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Theatre: The bladder's tale

Nature volume 551, pages S42S43 (09 November 2017) | Download Citation

What happens when a professor of theatre finds out she has bladder cancer? She writes a one-woman play about it, of course.

In an intimate, packed theatre at the Kansas City Fringe Festival in July 2017, Mechele Leon took her audience on a journey that began with the discovery of blood in her urine in March 2016 and ended with the removal of her bladder later that summer.

Mechele Leon wrote and performed her one-woman play Bladder Interrupted to convey her feelings about having bladder cancer. Image: Melanie Rodriguez

Leon, who teaches theatre at the University of Kansas, told her story in the one-woman show Bladder Interrupted through a series of smart, humorous skits. During the hour-long production, which she calls a self-story, she used fairy tales, puppets, comedy sketches and even a pastiche of the storytelling show The Moth to guide her audience through her journey of disbelief, fear, illness and recovery.

Cancer may be severe, Leon said in the opening, but that doesn't mean there's no comedy. “I called the incontinence hotline,” she began, “and they asked, 'Can you hold, please?'.”

The first chapter was a fairy tale, which began with plans for a nice evening walk. As Leon sat on stage, turning the pages of her oversized book, she delivered the tale in short sentences and a pleasant, sing-song voice that contrasted unnervingly with the unfolding severity of her condition. At first there was shock when she found that her toilet was full of blood. Then there was the discomfort of the intense bleeding that caused clots to form, preventing her from emptying her bladder. Leon described the worry she felt when the doctor told her that she might have bladder cancer. But it was only when she got the results of the tumour analysis and heard words such as 'muscle-invasive' and 'chemotherapy' that she admitted to herself: “Now I'm afraid.” As the lights dimmed and she put away her book, the room was still with the weight of her realization.

In a sketch set in a 'communiversity', Leon welcomed the audience as 'life-long learners' to her community-university class to learn about bladder-cancer treatment. As the teacher, Leon described the standard surgery in which the bladder (played in a cameo by Mr Potato Head) and the lymph nodes are removed, and a diversion is created to deliver urine through a new opening (a stoma) in the belly to a collecting bag. She teased her students with the names of the treatments, deliberately mispronouncing complex terms such as 'bilateral pelvic lymphadenectomy' (removal of the lymph nodes). Leon even used practical demonstrations, using sausages to illustrate how the small intestine is co-opted to shunt urine from the kidneys to the stoma and into the urostomy bag. Sticking with the earlier toy theme, she compared herself post-surgery to a Betsy Wetsy doll, which wets itself after drinking water.

Leon also drew on her blog C67point2 (https://c67point2.wordpress.com), named for the code for bladder cancer that US doctors use to claim reimbursement from insurers; she wrote the blog in the months after her diagnosis and continued it right through her treatment. Leon sat in silence as the stage went dark and her blog was typed out on a large screen. She conveyed the frustration she felt when she first looked up her condition online and discovered the scant facts about bladder cancer. At the time there was little genetic research, and treatment protocols had barely changed for 30 years.

“She felt that her bladder cancer made her seem a little less worthy.”

Bladder cancer, she lamented, receives only one-tenth as much US research funding as breast cancer. Although it is less common, she said, bladder cancer has a higher mortality rate than breast cancer. It seemed to her that breast cancer also elicited more sympathy. While she was having chemotherapy, volunteers passed her by to assist nearby breast-cancer patients wearing pink hats, pink t-shirts and pink ribbons. She was not part of the 'breast-cancer sisterhood', but belonged instead to the 'grandfather-has-bladder-cancer golf club'. She felt that her bladder cancer made her seem a little less worthy.

Leon's play ended on an upbeat note: a genuine voicemail from her doctor telling her that she was cancer free. The audience cheered and clapped with relief. In her final moments on stage, Leon looked back, able to contemplate her experience now she was on the other side. She realized that the mythology that attends cancer treatment — with patients valiantly 'fighting' for survival — did not apply to her. What got her through this challenge was not being a warrior, but being a story-teller. Initially the tale was dictated by the doctors and their information about her condition. But gradually, she was able to weave her own narrative as she progressed from diagnosis through treatment to recovery, which gave her the opportunity to “try on different roles with new stories to tell... and there are so many ways to do it.”

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  1. Tammy Worth is a freelance writer based in Kansas City, Missouri.

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https://doi.org/10.1038/551S42a

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