Aug 10, 2010
August 2010: Reid Scott, one of the leads on the TBS show My Boys, plays oncologist Dr. Todd Maurer on the new Showtime series The Big C, which debuted on August 16. The show is billed as a dark comedy about a woman—played by award-winning actress Laura Linney—who upon hearing that she has a potentially fatal form of melanoma starts living her life with abandon.
ASCO Connection thought it would be interesting to see how oncologists and the cancer care community in general are being portrayed on a major television show.
AC: Could you describe your role on the show?
I play [the Laura Linney character’s] young, earnest, eager, maybe innocent and naïve oncologist, and they develop a very special relationship beginning with the fact that he’s the only one she’s honest with because, for a while, he’s the only one who knows that she’s sick.
Laura’s character is the first patient he’s had on his own since starting his practice. He takes everything to heart. He cares very deeply about his patients and this disease, and he really wants to help. He’s not jaded by any means. He really believes he can make a difference, and that’s his MO. I wonder if a lot of career oncologists will look at this guy and say, “Oh, I remember when it was so inspiring to be that young and naïve, thinking that you can change the world.”
AC: How will this character evolve on the show?
We’ll slowly start to see him get a glimmer that there’s a lot of heavy stuff to deal with. I think he is unprepared for the emotional toll it takes on the doctor as well. This is his first patient so he’s along for the ride as much as she is, and that helps foster the relationship that develops between the two of them. She, by default, is always going to be a very special patient to him because she’s his first.
AC: What kind of research did you do for the role?
I’ve been poking around online and talking to doctors. I have experience with cancer in my family and have a fairly decent layperson’s understanding. I’ve been looking up medical terms and treatments—some of the really awful treatments the patients have to go through—to understand the gravity of things. I also have a lot of doctor friends I’ve talked to about the emotional side of dealing with patients. How far do you remove yourself? How much of a vested personal interest do you want to have with your patients beyond the obvious professionalism?
AC: This is a tough subject. Do you think the show will receive any backlash?
I think people will get it. It’s not a comedy about cancer. This is a comedy about how people deal with cancer. Anyone who’s ever dealt with it knows that it’s full of all kinds of different emotions. The family goes on their ride, the patient goes on their ride, I’m learning the doctor goes on their ride, and everybody has a completely different experience. Within something so dramatic and heavy, there’s laughing, there’s crying, there’s screaming and yelling, there’s falling apart and putting yourself back together.
Keep an eye out for the Cancer.Net posters, which ASCO supplied for the show’s set.
A Doctor’s Perspective on the Complexities of the Oncologist–Patient Relationship
By Lidia Schapira, MD
I now have a couple of decades of perspective on the oncologist–patient relationship, in addition to the experience of significant personal losses. I also have the incredible opportunity to listen to some of the young doctors who share their doubts, concerns, and feelings with me, and to be able to provide as much guidance as I am able or they are willing to receive.
The concept of “boundaries” is helpful early on in one’s career, but after a while, the distinctions between the suffering of the “other” (i.e. the patient) and one’s own become less clearly defined. There is a way in which a compassionate doctor not only mouths the right empathic phrases but feels some of the pain that forms the foundation of what we call a healing relationship. We can’t “die” with every patient, but we too suffer losses which are cumulative.
Early experiences are normative and help shape how we cope with future and repetitive losses. We can’t feel the same degree of pain or involvement with all patients, but there continue to be some who touch us deeply—perhaps because of personal identification, the timing in our own lives that make us more vulnerable, or some other peculiarities which vary from person to person. At those times, the depth of our own reaction (which I think of as a form of grief) seems disproportionate, but it is so great because it recalls all prior losses—one death can shake us because it carries the force of dozens or hundreds that precede it.
What one learns is, in my view, not to “detach” affectively because it is impossible to do so, but to develop a presence that becomes less porous and yet conveys the necessary respect and compassion to the patient. There are many different paths to this cultivated therapeutic “persona.” One I find most helpful is meditation. Through disciplining and training my mind, I find it bearable to be in the presence of another’s suffering without detaching and without crumbling. I also find more support in working as a member of a team, rather than solo—the latter may be unsustainable in the long run. Those working with seriously ill patients and who are therefore likely to experience many deaths and losses will corroborate this fact: that teamwork and the support from colleagues are essential to our own emotional well-being.
Finally, I think different people vary in their ability to carry these loads and endure repeated losses, and it is important for every one of us to calibrate our activities in order to preserve our own mental health. Taking time away from work is essential, as is diversifying activities, finding supportive relationships at work, and knowing how and when to delegate. I have also found that mentoring others provides an extraordinary source of renewal and inspiration. And I should mention the enormous restorative power of laughter and play.
Dr. Schapira is a medical oncologist specializing in breast cancer at the Massachusetts General Hospital Cancer Center. She was Chair of the 2003- 2004 Doctor–Patient Communications Workshop Steering Committee and currently serves on the Editorial Board of Cancer.Net. In 2001, Dr. Schapira produced a short documentary about her relationship with a terminally ill patient,One Story, Two Voices: A Candid Conversation between a Cancer Patient and Her Oncologist, available through the Kenneth B. Schwartz Center (theschwartzcenter.org).