I ask this because I've given one of my characters in my WIP a terminal cancer. In the story he has a month or so to live, he's not going through chemo or anything like that, but I have him dying much earlier than a month. I also have him dying by passing out while playing sports. I'm wondering if I'd be able to get away with something lie this, or if it would come off as insensitive? This story does not revolve around this character or this arc, by the way, if that helps. Thanks for reading!
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How important is it to be medically accurate?
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I am no cancer expert or anything, but a doctor's prognosis is never 100% accurate. I mean, haven't there been cases when people were supposed to have passed after a few months and then were still kicking years later? Further, you say he's playing sports. If he's only supposed to have a month tops by estimates, he's gotta be in pretty late stages where physical exertion like that is going to do a real number on the body. In those circumstances, definitely makes sense that he passes out and worsens his condition.
It has to be believable at the very least - and that generally means staying close to accuracy, if your story is set in this world.
One thing I've heard a lot is that is has a lot to do with the context/genre of your story. If it's a hardcore medical thriller, you're probably gonna need to be spot on with everything. If it's a romantic novel or commercial fiction, it should probably be able to fool the average reader into sounding like you know what you're talking about, but is probably OK if a doctor reads it and has some issues with the tiny aspects.
Since terminal cancer is a fairly common diagnosis and you're likely to get readers with some experience dealing with that, I'd say hew close to reality in this case. Different cancers, and different cases of each type of cancer, will likely play out differently, so there is some wiggle room and leeway, but some things are likely to be universal - lack of energy, perhaps lingering "chemo head," etc. And, as has been said, it's rare that a diagnosis of "a month to live" is precisely on the nose; it means one's in very dire straits and almost certainly has limited time left, but the patient could go earlier or later.
In general, it depends on how central the issue is to the story, how deep you want to research and how accurate you need to get - from "squint at a distance" to "down to the cellular level." (IIRC, the ailment suffered by Tiny Tim in Dickens's "A Chrismas Carol" is chronic literarydeviceitis, unknown in real-world medical circles, but the point of that story wasn't medical accuracy, nor was enough time really spent around him to make accurate details necessary; it was enough the boy was very sickly and that Scrooge's miserly ways were making things worse for him and his family, while generosity would lead to a miracle cure.)
In general, it depends on how central the issue is to the story, how deep you want to research and how accurate you need to get - from "squint at a distance" to "down to the cellular level." (IIRC, the ailment suffered by Tiny Tim in Dickens's "A Chrismas Carol" is chronic literarydeviceitis, unknown in real-world medical circles, but the point of that story wasn't medical accuracy, nor was enough time really spent around him to make accurate details necessary; it was enough the boy was very sickly and that Scrooge's miserly ways were making things worse for him and his family, while generosity would lead to a miracle cure.)
When my mom died of cancer, she could barely get out of bed, let alone play sports. So I'm not sure how believable I would find that particular detail, though it does depend on the execution.
What does insensitive have to do with it?
There are lots of ways to die suddenly from cancer or from additional causes. Not everyone wastes away though wasting away is much more common.
Why does it need to be a lie? All you need is a cause:
heart attack
stroke
tumor erodes through an artery
severe electrolyte imbalance (there are a number of ways this can happen)
stroke
tumor erodes through an artery
severe electrolyte imbalance (there are a number of ways this can happen)
Probably not very important. There's plenty of website devoted to pointing out inaccuracies in popular culture.
What *is* important, though, is that whatever inaccuracies you have in your narrative is matched at the least, surpassed at the most, by all of the narrative's strengths.
If your story is weak, having bad science is just going to heighten its other flaws.
What *is* important, though, is that whatever inaccuracies you have in your narrative is matched at the least, surpassed at the most, by all of the narrative's strengths.
If your story is weak, having bad science is just going to heighten its other flaws.
Cancer of what kind? Cancer is by no means a single affliction. Some cancers (lung cancer, pancreatic cancer, melanomas) are pretty much always terminal, although the time frame involved may vary a lot. Others (breast cancer, prostate cancer) are either curable or so treatable that death is postponed so long it is likely the patient will die of something else first. Likewise, some cancers are far more debilitating than others. You need to be more specific.
caw
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Many times late-stage cancer patients die in hospitals or at hospice. Some may die at home, especially if they make it clear to family they want to die at home, but usually there is some type of complication--pneumonia, a fall, etc. that sends them bed-ridden and then they don't recover. It's these complications that land them in medical facilities. Talia Joy was a child Youtuber who had terminal cancer and died. You can see through some of her final videos how the cancer was affecting her as it progressed.
There was an article some years back about a mother who died hours after diagnosis, but she, too, died at the hospital. Story Link.
So your execution wouldn't be believable to me. He could perhaps be particularly tired playing sports but push himself anyway because he wants to be with his friends, but he's so exhausted he passes out, and then becomes bed ridden and dies. What type of cancer does the character have? Because some cancers are more prone to causing anemia, and as someone who recently suffered severe anemia, I can tell you that he won't feel like playing sports. I sat down a lot leading up to me hospital admission. I was tired and my legs hurt and I was short of breath; I had headaches; I had mood-swings; I was depressed to the point of wishing for death. My judgment was off; I knew something wasn't right but never attempted to find out what it was. I was avoiding doctors.
I did clean out a back storage room the day my hospital admission before but very, very slowly. If he were to play sports he would be walking very slowly toward that soccer ball. He wouldn't even be playing. Diseases really take their toll on the body and cancer can be particularly aggressive so, yes, I would say being medically accurate is important. That doesn't mean you have to say what type of cancer it is or give the readers the staging or to which organs its metastasized or what the cat scan or x-ray reports reveal. The suffering that cancer causes on the body is what you want to be accurate.
There was an article some years back about a mother who died hours after diagnosis, but she, too, died at the hospital. Story Link.
So your execution wouldn't be believable to me. He could perhaps be particularly tired playing sports but push himself anyway because he wants to be with his friends, but he's so exhausted he passes out, and then becomes bed ridden and dies. What type of cancer does the character have? Because some cancers are more prone to causing anemia, and as someone who recently suffered severe anemia, I can tell you that he won't feel like playing sports. I sat down a lot leading up to me hospital admission. I was tired and my legs hurt and I was short of breath; I had headaches; I had mood-swings; I was depressed to the point of wishing for death. My judgment was off; I knew something wasn't right but never attempted to find out what it was. I was avoiding doctors.
I did clean out a back storage room the day my hospital admission before but very, very slowly. If he were to play sports he would be walking very slowly toward that soccer ball. He wouldn't even be playing. Diseases really take their toll on the body and cancer can be particularly aggressive so, yes, I would say being medically accurate is important. That doesn't mean you have to say what type of cancer it is or give the readers the staging or to which organs its metastasized or what the cat scan or x-ray reports reveal. The suffering that cancer causes on the body is what you want to be accurate.
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Probably a lot of people wouldn't know if it wasn't accurate but some would. So why not just run it by someone who would know?
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I would try to research the active dying process to get insight into the typical progression of things.
so.....a couple things:
1. People with cancer to the point of it killing them die from metasteses growing where they should not. Sometimes that means they grow places like the brain and physically squeeze out needed organs, sometimes they metastasize throughout the abdomen, or blood, or whatever else, and slowly starve the body as a whole both to feed themselves and because they cause a lot of bleeds, etc. as part of invasive tumor growth. In very few cases though as a patient's organs are failing, maybe their bones are becoming brittle, etc. do these people decide to go shoot hoops. So I'd have some issues with "cancer dude just drops fuckin dead, playing some 3-on-3" because cancer dudes who are near death don't tend to be tearing it up on the courts.
Does he need to die doing something physical? And does he need cancer? Because one of those might be a better fix than you trying to deep-dive into an improbably rare cancer/cancer-related event/chemo reaction/other to keep traveling this path. For example there are many heart defects that might work, like long q-t syndrome.
2. You're asking how accurate you need to be. Some would say "not very" but I tend to believe in damage mitigation--you're gonna fuck up parts of your story. So will I. Some you (or I) simply won't know about, or we may be unable to help ourselves. But some things (like doing your research) you have FULL control over. your mileage may, and will vary, but for me, I control what I can control. I'll fuck enough things up in my story the way it is that I don't need to fuck the research part or other things that I can actually fix through simple laziness. You don't HAVE to do the research. Any of it. But every single bit you mess up is a single small weight in your canoe. Eventually, given enough of them, the canoe sinks....
again, I choose to control whatever I can, instead of just willfully shoveling rocks into the canoe because it is easier than studying...
1. People with cancer to the point of it killing them die from metasteses growing where they should not. Sometimes that means they grow places like the brain and physically squeeze out needed organs, sometimes they metastasize throughout the abdomen, or blood, or whatever else, and slowly starve the body as a whole both to feed themselves and because they cause a lot of bleeds, etc. as part of invasive tumor growth. In very few cases though as a patient's organs are failing, maybe their bones are becoming brittle, etc. do these people decide to go shoot hoops. So I'd have some issues with "cancer dude just drops fuckin dead, playing some 3-on-3" because cancer dudes who are near death don't tend to be tearing it up on the courts.
Does he need to die doing something physical? And does he need cancer? Because one of those might be a better fix than you trying to deep-dive into an improbably rare cancer/cancer-related event/chemo reaction/other to keep traveling this path. For example there are many heart defects that might work, like long q-t syndrome.
2. You're asking how accurate you need to be. Some would say "not very" but I tend to believe in damage mitigation--you're gonna fuck up parts of your story. So will I. Some you (or I) simply won't know about, or we may be unable to help ourselves. But some things (like doing your research) you have FULL control over. your mileage may, and will vary, but for me, I control what I can control. I'll fuck enough things up in my story the way it is that I don't need to fuck the research part or other things that I can actually fix through simple laziness. You don't HAVE to do the research. Any of it. But every single bit you mess up is a single small weight in your canoe. Eventually, given enough of them, the canoe sinks....
again, I choose to control whatever I can, instead of just willfully shoveling rocks into the canoe because it is easier than studying...
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A writer never knows when a medical editor that works for, say, Reuters News Service, will read the work and give it a thumbs down based on medical inaccuracies. Others in the know from a medical perspective might consider minor technical errors to be indicative of the rest of the book. That, alone, could be a death knell for a new work by an emerging author. As already pointed out, cancers, for the most part, give a patient more than ample time to contemplate their demise, even heart cancers and tumors.
A possible alternative might be genetic heart disease which can, and does, kill some patients before it is discovered. I recall several national news stories reporting the death of high school or college athletes who dropped dead at home or even in class. Another story from about a decade or so ago was the US Navy Admiral who, on his morning jog in D.C. dropped dead in the street from a previously undiagnosed heart disease-and those guys get thorough medicals annually.
In the end, though, the writer will have to choose which circumstance best fits the story. I would go for medical accuracy as much as I could bring to the table, but that's me.
Good luck.
A possible alternative might be genetic heart disease which can, and does, kill some patients before it is discovered. I recall several national news stories reporting the death of high school or college athletes who dropped dead at home or even in class. Another story from about a decade or so ago was the US Navy Admiral who, on his morning jog in D.C. dropped dead in the street from a previously undiagnosed heart disease-and those guys get thorough medicals annually.
In the end, though, the writer will have to choose which circumstance best fits the story. I would go for medical accuracy as much as I could bring to the table, but that's me.
Good luck.
Give him an inoperable brain tumor. But give him longer than a month prognosis, say three to six months, to make it believable he's playing sports. The right tumor growth in the right location can induce a stroke and kill instantly. Otherwise, just give him an unexpected and undiagnosed heart failure to kill him off.
Jeff
I say "very". I research conditions in books,as a reader, and inaccuracies=book's over. I want to believe. I want to be there with the characters. In re: cancer, fantastic ideas have been offered in the thread.
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I mean, in theory, accuracy in that kind of stuff isn't TOO important.
For instance, think of how many movies you see where people are holding a conversation in a helicopter without any headsets. That's frankly impossible. But, they keep doing it, because no one really thinks about it.
On the other hand, I find accuracy to be a wonderful thing. I like it when it seems like the author took the time to research. I researched advancing technology in helicopters, where the blades are able to reduce the sound it creates--because I wanted my characters to talk in a helicopter.
For instance, think of how many movies you see where people are holding a conversation in a helicopter without any headsets. That's frankly impossible. But, they keep doing it, because no one really thinks about it.
On the other hand, I find accuracy to be a wonderful thing. I like it when it seems like the author took the time to research. I researched advancing technology in helicopters, where the blades are able to reduce the sound it creates--because I wanted my characters to talk in a helicopter.
What struck me was the playing sports bit. Most terminally ill cancer patients don't much feel like playing football.
I have a family member who was diagnosed with cancer and given 6 months (a very common prediction) to live. 30 years later, he is still playing football. In the last couple of years, I had one friend who was given the standard 6 months, went home and died that evening, and another who was given the same life expectancy and died two days after the diagnosis. Neither one of them was engaging in demanding physical activity. Cancer is unpredictable, but dropping dead in the middle of a game is highly unlikely. However, keep in mind that the demise of a cancer patient can be prompted by other things. Heart attacks, strokes, Ebola, murder.
Accuracy can be a problem. We see things in movies all the time that don't/can't happen in real life. Getting knocked out with no after effect is very common. No one ever suffers from concussion. If it's acceptable in a movie, does that make it acceptable in a book? I don't know. One of my books contains a scene where druids toss water in the face of their human sacrifice to revive him when he passes out. I am told that doesn't work. I left it in.
I have a family member who was diagnosed with cancer and given 6 months (a very common prediction) to live. 30 years later, he is still playing football. In the last couple of years, I had one friend who was given the standard 6 months, went home and died that evening, and another who was given the same life expectancy and died two days after the diagnosis. Neither one of them was engaging in demanding physical activity. Cancer is unpredictable, but dropping dead in the middle of a game is highly unlikely. However, keep in mind that the demise of a cancer patient can be prompted by other things. Heart attacks, strokes, Ebola, murder.
Accuracy can be a problem. We see things in movies all the time that don't/can't happen in real life. Getting knocked out with no after effect is very common. No one ever suffers from concussion. If it's acceptable in a movie, does that make it acceptable in a book? I don't know. One of my books contains a scene where druids toss water in the face of their human sacrifice to revive him when he passes out. I am told that doesn't work. I left it in.
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It's really going to depend on how rare it is. Having the experience of loved ones fighting cancer, or going through it themselves is not particularly uncommon for readers, and has spread even further via cultural osmosis, so the posited scenario, drops dead playing basketball, is one that's going to strike a lot of people as wrong.
'Accuracy' isn't the problem so much as verisimilitude. Even if it's not accurate, if it doesn't pull most people out of the story, it shouldn't be a problem. The presented situation seems to be the kind of thing that would.
'Accuracy' isn't the problem so much as verisimilitude. Even if it's not accurate, if it doesn't pull most people out of the story, it shouldn't be a problem. The presented situation seems to be the kind of thing that would.
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I notice scientifically and medically questionable content in novels. It's not always a deal breaker, depending on how central they are to the story, but they do make me wonder how carefully the writer has researched their book. I wonder if there are other inaccuracies that also crept in.
The biggest reservation I have re your example is that the people I know who died of cancer were not in any shape to be playing sports when they were within a month of their projected demise. Cancer can go very fast at the end, but even so, when someone is in a state where their doctor believes they are (barring a miraculous remission) within the final weeks of life, they are going to be weak, medicated heavily for pain, and very likely wheelchair bound or bedridden most of the time. At this stage, the cancer will have spread throughout the person's body and likely be in their bones and in other organs.
Or to put it another way, if a cancer patient still has the energy and physical strength to play football, he's likely not yet in what most doctors would consider the final weeks of his life.
It's possible for someone who has cancer in an earlier stage to die from sudden cardiac arrest during exertion, of course. This happens to people who don't have cancer as well. Also, chemotherapy and other cancer treatments do have complications, and they can weaken the heart or cause other issues that result in unexpected death.
Maybe there are unusual cancers that have a different pattern of decline, but I don't know of any. I can ask my brother, as he's an oncologist.
The biggest reservation I have re your example is that the people I know who died of cancer were not in any shape to be playing sports when they were within a month of their projected demise. Cancer can go very fast at the end, but even so, when someone is in a state where their doctor believes they are (barring a miraculous remission) within the final weeks of life, they are going to be weak, medicated heavily for pain, and very likely wheelchair bound or bedridden most of the time. At this stage, the cancer will have spread throughout the person's body and likely be in their bones and in other organs.
Or to put it another way, if a cancer patient still has the energy and physical strength to play football, he's likely not yet in what most doctors would consider the final weeks of his life.
It's possible for someone who has cancer in an earlier stage to die from sudden cardiac arrest during exertion, of course. This happens to people who don't have cancer as well. Also, chemotherapy and other cancer treatments do have complications, and they can weaken the heart or cause other issues that result in unexpected death.
Maybe there are unusual cancers that have a different pattern of decline, but I don't know of any. I can ask my brother, as he's an oncologist.
I would say it depends how relevant it is to the narrative in relation to how accurate (x and y axes).
If it's hugely relevant and moderately accurate, probably okay. If it's hugely relevant and really inaccurate*, I would say that's a problem.
If it's not relevant (background or fluff detail) it can still be okay even if wildly inaccurate, though it might put people off.
*thanks for the correction Buffy ;-)
If it's hugely relevant and moderately accurate, probably okay. If it's hugely relevant and really inaccurate*, I would say that's a problem.
If it's not relevant (background or fluff detail) it can still be okay even if wildly inaccurate, though it might put people off.
*thanks for the correction Buffy ;-)
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Melanomas are survivable if excised soon enough. Says someone who didn't become a widow 30+ years ago.
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I would strive to write a scenario that is plausible and will not pull readers out of the story. As others have noted, a terminal cancer diagnosis is something many probably have some familiarity with through a loved one or friend... very different than if you were writing about an obscure brain condition where if a tiny detail or two was accidentally off, maybe you'd only irk neurologists. For me, the first question that popped up was whether your character would really feel up to engaging in contact sports. I read novels that get the facts wrong in my former profession all the time, and it's sort of an eye roll moment, but you probably don't want to do it to the degree that every review of your book mentions it.
Several years ago I had an idea for a story about a man with a brain aneurysm that knows he is dying, and makes one final motorcycle ride across the country. In preparation, I spoke with my physician and got some idea - then (by providence) I recalled that a member of the motorcycle club I belong to was an ER Doc, so I called him up and nailed down the symptoms, how death would likely be experienced, and even got a list of drugs the MC would be taking. The story fell apart during the planning stages - but I may return to it someday.
My point is that there is information out there. Do your research and talk to your friends about your project. Use Google too - there's a ton of information about cancer on the internet.
Now - do you need to be 100% literal on all the symptoms regarding the condition you want your MC to suffer from? IMO, not necessarily because if you're writing fiction SOME coloring outside the lines is allowed. You just have to keep it plausible.
My point is that there is information out there. Do your research and talk to your friends about your project. Use Google too - there's a ton of information about cancer on the internet.
Now - do you need to be 100% literal on all the symptoms regarding the condition you want your MC to suffer from? IMO, not necessarily because if you're writing fiction SOME coloring outside the lines is allowed. You just have to keep it plausible.