Bad Cripple
She looks like a fairytale princess awaiting a kiss to wake her up. Her dark hair fans out across a pillow, and though she’s about to die of cancer, she just looks a little tired, like someone who stayed up too late studying for an exam. Though she has a lovely face, it’s that hair that keeps drawing your eye. Black as a crow’s wing, impossibly lush and shiny, she looks as if she’s going to get up and go directly to shoot a shampoo commercial.
The light above her hospital bed giving her an ethereal glow, she spends her last few minutes on this earth telling her newlywed husband that her final wish is that he be happy after she’s gone. Then, perhaps even lovelier than when we first saw her, healthy and full of life, she quietly, peacefully passes away.
So ends the story of Jennifer Cavelleri, tragic heroine of the 1970 opposites attract romance Love Story, at one time a contender for a Best Picture Academy Award, and now a mostly forgotten camp melodrama, with the absurd tagline “Love means never having to say you’re sorry.” Jennifer was portrayed by Ali MacGraw, and her performance inspired Roger Ebert to come up with the term “Ali MacGraw’s Disease” to refer to terminally ill movie characters who only become more beautiful as they draw closer to death. Some particularly serious cases have included Shailene Woodley in The Fault in Our Stars, Mandy Moore in A Walk to Remember, Robin Wright in Forrest Gump, and Nicole Kidman in Moulin Rouge.
Now, let me give you a brief overview of how I looked when I nearly died of kidney failure in 2020: due to severe anemia, I was covered in so many bruises that I looked like I had been beaten. So weak I was unable to wash or even brush my shoulder-length hair, it matted itself to my head. While trying to give a urine sample, I nearly fainted in the emergency room bathroom and ended up pissing all over myself. Any attempt to eat or drink something resulted in my explosively vomiting, at an uncontrollable force that made me wonder if perhaps I was possessed by a demon.
Even once I recovered and was discharged, I had new, even uglier bruises up and down my arms from countless injections and IV lines. I still hadn’t taken a shower. Unable to brush it out, a kind nurse had worked my hair into a bun while I slept, and it had come halfway loose by the time I left the hospital, a shapeless lump hanging from my head like some kind of unidentifiable animal. While I looked a lot better than when I was admitted, I still looked terrible. I was dirty. I smelled bad. This is the reality of serious illness. You don’t look angelic, and you definitely don’t look even more beautiful than you did when you were well. You just look sick.
Julia Robert, about to slip into a coma in Steel Magnolias
Obviously no one should look to television and movies for any sort of depiction of reality. Even in 2022, it can be a challenge to find oneself depicted in pop culture if you’re not young, thin and attractive. But where there seems to be a discernible commitment to false depiction is the portrayal of sick and dying people. So averse are Americans as a culture to the very idea of one’s body breaking down, let alone dying before we get to an acceptably old age, that we can’t bear to see it even in fiction. We prefer a sanitized approach, free of bodily fluids and scars, with sick people presented less as individuals with agency, and more as almost holy symbols of bravery and selflessness. Whatever anger and fear they may have about disability or dying conveniently happens off-camera, so that the audience only gets to see them being strong, and always putting others before themselves.
Let me take a moment to clarify that, while I am facing an eventual kidney transplant, I am not currently dying. Most days I feel quite well, and am in good enough health to maintain a full-time job. But I came very close to dying in the hospital, and what got me stable, and what keeps me stable now, is regular dialysis treatments. I would die without them, possibly as soon as a few weeks. So, as good as I feel most of the time, I am, by the definition of the word, a “sick” person. I have a serious, life-threatening illness. I think about death more often than is probably healthy. My reality is something that is softened, watered down, even in some ways romanticized, so that it’s more palatable to “normal” people.
Though 750,000 people in the U.S. are diagnosed with kidney failure each year, and 15% of adults have some form of chronic kidney disease, there is virtually no media representation of it. The most well-known is likely 1989’s Steel Magnolias, in which Julia Roberts, as the saintly Shelby, risks her health as a Type-1 diabetic in order to have a child. She has her baby, then almost immediately goes into kidney failure, begins dialysis (which is never shown), and then undergoes a transplant, all within just a year. If not for other characters frequently remarking upon Shelby’s fragile health (and the terrible short hair wig Roberts is inexplicably forced to wear about halfway through the movie), you would never know there was anything wrong with her. She glows with vitality, there are no visible scars or bruises on her arms from dialysis treatments, and she seems to have boundless energy right up until the very moment when she develops a post-transplant infection, after which she quietly, peacefully passes away, having given her life up for motherhood, as she wanted.
There’s also 2009’s ghoulish My Sister’s Keeper, in which Abigail Breslin plays Anna, who quite literally was created just to provide spare parts for Kate, her cancer-stricken older sister. When Kate’s kidneys stop working, it is simply assumed that Anna will give up one of hers, even though in real life no surgeon would perform a kidney transplant on someone actively undergoing cancer treatment, let alone accept an organ from an 11 year-old living donor. Anna’s mother (Cameron Diaz) is so unconcerned with the ethical issues of this situation that Anna is forced to sue to prevent the transplant from taking place.
As it turns out, Kate, who, like Shelby in Steel Magnolias, is a beacon of selflessness, has put Anna up to filing the lawsuit, because she no longer wishes to go on fighting for her life. She too quietly, peacefully passes away, and in a “touching” epilogue, we learn that her parents are finally able to do what they want with their lives, and her older brother, long ignored in favor of Kate’s needs, is able to go to art school in New York City. It’s meant to be an uplifting ending to nearly two hours of unrelenting sadness, but mostly it reinforces the fear that many chronically ill people (myself included) have: that we’re a burden on our loved ones, and they would be better off if we died.
Nicole Kidman, dying of tuberculosis in Moulin Rouge!
To say that both of these films downplay (if not ignore entirely) the grueling process, both physically and bureaucratically, of a kidney transplant would be a grievous understatement. But they’re hardly the only offenders in portraying failing bodies and human mortality as feel-good inspiration porn. Few, if any, movies involving a character with a serious illness ever touch upon such frivolities as health insurance, medical bills, disability, or the practicalities of balancing work (assuming you can still work), personal responsibilities and some semblance of a social life with endless doctor’s appointments, bouts of fatigue, and pain management. The concept of “crowdfunding” to pay for medications, or an experimental treatment that insurance refuses to cover, doesn’t exist. The path from diagnosis to a quiet, peaceful death is a straight, uncomplicated line.
Let me again clarify that I am in a much better position than many other chronically ill people. I’m still able to maintain a full-time job, and my employer offers enough scheduling flexibility to attend my dialysis appointments (though it means waking up at five in the morning to do so). I’m not forced to live on the pittance offered through federal disability benefits, or to abide by its restrictive rules on personal savings and whether or not a recipient can get married. I have reliable health insurance coverage, and don’t have to fear that every doctor’s visit or medical procedure will result in a massive bill weeks later.
But I’m also keenly aware that these are all situations that could change in an instant. My health could decline to the point where I am no longer able to work, or, at least, to a point that is no longer sustainable for my employer. Health insurance is finite – employers drop or change plans, doctors refuse to work with providers or vice versa, people lose jobs, and it’s all out of the patient’s hands. I do not sleep confident in the knowledge that things will be the same a year, or even a month from now. It is a matter of taking things one day at a time, and hoping that things will end the same way they started, and that an envelope or a phone call won’t immediately change my life for the worse.
Charlize Theron, terminally ill from Hodgkin’s Disease in Sweet November
No one ever talks about these things in the movies. Words like “insurance” and “premiums” and “outstanding balances” are never mentioned. Medical bills are always paid, with plenty of money leftover for luxurious homes and the crossing off of extravagant bucket lists. For all we know, life-saving medication is free, and doctors treat their patients in exchange for eggs and butter. All that’s missing to make it a complete fantasy is a wizard and some dragons.
Similar to the “magical negro” trope, in which a person of color exists solely to offer support and wisdom to a white protagonist, sick people in movies don’t seem to have much of an internal life. Their purpose is mostly to bring other characters together, and teach them to appreciate the value of life, before shuffling off this mortal coil. Any struggle they may have with anger or depression in processing their illness, or the fact that they may die, is never shown. Rather, they’re epitomes of dignity and grace, their primary concern not themselves, but the people in their lives.
In Steel Magnolias, Shelby’s primary concern was giving her husband a baby. For Kate in My Sister’s Keeper, it was making sure her younger sister got to live a normal life. Charlize Theron, suffering from a lethal combination of both Ali MacGraw’s Disease and Manic Pixie Dream Girl Syndrome in 2001’s Sweet November, does little more with her remaining time on Earth but give the various men she dates personality makeovers. We don’t even see her pass away, she simply slips away and disappears, sparing love interest Keanu Reeves (and the audience) any unpleasantness. Susan Sarandon’s primary concern in 1998’s Stepmom isn’t the cancer that’s slowly killing her, but training her ex-husband’s new wife to be a proper stepparent. In 1982’s particularly noxious Six Weeks, preteen Nicole (Katherine Healy) cannot rest in peace until her mother finds a new boyfriend. As with Shelby in Steel Magnolias, were it not for characters often mentioning that Nicole is dying of leukemia, it would be impossible to tell. She even has the strength to dance in a Lincoln Center production of The Nutcracker, then dies later that night, just looking a little pale.
Katherine Healy, a day before dying of leukemia in Six Weeks
Forgive my selfishness, but should my condition take a turn for the worse, I would not be terribly concerned about auditioning people to slip into the role of me in my loved ones’ lives. In fact, I can’t think of anything more existentially depressing than the idea that if I die I can simply be replaced, a blank space for someone else to fill, as if I had never been there in the first place. I can’t imagine I’d suddenly be a font of wisdom for my loved ones, thinking of nothing but their needs and concerns. I’d be angry. I’d be scared. I’d be sad. All of those things that are apparently too upsetting (or distasteful) for movie audiences to see.
I’m not even dying, my health remains stable, and even still I’m angry and self-pitying. I am a bad cripple. I think of no one but myself.
One of the very few movies that gets both the emotional and physical strain of being a sick person right is 1993’s Philadelphia. Tom Hanks as lawyer Andrew Beckett starts the film already losing his battle with HIV, and visibly deteriorates over the course of it. He doesn’t simply look a little tired, he loses weight, his face becomes drawn, dark circles form under his eyes, and he develops Kaposi’s sarcoma, unsightly skin lesions most commonly associated with AIDS. In fact, one of the most gripping scenes involves Andrew being asked to sit in a private room at a law library, because his sickly appearance is too upsetting to the people around him.
As opposed to merely being a personality-free symbol of grace and strength in adversity, Andrew is the main character in Philadelphia. Much of what happens is from his perspective, and his primary concern is not making sure the other people in his life are happy and taken care of, but that he gets justice for the unfair and illegal loss of his job. Most importantly, we know how Andrew feels about his situation. He’s scared, he’s angry, and he’s despondent, as illustrated when he weeps while listening to a Maria Callas aria. While he does get a quiet and peaceful death, one gets the impression that it wasn’t without a fight in his heart. Because Andrew is a real, fleshed out character, his loss feels genuine, and not just a cheap, manipulative tactic to wring tears out of the audience.
If a sick or dying person must be depicted on film, it should not be too much to ask that they be portrayed honestly, as real people and not secular saints. I want their experiences to be familiar, relatable, even if it means just one scene where they’re fighting with their insurance provider to get a bill covered, or having to deal with an unpleasant side effect. I want them to express fear, sadness, and most of all, anger. Without fear of offending anyone’s delicate sensibilities, they should be able to rail to the heavens, and cry out it’s not fair, it’s not fair, it’s not fair. Because it isn’t. It isn’t fair.
