Undeniably, effective communication practices are necessary for the establishment of the therapeutic patent-nurse relationship and in the provision of ethical, safe and person-centered nursing care (Keaveney, 2004). On the same note, therapeutic communication refers to the face-to-face process of interaction that involves an emphasis on the emotional and physical wellbeing of a patient. Drawing on the film The Wit by Margaret Edson, I aim at identifying and discussing the examples of ineffective and efficient communications portrayed in the movie. Additionally, I seek to give a reflection on the identified examples of therapeutic communication used in the film and the context in which they are applicable. The award-winning play was a story about Dr. Vivian in her final weeks of life when she was undergoing eight months of rigorous and painful experimental treatments of ovarian cancer. Notably, Dr. Vivian is portrayed as a scholar of the seventeenth century and an accomplished professor, but her success has only made her live in isolation and only sought companionship in her books. All through the film, she speaks directly to a camera that represents viewers while reflecting, confessing and bantering viewers behind the lens. Apparently, the examples of verbal and nonverbal techniques used in the film include the use of tone, volume, and speed of interactions and body language. Additional methods employed by the writer of this movie include the use of irony, juxtaposition, the play of words, themes and paradox that makes this story easier to understand.
The Use of Dramatic Technique
Edson adopted an objective approach as shown in Vivian Bearing addressing viewers directly through the lens, which destroys illusions of an empathetic theater in existence. Apparently, the use of this technique has an effect of detaching and engaging audience objectively and not emotionally. Additionally, the use of direct narration to the viewers helps in speeding up the distribution of information, which translates to profit economically (Cooper, 2013, pg 24). The use of other alienating devices such as flashbacks, ironies and rapid change of scenes help in the understanding of the past of Vivian. Deductively the role played by these alienating devices is that viewers do not experience identification emotionally, Catharsis or Pathos (fear or pity). Instead, viewers are engaged intellectually, which leads to mental fascination in detached considerations of issues of death and life.
Use of Language and Tone
Edson focuses on the language of students and the manner in which they can improve or mislead communications, and she depends on the precision of language in conveying rigorous and disciplined analysis of her problems.
The Use of Rituals and Empty Platitudes
A platitude refers towards with pretense of truth and has been used in this film by characters such as Vivian, Jason, and Kelekian. In Vivian's case, she considers the formal greetings she receives as meaningless and just habitual practices. In the case of Jason and Kelekian, they refer to clinical procedures as a term used by medical practitioners to show personal interest.
The Use of Juxtaposition and Imaginative Language
Edson demonstrates how language is capable of adapting and the manner in which different areas of study use same words in meaning different things, which cause confusions and miscommunications. For example, in this film, the word alcohol can denote ethanol in medical research and Wine in the literary study while the term examinations are physical probing in medicine and questions for grading in literary study.
Play on Words
Play on words includes the use of irony, slang, paradox, punctuations and words with double meanings.
1. The use of Irony
The statement “Cancer is the only thing I’ve ever wanted.” Shows how fate has inverted the positions of authority between Bearing and Posner who has the passion for medical research. Cancer is the last thing that Vivian wanted, and while all her career she has focused on concepts of death, she is not prepared to face her own.
2. The use of Slang
This technique has been used in times of stress and crisis, such as when the suffering, pains, and humiliations of Vivian increased, she loses her ability to explain her condition.
3. The use of Paradox
The statement “My treatment imperils my health.” shows that the medications given to Vivian are not a cure but experiment for researchers to use on their future patients (Pg 30).
Punctuation has been utilized in this film in changing the meaning of words, for example in the case where Vivian, like Donne, view death as unrelated to life, can have different meanings with the use of proper communication. With proper punctuation, it is evident that life and death are intimately related and are only divided by a breath.
Reflection on the Film and Solutions to Gap Analysis
Researchers on the play Wit by Margaret Edson have identified the medical themes as a means of improving the health standards of the dying (Marks et al., 1998). However, my knowledge suggests an entirely different approach, a gap in the field of medicine, which when considered, has an effect of improving the standards of care for patients. The approach I have identified demands that health practitioners become more engaged with the underlying themes of the play particularly those of forgiveness, relationship, and forgiveness. On the same note, health professionals who consider this have the possibility of undergoing the personal transformation, which allows them to relate dying patients as human beings. I believe that the message in this play is for all audiences, and when doctors learn the words, they will learn useful things.
Gaps and Solutions
Forgiveness is a complicated concept, and it needs the recognition of one's feelings, but I also believe it requires assurances of acceptance and love to an individual. In the excerpt, I consider the theme as one that is forced, beginning from the onset of the play where Professor Bearing begs the audience to forgive her (Edson, 2001, pg 5). It is my belief that the poem by Vivian is a plea to God for forgiveness, and is spoken by an individual who does not accept the responsibility of forgiveness itself (Edson, 2001, Pg 50). It is my understanding that Vivian needs forgive her sins are overweening overwrought and intellect dramatics. However, she does not believe it is even possible for her to be forgiven and she has no slightest idea of how to ask for it. I believe that for one to be forgiven, there is the need for understanding our wrongs, and this concept would be beneficial to healthcare professionals and physicians. There is the need for learning what broke in relationships and the plot of the film is not what is important but the underlying truth. Therefore, we need to know that we are people of reconciling love before we are allowed to meet the demands of dying patients.
Relationships are necessary for forgiveness and dignity, and this is shown by the description of Posner on how humans form the glue that binds dignity by describing cancer to Vivian (Henley, 2015). This dialogue makes us understand the irony in the play as Vivian and Posner describe intellectual interests that they are themselves devoid of. Apparently, both find it impressive that cancer cells cause loss of contact inhibition, but instead they have lost their contacts with humans. This helps us to understand the extent of loneliness in the life of Vivian, through hints of childhood and incident of the death of her mother. Additionally, this gives us an understanding that she preferred the company of the library to that of her peers, and the reasons as for why she is unmarried and childless. Moreover, the relationship between Vivian and Kelekian is intellectual, and this is shown by their cries on the dullness of their students (Edson, 2001, pg 10). This indicates that there is the need for the establishment of a relationship towards improvements in the provision of healthcare services.
Dignity refers to worth or value, and each human being possesses it by being human, and the journey of Vivian throughout the play is oriented towards dignity despite the many suffering she undergoes (Edson 2001, pg 41). Apparently, I believe that Vivian thinks that her pride stems from her title, but on the other thought, her title shifts from “Doctor” to “Ms.” to “Vivian.” on the other hand, I believe that she might have thought that her dignity is because of her appearance, but her beauty fades with her hair that vanishes publicly (Edson 2001, pg 40). Additionally, she might have adduced that her pride stems from her freedom from enjoying life pleasures and pain, but her pain hurts like hell (Edson, 2001, pg 70). It is my understanding that pride is not connected to power and control as it is absent in the play from the onset and Vivian has to come to terms that her only worth and value is herself.
This paper has effectively covered on the verbal and nonverbal methods used in communications in the film and the effect they have on the plot. Additionally, the gap analysis on my knowledge, alongside the reflections, is critical in establishing an effective patient-nurse relationship that increases the quality of healthcare services.