50/50

I know it first came out almost exactly a year ago, but I finally got to see the movie 50/50. I really liked it. I think it says a lot about the emotional trials that cancer patients go through.

The movie is about a 27 year old man named Adam who is diagnosed with spinal cancer. It was written by Will Reiser, a TV and film producer, who was diagnosed with cancer in his early 20's, and it's based on a lot of his experiences. It co-stars Seth Rogan, who was Resier's best friend in real life, and plays Adam's best friend in the movie.

Adam is, of course, shocked by the diagnosis ("That doesn't make any sense," he says to the doctor. "I mean, I don't smoke, I don't drink... I recycle..."). He's a good person who gets randomly hit -- like most of us.

The movie deals with what he has to go through physically, but really, it's about the relationships he has with other people. His girlfriend, a self-centered artist, can't deal with his illness and cheats on him. His best friend sees the cancer as an opportunity to meet women. His mother wants to help,but is also dealing with Adam's father's Alzheimer's. His co-workers have written him off for dead, and say everything to him that you shouldn't say to a cancer patient. His therapist is 24 years old, inexperienced, and sees him (at first) as part of her doctoral dissertation.

All of those relationship issues were the part that I liked most, and thought were very realistic. Everyone deals with someone else's cancer in their own way, and it's often not the way we want them to deal with it. The bigger problem is, we often don't know how we want them to deal with it, exactly.

I read an interesting review of the movie in Slate.  The reviewer had some problems with the film, particularly with the way Adam was portrayed. She says, "But Katherine [his therapist]’s not the only one who fails to get to the bottom of what Adam’s feeling: For the majority of the movie this quiet, sardonic young man remains impenetrable to the audience, too. Gordon-Levitt, a generous and versatile actor, rarely gets the chance to play anything beyond stoic repression" [until a couple of crucial scenes pop up].

I think she misses the point -- and it's certainly a point that the writer would have understood perfectly. We don't know how to act. We're trying to deal with the sometimes off reactions of the people around us. We're trying like hell to keep it together. If that looks like stoic repression -- keeping a straight face and holding it all inside -- then that's probably what it is. I'm glad the reviewer has never had someone close to her have to deal with cancer. I hope it stays that way for her.

Of course, this is a movie, and not real life. I get that, and I know a movie reviewer's job is to think about a movie as a movie, not as an emotional map for cancer patients. If this was a real movie, the anesthesiologist wouldn't have started the drip while still in Adam's room, instead of in the operating room, and Adam wouldn't have been asked to consider organ donation. And, I hope, in real life every medical professional wouldn't be quite as insensitive as they were in this movie. Really. They weren't monsters, but they were all kind of clueless about his feelings.

So I can't help but make a connection to real life. And here's the really sick part, the part that lets me know I'm about as deep into this whole lymphoma thing as I can get. At his first chemo session, Adam meets two other patients, one of whom has metastatic prostate cancer and the other "stage III lymphoma." Adam encounters them several more times in the chemo room. The prostate cancer patient has lost his hair; the lymphoma patient has not lost any. So I start figuring: OK, what are the chances that all three of them are on the exact same treatment schedule, that they're always in the treatment room together? I don't know standard treatments for the other two, but "stage III lymphoma" can be a million things. Let's narrow it down: no hair loss, so maybe he's on Rituxan? Or maybe Bendamustine? Off the top of my head, I know Bendamustine has a 21 day treatment cycle, with infusions on day 1 and 2. If Adam's spinal cancer is that aggressive, let's assume he's getting treatment weekly -- maybe every two weeks. That means Bendamustine is probably out for the lymphoma patient; Adam wouldn't see him weekly. Unless he's talking B + R, in which case he's been in for weekly Rituxan infusions. And that would explain the lack of hair loss, given the toxicity profile for B + R. And the lymphoma patient is snacking on marijuana-laced macaroons, probably to curb side effects like nausea that might come from Bendamustine. So, I have to say, the lymphoma patient either has Follicular NHL (or maybe Chronic Lymphocytic Leukemia, but they wouldn't have called it Lymphoma if that were the case), probably relapsed, and he's early in his 8 cycles of Bendamustine plus Rituxan.

Yes, that's the kind of thing I think about when I watch movies.

And this was a good one.