In the Health section's Second Opinion column last Tuesday, Dan Collison's name was misspelled. Collison was a producer, director and photographer for the film "Scenes From a Transplant: A Cancer Diary." (Published 12/14/99)
It's the ordinariness of the scenes: raking leaves in baggy pants and a charcoal hat, reading aloud from "Owl Babies," eating a chicken melt at Waffle House, walking through a blizzard. Scenes from a young woman's life. But as this extraordinary documentary begins, you wonder if these might be scenes from a young woman's death.
Rebecca Perl, of Silver Spring, has been diagnosed with non-Hodgkin's lymphoma, a form of cancer. After a year of unsuccessful treatment with radiation and chemotherapy, a bone marrow transplant is her only hope. A medical reporter for National Public Radio, she knows the University of Nebraska Medical Center is a mecca for this last-ditch procedure, and she has convinced her health plan to pay for it. So on a bright fall day, after saying goodbye to her 2-year-old son, she and her husband, along with a family friend, drive across the country to try to save her life.
Meanwhile they make a home video of the trip. Her husband, Tom Jennings, is a film maker and the friend, Dan Kollison, is a producer. The result is "Scenes from a Transplant: A Cancer Diary," an HBO documentary that airs tonight at 6:30 on Cinemax.
People who have cancer have a message for the rest of us. Whatever their fate, they are changed by the experience of facing their mortality in a society besotted with images of eternal youth and prosperity. In recent decades, a vibrant cancer culture has emerged in books and art and film. Not only is cancer more common with the aging of the population, but more and more people are surviving the disease. Health officials estimate that more than 8 million Americans have a history of cancer and a significant number are considered cured.
Perl, now 40, is a survivor. It's been three years since the transplant. But the experience is still vivid. Her story breaks through the country's collective denial of illness. In the seat opposite us on the Metro, in the line at the cafeteria, in the house across the street, "we are dealing with some really nasty stuff here," as Perl puts it.
In the surreal world of bone marrow transplants, the strategy is to destroy the body in order to save it. First, blood cells are harvested from Perl and frozen for later. Then she undergoes lethal doses of chemotherapy to try to wipe out her tumor--but the drugs are so powerful that they shut down her immune system as well. Doctors then infuse her own bone marrow cells to restore her immunity. The chances of success are only about 50 percent. "When you see six people in a room, that's what I think about," she says.
The documentary illustrates the gulf between those with cancer and people without it. All the doctors and nurses in the film are nice and competent. But people who don't have cancer, even medical personnel, have a different mind-set. They look at the disease as a foe to be vanquished. To them, treating patients is like waging war. Or competing in a football game. What counts is the score. So there's a rah-rah subtext: Gotta fight. Gotta keep your spirits up. Gotta win.
In one scene, a well-meaning nurse says to Perl and her husband: "Have a good weekend. It's supposed to be nice here." And you wonder: What planet does this nurse live on? Perl is pale, exhausted, hairless. She's throwing up. One time she blacks out in the apartment they've rented in Omaha and is rushed to the hospital. She gets an infection. Meanwhile, it's winter in Nebraska--15 degrees below zero and snowing.
When Perl gets a good result, it's like she has made a touchdown. After the transplant, a nurse says: "She did a great job." And when her immune system starts to kick in, the doctor exclaims: "You did it." At the end, months after the transplant, when Perl is pronounced a success, she says: "I feel like a contestant in a game show."
But that's not what having cancer is all about. As the documentary makes clear, it's not a game, or a war. If Perl has a setback, does that mean she did a bad job? Whatever the outcome, having cancer is having a life shaped by the duality of light and dark. It's not about being a soldier, but being human; not about winning or losing, but about taking what comes and loving those close to you. As a fellow transplant patient explains, it's "the only way to go . . . . Every day is anxiety . . . . Every day you're evaluating your life."
Much of the film's power comes from the other patients in the clinic. There's the toddler whose mom points to Christmas decorations and says in that special voice mothers use for children, "There's a bird, there's a snowflake"--the same way Perl sings to her son over the phone, "I have a littly pony, his name is Macaroni." When another patient suffers what proved to be fatal complications, his 8-year-old daughter comes in and plays the flute. "He did get better when I played for him," she says with a big smile.
In the transplant unit, the people with cancer are all the same. Yet some will survive and some won't. Their precarious world is stripped to the most important elements: love for a child, love for a spouse, love for a parent, love for a friend.
So is the documentary: spare and moving.
CAPTION: In the documentary about her cancer treatment, Rebecca Perl reads to her son.