Abstract
A quintessential love story, the Netflix miniseries From Scratch, appears predictable at first: Boy meets girl, but girl is seeing someone else; boy works hard to woo girl, and eventually boy and girl fall in love. But, life is not so simple. Amy is a Black American studying art in Florence and Lino is a Sicilian chef working there away from home. There are cultural differences galore and lots of family drama over the young couple's decisions about everything from career choices to life partners, but the couple is determined to make their love work. Despite disapproval from Lino's father, they get married, vowing to be there for each other no matter what life throws at them. They are each other's biggest fan, support each other's dreams, and make sacrifices together to make sure that neither one has to put dreams on hold.
Life is good. They are happily married. Amy's career is taking off, and her art gives her personal fulfillment and joy. Lino is finally a chef in his own restaurant in the United States and is looking forward to sharing his amazing food with the world. They have come a long way and have a long history of love, sacrifice, and togetherness. It is now that life begins to crash right in front of their eyes. They get devasting news, in just about the worst way a doctor could deliver bad news. The treatment plans and explanations they get about Lino's health are superficial and full of jargon, lacking in support or compassion.
The life they just built crumbles under their feet, and they start the long road into cancer treatment. Their love is palpable, and as Lino prepares to go into surgery, Amy tells him “You are more than a tumor. You are a man with people who love you” to encourage him. Lino's parents come to the United States from Sicily for the surgery and through the tensions of life-threatening illness and family feuds, Lino and his father find the love they have for each other again. The day-to-day of serious illness is portrayed for all to see: the distress that is part of their daily life, the physical pain that comes with serious illness—we go behind the scenes and see the suffering so often under-reported in clinic.
Lino goes into remission and life is good again—not as good as it was supposed to be, but it is good. They are happy and adopt a baby, Idalia, who fills their life with joy and love. They continue to compromise and sacrifice for each other, and Lino continues the routine of cancer surveillance. Even undercover, cancer continues to take from them, their marriage, their plans; and then one day it rears its ugly head again. This series does an amazing job of showing us both their joys and the daily poignant struggles that families with serious illness confront every day. When their seven-year-old daughter is told the cancer is back, her first question is “Will Babbo still make my lunch?” Treatment starts again, the oncologist somewhat making light of the recurrence and promising lots of treatment options.
Lino struggles through treatment and so does the entire extended family. They are lucky in some ways—they have flexibility and are able to help Amy cope with his illness and Idalia's care. But as cancer will do, things get worse, not better. Lino gets admitted to the hospital, and the barrage of multiple teams rushes in to run tests and speak among themselves, leaving Amy and Lino out. Lino is worse and no one will tell them; the doctors just keep running more tests.
Finally, a palliative medicine doctor comes in. For the first time by anyone this entire hospitalization, she sits down and asks Lino how he is feeling and what he thinks of all of this, providing them with information and options. They decide to go home with hospice care. A child development social worker comes to help, and as a result, Idalia spends more time with Lino. He enjoys his remaining time with family and friends before dying peacefully at home. His death is portrayed as the ideal hospice death: at home with loved ones, celebrating life while being honest about the work it entails to have someone die at home.
This was the second time I watched this series and it is a tear jerker for sure. This series is based on a true story, a memoir with the same title by Tembi Locke. What struck me both times is not only how well it is done and how accurate it feels, but also how different the practice style is between the specialists and the palliative doctor, the one who tells them that the goal is to provide support and offers the clarity and honesty needed to actually provide that support. The story paints the painful picture of what families go through when they are diagnosed with a serious illness including the frustration; the logistical nightmares; the physical, emotional, and financial pain; and the struggles that come from lack of understanding.
As a palliative doctor, it was hard to watch them suffer, realizing that this is the way most of our patients and their families experience serious illness, whereas on the other hand, it felt good that palliative medicine was portrayed in such a positive light where we are honest and allow for closure to happen while it still can. Palliative medicine is inherently a sad field, but this series shows that there can be joy in sadness. It is an eight-episode series, short enough to be a small commitment. More people should watch it to understand what palliative medicine is and how the entire team tries to help patients and their families who are too sick to be helped by modern medicine.
—Ana Leech, MD, MS, FAAHPM
Department of Palliative Medicine
McGovern Medical School at UT Houston
6431 Fannin Street, JJL 450
Houston, TX 77030
USA
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