Review: A PACIFIST'S GUIDE TO THE WAR ON CANCER, National Theatre, 19 October 2016

How do you make a musical about cancer? This latest work from Bryony Kimmings isn't just theatre, but metatheatre. Her voiceovers and the emails published in the programme detail the at times highly personal development process, and a gut punch of a last 15 minutes strip away the comfort of fictional distance. It could be self-indulgent; instead, it becomes an effective method for making us confront that other, bigger question: how do we talk about, prepare for and deal with illness?

Our introduction to the "Kingdom of the Sick" comes through Emma, a single mum who's brought her baby into hospital for tests. Here, she encounters fellow sufferers: Laura, in denial about her prognosis; Mark, the chain-smoking, estranged father with lung cancer; Shannon, who has a genetic illness she's afraid may have been passed to her unborn child; American Gia, trying to reclaim her body; and Stephen, who both needs and resents his overbearing mum.

Lucy Osborne provides a stark grey hospital with queasy strip lights and glowing Exit signs, which gradually transforms into a surreal house of horrors. Giant, bulbous tumours swell out of the walls and block the doors, while the supporting cast pop up as similarly engorged grotesques, incongruously colourful and clownish - one spouting Lewis Carroll-esque verse. This is cancer as absurd and revolting, comical and inescapable. It's gleefully destabilising cabaret.

The patients - emblazoned with the words "hospital property" - fight to regain their identities, while sharing their experiences through Tom Parkinson's eclectic score. The sensational Golda Rosheuvel belts out a disco number as Laura grasps the hope of a miracle cure, and later a heartfelt 11 o'clock number that is both empowering and devastating. Rose Shalloo provides a plaintive ballad as Shannon confronts an impossible situation, Naana Agyei-Ampadu a brassy turn in the chemo suite, complete with accompanying hoedown (the IV lasso a great touch from choreographer Lizzi Gee), and Hal Fowler a country song punctuated by ragged breathing.

There's a strong marriage between the score and Lewis Gibson's sound design, with music emerging from the soundscape of illness. Emma is tortured by the relentless hum of machines, and percussion accompanies her restless pacing of the waiting room. Echoing, offhand tannoy announcements add to a sensory overload, climaxing in her meeting with a doctor where the words are distorted, as though spoken underwater. It's candid, matter-of-fact and immersive.

Kimmings collaborated with fellow performance artist Brian Lobel, who has extensive experience making work about cancer, and the show is awash with helpful advice, wittily expressed. Don't make a "cancer face" of exaggerated sympathy, subject people to your aggressive sorrow, harass them with endless positivity, or use their tragedy "as a springboard for your emotions". But it's also sympathetic to the contradictions of wanting support while urgently needing autonomy in the face of a disease eating away at your control.

However, one of the strong messages of the piece is that we shouldn't generalise, but instead respect every individual's choices and experience, and here it runs into difficulty. We're only afforded a surface-level glimpse of each character, and Emma is more observer than protagonist - her journey come into focus thanks to a late intervention from Kimmings, but is otherwise too non-specific. A few side characters, like a friendly Welsh cleaner, feel superfluous, and the freeform structure rather meandering.

Given the power of the deconstructed climax, whose verbatim elements recall the indelible London Road, one might almost wish for more formal experimentation throughout. It sometimes feels constrained by convention, and where it does obey the rules of the musical, the results are mixed - for every biting and bracingly expletive-laden lyric, there's a bland one, and the show lacks a clear centre.

When Kimmings (whose work is usually fiercely autobiographical) enters that role, the piece goes up a gear. Her final involvement of the audience is shatteringly raw, speaking directly to our shared experience of illness - past, present or future. Uneven, but a bold and challenging show that just about solves the paradox of advocating for truth through a work of fiction.

A Pacifist's Guide to the War on Cancer at National Theatre until 29 November

Photo credit: Mark Douet

Read our interview with Brian Lobel

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