On September 14, 2011, I was invited to a special premiere of the movie 50/50. A group of cancer care providers packed into a movie theater in Georgetown anxiously awaiting the film to begin. I’ve been hearing about this movie for months; there’s been quite a buzz in the young survivors’ community about its startlingly accurate portrayal of a young patient’s transition from vitality and strength to illness and dependence.
In this movie, a young man fights cancer, but the story is told through the lens of Hollywood slapstick comedy. Before I saw the movie, I felt a bit unnerved by this.
Based on a true story, 50/50 screenwriter Will Reiser recounts his experiences of diagnosis and treatment of a spinal sarcoma (referred to in the movie as “back cancer.”) Produced and co-starring Seth Rogen as the best friend of a cancer patient played by Joseph Gordon-Levitt, this very intimate, personal portrayal had me laughing out loud many times throughout the film. It was an incredible sense of release to find the ridiculousness and absurdities rooted in a frightening diagnosis—embedded in the indignities faced by one person struggling with uncertainty, fear, frustration, and sadness.
The film is a powerful reminder that, even though many people survive longer and often with a better quality of life today than cancer patients of the past, the advances in detection, technologies, and treatment are not the same as developing ways to deliver patient-centered care through the disease and its aftermath.
This may be especially true in the young cancer community. A population that often feels lost between two worlds--too old to fall under the care of pediatricians, but way too young to relate to survivors who may be 50 years and older.
There were several “teachable moments” in this film that hopefully shed light on some of the adversities faced by young people grappling with this disease. Humor was a powerful inspiration, urging more thoughtful consideration of how to care for people going through the ordeal of cancer. For example, the relationship between Gordon-Levitt and his doctor in this film lacked any empathy and compassion. When delivering the diagnosis of cancer, the oncologist failed to even look up from Gordon-Levitt's medical chart and rattled off figures and technical terms using medical jargon that would be difficult for anyone to follow. This failure to connect with Gordon-Levitt and his family was a reoccurring theme in the movie.
Within moments of the movie ending, I overheard several audience members comment that “doctors are not that bad” and “I would never treat a patient that way.” Except that it does happen.
This over-the-top depiction gave many of us something to think about. We should focus on the importance of making eye contact, reading non-verbal cues, having patients be part of the decision-making process, explaining the diagnosis and treatment options slowly and in simple terms, allowing for questions, and how a gentle touch can make a world of difference to someone who is receiving devastating news.
I do have one criticism of this movie: it is occasionally formulaic and predictable. The components of a Hollywood comedy are in evidence: the twenty-something year-old break-up turning into a taboo love story with the unlicensed social worker, the over-bearing mother who feels the need to offer all the wrong kinds of support, and the over-the top stereotypical medical oncologist who lacks humanity or compassion. At the same time, the budget was small, and Reiser and Rogen decided to make the film without the backing of a major production company; they clearly have a story they want to share.
The screening event was sponsored through the Lance Armstrong Foundation whose mission is to improve the lives of those living with (and through) cancer. The Foundation has promoted this film, hoping it will help challenge the social construct of the face of cancer. Throughout the movie, you feel that these two men are on a mission to convey an important story, but with humor. What matters most is that it is an important social intervention. Reiser and Rogen are capitalizing on their star power to tell a powerful and evocative story. And by telling this story, they’re making other patients laugh, and making people who may someday have cancer aware of the importance of laughter.