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By Elaine Schattner, MD, on September 28th, 2011 Last night Showtime aired the second season’s finale of the Big C. As usual, there was no detail whatsoever about Cathy’s advanced melanoma or treatment.
I didn’t think the show could get worse, in the reality-of-having-cancer sense, but it did. Cathy, who still looks great and complains of no physical problems, determinately runs, walks and trudges through a New Year’s marathon. OK, that might happen, but it shouldn’t.
Biggest mistake ever in this series so far: In a scene near the end, Cathy’s first oncologist shows up at the race to see her meet the finish line. While they’re waiting, he and Cathy’s teenage son Adam go to a diner. Adam asks the doctor about his mom’s prognosis, and the oncologist answers.
It’s a blatant, medical ethics 101 no-no — talking to a patient’s family member without her permission. And to a minor, no less.
I just read the program
See more End of the Big C Season 2, ML Coverage Stops
By Elaine Schattner, MD, on September 20th, 2011 I stayed up last night watching the Big C. The latest episode, The Darkest Day, takes place on Dec 21 at the end of the show’s pseudo-fall second season.
Here, two things happen of above-average interest to this doctor-patient-viewer:
First, the characters’ usual and crude shenanigans are interrupted by Cathy’s visit to a class of future cancer doctors. (Can we say “oncologists”? No, it’s too big a word for this program.)
Second, Cathy aborts her family’s planned vacation to stay with her friend Lee, who’s dying. Her decision to stay with Lee is perhaps the most interesting, and controversial, decision she’s made so far, but I won’t harp on this, because how can anyone judge what she’s doing?
The lecture scene:
Dr. Sherman (Alan Alda) “presents” Cathy (Laura Linney) to his class, a group of diverse young people most of whom are taking notes on (Apple – another story) laptops
See more Cathy Tells Future Cancer Docs to Shut their Laptops and Speak Plainly
By Elaine Schattner, MD, on September 15th, 2011 Watching the Big C feels like a chore lately.
It reminds me of the feeling I used to get when I had to see and examine a patient in the hospital, under my care for some administrative non-reason, who didn’t need to be in the hospital IMO, and whose hospital presence took time my time away from patients who needed my attention. But because I was responsible, I’d go and see her every day just the same, and listen and examine, make notes and occasional suggestions.
The show is terrible. There, I said it on the Internet.
In the most recent episode, Cathy (the melanoma patient who’s said to be responding to a treatment about which viewers know nothing) runs into her oncologist at the pool where she symptom-freely coaches a swim team. The doctor, portrayed by Alan Alda, has a young wife who talks openly about sex with her
See more ‘The Big C’ is Failing
By Elaine Schattner, MD, on September 12th, 2011 
A Labor Day break in broadcasting afforded some respite from the Big C. The latest episode continues with its focus on normal and not-so-normal life among Cathy’s family and friends.
On the family front, her teenage son “Adam” goes with the woman he met on-line in a cancer kids’ support forum to her high school reunion and has a good time there, despite a strange blip in which she calls from the ladies’ room and asks him to buy her tampons. Cathy’s brother, said to have manic depression but to this doctor-TV-critic seeming more like a schizophrenic, continues to deteriorate off his meds. Cathy’s overweight husband buys a fancy scale with a computerized voice that tells him his “metabolic age” is too high.
About cancer, there’s little on screen: Lee, Cathy’s “cancer friend” and clinical trial companion, is coughing, but that detail goes unmentioned. He mentions that Dr. Sherman, the
See more The Big C Continues: on Family Life and Friendship, Season 2, Episode 10
By Elaine Schattner, MD, on August 23rd, 2011 Last night’s episode of the Big C may been the strangest yet. What happens, more or less, is that Cathy (Laura Linney) gets to attend her own funeral.
This odd situation arises because Cathy’s old, recently-pregnant friend (Cynthia Nixon) miscarries the child who would have been named in Cathy’s honor. Through a series of errors including miscommunication attributed to Twitter, some of Cathy’s childhood friends think that she has died. They arrive at the memorial service for the unborn child, thinking it will be Cathy’s funeral.
So the sad gathering turns into a weird reunion for people who care about the protagonist, along the lines of fulfilling a psychological fantasy about seeing who’d show up at one’s funeral, replete with the message that “life is short” and you shouldn’t wait to do what makes you happy.
No news, still, on Cathy’s melanoma, treatment or progress -
This show may lose
See more Cathy Attends What Friends Think Is Her Funeral
By Elaine Schattner, MD, on August 16th, 2011 I found it hard to stomach yesterday’s Last Thanksgiving episode of the Big C.
Besides that it’s August, and ill-timed, the show was just plain awful. (Sorry, Showtime, but if you don’t get this patient back on track you’re gonna lose her.)
Cancer was absent again. But I really want to know: What drug is Cathy on? Is it intravenous? Is it a pill? How often does she take it? Is she anemic? Does she have mets in her liver? Does she have pain? Give the audience something real to wonder and care about, please. Even one, meaningfully-informed treatment decision would be welcome. I have full confidence Laura Linney could handle the discussion, and more.
The only reference to the drug is that Cathy’s fingernails are falling off, said to be a side effect of the drug. So as not to make her cancer friend jealous, she covers the tips
See more A Miserable Episode of ‘The Big C’
By Elaine Schattner, MD, on August 9th, 2011 
This week’s installment of the Big C starts, promisingly, in a medical facility. A nurse or technologists notes that Cathy, melanoma patient extraordinaire, has high blood pressure. The plan is that Cathy should try to relax, and she’ll speak with “the doctor” next week about possible pills for treating the hypertension.
When she leaves the clinic we have no inkling about the protocol or what kind of experimental treatment she’s getting.
At the Bear Bar (“The Big C” Season 2, Episode 7)
Lee, Cathy’s friend in cancer-land on the show (portrayed by Hugh Dancy), suggests she try acupuncture. She’s open to this, of course. The duo go to an odd place where a woman inserts needles into Cathy’s head while telling her about chi (aka qi) and medical terms like anastomosis and symbiosis. This viewer learned that these words can apply to interpersonal relationships and connections between people. Great!
See more Life on the Big C – Cathy Tries Acupuncture and Visits a Gay Bar (Season 2, Episode 7)
By Elaine Schattner, MD, on August 3rd, 2011 
I almost liked the latest installment of the Big C. Cathy swims, for starters. I could relate.
She’s wearing goggles, no less. That’s universal “code” for seriousness about swimming, or acting. She swims well and pretty fast. Within seconds she befriends the competitive girl-swimmer in the next lane and, wouldn’t you know it, the girl’s team needs a new coach.
Cathy, who is undergoing treatment for Stage IV melanoma in a clinical trial about which the audience knows 0, steps in to coach the team. She meets some resistance from parents who worry about her condition and associated unreliability. She alludes, vaguely, to her rights as a cancer patient and firmly vows to lead the team.
“I can do it” is this episode’s message.
After some ups and downs, and after the viewer suffers from the director’s crude decision to mix the patient’s possibly having a pelvic rash as a
See more Cathy Swims and Runs in Episode 6, Season 2 of the Big C
By Elaine Schattner, MD, on July 26th, 2011 
Last night I stayed up to watch the Big C. Really it was a sleeper, except if you get excited when Cathy’s teenage son hires a dominatrix and then can’t pay the bill.
Cathy’s son in an experimental phase, Showtime’s “The Big C”
On the cancer front, there’s nothing new to report. We still don’t know what kind of treatment Cathy’s getting. The only “medical” topic is the uncovered cost of some procedures, like $1800 for an MRI, and her husband’s lack of an insurance-carrying job.
Emotionally there’s some development in this episode. Cathy befriends a young man, another patient on the clinical trial. The two talk about life and death in a college dorm-y way. They go to his apartment and get drunk. Wow.
This can’t be as deep as it gets.
Feels like a long season, already. As I said last week, I’ll stick with the show
See more Cathy Bonds With a Fellow Patient in the Big C Season 2 Episode 5
By Elaine Schattner, MD, on July 20th, 2011 
In this week’s episode, Boo!, Cathy wakes up in the morning eager and ready to start treatment on a clinical trial. The day doesn’t go well – the local treatment center doesn’t have needed information about her insurance, which can’t be tracked down on time, her 15 year old son gets in trouble at school, and her husband loses his job.
That kind of day – when it seems like everything possible that can go wrong, goes wrong – will seem familiar to many if not all cancer patients.
But the show continues to fail in providing any meaningful cancer information whatsoever. OK, I’m starting to accept the fact that ratings would suffer if the doctor gave even a 30 second mini-talk on BRAF mutations in melanoma. There will be no science on Showtime. But the scriptwriters could, at least, have included the discussion of the doctor and Cathy’s
See more The Big C: Cathy Goes For Treatment
By Elaine Schattner, MD, on July 12th, 2011 
Last night’s episode of Showtime’s The Big C — Season 2, Episode 3 — was about sex: high school sex, pregnant woman with her manic, now-medicated boyfriend sex, marital sex, masturbation sex and marital sex. And that was about it.
Laura Linney’s character looks at the man portraying her husband, in “The Big C”
Cancer and sex is an important topic, but I think it could have been handled better with a more focused, subtler study of the relationship between the patient and her husband during a period of illness. (The image with Cathy’s glance, above, is about as revealing as the story gets, in terms of Cathy’s feelings and her husband’s coping strategy — which is to keep busy with superficial activities.) Nestling their struggle with intimacy between the other, kinky and adolescent stuff in the episode distracts, clumsily, from the genuine issue.
My main disappointment with the
See more The Big C Tries to Get Sexy
By Elaine Schattner, MD, on July 5th, 2011 
The Big C stepped it up a notch last night, with a much better episode.
In the first scene Cathy, played deftly by Laura Linney, returns to the school where she works. She finds the kids are selling cupcakes, each decorated with a “C,” in a fundraising effort that’s intended, somehow in a manner unspecified, to help her cause. Her son’s getting lots of warm attention due to her illness.
Cathy appreciates it when one of her students, Andrea, portrayed by the actress Gabourey Sidibe, says, directly, “You don’t look good.” To this the protagonist responds with an immediate: “Thank you;” she’s glad that someone’s being honest with her.
Laura Linney and Oliver Platt in “The Big C”
Next, in perhaps the most credible scene so far, Cathy and her husband drink scotch while pouring over her insurance bills and writing checks for co-pays.
The show moves
See more Cupcakes (and cancer) for Cathy — Big C, Season 2, Episode 2
By Elaine Schattner, MD, on June 28th, 2011 
Last night the Big C returned, not surprisingly with an opening dream sequence. Laura Linney, portraying Cathy Jamison in the Showtime series, is running. The scene turns out to be a nightmare, and she awakens with a headache and her husband by her side.
Laura Linney portrays Cathy, hugging her son in Showtime’s “The Big C”
OK so far.
Within a few minutes, Cathy’s young oncologist informs her that the interleukin 2 hasn’t worked; after two rounds of “chemo” the melanoma hasn’t budged. Sitting at his desk in the consultation room, he suggests she roll some joints for relief of headaches. She says she wants another opinion. It’s about time.
The main problem Cathy faces in this episode is that she can’t get an appointment with her oncologist of choice, Dr. Atticus Sherman despite calling, calling and calling. So finally she thinks out of the box: “That would be
See more Cathy Wants a New Doctor and a Second Opinion
By Elaine Schattner, MD, on June 21st, 2011 
(Hopefully a second opinion)
When I last wrote on The Big C, a Showtime series in which the actress Laura Linney portrays a woman in her forties with advanced melanoma, I considered some of the options she might choose when the series resumes next Monday night.
Laura Linney, in Showtime’s ‘Big C’
At the end of Season 1, she elected to try a course of IL-2 as was recommended by her young oncologist. Meanwhile, the FDA has approved Ipilimumab (Yervoy), an antibody treatment that revs up the immune system. And she’s in line, according to the script, for possible entry into a clinical trial that likely involves a targeted therapy, like vemurafenib for patients whose malignant cells have a genetic mutation in B-RAF.
What I expect Cathy will do, before anything else happens and she receives any additional non-urgent treatment for her advanced melanoma, is get a second opinion.
See more What’s Next on the Big C? (Hopefully a Second Opinion)
By Elaine Schattner, MD, on May 12th, 2011 
I’ve been toying with the idea of messing with a cable TV show’s plotline. At the first season’s end of The Big C, the story’s protagonist decides to accept a harsh and usually ineffective treatment for her advanced melanoma: interleukin-2 (IL-2).
Laura Linney as Cathy (Showtime image, The Big C)
Cathy, played by the actress Laura Linney, understands the goal is not for a cure, but to temporize her disease for six months, when she might be eligible for a new melanoma drug through a clinical trial. Her oncologist has already completed the paperwork, according to the old script. The season ends with Cathy in a hospital bed with an IV catheter, presumably receiving the IL-2, and dreaming.
So I thought I’d explain a bit on interleukins and IL-2 in particular:
Interleukins are proteins defined by their capacity to communicate between different populations of white blood cells (between leukocytes).
See more Interleukin 2, Cathy’s Planned Treatment in the Big C
By Elaine Schattner, MD, on November 22nd, 2010 
“I don’t want to get sicker trying to get better and then just end up dying anyway” – Cathy, the 42 year old protagonist, with advanced melanoma, on the Big C.
Spoiler alert: Don’t read this post if you don’t want to know what happens to Cathy in the Big C…After months of unusual and comfort zone-breaking behavior, Cathy
See more Does Cathy Make the Right Cancer Treatment Decision in the Big C?
By Elaine Schattner, MD, on November 16th, 2010 
Last night I stayed up late to see the season finale of the Big C. For the first time in watching this series about a 42 year old woman with advanced melanoma, in a near-final scene involving the protagonist Cathy’s teenage son, I cried.
The storyline is moving, finally, in a real and not necessarily happy direction.
See more First Season Ending of the Big C
By Elaine Schattner M.D., on August 17th, 2010 
The Big C’s plot includes at least two “atypical” and potentially complex features. First, Cathy chooses not to take chemotherapy or other treatment. This intrigues me, and may be the show’s most essential component – that she doesn’t just follow her doctor’s advice. Second, she doesn’t go ahead and inform her husband, brother or son about the condition, at least not so far…
See more First Take On the Big C
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