Wit Film Reflection
The movie Wit is about an English Literature Professor, Dr.Vivian Bearing, a scholar of seventeenth century poetry. Vivian is diagnosed with stage IV Ovarian Cancer. Throughout the movie, she reflects on her life, and viewers witness her painful journey as she endures eight months of brutal/intense experimental chemotherapy treatment. The manner in which Vivian was treated by most of the healthcare providers in charge of her care was heartless, inhumane, insensitive, callous, and unprofessional to say the least.
Wit begins with Dr. Kelekian delivering the diagnosis of cancer to Vivian, he was condescending and assuming when Vivian asked him to go on, and Dr. Kelekian responded “you are a professor”. Such response was unprofessional, and suggestive that because she is educated and is a scholar, Vivian should automatically know the severity and details of such diagnosis. The doctor continued to use medical jargon as he communicated with his patient, and rambled about the experimental drug treatment that they are developing. Dr. Kelekian did not allow Vivian to gather her thoughts or explore feelings. He then informs Vivian that as research, the treatment she’s to receive, will make a significant contribution to their knowledge. Therefore, the primary focus is not the patient, but the doctors/researchers. Vivian’s autonomy and right to choose was violated and taken away. She should have been afforded the opportunity to go home, think about what was discussed, and then decide what is best for her, not the researchers. She was denied the opportunity to grieve, be angry, and express her inner thoughts, and feelings.
Next, Vivian encounters Jason, Dr. Kelekian’s Fellow, and former student of Vivian. Jason’s behavior was awkward and subpar, not to mention unprofessional. After questioning Vivian about her medical history, he attempted to perform a vaginal exam without obtaining patient’s verbal consent, or explaining the procedure to her. He then realized the need for a female to be in the room during such examination. Jason ran out to get Nurse Susie, left the door open for several seconds, exposing Vivian with her legs up in the stirrups, before closing the door. Upon entering the examination room, the nurse immediately chastised Jason for leaving the patient in such an uncomfortable position. During the vaginal exam, Jason focused on himself, rather than the patient. He talked about how well he did in Vivian’s class and how great taking her class looked on his transcript. Once again, Jason failed to display compassion and professionalism that’s expected from one of such profession. He should have maintained eye contact with his patient, made her comfortable/put her at ease, asked if she was in pain, and explained in layman’s term what he was doing, as he performed the procedure. To make matters worse, after completing the exam, he took off his gloves, stated he had to leave, and then exited the room without washing his hands. Additionally, Jason left without discussing his findings with Vivian, and did not afford her the opportunity to ask questions.
Anger, rage, and disappointment were the emotions evoked within me as I watched the movie. I thought about how many patients, to this day, are treated in the same manner as Vivian. Patients, especially the elderly, immigrants, and of low health literacy/low socioeconomic status, are treated this way. Such patients hesitate to question the doctor out of fear of being labeled difficult, or believe the doctor knows best, since he/she is the health care provider, allowing the doctor to make all the decisions. Patients lacking the support and presence of family members to speak up for them, like Vivian (despite literacy level), often remain silent as well. Our job as clinicians is to provide the patient with information as plain as possible, and involve them in the decision making process, every step of the way. We must empower the patient and promote autonomy, no matter what the outcome may be.
Throughout the movie, I witnessed the numerous occasions where Vivian was treated less like a human being, and more like a subject, a guinea pig whose sole purpose was to provide the researchers with more “knowledge”. Upon grand rounds, Jason pulled up Vivian’s gown, exposed her body, without asking permission. He then roughly palpated her abdomen and had the other residents, at the same time, touch her abdomen as well, again failing to obtain consent. The doctors also spoke over Vivian, using medical terminology, never once communicating with her. It was as if she wasn’t present in the room. The lack of communication and disregard for Vivian was deplorable. I wondered if the use of therapeutic communication and emotional intelligence is encouraged and taught in medical school.
Nurse Susie, on the other hand, displayed true professionalism. She treated Vivian as a human being, demonstrating compassion, honesty, and empathy. She represented Jean Watson’s theory of caring to the utmost. The nurse allowed Vivian to express her feelings. She listened intently, and provided comfort as her patient was alone and had no family members. Vivian trusted Susie, this was demonstrated when she cried, and told Susie that she was scared. Finally, she was allowed to show her true emotions. While eating popsicles, Susie informed Vivian of information that the doctors withheld from her, which was that she wasn’t going to get better. The nurse took the opportunity to also explain what DNR/DNI is, and allowed Vivian to truly make an informed decision regarding her health. Although it was clear to Vivian that death was imminent, she felt better, as Susie helped her regain her autonomy. Susie advocated for her patient on numerous occasions. She asked Jason to have the medication dosage lowered, as the patient experienced horrid side effects, but he failed to consider her input. Susie suggested to Dr. Kelekian to order PCA pump to ease Vivian’s pain and to keep her more alert, he too ignored her plea.
Down to the end of Vivian’s life, Jason continued to behave below the standard of a true professional. Upon learning that the patient was dead, Jason disregarded the DNR, performed CPR, and called a code. He went as far as to refer to Vivian as “research” when Susie pushed him out of the way, and yelled that the patient is DNR. This nurse truly advocated and cared for her patient. However, I would like to have seen Susie report the researchers’ deplorable actions to the higher powers that be from the very beginning. Although Vivian’s death would not have been prevented, she would have probably received better care, been informed about her prognosis, and included in the decision making process. She deserved to be treated humanely and the doctors should have payed the price for treating her as “research”. It’s imperative for all healthcare workers to encourage one another to practice with honesty, kindness, gentleness, and compassion. Treating patients, and each other, the way one would like to be treated. Also, we must remember to live a balanced life. One must work, but must also live and enjoy life, as illness and death is no respecter of person or status.
