)

Because there are no proven alter­na­tives, the doc­tor per­suades her to par­tic­i­pate in a research pro­gram, one that entails a highly aggres­sive form of chemother­apy, with well-known and quite hor­ri­ble side-effects. He gets her to sign the release form with­out mak­ing sure she under­stands the side-effects that she may encounter (such as liver necro­sis.) You later dis­cover that the researchers are sim­ply try­ing to dis­cover how many rounds of ther­apy the patient can endure before death wins the bat­tle…

Dur­ing this key scene and through­out the treat­ment régime, the oncol­o­gist and his ambi­tious research assis­tant dis­play a ruth­less lack of empa­thy for what ter­mi­nal can­cer means to the patient. They do not want to hear about the suf­fer­ing their research trial is inflict­ing upon her — they insist on con­tin­u­ing treat­ment well past the point when it’s obvi­ous to every­one that the aggres­sive chemo can­not save her life.

Wit is a one-sided story, told from the point-of-view of the patient under­go­ing a can­cer treat­ment pro­gram at a research insti­tute. Its char­ac­ters are mono-dimen­sional — task-focused research doc­tors unable to dis­play com­pas­sion or deal effec­tively with a patien­t’s emo­tional real­ity.

Finding Compassion

I’d like to imag­ine that Emma’s story is unusual — that most hos­pi­tals (includ­ing research cen­ters or teach­ing hos­pi­tals) employ peo­ple who are com­pas­sion­ate, able to engage with patients’ feel­ings when they must deliver painful or life-threat­en­ing news.

Thank­fully, Emma’s char­ac­ter is cared for by Suzie, a nurse who takes time to inter­act with her patient. Suzie has the strength to acknowl­edge and respond to Emma’s suf­fer­ing. She knows how to cel­e­brate those small moments worth cher­ish­ing.

Emma’s inter­ac­tions with Suzie and a deathbed scene with her men­tor (for­mer aca­d­e­mic advi­sor) pro­vide the soli­tary notes of lov­ing kind­ness in this tragi-comic film.

It does not need to be that way.

My niece died two years ago at age 21, after a 2‑year bout with an aggres­sive nerve sheath can­cer. My niece’s sit­u­a­tion was the polar oppo­site of what Emma’s char­ac­ter faced. My niece was blessed with a lov­ing fam­ily; cared for by an empa­thetic med­ical staff that went out of their way to cel­e­brate her life, death and all the things that made my niece so spe­cial.

In the decade that has passed since Wit was released, I hope that the med­ical com­mu­nity has become more skilled at find­ing the right bal­ance between pro­fes­sion­al­ism and com­pas­sion. It is, as the film so deftly notes, a mat­ter of life and death.