BMJ  2003;327:755 (27 September), doi:10.1136/bmj.327.7417.755

reviews

Theatre

Breast

A play written by Polly Toynbee

Directed by Paul Clayton

East Midlands Conference Centre, Nottingham, 17 September 2003

Rating:

Four years ago I had a benign lump the size of a golf ball removed from my breast. That it was anything other than benign was very much a possibility in my mind, despite my youth. However, the experiences that Guardian journalist and breast cancer survivor Polly Toynbee portrays in her first play, Breast—previewed last week at the Nottingham Breast Cancer Meeting—seem like Mount Everest in comparison with my own.

Two actresses stand on either side of the stage, with a mammogram projected behind them. Souad Faress plays the central character, a woman who has breast cancer. Leslie Nicol portrays her male doctor, and slips into other characters from time to time. Faress lets out a blood curdling scream within the first minute—this is serious business. Yet it's peppered with sly jokes and, while deadly serious, manages to entertain.

There are certain universal truths that come through, like the need to blame someone. And when Faress tells her family that she has cancer, it is she who ends up comforting them.

The doctor ponders what it's like to bring such bad news to women, and says there's no way to break it kindly. He doesn't feel the same empathy with every patient. "Sometimes I feel tired or bored or not in the mood to feel their pain."

There is a strong political voice in this play. In a monologue near the end, where the doctor ponders the state of the NHS, you can almost hear the voice of Toynbee the political journalist, as if this were an extract from one of her columns. The play is also cleverly injected with bits of science, including a particularly smart description of "exquisite [cell] division."

But the play is perhaps at its best in examining the notion of patient choice. Faress's character faces the option of lumpectomy or mastectomy. The doctor explains the risks and benefits of both, saying it is Faress's decision. Faress tries to tease an opinion out of him, even guesses what he thinks. The suggestion is that patient choice is not all that it is cracked up to be—sometimes patients want to be guided.

I didn't have breast cancer, or even much of a chance of it. Yet I felt a tiny bit of what it might be like. But 10% of women in the United Kingdom do have it at some point in their lives. This play is an important step towards a better understanding of their plight.

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University of Sheffield

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