Shu Wen Xie

Experiencing a Health Challenge: Effects on Vivian Bearing

Margaret Edsons 1999 Pulitzer Prize winning play Wit describes a patients (Vivian
Bearing) battle with death and in the process reveals the need for humanity in the sterile
healthcare environment. Vivian Bearing, 50 years old, lives a life of solitude and devotes all her
time in studying and teaching the brilliantly difficult Holy Sonnets of John Donne. She is
diagnosed with advanced (stage IV) metastatic ovarian cancer by Dr. Harvey Kelekian, who
enrols Vivian in an experimental chemotherapy treatment program. Vivian survived the eight
gruelling treatments at the full dose; however, she is dying. As Vivians condition gets worse and
fear increases, she begins to reassess the meaning of her life and work, while struggles to cope
with her imminent death.
Three significant physical effects of health challenge: Vivian experiences chemotherapy-induced
nausea and vomiting, neutropenia and intensive pain caused by advancing cancer. 1)During the
first cycle of chemotherapy, Vivian experienced severe nausea, vomiting and anorexia. Dr. Jason
Posner stated that nausea and vomiting is routine, and did not address the negative impact it has
on Vivian. Studies have showed that chemotherapy-induced nausea and vomiting has a
significant negative impact on the individuals quality of life (Navari, 2013).

Prophylaxis anti-

emetic therapy is preventative measure to reduce these symptoms, which will lower risks of
complications related to nutrition and fluid imbalance (Navari, 2013; Lewis, Dirkse, Heitkemper,
Bucher & Camera, 2014). 2) After the fourth cycle of treatment, Vivian returns to the hospital
with a fever of 39.4C and neutropenia (a condition associated with abnormally low level of white
blood cells). She is in isolation because the chemotherapeutic agents have eradicated her
immune system. Febrile neutropenia may associate with life-threatening complications such as
multi-organ failure (Lyman, 2006). While in isolation, Dr. Kelekian begins the fifth cycle of

Shu Wen Xie

treatment at full dose despite Vivians current fragile state of health. According to the study by
Lyman (2006), chemotherapy dose reduction may prevent neutropenia; however, decreasing
doses may decrease efficacy and increase risks of disease progression. Vivian expressed the
paradox of her treatment imperils her health. 3) Vivian miraculously survived eight treatments of
Hexamethophosphacil and Vinplatin at full dose. Unfortunately, cancer has metastasized to the
bone, in her pelvis and both femurs. She is writhing in pain. It is common for patients with bone
cancer experience moderate to severe pain and treatment priority is pain management (Lewis et
al., 2014). Dr. Kelekian denied Susies request Patient-Controlled Analgesic (PCA) and ordered
a morphine drip. Slowly the effect of morphine kicks in, Vivian falls asleep and eventually the
morphine puts her in a coma.
Three significant psychosocial effects of health challenge: As Vivian is suffering with
debilitating physical illness, she is also experiencing psychosocial stresses such as
loneliness/isolation, loss of identity and powerlessness. 1) Vivian is battling the fatal illness all
alone. During the entirety of her illness, she only received one visitor Professor E.M. Ashford
(her former mentor) at the last movement of her life. The team of physicians are impersonal and
lacks empathy towards her. While in isolation, the solitude she once enjoyed has turned into
unbearable loneliness. Finally, she let down of her guard and reaches out to her former student
Dr. Posner. He thought the change in her attitude is a sign of confusion. Vivian sadly stated,
The young doctor, like the senior scholar, prefers research to humanity. At the same time, the
senior scholar, in her pathetic state as a simpering victim, wishes the young doctor would take
more interest in personal contact. (Edson,1999, p.59) 2) Ovarian cancer not only ravaged
Vivians health but she also loss her personal identity in the process. Her personal identity as a
scholar is being strip away when she becomes a patient. The immediate focus is on the