Cancer management is reduced to a choice between optimism and pessimism, while the hard questions — the unequal distribution of medical resources, stigmatization of patients and the poverty that comes with illness — remain mostly unexamined.
By ZHAO Yunxian
Translated By GU Yiwei
“Perseverance brings victory”: This appears to be the message of A Little Red Flower. Teenager WEI Yihang is recuperating after a brain tumor surgery when he meets and falls in love with another young patient MA Xiaoyuan. Pedestrian and predictable, Xiaoyuan teaches the cynical and disheartened Yihang to fight cancer “like a warrior,” gets him back together with his estranged family, and shows him the joy and meaning of life.
At the end of the movie, after Xiaoyuan’s death, Yihang travels to the seaside town where the two had dreamed of leading a “normal, happy life” as if in a parallel, cancer-free universe.
Cynically tear-jerking, there is something essential missing from Flower: cancer. The loss of bodily functions, the psychological strain, the sheer filth, and pain — are nowhere to be seen as beautiful (healthy) actors act out lofty two-dimensional messages such as “attitude is everything” and “perseverance brings victory.” With the uplifting tone already set, cancer management is reduced to a personal choice between optimism and pessimism. Hard questions — distribution of medical resources, stigmatization of cancer and cancer patients, and disease-induced poverty — mostly remain unexamined, almost as if reality would ruin the beauty of the message.
This euphoric depiction of “cancer fighters'' must at least be partly responsible for the recent cyber violence against a young patient who vlogged about her experiences. Behind the hatred and insults lie social and economic injustice, completely ignored in Flower. The disease is not beautiful. Positivity does not cure anything.
In Flower, Yihang’s despondence and anger are depicted as personality flaws that can be easily corrected. As proof, Xiaoyuan, who suffers from a more severe condition, is able to live a “normal” and productive life through the power of her smile. She berates Yihang for his self-pity and cynicism, which, as she not so subtly points out, exacerbates his anger and sadness.
This runs counter to research that shows that emotional distresses are common among cancer patients, and it is the direct result of the treatment itself. A five-year study in Guangzhou documented personality changes in multiple patients during treatment. One of them, an amicable and even-tempered man rehospitalized after a home accident was found to be suddenly prone to anger despite the short period between the two hospitalizations.
Depression and anger are often wrongly attributed to physical discomfort and expected to go away with the pain. For patients, however, the shock and humiliation associated with the loss of autonomy linger long after treatment is over, just like any other case of posttraumatic stress disorder (PTSD). Yihang’s inadvertent and ignored PTSD is one of the few accurate aspects of Flower.
The recovery process can aggravate the trauma and the emphasis on curing a physiological condition has obscured the psychological and social ramifications of treatment. Harvard professor Arthur Kleinman draws a distinction between "disease" and “illness.” Disease, according to Kleinman, is a biochemical phenomenon, while illness encompasses symptoms and suffering, including how the patient interprets the disease itself and his or her own relationship with it. Cancer treatment is focused on physiological fixes, leaving the patients’ mental suffering largely untended. When the body is cancer-free, all other effects are expected just to disappear, but in many cases, the “cure” leaves patients in endless fear of recurrence, forever changing the way they think and live. Boiling this wide spectrum of emotion down to “optimism” and “pessimism” is naive, counterproductive, and cruel.
Modern illnesses, from migraine to cancer, are complex and long-lasting. They have no cure as such, with patients learning to live with the symptoms rather than becoming completely well.
As diseases like cholera and tuberculosis become less threatening, cancer, which has been with us for thousands of years, looms larger than ever. As treatment becomes available and affordable, more patients get cancer under control and coexist with the condition, often with a decent quality of life.
One problem is the language of cliche and slogans we use for cancer. Patients are “fighters” who “battle” with cancer. But recurrence is always a possibility and the battle is rarely definitively “won.” The mindset is switching from “fighting” to “living with” cancer. Rather than war, peace, and the quality of life it brings, are the new objectives – objectives completely ignored by the makers of Flower.
Many patients adopt that mindset without much prompting. Perseverance brings victory, but for many, perseverance simply means getting back to normal. The new normal often means carrying prescription medicine everywhere or intravenous feeding. Courage and resilience deserve everyone’s respect, but what if a patient chooses to be angry, sad, or simply give up?
The movie uses Xiaoyuan, a cancer patient herself, to criticize Yihang for reducing himself to a constant state of despondency, in an attempt to avoid being accused of moral coercion. But in real life, positivity is no magic cure-all. Plus, who are we to judge?
Another mantra repeated by doctors and families is “no one is alone,” but compared to positivity-fueled pep talks, listening, companionship, and respect may be better for the patient.
More troubling than the movie’s endless positivity is the helplessness, stigma, and sometimes cruelty faced by cancer patients and their families in reality. The cyber violence visited upon a young woman, even after her death, served as a painful reminder of the lack of compassion in patient care and systemic inequality in healthcare.
Ms. Muffin, as the 26-year-old called herself, was living in Boston working towards a graduate degree in 2019 when diagnosed with terminal cancer. She vlogged about her treatment, during which she traveled, worked out, and kept up with school work. Almost from day one her social media pages were inundated with derision and insults. People questioned why she was able to still “look glowing” and why she had any hair left. They accused her of having the money and resources to “afford treatment in America”, and offhandedly body-shamed her. The initial shock of seeing a real-life cancer patient who is neither ugly nor miserable turned into hatred, which hadn’t stopped long after Ms. Muffin was dead.
Stigmatization takes many forms. Medical workers and family members try to avoid using the very word “cancer,” resorting to euphemisms such as “that thing.” Neighbors and friends often avoid socializing with patients in remission. Cancer is associated with filth, chaos, poverty and death in the public imagination, an inconvenient reminder of the helplessness in the face of “something bigger,” be it mother nature, an unequal society, or an inadequate healthcare system. The Ms. Muffin affair showcased hatred for the rich and jealousy towards anything beautiful. It was a perfect outlet for pent-up fear of cancer and all the social and economic injustices involved.
Cancer, like many other diseases, is a political problem. In China, cancer and severe conditions is a major cause of poverty. In the movie, Yihang’s dad juggles several jobs; his grandma spends her life’s savings and sells her house. Unfortunately, the exploration of illness-induced poverty stops there. Unequal distribution of healthcare resources, medical insurance and at-home patient care are left largely untouched. In real life, these are often the biggest issues.
It would be a bit of a stretch to imply that the group of cancer patients has any political power, but no group alone will be able to single-handedly bring about reform. Systemic improvements are needed in healthcare, social security and even public education. Ms. Muffin’s saga is a somber reminder that positivity and optimism alone do not work.
Flower is tone-deaf, self-congratulatory and out of touch. The end of the movie shows a montage of delivery staff in heavy rain, tired office workers on crowded subway trains, and farmers whose homes were destroyed in a flood, with the caption, “To those who face life positively.”
Evasive on the pressing systemic inequalities while lecturing the audience to face them “positively,” the message is a slap in the face to the very people it purports to celebrate.