The Times
Ann Treneman
Gerry Gajadharsingh:
The following article was sent to me by a patient, it’s part of my research for my new book, one of the chapters is about medical communication or rather miscommunication. I haven’t seen the play but the article picks up on the common theme of the differences in communication between doctors and their patients.
Medicine has a habit of making patients fearful, partly because of the terminology that is often used. I’ve lost track of the number of patients who I have seen, who think their spine is “disintegrating” or “crumbling” – their words not mine – simply because the radiology report (x-ray or MRI report), refers to degenerative change in their spine. This is often simply “wear and tear”. When a patient needs a PET scan they have to go to the Nuclear Medicine center! These are just two examples.Listening to patients and being sensitive to their understanding and using language that minimizes stress and fear could be so helpful, I’m surprised we have not addressed this is medicine before.
This play by Nick Payne, at just over an hour, is short but also very intense. It takes us to the near future, to a time when the brain will no longer be a total mystery. We meet a couple, two women, both in their early sixties.
They met in the forties, when they were both teachers. They fell in love and got married but Lorna has a debilitating brain disease (it is never given a name) which makes her forget where she is, what she just said, what she is doing.
Carrie and Lorna, in this near future, have a choice to make: will they opt for Lorna to carry on and eventually die or will they choose for her to have surgery, to replace the diseased part of her brain with a chip. This will save her life but her memory of the recent past will be wiped out. So if Lorna is to live, she will not remember Carrie. We see them before, during, and after the decision.
This play has been described as sci-fi but it feels like non-fiction. We watch as Carrie (Barbara Flynn) and Lorna (Zoe Wanamaker) grapple with their choice, trying to talk to their doctor Miriam (Nina Sosanya) who communicates in a way that way too many doctors do — ie they don’t.
There is one particular scene in which Miriam is enthusiastically explaining the science of what is to come, how the goal is to create a “hippocampal prosthesis”, which has been programmed to re-create at least some of our memories. So far, she explains, it’s only been done in mice.
“Mice?” asks Lorna, incredulous.
“Yes. And rats. Mice and rats and zebra fish . . .” notes Miriam.
For the couple, it is a life and death decision. For the doctor, it’s about process, science, mice and zebra fish. The miscommunication here is not that unusual. This is a play that doctors should go to, however much they think they shouldn’t.
The Donmar’s Josie Rourke directs with a confidence that the audience will be a thinking one. At times the play confuses, perhaps on purpose. The acting is flawless but, then, if it wasn’t, the play would simply crack.
The set, by Tom Scutt, is simple, mostly consisting of chairs, though there is an almighty tree trunk, split by lightning, encased in glass, at its centre.
My father died from brain cancer, a long time ago now. He was a doctor and he loved sci-fi. You can see why I would be entranced with this subject.
But this play goes beyond the personal, helping us all to ponder how science may change our lives and choices in the future. Payne has reached the parts that other plays about science often don’t reach.