Vivian is fifty again, and back at the hospital, this time getting a chest x-ray. A technician is performing the x-ray, and he asks her a number of questions about herself, such as her name and her doctor. To the latter question, she (perhaps purposefully) wrongly answers that she does, in fact, have a PhD. The technician humorlessly corrects her—he wanted to know who her primary doctor at the hospital was. She gives Dr. Kelekian’s name, and then explains that she herself is a doctor of philosophy.
Vivian’s treatment is beginning, but she is still able to remain rather detached from the reality of her situation, making jokes to the technicians and emphasizing her own academic credentials to make her feel powerful and in control.
As more technicians ask her to raise and lower various parts of her body, turn sideways, etc., Vivian introduces herself in a self-aggrandizing manner: “I have made an immeasurable contribution to the discipline of English literature.” She discusses the specifics of her work at length, including the fact that she specializes in John Donne’s sonnets, that she served as a research assistant for the renowned Dr. E. M. Ashford as a graduate student, and that she wrote an “exhaustive” book of essays about Donne that has remained an integral text in her field ever since. As she is describing her essays, she is lifted and set onto a stretcher.
It’s suggested that Vivian assumes that her own formidable academic accomplishments somehow separate her from other patients, and even from the harsher realities of her own illness and treatment. At the same time, the action on stage bears out the foolishness of such assumptions, as she is handled like any other patient by the detached, seemingly uninterested technicians, and treated more as an object than an individual. This contrast then emphasizes the irony of her boasting about her unique accomplishments.
Vivian continues to speak about herself and her accomplishments even as the various technicians enter and exit, performing diagnostic tests and measurements. The hospital swirls around her, she is prodded and poked, and all the while she is steadfast in her monologue. At this point, Vivian is addressing the audience more than she is addressing the other characters in the room; she seems to exist somewhere between her narrator-self and her character-self.
This scene is a montage of sorts, showing how Vivian spends her life now—being treated as test subject or object of research, while still assuming that her own intellect (or even the uniqueness of her treatment) makes her special and exempt from certain realities.
Vivian’s train of thought is interrupted by a technician who is looking for her wheelchair—a shift that momentarily takes her fully back into the scene. She responds sarcastically, saying that she doesn’t know where the wheelchair is, and that they shouldn’t “inconvenience [themselves] on [her] behalf.” After the technician leaves, she continues her monologue as if nothing happened. She notes that her second major success was an essay about the sonnet “Death be not proud,” the same sonnet that she and E. M. Ashford discussed in the grad school flashback.
At this point Vivian has no desire to interact with her caretakers in a personal way at all, and they seem to feel the same way about her. Clearly Vivian has spent a great deal of time studying the poem she discussed with E. M. Ashford in the flashback, but it also seems that she hasn’t absorbed any real life lessons from it, despite her technical mastery of Donne. She has continued to focus on the “wit,” rather than the “truth.”
Vivian then introduces the concept of “wit,” which she says is a pillar of Donne’s poetic works, one that requires “scrupulously detailed examination…exacting and seemingly pointless scrutiny.” Meanwhile Susie Monahan, the head oncology nurse, enters and wheels Vivian to her exam room. Vivian does not seem to notice and continues to discuss her academic work. She references the complexities of Donne’s poems (“the subtleties of seventeenth-century vocabulary, versification…” etc.) and ends by saying that “Donne’s wit is…a way to see how good you really are. After twenty years, I can say with confidence, no one is quite as good as I.”
This is another crucial passage, as Vivian makes known her hubris and naïveté as well as explicitly describing her area of expertise—John Donne’s wit, which to most people is “seemingly pointless.” Notably, it is during this monologue of intellectual boasting that Susie first enters the play. Susie comes to be a foil to Vivian, someone who embraces the parts of the human experience that Vivian has rejected: emotion, kindness, and friendship.
Susie has now helped Vivian sit on the exam table, and Jason Posner, a young medical fellow under Dr. Kelekian, enters. He introduces himself, calling Vivian “Professor Bearing,” and says that as an undergraduate he took her course in 17th-century poetry. Jason says he wasn’t an English major, but he challenged himself to get an A in the “three hardest courses on campus,” and one of those was hers. He admits to Vivian that he got an A minus. Susie exits.
Jason, as Edson will show, is a character similar to the young Vivian—entirely focused on his research to the detriment of his relationships with others. He immediately presents himself here as someone who is very intelligent and has high standards for himself—qualities Vivian admires (at this point, at least).
Jason, who seems nervous, starts to ask Vivian some questions about her medical history. Vivian notes that Dr. Kelekian already did this, but Jason says that Kelekian wanted him to do it, too. He starts by asking, “How are you feeling today?”, to which Vivian responds, “Fine, thank you.” A quick series of questions and answers then follows, as Vivian states that she is fifty years old, unmarried, without siblings, and both her parents are dead. She has never been pregnant or had any serious medical or psychological issues before now, and she occasionally drinks wine and frequently drinks coffee, but uses no other substances. For exercise she “paces,” and she is not currently sexually active.
While Jason is very intelligent and capable in the research aspect of medicine, he is still clearly a student and lacks the “bedside manner” that would allow him to truly connect with patients. He then becomes the primary asker of the detached, meaningless “how are you feeling today?” question that Vivian mentioned at the beginning of the play. Edson also includes these basic questions to give more information about Vivian: she seemingly has no close personal relationships, whether with friends, romantic partners, or family, and focuses entirely on the life of the mind, not the body (as shown in her choice of “exercise” and substances).
Jason then asks Vivian about how her “present complaint” started, and Vivian describes a gradually growing pain in her abdomen. She says she was working on a major article about Donne with a strict deadline at the time, and so was stressed, but not “much more stress than usual”—the difference was she “couldn’t withstand it this time.” After she turned in the article, Vivian says, she visited her gynecologist, who sent her to another specialist, who sent her to Dr. Kelekian.
Vivian is used to stress and anxiety, but is so confident in her toughness that she always pushes through and, it seems, succeeds. What was frightening about this time, however, is that she “couldn’t withstand” the stress. Her body has forced her to leave behind her abstract and academic existence and acknowledge her reality as a vulnerable human being.
Jason, growing more nervous and flustered, prepares Vivian for her physical exam. He puts her legs in stirrups and places a paper sheet over her. He then says he has to get Susie, because there’s a rule that he’s “got to have a girl here.” Jason leaves and walks through the halls, calling for Susie, and Vivian sits in silence. Vivian then starts to recite the Donne poem “Death be not proud,” her lines interrupted by Jason’s calls for Susie. Jason finally reenters with Susie, just after Vivian recites the line she had discussed with E.M. in her flashback: “And death shall be no more—comma—Death thou shalt die.”
Jason is clearly uncomfortable giving Vivian a physical exam, and there is an odd power dynamic here as well, considering that he was once her student but is now interacting with her when she is at her most vulnerable and he is in a position of power. Vivian seems to turn to Donne for comfort here, but as usual she lingers on details like the punctuation rather than applying the meaning of the lines to her own life.
Susie seems upset that Jason left Vivian alone in the stirrups, but Jason interrupts her and begins the pelvic exam. As he feels around inside Vivian, he makes awkward small talk with Susie about how he once took Vivian’s literature course. Jason then feels the tumor and interjects “Jesus!”, but tries to recover from his surprise and continues talking about John Donne and how difficult Donne’s poetry is. The exam over, Jason awkwardly leaves, followed by Vivian. Susie cleans up and exits, as well.
Susie is already concerned about Vivian as a person—she’s upset that Jason left her alone in the stirrups, an extremely vulnerable and exposed position—but Jason brushes her aside and perhaps doesn’t even notice the indignity he has subjected Vivian to. Jason then once more shows his ineptitude at interpersonal connection, as his exclamation at the tumor is surely shocking and terrifying for Vivian. Note also that Jason focuses only on the intellectual difficulty of Donne’s poetry and Vivian’s course, rather than anything meaningful about life he might have learned from either.