Brief: A conversation between a doctor and a patient. The patient doesn’t know that the doctor has really bad news to impart e.g. The results of a routine medical where something serious has been found. There should be a strong contrast between the doctor and the patient.
Time: evening time – around 8 pm
Place: A hospital – paediatric cancer ward
Cast: Emily – Patient
Jenny – Emily’s mum
Dr Litt – initial A&E Doctor
Dr Reynolds- Oncology Specialist
The stage is in blackout, except for 1 spotlight on Emily, a fifteen-year-old cancer patient lying in a hospital bed. Emily is wearing a hospital gown and has oxygen pipes linked to her nose. In the background, there is the low hum of machines and a heart monitor beeping. Emily is explaining the journey she has been on at the hospital, with flashbacks to distinct scenes in her childhood.
This is it. I know I’m going to die soon, I guess I’ve always known it was going to happen, I just didn’t know when. But I’m okay with it now. I don’t mind my disease killing me because I know it’ll set my family free, and instead of me taking all the attention when others need it most, it can be shared again. Eleven years ago this whole ordeal started, and it’s been hell ever since. Even though at the time of diagnosis I was only three it didn’t take me long to come to realise that things were never going to change, I was never going to have a normal childhood, it’s hard to imagine what that even means.
The lights fade into a paediatrician’s office twelve years earlier. Emily, now a three-year-old girl, is sat on the floor colouring in, while Doctor Litt and Jenny, her mother, are sat across from each other at a desk. The stage is fully lit with a yellow wash, creating a sterile, dry hospital atmosphere.
Mrs Stevenson, the bloods we drew earlier are showing that Emily’s white blood cell count is much lower than normal.
So what does that mean? It could just be anaemia right, that isn’t something unusual for a girl her age.
I don’t know yet. It could be an Autoimmune Deficiency; it could be a lab error. But we’ll need to run more tests before we know for certain.
I’m going to refer Emily to a specialist for now though. In the meantime, we’ll need you to sit tight and be patient.
(The doctor hands Jenny a business card with Doctor Kate Reynolds details on. Oncology specialist. )
(Panic begins to set in)
Oncology? But that’s cancer, isn’t it?
In a hospital waiting room: Emily is sat on Jenny’s knee, and they are flicking through a children’s book and laughing together. The set should be bright and stark so that all attention is on the actors in the scene.
Mrs Stevenson? I’m Dr Kate Reynolds, Paediatric Oncology Specialist here at Mount View Hospital.
(Dr Reynolds’ pulls round a chair to face Jenny and Emily, before slowly sitting down, and glancing over her notes.)
Dr Reynolds (continued):
So, I took a look at Emily’s CBC, her white blood count is very low. (Pause)
The tests also showed that there are 12% Promyelocytes, and 5% Blasts in her blood.
There’s no easy way to tell you this, but this suggests a leukemic syndrome.
(Silence – Jenny reacts to this news, her face dropping and eyes widening.)
I’ll need a bone marrow sample to confirm, but it seems that Emily has Acute Promyelocytic Leukaemia.
No, no, no, this must be a mistake.
(Starts to break down emotionally, hugging Emily tight to her)
You’re sure? How can this be possible, she’s three years old? How am I meant to explain this to her?
My team are prepping a room now to begin the procedure as soon as possible until we have a definite answer we need you to try and stay positive for Emily. When the time is right we will help you explain to her.
Once again, Mrs Stevenson, I’m very sorry.
The scenery changes back to the setting of scene 1. Emily is in her hospital bed, with a spotlight on her, the rest of the set is in blackout, as though it is night-time in the ward.
I practically lived in the hospital from that day onwards. Dr Reynolds had been right. Over twenty-three percent of my cells had been infected with leukemic poison, and it was spreading further every day. By the age of eight, I had dropped out of school completely, too sick to study. I didn’t have friends anymore: no one wanted to be friends with the girl who had no hair after all, and even my mum’s attempts at styling my wig didn’t make me feel much better about myself. The only kids I knew now were cancer kids; those who, like me, spent more time in a ward than their own home. In fact, I barely even remember what my old room looked like.
I remember my tenth birthday, a chemo day none the less, my mum and the nurses organised a birthday party for me with the other children scheduled in for that day. It started well, we played pass the parcel from our chairs and a sitting down version of musical statues. Everyone was happy and enjoying themselves… but the fun and games really began when I became sick just as the cake was being brought over and ended up projectile vomiting all over it.
From there onwards, the hospital became my permanent home, and it was just one downwards spiral after another of depression and organ failure that threw us over the edge as I reached 14 years old.
Even though I knew mum would never stop fighting, I knew the battle would soon be over.
Dr Reynolds and Jenny join Emily on stage. Jenny sitting next to Emily in bed and Dr Reynolds on the other side, she is about to bring another round of bad news to Jenny and Emily. Jenny makes small talk with Emily as she enters, whilst Dr Reynolds checks machines and her clipboard.
How do you rate your pain at the moment, Emily?
Around a six today, but it’s better than yesterday.
Good good. We’ll get some pain relief sorted for you in just a moment. Before I go though we need to discuss your latest check up, Jenny if you wouldn’t mind stepping outside with me for a moment.
(Jenny and Dr Reynolds move across the stage. Emily’s side of the stage falls to black out, while Jenny and Dr Reynolds stay lit up.)
There must be some good news right?
I’m afraid not. Leukaemia isn’t just Emily’s problem anymore; the chemotherapy has taken its toll on her body and is causing one of her Kidney’s to completely shut down. Without a match being found soon, there isn’t much left we can do except make Emily as comfortable as possible.
What about me? Or her father, one of us must be a match for her. There must be a family member that can help us surely. She won’t be strong enough for much longer, we need to find someone now. Please, I’m begging you, She’s my baby girl and she’s fought too hard for this now.
Sadly, it’s an extremely unlikely circumstance for us to find a donor in your family. There’s only a one in two hundred chance of parent and child having the perfect Histocompatible HLA match. Of course, we will run tests, but the odds aren’t in Emily’s favour anymore.
(Agitated and in shock)
No, you’re wrong. She’s my miracle child, a fighter. She wasn’t meant to live past five years old, let alone be fourteen. She will beat this and when a donor is found she will be strong enough for the surgery. I know my daughter and she can do this.
I understand Jenny, but even though Emily has stayed with us for so long, her body is weak, and the more dialysis she faces the more infected her blood and body will become.
Then we need to work harder to find a donor.
Yes, but for now we need to ask Emily what she wants to do.
She’s my daughter and only a child; I know what is best for her.
You may feel that way Jenny, but after working with you both for so long now we really need to discuss this with Emily first.
I know you don’t want to hear this but it might be time that you contact Make A Wish and discuss with Emily how she wants to spend what time she has left.
Believe me, I know what she’ll say.