The Big C is a dark comedy on Showtime about one woman’s courageous journey with cancer. Cathy Jamison has always played by the rules until she finds out that she has cancer. The writers use comedy to get close to this difficult topic, and each character has developed over the last four seasons as a result of the impact of Cathy’s cancer diagnosis.
It is not easy to think about one’s own mortality. I discovered this series several years ago when I was first diagnosed with cancer. It was amazing how the character Cathy was actually talking about the same feelings that I was experiencing. The writers very adeptly divided the series into the five stages of grieving, as defined by Kübler-Ross.
In the first season, Cathy, our courageous patient, receives the diagnosis of melanoma. She displays the classic symptoms of denial, followed by anger. At times her behavior is erratic and reckless. Cathy moves through the bargaining phase and addresses issues of clinical trials and changing relationships with family.
The first three seasons were all about humor surrounding the crazy life adjustments that Cathy makes in coping with her cancer fight. The writers were able to balance comedy with the more serious topic of mortality. At one moment I was laughing at a funny joke, and then the next, I was moved to tears as Cathy stocked a storage unit with presents for each of her son’s birthdays that she would miss after she passed away. This actually gave me the idea to buy special birthday cards and indicate gifts to be given for my granddaughter should I not be around to see it.
Throughout the four seasons, Cathy struggles to maintain control. Is this not true of our patients as well? As we move into the final season, Cathy receives news that her tumors have grown in spite of the chemotherapy and displays acceptance of the ultimate outcome of this disease. We see the following issues addressed:
- Bucket list items to be accomplished
- An oncologist who at times is very impatient only to reveal that he too is dying from cancer
- The positive effects of a psychotherapist
- The role of an inpatient hospice facility
- The supportive caring role of a “chatty” home hospice nurse
- The troubling side effects of chemotherapy
- The devastating results of metastasis.
This final season was a lot less about humor and much more about truth. I watched the last episode and felt as though I had lost a dear friend. While saddened, I was pleased that Cathy could say goodbye with everyone she loved at a final meal. She was even able to find closure with her estranged father. While dying, Cathy focused on her loved ones. She insisted that each should continue to follow their dreams.
It was actually comforting to observe Cathy’s final journey with both humor and respect. The writers should be commended for artfully dealing with such a difficult topic.
Oncology nurses witness the above behaviors everyday. Do you find that most of your advanced cancer patients experience the five stages of grieving?