“Five Feet Apart” is a Dangerous Misrepresentation

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The trailer for “Five Feet Apart” was released on Friday.  Within a day, the Facebook clip alone has close to 4 million views.  Many people see that as a whole lot of great cystic fibrosis awareness. I challenge that.  Awareness that comes from misinformation is damaging.  There is an ethical responsibility when we are talking about the risk to human life.

In the Justin Baldoni directed film, two cystic fibrosis (CF) patients fall in love from a distance while in the hospital.  As a CF patient who has been hospitalized many times, my healthcare team has been devoted to never allowing me to come into contact with another CF patient.  Beyond my team’s devotion, they have a moral and ethical duty to provide the safest care. The World Health Organization states, “Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of unnecessary harm.”  Exposing cystic fibrosis patients to deadly bacteria through cross-contamination, in the name of love, is a violation of the most fundamental principle of medical ethics — “Do No Harm.”  That’s the way it should be.  Person-to-person interaction between cystic fibrosis patients can lead to the transmission of CF pathogens that can adversely change the course of a patient’s life. There are lives at stake when it comes to infection control. This is not something I, or medical professionals, see as optional. 

The trailer shows the main characters touching each others’ medications and walking together with no masks. No responsible doctor or nurse would allow or promote this.

CFF.org infection control guidelines include:

  • Contact precautions for all CF patients regardless of pathogen status
  • Mask use by patients in common areas in health care settings
  • A minimum six-foot distance between patients

Cystic fibrosis clinics across the nation take these guidelines a step further by scheduling patients on different days based on the bacteria in their lungs, so there is no risk of us transmitting these pathogens by even touching the same door handle.

The guidelines have become even more stringent over the years as we painfully learned that the cost of not adhering to these guidelines resulted in CF lives lost.  

When I was a young child, before anyone knew about the dangers of cross-contamination, my mother hosted parties for families battling cystic fibrosis. She knew it would be comforting to have peer-to-peer support. As soon as the CF community learned about these dangers, those parties, camps, and support groups across the country came to an end. That has always been so sad for me, but I always understood the risk.

The social isolation is quite frankly one of the hardest parts about living with cystic fibrosis — once you get past the burden of the whole progressive, chronic illness thing 😉.  I hate abiding by these guidelines as much as anyone else.  I will never forget when I was a keynote speaker in 2008 at a CF fundraiser. There was a little girl there named Grace.  She was on the dance floor and waved to me.  I hugged her mom and we cried together.  All I wanted to do was hug Grace, but I couldn’t. I waved from across the room (this was before the CF Foundation released new guidelines in 2013 that allows only one person with CF at an indoor fundraising function).  I am still in touch with Grace and her mom — from a safe distance…online.  

Gunnar Esiason, another incredible cystic fibrosis advocate, the third brother I never wanted 🙃 is my close friend, but we have never met.  We are Rangers fans (and because he’ll call me out on this: he is diehard, I really just love watching hockey at Madison Square Garden). We have been to the same games, yet we still just wave from 700 feet apart.  Trust me, I’d love to grab a beer with Gunnar, but it isn’t worth risking both of our lives.  As public advocates for this illness, we understand how important it is for other patients to see how seriously we abide by infection control guidelines.  I deeply care about Gunnar and his well-being and when you deeply care about somebody you don’t want to risk their safety — their life.  Romanticizing the breaking of these guidelines in the name of young love, as this trailer does, is irresponsible. 

I voiced my concerns to Justin Baldoni on his Instagram post of the movie’s poster.  He responded arguing that he consulted with a CF patient and CF nurse throughout filming and he added that “this is a film and creative license is always necessary to tell a complete story in two hours.”  I argue infection control is a serious issue in the cystic fibrosis community.  It is not a topic that allows any room for “creative license.”  Moreover, there are plenty of more creative ways that cystic fibrosis could have been brought to the silver screen. 

Furthermore, Justin refers to us as “CFers.”  I take personal offense to this term.  While cystic fibrosis has certainly informed who we are, it is not our identity.  Psychologists share that our identity is linked to self-esteem which then informs our resilience.  Our sense of identity can influence our life experiences and success.  Though it may be popular to identify cystic fibrosis patients as “CFers” or  “cysters and fibros.” I believe it changes the way we perceive our own identity.  If we identify ourselves as the disease itself, it can negatively impact how we see ourselves and how we handle the obstacles we face due to cystic fibrosis.  

Let’s pause for a minute and try to find another illness that identifies its patients as the illness itself…we do not call those who have diabetes “diabetesers” or those battling muscular dystrophy “MDers” or cancer patients “cancers.” I find it offensive.  If you have cystic fibrosis, you should too. You are so much more than the battles you are fighting. You are strong.  You are not cystic fibrosis and you are not a CFer. You are you, with your unique gifts and talents. The identifier I would use for you is warrior. 

I feel compelled to write this op-ed because movies, movie stars, and the bright lights of Hollywood are hugely influential. The premise of the film and the trailer alone is a missed opportunity and dangerous misrepresentation of cystic fibrosis. The star of the film, Cole Sprouse, also stars in the widely popular television series, “Riverdale.”  He has 19.2 million followers.  That’s quite a bit of influence.  I imagine many young CF patients are massive fans of his. I fear they will see this film and begin to think to themselves, “Maybe the love of my life has CF…”  That thought is heartbreaking to me.  My hope is that cystic fibrosis fighters get to see a movie in the future and walk away thinking, “Wow, look at all I can do with my life, in spite of CF.”  If you are the parent of a young cystic fibrosis warrior, I hope you think twice about taking them or allowing them to see this film.  I don’t think the cystic fibrosis community should be grateful for or endorse a film that is this irresponsible in its depiction. 

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The only way I am allowed to step foot out of my hospital room: masked, gowned and gloved. (If you can’t tell by my expression, it’s annoying — but of the utmost importance) 

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Gunnar and I “together” at a Rangers Game. We take infection control seriously and we are able to have some fun with it 😉 

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3 thoughts on ““Five Feet Apart” is a Dangerous Misrepresentation

  1. bravestredhead

    I’m not sure how old you are, but I’m guessing we are similar. I remember when they shut down the CF summer camp when they discovered that negative patients were converting to positive. I remember in that camp we all did our postural draininage in the same ROOM! After that, my Mom (an ex nurse) kept me so well isolated so as to mean I had NO friends with CF. The internet has changed all that, and I can wave to people from behind a mask in clinic, and then really CHAT to them and get to know them on skype without fear that we’ll swap droplets. There was a very active friend group of negative CF patients at the time I got my transplant. I knew about them hanging out socially. One of them became cepacia positive. Then another and another. Lives & lifespans were absolutly impacted. It was so frightening. I remember that is when our local program REALLY stepped up the infection control part of things. I appreciate all they do to keep us apart and am grateful that we have the internet and telephones to be able to be friends from a safe distance. We have unique lives, so it’s good to be able to share them with other unique people. Signed, Darth Vadar (named for my mask)

  2. Alugo

    Thank you so much for sharing your views and insight. From a parent of a 11 year old girl with Cystic Fibrosis I truely appreciate it. We have been guiding our daughter to be the best version of herself, CF is just the challenge/obstacle that she has to deal with in life, others carry and or deal with other obstacles. I am also very apposed to the identity of being a CFer….

    I am so thankful for you sharing, enabling me to be able to prepare on how to discuss this Movie with her. Unfortunately even if we don’t take her to see it or try to shelter her from it, her friends and or peers may see it and bring up in discussion or catch her off guard with comments. It’s in her best interest, even though extremely challenging for me (since I tend to get emotional with these topics) that it be discussed and focus on the fact that this film is fiction, not a medical documentary.

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