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‘A Significant Contribution to Science’: Why the Film Wit Is Shown to Medical Students
Warning: this article contains spoilers!
‘A Significant Contribution to Science’: Why the Film Wit Is Shown to Medical Students
Warning: this article contains spoilers!
Изображение: HBO Films, 2001.
«Остров любви»
«Остров любви» («Love Island USA», CBS, 2018) — американское реалити-шоу о знакомствах, основанное на британском сериале «Love Island».
Author: Uliana Pavlovskaia, PACED
We continue to highlight works that offer fresh perspectives on palliative care, medical ethics, and patient communication.
Today, we take a look at the film Wit (2001). Although it was released twenty-five years ago, it remains one of the most relevant works on the experience of a critically ill person within the healthcare system. The film is regularly recommended to medical students, doctors, nurses, and palliative care specialists to raise complex, still unresolved ethical questions.
The film is based on Margaret Edson’s play of the same name. The play earned the writer a Pulitzer Prize in 1999.
The film is based on Margaret Edson’s play of the same name. The play earned the writer a Pulitzer Prize in 1999.
Professor Vivian Bearing at a doctor's appointment, a still from the film. Image: HBO Films, 2001.
The Plot
The main character is Vivian Bearing, a professor of English literature and a specialist in John Donne’s metaphysical poetry. She is diagnosed with advanced ovarian cancer and agrees to undergo an experimental course of chemotherapy at the maximum tolerable dose. Her attending physician explains that the treatment may not save her life, but the data collected will make ‘a significant contribution to science.’
This phrase sets the tone for the entire film: what happens when the pursuit of scientific knowledge completely overshadows humanity?
Vivian is a brilliant scholar. Her course is widely regarded as one of the most demanding at the university. Having been educated by a stern mentor, she has devoted her life to upholding unquestioning academic standards and has demanded the same of her students. Throughout the film, the viewer watches not so much a medical history as a gradual shift in the heroine's perspective on the people around her, on science, and on her own life.
This phrase sets the tone for the entire film: what happens when the pursuit of scientific knowledge completely overshadows humanity?
Vivian is a brilliant scholar. Her course is widely regarded as one of the most demanding at the university. Having been educated by a stern mentor, she has devoted her life to upholding unquestioning academic standards and has demanded the same of her students. Throughout the film, the viewer watches not so much a medical history as a gradual shift in the heroine's perspective on the people around her, on science, and on her own life.
The Viewer's Role
One of the key artistic devices in Wit is the breaking of the fourth wall. Most of the time, Vivian addresses the audience directly: commenting on what is happening, explaining her reactions, recalling the past, and making ironic remarks about hospital rituals.
This device is fundamental to the film: we observe the situation from the patient's perspective. Even more—we become her allies. While the doctors discuss indicators, lab results, and the effectiveness of the treatment regimen, Vivian tells us what they fail to notice: the fear, the awkwardness, the pain, and the solitude. She tells us how she tries not to lose herself in circumstances where less and less belongs to her—both because of the illness and because of depersonalisation on the part of the doctors.
This device is fundamental to the film: we observe the situation from the patient's perspective. Even more—we become her allies. While the doctors discuss indicators, lab results, and the effectiveness of the treatment regimen, Vivian tells us what they fail to notice: the fear, the awkwardness, the pain, and the solitude. She tells us how she tries not to lose herself in circumstances where less and less belongs to her—both because of the illness and because of depersonalisation on the part of the doctors.
Professor Vivian Bearing, a still from the film. Image: HBO Films, 2001.
Depersonalisation Taken to the Point of Absurdity
The plot starkly demonstrates what depersonalisation of a patient actually means. For example, the question ‘How are we feeling today?’ is repeated so frequently and automatically by medical staff that it completely loses its meaning. In one monologue, Vivian recalls being asked this question while vomiting into a plastic basin. The same question is mechanically posed to Vivian by a young doctor while she is already unconscious.
Another example is the regular ward round. Vivian remains conscious and feels relatively well. Her attending physician, Dr Kelekian, enters the room with a group of young interns, lifts her gown, and they all examine her tumour.
Before leaving the room, Dr Kelekian stops the young Dr Posner and asks him to ‘finish the exam.’ We expect further procedures or questions, but it turns out only the final line of the protocol needs to be reached. Dr Posner turns around, says, ‘Thank you very much, Miss Bearing,’ and they all leave.
Another example is the regular ward round. Vivian remains conscious and feels relatively well. Her attending physician, Dr Kelekian, enters the room with a group of young interns, lifts her gown, and they all examine her tumour.
Before leaving the room, Dr Kelekian stops the young Dr Posner and asks him to ‘finish the exam.’ We expect further procedures or questions, but it turns out only the final line of the protocol needs to be reached. Dr Posner turns around, says, ‘Thank you very much, Miss Bearing,’ and they all leave.
A scene of a regular ward round with interns. Image: HBO Film, 2001.
Keeping a Stiff Upper Lip
The harshest judge of Vivian is Vivian herself. The film opens with her attending physician delivering the terrible news—no muscle in her face twitches. ‘You are a professor, Miss Bearing,’ Dr Kelekian says. ‘Like yourself, Dr Kelekian,’ Vivian retorts.
After describing the arduous course of therapy, Dr Kelekian tells Vivian she will need to be very tough and asks whether she can manage it. At first glance, this might sound supportive. But there is another side to this phrasing. If agreeing to the most aggressive treatment means ‘being tough,’ then what does refusal become? Weakness?
Vivian agrees.
Formally, she has been informed. Formally, she has given consent. But can this decision truly be considered informed?
After describing the arduous course of therapy, Dr Kelekian tells Vivian she will need to be very tough and asks whether she can manage it. At first glance, this might sound supportive. But there is another side to this phrasing. If agreeing to the most aggressive treatment means ‘being tough,’ then what does refusal become? Weakness?
Vivian agrees.
Formally, she has been informed. Formally, she has given consent. But can this decision truly be considered informed?
‘My Only Defence Is the Acquisition of Vocabulary’
We never tire of repeating that communication is much more than the ability to speak. The film's characters view communication with patients in vastly different ways. Dr Kelekian clearly believes he is doing wonderfully: he chats with Vivian semi-jokingly, professor to professor, and ‘encourages’ her with phrases like ‘keep pushing the fluids’ (meaning they must not reduce the chemotherapy dose).
His intern, young Dr Jason Posner (a former student of Vivian's who takes immense pride in having once passed her notoriously difficult exam), puts it even more bluntly. He tells Vivian that an entire university course was dedicated to patient communication, calling it ‘a colossal waste of time for a researcher.’
‘And what do you say when a patient is apprehensive, frightened?’ Vivian asks him. ‘Of who?’ Dr Posner asks, genuinely bewildered.
His intern, young Dr Jason Posner (a former student of Vivian's who takes immense pride in having once passed her notoriously difficult exam), puts it even more bluntly. He tells Vivian that an entire university course was dedicated to patient communication, calling it ‘a colossal waste of time for a researcher.’
‘And what do you say when a patient is apprehensive, frightened?’ Vivian asks him. ‘Of who?’ Dr Posner asks, genuinely bewildered.
For Vivian—a professor of literature and an expert in metaphysical poetry—words and meanings have always been her primary tools. In the face of the doctors' communicative deafness and emotional detachment, she begins to defend herself using her familiar method: she learns their medical terminology to understand everything they discuss in her presence, without being personally explained to.
Yet, towards the end of the film, Vivian articulates a fundamental shift in her perception of what is happening:
‘Now is not the time for verbal swordplay… Now is the time for simplicity… Now is the time for—dare I say it—kindness.’
Yet, towards the end of the film, Vivian articulates a fundamental shift in her perception of what is happening:
‘Now is not the time for verbal swordplay… Now is the time for simplicity… Now is the time for—dare I say it—kindness.’
Stills from the film: Dr. Posner conducting an examination (top), Professor Ashford and Vivian (bottom).
Image: HBO Films, 2001.
Kindness
Of course, the creators could not fail to offer us a positive example. Against the backdrop of the system's cold functionality, nurse Susie Monahan demonstrates a fundamentally different approach. In a world where every action is directed towards obtaining data, Susie restores Vivian's agency: she covers Vivian during a gynaecological exam, talks to her, explains the actions taken during medical procedures, and is actively present in Vivian's life.
It is Susie who has an honest conversation with Vivian about the possibility that the cancer may not recede, suggesting that she record her consent or refusal regarding resuscitation in advance, thereby protecting her autonomy.
Even when Vivian is unconscious, Susie continues to talk through each action she takes. When a doctor asks sceptically why she is doing this, given that the patient cannot hear, Susie answers simply: ‘It's just nice to do.’
This episode encapsulates a crucial point about dignity: respect for a patient should not depend on their ability to respond, express gratitude, understand an explanation, or even hear it. The promise made to Vivian to ‘be there’ remains in force even when she can no longer verify whether it has been kept.
It is Susie who has an honest conversation with Vivian about the possibility that the cancer may not recede, suggesting that she record her consent or refusal regarding resuscitation in advance, thereby protecting her autonomy.
Even when Vivian is unconscious, Susie continues to talk through each action she takes. When a doctor asks sceptically why she is doing this, given that the patient cannot hear, Susie answers simply: ‘It's just nice to do.’
This episode encapsulates a crucial point about dignity: respect for a patient should not depend on their ability to respond, express gratitude, understand an explanation, or even hear it. The promise made to Vivian to ‘be there’ remains in force even when she can no longer verify whether it has been kept.
Vivian and Nurse Susie, , a still from the film. Image: HBO Films, 2001.
Conclusion
One of the most poignant and accurate observations was made by Vivian herself: ‘I am not in isolation because I have cancer. I am in isolation... because I am being treated for cancer.’
The film demonstrates with utmost precision that the loss of a patient's agency rarely stems from deliberate malice. Far more often, it is brought about by a chain of ordinary details: a person was not covered after an exam, was discussed in the third person in their presence, had someone enter their room unannounced, was not given an explanation of a procedure, or was asked a superficial question without waiting for an answer.
None of these episodes looks like a catastrophe on its own, but accumulated, they radically alter the experience of illness.
The film Wit is not merely a drama about disease. It is a stark and candid conversation about where the boundary lies between striving for results—be it gaining knowledge or even achieving a cure—and preserving humanity. We strongly recommend this film to anyone who works with patients. Once you have watched it, it becomes impossible to forget that at one time you were Vivian Bearing's sole ally in her quiet struggle for her own dignity.
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