Unstrung Heroes (1995) and Ovarian Cancer

Los Angeles, in the early 1960s. Twelve-year-old Steven Lidz lives with his mother Selma, who is warm and steady, and his father Sid, an inventor who believes logic can solve anything.

Selma is diagnosed with ovarian cancer. Sid cannot cope. He swings between denial and collapse, and the household stops working.

Steven goes to live with his two uncles, Danny and Arthur, who share a room in a decaying hotel. Danny is a conspiracy-minded talker. Arthur keeps everything, from balls of string to old newspapers. They rename him Franz and take him to synagogue, over his father's objections. They give him a version of childhood his parents can no longer supply.

Steven quietly assembles a box of his mother's belongings, a memorial made before she has died. Selma dies. Steven rescues the home movies his father threw out, and father and son watch them together.

The film ends there, and so this page discusses that ending.

The real subject is a child displaced by a parent's illness, and the film draws it precisely.

Steven is told very little. He works out most of it himself, from tones of voice and half-finished sentences. He is sent away in the name of protecting him.

That instinct is understandable and it usually backfires. Children notice the change in the house long before anyone explains it, and what they invent to fill the gap is generally worse than the truth. They also tend to assume the illness is somehow their doing.

Being told plainly, in words matched to their age, and being allowed to ask again later, is what actually helps. Silence is not protection. It is a job handed to the child.

The disintegration of the surviving parent is unusually honest here. Sid is not a villain. He is a man out of his depth, whose whole method for handling problems has stopped working.

The uncles do what would now be called informal kinship care. They absorb a child no service is going to help. That is still how most of this gets covered when a parent is seriously ill.

As a portrait of ovarian cancer, the film is almost blank. There is no diagnostic story, no surgery, no chemotherapy, no oncologist. Selma is well, then unwell, then gone.

She stays lucid, gentle and composed to the last, and dies in an armchair after a round of affectionate goodbyes. Advanced ovarian cancer more often involves a swollen abdomen from fluid, bowel obstruction, repeated hospital admissions and heavy symptom control.

The film's tastefulness costs it the truth of the deathbed. That has a cost for viewers, because the fear people carry into a real one is usually of things this film promises will not happen.

It is also set in the early 1960s, before modern chemotherapy for ovarian cancer existed. Nothing about Selma's care describes treatment today.

The screenplay is adapted from Franz Lidz's memoir, and the adaptation moved things. The memoir is set in New York City; the film relocates to Southern California. The memoir has four uncles; the film condenses them into two.

That is worth knowing before treating any detail here as testimony. This is a remembered childhood, reshaped twice.

NCI states that ovarian cancer may cause no early signs or symptoms, and that when signs do appear the cancer is often already advanced.

The signs it lists are:

• pain, swelling, or a feeling of pressure in the abdomen or pelvis
• a sudden or frequent urge to urinate
• trouble eating, or feeling full quickly
• a lump in the pelvic area
• gas, bloating or constipation

Every item there is also a description of an ordinary week. That is precisely why ovarian cancer is missed, and why it gets filed under irritable bowel syndrome or the menopause.

The pattern that changes the meaning is repetition. New symptoms, that persist, and that are present most days across several weeks, deserve an appointment. NCI's advice is the same: if they get worse or do not go away on their own, get checked.

In February 2018 the US Preventive Services Task Force gave ovarian cancer screening a grade D, meaning it recommends against screening women who have no symptoms and no known high-risk inherited syndrome.

NCI puts it in plainer terms. Screening for ovarian cancer may not help a person live longer. Pelvic exams, transvaginal ultrasound and the CA-125 blood test have each been studied, and none has been shown to reduce deaths from the disease.

Women with a strong family history of ovarian or breast cancer, or a known BRCA1 or BRCA2 change, are managed differently and should be referred for genetic counselling.

This is the single most useful sentence on the page, because the belief is widespread and it delays diagnoses.

A cervical screening test, whether a smear or an HPV test, samples cells from the cervix. It looks for changes that could become cervical cancer. It does not look at the ovaries, and a normal result says nothing about them.

So a woman with months of bloating who has recently had a normal cervical screen has no reassurance at all about her symptoms. She still needs them assessed.

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Steven's box, assembled while his mother is still alive, is the film's best observation. Children grieve before a death, and they often do it through objects rather than words.

The film also understands what helps afterwards. Not speeches. Photographs, keepsakes, film reels, the physical remnants of a person.

If you are the well parent in a version of this story, the practical lesson is small. Tell the child the truth in plain words, let them ask again, and let them keep things. Unstrung Heroes cannot tell you what to watch for, but screening and possible warning signs can.

• NCI — Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®), Patient Version
• NCI — Ovarian, Fallopian Tube, and Primary Peritoneal Cancers Screening (PDQ®), Patient Version
• US Preventive Services Task Force — Ovarian Cancer: Screening (2018)

This page discusses Unstrung Heroes for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email [email protected].