Between hit movies like The Fault in Our Stars and The Notebook, Hollywood has had a history of depicting a number of serious illnesses on the big screen. And while we all know these are just movies, these illnesses are all too real for so many.
Five Feet Apart is the latest featured film creating buzz for its plot that is centered around a romance between two teenagers living in the hospital with cystic fibrosis (CF). CF is a rare lung and digestive system disease that makes the body produce very thick mucus that can clog the lungs and lead to severe infections, making it very serious and sometimes life-threatening for some patients.
So, just how accurately does the film represent CF? We spoke with Dennis Schellhase, MD, center director of Atrium Health’s Cystic Fibrosis Program and program director of Atrium Health Levine Children’s Cystic Fibrosis Program, who recently saw Five Feet Apart with the CF care team to assess how well – or not well – the film portrayed CF for patients who live with it.
Six feet apart – not five
Stella Grant is the first CF patient who is introduced in the film when she checks into the hospital for an extended stay as she awaits a lung transplant. Soon after, she comes into contact with another CF patient, Will Newman, who is placed on the same floor to take part in a clinical trial in an attempt to get rid of a bacterial infection that he has contracted.
It’s important to note that these bacterial infections are extremely dangerous for CF patients and can often be life-threatening. For those reasons, doctors strongly enforce the rule that CF patients should stay a minimum of six feet apart from one another in order to prevent the risk of spreading infections. As a compliant patient, Stella follows the rules given to her by her care team, but as Stella and Will grow closer, Stella decides to “take one-foot back” from Will, roaming the halls of the hospital at a five-foot distance instead of six.
“Overall their infection control [in the movie] is very poor,” says Dr. Schellhase. “We don’t let kids congregate out in the hall, or roam around the hospital at LCH. And in addition to the six-foot rule, patients are also asked to wear a mask and practice good hand hygiene – something that’s not addressed well in the movie.”
The everyday hospital grind for a CF patient
Throughout the majority of the film, Stella, Will and their other friend with CF, Poe, are all living in a hospital setting under very severe circumstances. So is hospital life for these three CF patients represented accurately? To the film crew’s credit, several nurses and CF patients were consulted on the script to gain a better understanding of how these patients were treated by their care teams and what their routines looked like on a day-to-day basis.
Yet with medical advancements and strict infection prevention control that have improved the life-span and overall health of patients living with CF over the past few decades, Dr. Schellhase says that it’s not likely that there would be multiple end of life patients staying in the same hospital at the same time, much less on the same floor.
“Will would have been strictly isolated given his specific bacterial infection,” says Dr. Schellhase. “And the fact that there are three severely affected patients on the same floor at the same time is unusual from what we typically see in the children’s hospital. The outcome for CF has changed dramatically over the past 20 years as new medicines and therapies have come on board – meaning you’re probably not going to have three end of life patients in the hospital at the same time.”
But what was seen as the most unrealistic part of the film would be the kids’ ability to roam the hospital and leave the facility without parent or hospital supervision or being formally discharged. “When Stella and Will sneak off and disappear – it wouldn’t happen,” he says. “Those things are needed for the plot, but it wouldn’t happen in real life.”
Despite these Hollywoodized scenes, Dr. Schellhase reports that as far as the individual experiences and the individual therapies, their daily medical routines that they have in the hospital are pretty real.
“What Stella goes through in her daily regimen – in her pills, in her therapy – it’s accurate. She represents a compliant patient,” says Dr. Schellhase. “Will, on the other hand, is less compliant. The two patients represent two different extremes, but what they do every day and how they think about and react to their disease are representative of our patients.”
So, what is Dr. Schellhase advising for patients living with cystic fibrosis to keep in mind if they plan on seeing the movie?
“If our patients go to see the movie, I want them to be aware that a lot of situations in the movie are showing the outcomes of the worst-case scenarios – something that we here at Atrium Health don’t see often in children and young adults and work hard to prevent. And we hope that with future new medicines and therapies, we will see less and less.”
Did you know that Atrium Health and Atrium Health Levine Children’s Hospital have been recognized by the Cystic Fibrosis Foundation (CFF) as an officially accredited Cystic Fibrosis Center for both children and adults? Read more about the recent accreditation
