W;t (pronounced wit) by Margaret Edison, winner of the Pulitzer Prize for drama in 1999, has been the focus of discussion in the medical profession nationwide, and its potential lessons have not been lost on medical educators.1
In the summer of 2000, the Emily Company produced the play in Salt Lake City with 28 sold-out performances; this stimulated a seminar conference sponsored by the University of Utah School of Medicine's Division of Medical Ethics. An abridged production followed by a question-and-answer session with the cast was presented at the annual summer retreat of the Department of Family and Preventive Medicine. In addition, a special performance was conducted for first- and second-year students.
The play portrays a human being's quest for redemption. The protagonist is Dr. Vivian Bearing, a professor of 17th century poetry who has been diagnosed as having Stage IV ovarian cancer. As Professor Bearing reminds the audience, “There is no Stage V.” In this play, we observe Vivian's ordeal: an eight-month course of experimental chemotherapy, which ultimately does not cure her. In fact, the goal of the treatment was never to cure—its purpose was to advance knowledge. When a nurse commiserates that the doctors should have explained this better, Vivian responds that she knew it all along: “I read between the lines.”
The play derives its title and main theme from a poem by John Donne, “Death Be Not Proud.” In a flashback, Vivian recalls an encounter with one of her college professors, Evelyn Ashford, in which Dr. Ashford corrected Vivian's understanding of the last line of the poem. When the line is correctly punctuated, the words “life” and “death” are separated by a comma, not a semicolon, indicating only a pause between earthly life and eternal life (hence the semicolon in the title of the play).
The word wit in the Elizabethan world referred not only to clever or ingenious wordplay but also to the paradoxical or even the bizarre. It was a device used by 17th century poets, including Donne, who are known today as “meta-physical” poets. The root of the word wit is the Old English word witan, meaning to know. In Anglo-Saxon times, the Witan, a forerunner of the English parliament, was the King's Council.
In Romeo and Juliet, Mercutio speaks of Romeo's “five wits” (Act II, scene iii). Presumably, the Elizabethan audience knew that the five wits were memory, judgment, common sense, imagination, and fantasy. All of these elements can be found in Professor Bearing's repartee with members of the hospital staff until she comes near the end of her journey and realizes that “Now is not the time for verbal swordplay, for unlikely flights of imagination and wildly shifting perspectives, for metaphysical conceit, for wit…. Now is a time for simplicity. Now is a time for, dare I say it, kindness.”
Shakespeare enters into the play to indicate that it is time to leave wit behind. In a flashback to her college days, Professor Ashford had admonished Vivian for lack of academic rigor in her paper on Donne: “If you go in for this sort of thing, I suggest you take up Shakespeare.” Near the end, Ashford, her only hospital visitor in eight months, kisses a sleeping Vivian goodbye, telling her “It's time to go” and whispering Horatio's farewell to a dying Hamlet, “And flights of angels sing thee to thy rest.”
Reflecting on my experience in the theater, as well as my participation in the Medical Ethics Division seminar and my department retreat, I can report that W;t provides rich material for medical education. According to H. G. Fowler, the aim of humor is discovery of human nature, using observation to entertain a sympathetic audience, whereas the aim of wit is to throw light on words and ideas, using surprise to entertain an intelligent audience. I think audience members will find both humor and wit in this play, as well as feel empathy with and sympathy for its main protagonist and supporting characters.
1. W;t gives young physicians a taste of their own medicine. AAMC Reporter. 2000;9(10):1.