Medicine Needs More Than Wit

by Angeline R. Larimer

I was in a research hospital conference room, sitting at the table, surrounded by doctors. My turn to introduce myself, I mentioned my work in medical humanities, my expansion into bioethics, and then at the end added, “I’m also an MFA playwright.” That may have been my ‘something unusual about yourself,’ answer, but I’m on a mission to promote and normalize the interdisciplinary relevance of MFAs whenever possible. After that, the head physician of the meeting blurted out, “Playwright!?! You’re not here to write another Wit, I hope!” Credit where credit is due, what a remarkable reaction for a playwright to experience. I will always admire Margaret Edson for giving me that moment.

Some in the room didn’t know Wit, maybe, and were confused, but I suspect most of them did. It tells the story of Dr. Vivian Bearing, a brilliant but severe English professor diagnosed at the top of the play with Stage IV metastatic ovarian cancer. Her commitment to higher learning influences her decision to participate in a clinical trial. Dr. Bearing’s life’s work was about preparing herself for a noble end, but the dehumanizing effects of chemo and scientific research take a toll. In the end, she realizes what matters most to her is kindness.

Wit rippled through the healthcare community in the late 1990s. Doctors went to the theatre on their nights off to see this critically acclaimed play everyone was talking about, then felt attacked by it afterward. Beyond their initial defensiveness, they started questioning their colleagues, “Are we really this bad?” And to their credit, it mattered to them. Wit’s outsider’s view of medical research from the patient’s perspective really shook things up in health care after that. Medical schools and medical humanities programs have added Wit to their syllabi ever since. It may not seem like there has been a great impact now because of how inequitable and unaffordable medical treatment often is, but medical educators are still using Wit to show students the dehumanization of patients is not okay. Friends, holding up the mirror actually worked. It facilitated a much-needed change.

I was not at the meeting to research for a new play, but with all respect to Margaret Edson, I had at one time been planning a follow-up to Wit. When I first read Wit in 1999 as an MFA student, I related much more to Dr. Vivian Bearing’s students than I did to the protagonist. Fifteen years later and reading it again with my illness narratives class, Wit had become a very different play for me. I was closer to Dr. Bearing’s issues in age and experience, but also, Wit was a model for contemporary plays able to transcend mainstage theatres and become a vehicle for education. If Wit could do this, what else could new plays do? And what about long-forgotten plays, including the obscure ones never given a chance to live? What overlooked insights did these plays still have to teach us? 

Wit’s afterlife in medical education reignited my desire to write plays because it showed me what plays can accomplish outside of the glitz and glamor and perfect headshot ‘life’ that swirls around theatres which I have never been comfortable around, but also because the story itself provoked a frustrated realization – the treatment options for ovarian cancer had not seemed to have changed much since Margaret Edson wrote her Pulitzer Prize winning play in 1991. With all the advancements in medical research and technology, why was this true? I wanted to draw attention to the sad fact that debulking or double mastectomies were being promoted as the best plan of action after a BRCA gene discovery. But I didn’t know enough about the disease and its treatment choices, so I sought out an ovarian cancer specialist through my medical humanities connections, with the intention of picking up where Edson left off. The script hasn’t been written (yet) for two reasons; My initial contact in gynecologic oncology kept having scheduling conflicts and so nothing was going forward. Another oncologist was interested in working with me but wasn’t a specialist in ovarian cancer. I decided to follow that opportunity anyway and was rewarded with several unexpected opportunities to shadow inside hospital and clinical settings for over three years. 

Those experiences shifted my attention away from playwriting for a while but led me to a much valued degree in bioethics. Those years, I was given access to rooms where so many difficult decisions were made. Some patients received happy news. Their treatments had worked. Some were in shock. Some went home. Some were terrible to the nurses. A few were very tragic, and I had to stand through it. ‘How do people do this every day?’ I often asked myself. Grieving spouses almost always thanked the same doctors who had just turned off the life support machines. That was particularly surreal and poignant; the humility of bargaining for any last shreds of hope, and then that broken-hearted gratitude – the ‘thank you for trying’ forgiveness that’s just astonishing to me. My time shadowing, several people also opened up to me. They never asked why I was there. I never said, “Tell me your story.” Stories just poured out. Medical humanities, specifically narrative medicine, teaches about the therapeutic release that comes from sharing one’s experience. Theatre’s catharsis, of course. I was the one-person audience for these mini plays. They just needed me to hear, nod, and feel something. Most of what I do now as a bioethicist is listen like this. Occasionally I point out something that’s getting lost because of miscommunication, ask clarifying questions, and point out any serious concerns. This is what Edson did with Wit. It does not surprise me that she worked as a clerk in a research hospital. I imagine her mother’s occupation as a medical social worker was also influential.  

Wit has influenced me a great deal. I’m thankful it is still being taught and continues to provoke responses from doctors. But as a medical humanities instructor trying to get more theatre included into education, we need to promote more teachable plays! These plays can and should extend beyond the hospital setting. I teach Karel Čapek’s Věc Makropulos, which examines the tediousness of immortality. We discuss questions like; What is medicine doing if not extending life? How many years become too many? What are the problems with living forever? What does that look like for someone whose occupation is hard labor or who does not have access to privilege, or even to basic needs? Who can really afford it? Can our planet? Health professionals need to be considering these questions, and theatre is an excellent way to start those conversations. 

I’m seeing more collaborations between public health and theatre professionals, and I’m thrilled, but medical schools and medical humanities programs could still use a boost. Dramaturgs can be helpful in this by promoting work that fits into a medical humanities curriculum. Reaching out to health humanities programs whenever a relevant play is being produced, such as Jennifer Blackmer’s play Predictor about the first home pregnancy test, is also helpful. Get students in those seats! The plays are out there. Let’s not stop at Wit. I’m hoping to hear more titles blurted out at me in meetings. Not that I am suggesting we remove Wit from the curriculum. I’m just asking for it to gain some companions. And maybe someday I will get back to the Wit follow-up story. If you know a gynecologic oncologist with a lighter schedule, please let me know. If you’re inspired to tackle the topic yourself, go for it! There are so many stories still to tell.

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