Drugs,Death,Denial and Cancer Care: Using Breaking Bad in the spiritual care of cancer patients

Abstract

This article argues that watching Breaking Bad (2008–13) could encourage people affected by cancer to recognise and reconsider damaging reactions to their condition. If viewers are invited to see the series’ antihero, Walter White, as an iconic ‘silhouette’ of a better path not taken, this can provoke them to entertain more honest, constructive attitudes to cancer and death. Using the theological concept of a ‘silhouette of goodness’ and Jung’s theory of the ego-life and true Self, this article suggests that symbolic moments in Walt’s descent into chaotic criminality could help caregivers to meet the ‘need for symbols’ in cancer care.

In January 2020, a trial began in several Maggie’s cancer care centres which included Breaking Bad in a new ‘Fiction Library’ resource intended to enhance the spiritual care of cancer patients, containing novels, films, and television series which address particular aspects of cancer patients’ experiences. In collaboration with Maggie’s psychologists and cancer care specialists, I designed and wrote an accompanying guidebook, providing advice and suggestions on how these popular artworks might reflect and even transform our perspectives on living with cancer. The guide invites participants in the trial to interpret Breaking Bad as an ‘exploration of how a single-minded preoccupation with fighting cancer…can distract both patients and doctors from the human dimension of patients’ lives’, then directs them towards support groups and psychology sessions designed to address this imbalance. Contemporary practices in Western medicine have often failed to engage sufficiently with this human dimension of cancer: the emotional and existential concerns it creates (Astrow et al., 2007). So, in a society frequently accused of ‘weakness’ in its dealings with disease and mortality (Keller, 2013), new tools for helping those affected by cancer to cope with the fear and frustration a diagnosis can cause are urgently needed (Swinton and Pattison, 2010). In this article, I argue that when Breaking Bad, and specifically the figure of Walter White, are used as iconic illustrations of what not to do, this could provide one such tool.

Although a series about an insular, emotionally illiterate character who allows denial and anger to dictate his response to cancer might seem a strange choice for a care resource, Walter White’s fictional failings could help real people impacted by cancer to recognise and reappraise thoughtless, harmful reactions to their situation. As traditional morality plays used a ‘tissue of metaphor’ to dramatise the threats of avarice and materialism and ‘generate pressure upon their audiences’ emotionally and intellectually (King, 2011: 236–238), so Walt’s destructive pursuit of wealth exposes real world concerns surrounding mortality and meaninglessness. It is precisely because Walt stubbornly refuses to look for the forms of emotional, psychological support organisations like Maggie’s offer that his story can challenge these reactions. Every time he chooses to trust in his ability to grapple with the prospect of suffering and loss alone, the tragic, shocking consequences of Walt’s futile fight against cancer reveal why seeking support is so crucial. The series creates symbols representative of the dangers of denial and the need for more hopeful, imaginative perspectives on ‘the pain that ripples out from each diagnosis of cancer’ (Haidt, 2007: 141).

When participants in a support group for men affected by cancer were shown clips from Breaking Bad, some saw their own denial and evasion reflected in Walt: ‘the shutters have come down and he’s in denial…I did react like that’. But they were also prompted by Walt’s egotism and immorality to discuss the value of what help they did accept – ‘that’s why I took somebody with me [when being tested and diagnosed]’ – as well as the empathetic, selfless decisions they made: ‘I had to look after my wife…and worry about me later on’ (all quotations from the support group are anonymised contributions to two focus groups conducted by the author at the Maggie’s Dundee centre, on 4th November 2019, and 9th November 2019). Real people facing the same decisions as Walt saw him both as an illustration of ‘how not to do things’ and as the starting point for a conversation about how things should be done. Breaking Bad is an instance of a series able to ‘speak…intimately to personal, emotional and psychological experience’ (Bainbridge, 2019: 292), in that it can capture a viewer’s inclinations towards denial and insularity and the dangers of following these instincts. However, it seems it can also prompt viewers to re-evaluate their own choices and to appreciate the importance of emotional and practical support.

I begin this article by using the Christian theological concept of the iconic ‘silhouette of goodness’, linked to Jung’s theory of the ‘ego-life’ disconnected from the true Self, to describe in detail how Walter White’s character could be used to provoke ‘psychological change’ in cancer patients. Using these concepts to analyse Walt’s response to his diagnosis, I then outline how Walt can be interpreted as a ‘negative image’ revealing the dangers of the clinical and societal dehumanising of death and disease. Having shown how Walt, viewed in these terms, also ironically symbolises the alternative choices he did not make and different perspectives he never embraced, I conclude by suggesting that Breaking Bad creates a modern, secular reimagining of the iconography of death around Walter White: a symbol system which could draw viewers into ‘an unexpected encounter with an alternative vision of life’ (Connell, 1998: 108).

Walter White: A symbol of ‘misplaced energy’

In a significant scene in the Breaking Bad spin-off El Camino (2019), a flashback shows Walt and his partner, Jesse, sitting in a diner and discussing the future. Seemingly set during the Breaking Bad episode ‘4 Days Out’ (2: 9), the scene revisits the imagery of light, darkness and shadow which forms an integral part of Breaking Bad’s aesthetic. Walt, sitting by the window and gazing wistfully into the sunshine, turns back into the shade and says to Jesse: ‘You’re really lucky, you know that, that you didn’t have to wait your whole life to do something special’. His words are an empty promise devoid of authenticity or substance. Walt has not achieved anything ‘special’ and has lured Jesse into destroying his own prospects, too. While he is speaking, one side of Walt’s face is still catching the glow from the window, but he remains stuck on the wrong side of the glass in the darkness he has trapped himself in. Dialogue and visual symbolism together capture Walt’s transformation into a shadow: the empty outline of all the warmth and light he has drained from his life. His words and actions have become ironic signs of the truly ‘special’ things he has neglected in his pursuit of prestige and wealth.

There is a tradition in Christian art of imagery which portrays evil in the form of a ‘silhouette of goodness’: a ‘negative image’ of virtue in which sin becomes an absence that points towards a better path not chosen (Kirkpatrick, 2005: 445). Breaking Bad uses its narrative and aesthetics in an analogous way, depicting Walt’s assertions of independence, and rejection of help and sympathy, as a revealing ‘silhouette’ of different decisions he could have made and of the strength he would have gained by accepting help. The vision of hell Dante Alighieri creates in his Commedia illustrates this instructive use of the vacuity of immorality. It is full of lonely, isolated individuals who chose to ‘abandon themselves to the emptiness of evil’ and submit to ‘dullness and death’, yet Dante describes his ‘authorial task’ within the Inferno as a struggle to write of the ‘good’ he found in Hell, creating a narrative with the ‘moral and intellectual purpose’ of turning the bitterness of sin and death into inspiring intimations of goodness (Kirkpatrick, 2005: lxxv). The ‘emptiness of evil’ serves as a ‘negative image’ of a possible good (Kirkpatrick, 2005: 445–447), just as the hellish existence Walt has trapped himself in can be viewed as a story that points to the choices he did not make.

Encouraging viewers to see Walt as a ‘negative image’ turns his character into a dramatic illustration of the consequences of allowing our responses to a diagnosis to be dictated by pride and fear. Walt becomes a ‘silhouette’ serving a specific moral and therapeutic purpose. In the past, religious art played a vital role in a society which had integrated death into a metaphysical framework promising salvation and resurrection. In hospices such as Beaune – the famous 15th century religious house of healing – paintings of the dying Christ formed a crucial part of a system of care offering ‘luxurious attention for the sick and dying’ (Groves and Klauser, 2005: 14–15). The decline in religious observance in Western society has led to the end of this kind of care (Keller, 2013; Lewis, 2001). In secular healthcare institutions like the NHS, portraits of Christ in the tomb are no longer appropriate palliative spaces, as they would not affect most patients in the manner they once did. However, psychologist Viktor Frankl argues the ‘need for symbols’ to address sickness and death remains and that ‘even the die-hard atheist or agnostic cannot ignore this’ (Frankl, 1997: 18–19). This need is highlighted in the context of cancer care by psychologist Ian Kerr, who writes that ‘to deny a patient the transformative potential of symbol is to deny the means by which he might achieve psychological change’ (Kerr, 1998: 139).

Walter White is a patient in desperate need of ‘psychological change’, who has cut himself off from the sources of love, meaning and consolation which his life once contained. Jungian psychology captures this predicament, warning of the ‘misplaced energy’ leading to ‘neurosis or psychosis’ which can result from such a ‘failure to secure any reliable connection to psychic realities that religion once supplied though its various symbol systems’ (Ulanov, 2008: 316). Walt becomes an ego disconnected from the Self: a shadow cut off from the central, ordering axis which ‘extends beyond our psyche into the centre of reality’: he is so caught up in his ‘ego life’, shaped by ‘ideas and feelings and cultures’ driving him to deny his diagnosis, that he has lost contact with the realm of ‘instincts, affects and images’ which fuels connectivity and meaning-making (Ulanov, 2008: 315–318). When Walt develops his criminal ‘Heisenberg’ persona it hardens the ego concealing his true Self, further suppressing any inclination to seek out community and support. Ironically, his fictional plight supplies the raw material for the kind of ‘transformative’ symbolism which he needed himself: iconic imagery of silhouettes and absences which could help viewers achieve psychological change. By creating ‘iconic moments’ that invite the audience to ‘unpeel layer upon layer, exploring depths…beyond the surface narrative’ (San Juan, 2013: 9), the series pushes us away from Walt’s repellent example and towards an ‘alternative vision of life’ (Connell, 1998: 108).

‘There’s nothing but chemistry here’: Walter White as an ironic challenge to the dehumanisation of death

The absences Walt’s character represents highlight the problems caused by treating death as a resolvable ‘scientific problem’ while ignoring its emotional, psychological impact (Jung and Winston, 1983: 18). Because Breaking Bad’s portrayal of Walt’s descent reveals how learned attitudes of denial can spill out of the clinic and into the public domain and family home, it invites audiences to recognise how harmful and pervasive these attitudes can be. Its plot, dialogue and imagery connect common, uncritical assumptions about the power and authority of empirical science to dangerous delusions concerning disease and mortality. As this provides context for Walt’s denial and evasion, appealing to recognisable, ‘real-world’ problems to explain his behaviour, elements of patients’ experiences which can seem isolating and inexpressible are translated into scenes and images imbued with ‘relatability’ (Bainbridge, 2019). Yet these symbolic moments also challenge audiences to avoid the drastic mistakes which come to shape Walt’s narrative, pushing them to imagine alternative actions and attitudes which avoid disconnecting the ego from the foundations of connection and community. This section describes how the impact of denial and dehumanisation on patients’ lives is reflected in Walt’s behaviour, then reframed as a negative image symbolising the hollowness and evasion which often characterise modern medical or cultural responses to cancer and mortality.

Through the character of Walter White, Breaking Bad provides a detailed examination of the ways in which the ‘medical sanitization of death’ influences cancer patients (Frankl, 1997: 91). The series intensifies the narrative of the war against cancer, suggesting in dramatic form how this perspective might affect those involved. In healthcare institutions the medical treatment of cancer is often characterised as a violent assault against death and disease. As soon as they enter the clinic, ‘the patient ill with cancer stands at the centre of an emotional battleground’ (Jackson, 1981: 1–2). It can appear that they are part of an aggressive campaign in which the cancer is ‘attacked by poison and nuclear machines’ and is ‘always about to be conquered’ (Todd, 2018: 46). Oncologists and nurses often employ ‘battle terminology’: the language of ‘staying strong’ and ‘fighting’ death (Porter, 2019). Consequently, there is a reluctance to entertain the idea of ‘reconciliation with life and death’, or a more constructive, optimistic acceptance of the inevitability of death (Chi, 2007: 415). Instead the medical ‘language of rationality’, and ‘physically and emotionally sterilised atmosphere of a hospital or clinic’ (Gordon, 2000: 8–9) ensure that cancer is regarded as an intolerable, unnatural intrusion into a ‘culture that trumpets to itself the defeat of death’ (Lewis, 2001: 417).

Margaret Edson’s Pulitzer-prize winning play Wit (1999) attracted critical acclaim and ‘widespread interest among physicians’ for the skill with which it exposed the lack of ‘meaningful interactions’ between patients and staff in cancer wards, drawing attention to the ‘intellectual barriers’ healthcare professionals use to avoid engaging with dying patients as people (Sulmasy, 2006: 213–221). Walt’s journey highlights these same absences and barriers by exploring how the influence of this culture can shape patients’ responses to their condition. Like several of the characters in Wit, he exemplifies a form of ‘calculative’ reason representative of the ‘very modern, rational way of thinking’ about cancer which Edson’s work critiqued (Simpson, 2012: 61). Walt’s personal philosophy is typical of a familiar fixation with ‘empirical science’ and the ‘goal of understanding and controlling a complex world’ (Kadonaga, 2012: 183). The series holds up a mirror to this philosophy, encouraging cancer patients to consider how and why they might have chosen to deny death and disease by associating these impulses with the intellectual barriers that restrict the clinical treatment of cancer patients.

The problems surrounding Walt’s reliance on ‘calculative reason’ and obsession with ‘controlling a complex world’ are exposed throughout the series. In an episode in season 3 entitled ‘Fly’ (3: 10), the discovery of a housefly in Walt’s carefully maintained meth-lab environment results in an ‘Ahab-like mission to kill it’ (Simpson, 2012: 61): a campaign against the offending contaminant which occupies the entire episode. Walt’s high-tech machinery is useless against this unexpected enemy, and the fruitless hunt becomes a metaphor for his war against another unwanted intrusion: death. Nothing in his scientific armoury can help in the fight against the fly and the audience is given an entire episode to reflect on the limitations of Walter’s stubborn, materialist worldview when it is confronted with the unpredictable, ungovernable forces of nature and mortality. He insists the cook cannot begin until the fly is disposed of, as his increasingly ludicrous attempts to swat the insect link a banal, relatable domestic irritation to his obsessional battle with cancer. The empty pointlessness of his behaviour becomes a negative image signifying the deficiencies of ‘calculative reason’ when it is applied to tragedy and trauma.

Walt’s actions provide similar insight to the story of a real cancer patient who continued the war against death by trying to annihilate all traces of dirt and germs in her own house, in a desperate attempt to re-establish a sense of control. Having been treated in the ‘physically and emotionally sterilised atmosphere of a hospital’ she created an environment in her home in which ‘a germ couldn’t live for thirty seconds’, using chemical products to attack ‘ghosts of the past’ in a campaign inspired by the clinical battle against death and disease (Groves and Klauser, 2005: 64–65). Like Walt, the patient had adopted the toxic scientific weapons of denial but had learned nothing about accepting or living with death. The audience sees Walt unwittingly reveal these connections between the way medical practice approaches the problem of death and smaller, everyday manifestations of the ‘very modern’ fixation with ‘controlling a complex world’.

A more extreme, jarring instance of this insight comes through Walt and Jesse’s treatment of the body of a drug dealer, whom they accidentally kill in the second episode of series one. To dispose of the evidence, Walt suggests they resort to ‘chemical disincorporation’: technical jargon for dissolving the body in acid. Walt uses his scientific expertise to annihilate all traces of the man’s death, while also avoiding direct discussion of the deed. Euphemistic references to ‘the body situation’ and ‘the thing’ betray Walt and Jesse’s unwillingness to engage with the human dimension of their victim’s death. As they wipe up the gruesome physical remains from the ‘disincorporation’, a revealing sequence of flashbacks shows the audience a younger Walt in a classroom, explaining how science can account for ‘99.88804%’ of the human body’s composition, before concluding ‘there’s nothing but chemistry here’ (1: 3). Clever editing links Walt’s ‘materialist’ conviction that ‘chemistry and matter is “all of life”’ to the murderous path his cancer diagnosis has taken him down (Murphy, 2012: 16). Exaggeration and extremity prompt viewers to think about this scene in relation to the potential consequences of the medical dehumanising of life, death and disease, which sees junior doctors ‘whisked past’ dying patients during training and oncologists refuse to ‘talk about death’ (Porter, 2019). Writing on the individual’s progress towards the central reality of the Self, Jung asserts that we ‘cannot employ the language of science to trace this process of growth’ and is eager to warn against reducing our existence to a ‘scientific problem’ (Jung and Winston, 1983: 18), yet Walt’s instinct is to treat human life as a list of biochemical components. He allows the ‘decay of life’ and ‘impression of absolute nullity’ it brings to overshadow ‘that something that lives and endures underneath the eternal flux’: the invisible ‘true life’ hidden in the mysterious 0.1196% science cannot account for (Jung and Winston, 1983: 18).

Breaking Bad also allows its audience to explore the feelings of isolation and stigma caused by treating cancer as an unwelcome ‘scientific problem’ (Faull and Nicholson, 2005: 8). Patients often report that their experiences of diagnosis and treatment are something that ‘nobody can actually share’, finding themselves faced with a sense of ‘existential aloneness’ (Swinton et al., 2011: 646). When healthcare professionals should be offering ‘a bridge between the world of the ill and the healthy’ their attitudes towards cancer and death often create an ‘immense gulf’ between patient and carer instead (Hauerwas, 1985: 45). Radiation burns, scars, emaciation and hair-loss caused by cancer treatment become ‘the indelible marks of our mortality’ painfully visible in a world desperate to distance itself from all traces of this vulnerability (Musgrave and McFarlane, 2003: 523).

Breaking Bad draws viewers into immediate, empathetic engagement with such loneliness, penetrating this isolation by providing an imaginative bridge which erases the gulf between the viewer and the world of the ill. In the final scene of the first episode, after Walt has been given his terminal diagnosis yet chosen not to tell his family, we are shown Skyler trying to determine why her husband has been acting strangely, telling him ‘the worst thing you can do is shut me out’ (1: 1). As the viewer has already witnessed Walt’s panicked, unreasoning response to his prognosis, this sets up a powerful tension between what the audience has seen and what Walt has shared with his wife. Their relationship starts to resemble an empty shell, denuded of meaningful, honest communication, as the strain created by Walt’s desire to ‘keep it all in’ becomes something the viewer feels complicit in. However, when he is finally forced to disclose the truth, the situation does not improve. His abrupt pronouncement – ‘I have cancer…It’s bad’ – is met with several seconds of agonising silence, as the camera flits furtively between his assembled family members, glancing at each other with shocked, uneasy expressions (1: 4). Walt and the viewer instantly encounter the ‘emotional separation’ and ‘halting conversations’ which real patients describe (Hinton, 1972: 87–88). In this moment, ‘the viewer understands why Walt has been hesitant to tell his family’ (Du Vernay, 2012: 193), as the camera captures the fear and stigma surrounding cancer in the faces that meet Walt’s disclosure. When we watch Walt ‘made aware of his own embodied existence as a finite being…[in] a culture of widespread death anxiety’ (Simpson, 2012: 60), we better understand the way cancer throws this tension into sharp relief. Abstract ideas of ‘widespread death anxiety’ are manifested in relatable human problems caused by Walt’s retreat into his lonely ego-life.

Initially, Walt’s difficulties in relating to those around him remain comprehensible to viewers because Breaking Bad uses its medium to immerse the audience in the frightening, unsettling world of cancer treatment, which would otherwise remain unknown to those untouched by the disease. In the first episode, we see Walt in an MRI scanner, shot from above and upside-down. The camera angle, Walt’s bewildered expression and the loud mechanical noises emanating from the machine create a disorientating experience for the viewer, making it easy to share in Walt’s anxiety. When Walt moves into the oncologist’s office the noise from the machine is carried over as an extra-diegetic intrusion, ensuring the audience can only hear blurred, incomprehensible speech. Like Walt, the viewer cannot grasp or process the conversation and the distorting mechanical sounds are only removed in time for us to hear ‘Lung cancer. Inoperable…do you understand?’ (1: 1). The scene gives the audience privileged access to the post-diagnosis ‘daze’ that real patients describe: the feeling that ‘the bottom had fallen out’ of their world, and they had slipped into a ‘dark, lonely’ nightmare (Wolfe, 2007: 30).

Yet as the series develops, Breaking Bad also draws attention to the extent to which Walt actively seeks out solitude and isolation, intentionally pushing others away and insulating his ego against external connections. While Walt’s criminal undertakings gather pace, an increasingly pronounced facet of his character is a form of ‘self-romanticising’, furthered with ‘self-justifying language steeped in amorality or emotional detachment’ (Gibson, 2018: 410). In a grandiose, melodramatic speech to his tearful, distressed family, Walt’s indulgent egotism is obvious: ‘I have lived under the threat of death for a year now, and because of that I’ve made choices…I alone should suffer the consequences’ (4: 12). Cancer support specialist Pamela Brown observes that patients are often conditioned to believe ‘that it’s a strength to be independent, to not ask for help’ (Brown, 1999: 15). Walt gives the viewer an in-extremis exploration of the negative dimensions of this ideal of self-sufficiency, as his desire to bear the burden of cancer alone evolves into the introversion and deceit of covert criminality. We see him absorb these societal, medical influences which can push a cancer patient towards privacy and solitude, allowing them to draw him into a drastic, deplorable course of action.

‘At least last night you were real’: Walter White as the shadow of what might have been

Understood as a negative image, Walt’s response to cancer is not only a sign of his failings, as it also functions as a symbol of more meaningful, imaginative ways of living with cancer. In its unique depiction of life with cancer, Breaking Bad shows how television drama can create a ‘space for exploration’ which reflects viewers’ concerns yet also encourages them to ‘forge new perspectives on their own lived experience’ (Bainbridge, 2019: 300–302). In cancer care this can be a vital asset, as meaning must be ‘sought or constructed in the midst of pain and tears’ (Maclaren, 2014: 20). Simply telling patients to find meaning by ignoring or overcoming feelings of anger, fear and loneliness, rather than recognising them as natural, relatable responses, will not work. However, it is also clear from patient experiences that ‘to allow cancer to take the lead will always leave us bankrupt’ – spiritually ‘impoverished’ and trapped in meaninglessness like Walt himself (Mick, 2014: 77). Arthur Koestler argues that modern ‘technological man’ has ‘forgotten that the awareness of our own mortality can render our lives more valuable, more precious’ (see Gordon, 2000: 12). And while Walter White encapsulates the spiritual limitations of the ‘technological man’, the aesthetics, imagery and depth of meaning in Breaking Bad point towards alternative approaches to mortality which could help patients to reappraise their own situation and escape these limitations. The series creates depths of meaning discernible beyond the surface of Walt’s ego, evoking the vital, enriching forms of symbolism and interrelation which he has lost sight of. This section describes two examples of this symbolism, showing how it points to the ‘more valuable, more precious’ life that Walt could have lived.

One such example is created though Walt’s response to hair-loss. In a significant moment in season one, the viewer watches Walt, who has noticed the side effects of chemotherapy, playing with his thinning hair in the mirror then picking up a razor. The next shot – before we see Walt’s new haircut – shows the stunned reactions of Skyler and Walter Jr. as Walt enters the room. He has shaved his head entirely, embracing his changing appearance, and the audience first witnesses this reflected in the stunned faces of his family and his son’s delight and pride: ‘Badass, dad!’ (1: 6). Director Vince Gilligan ‘plays with perspective, style and structure’ in a manner that is ‘persistently challenging the viewer’s preconceptions’ (MacInnes, 2018). Camerawork and sequencing ensure we first ‘see’ Walt’s baldness through the reactions of his astonished family members, whose assumptions about living with cancer are suddenly disrupted. Walt’s chaotic progress towards infamy and evil includes these moments of liberating ‘freedom’ and ‘artistry’ mixed into the ‘maelstrom of gale-force-winded values in flux’ (DuBose, 2016: 293). Ironically and unintentionally, his attempt to craft an authoritative ‘Heisenberg’ persona reflects aspects of the bravery and ingenuity shown by cancer patients who chose to embrace their changed appearance. Like the woman who ‘enriched’ her life by accepting hair loss and openly acknowledging her disease and its treatment (Wolfe, 2007: 5–11), Walt seems momentarily to epitomise courageous, honest reconciliation with cancer. In a show which often ‘suspends…our narratives of common sense’ and then ‘pushes them in unexpected directions’ (Restivo, 2019: 11), Walt’s spontaneous shaving accidentally models this paradoxical use of loss as an opportunity for reinvention.

Another excellent illustration of the challenge Breaking Bad presents to conventional ideas about the physical treatment of cancer is the family ‘intervention’ scene in season one, episode five. Like the clinicians who instinctively resort to ‘big treatment’, Walt’s wife, Skyler, is convinced that using toxic chemicals to attack his cancer is the only viable course of action. Emboldened by his mother’s passion, Walter Jr. also mocks his father for being ‘scared of a little chemotherapy’, but Walt’s riposte to his loved ones introduces a very different perspective. He condemns the medical culture that sees ‘doctors talking about surviving as if it’s the only thing that matters’ and often leaves patients ‘artificially alive’ and ‘just marking time’. Ironically, those real patients who found meaning through facing up to mortality, and holding life and death in balance, would share Walt’s belief that living well is not solely about deferring death. Again, in his desperation to defy his condition Walt stumbles upon ideas which could be interesting and even inspiring when applied to a different context. Analysing the scene, a palliative care expert notes that by setting Skyler’s desire to ‘fight the good fight’ against Walt’s willingness to accept death, ‘Breaking Bad’s writers found a way to allow us to view that conundrum’, raising issues ‘that would have taken hours to unmask even with the help of a skilled counsellor’ (Miori, 2012: 28–33). The scene demonstrates how television dramas can generate conversations about serious, sensitive subjects which might otherwise remain untouched and taboo (Byrne and Taddeo, 2019: 379), using Walt’s unpredictable, disruptive presence to ‘unmask’ relevant concerns.

As well as imagery that raises the possibility of forms of creative resignation, Breaking Bad also offers shadows and echoes of the strange strength patients gain through accepting dependence. Many patients say that their experience of cancer has resulted in ‘a fresh realisation that we are interdependent’ (Swinton et al., 2011: 643) – a renewed appreciation of the strength and spiritual support that can be gained through reliance on those around us. Strangely, it is Walt’s refusal to rely upon the loving support of his family which reveals the value of accepting such dependence. In a revealing scene towards the end of the fourth season of Breaking Bad, Walter Jr. finds his father cut, bruised and fragile following an altercation with his drug-dealing associates. In a rare moment of vulnerability, Walt suddenly opens up to his son about his own experience of seeing his father in hospital dying of Huntingdon’s disease. The unexpected, poignant qualities of this image of a weeping, battered cancer patient highlight what Walt has been missing up to this point: the shared understanding which submitting to weakness and reliance makes possible. When Walt tries to reinstate the façade of the strong, solitary cancer-warrior the next day, his son’s reaction serves to reinforce this message: ‘at least last night you were real’ (4: 10). Walt’s reaction to his slip into honesty provides a revealing contrast to a real father facing a potentially fatal cancer who decided to be ‘open’ and ‘talked to both [his] children about death’. Though he ‘could not stop crying’, he later recognised that discussing death with his family had been a crucial stage in his spiritual recovery: ‘I think I needed that low moment in a strange way’ (Wolfe, 2007: 124). When this father reached his tearful ‘low moment’, sharing the burden of his fragility with his family, it instigated a process of healing, yet Walt treats his own acknowledgement of anxiety as an aberrant display of vulnerability. Walter Jr. suddenly see his father’s ‘real’, vulnerable Self open to meaningful connection, before it is obscured again by the Heisenberg mask. The audience is reminded that they are seeing symbols of what could have been: fragments of the loving relationships Walt could have depended on.

This is not the only moment in which Walt’s shadow-life comes to symbolise the empathy and love he has pushed away. In the final season, Walt celebrates his birthday with his family by giving a speech thanking his loved ones for their support: ‘I did not want to get any treatment, I think I was too angry, too scared…but you guys got me through it’ (5: 4). Superficially, Walt’s words reflect the experiences of patients whose struggles with cancer brought them closer to their families, strengthening their resolve and resilience. However, the viewer sees this deceitful display of hollow gratitude set against a backdrop of Skyler, distraught and despairing after learning about Walt’s crimes, slowly walking into their family pool as if attempting to drown herself. The effect of placing these two figures in a single shot is a shockingly discordant televisual moment, with Walt oblivious to the way his wife’s tragic behaviour is exposing the cynicism of his speech even as he delivers it. Walt’s monologue becomes a parodic silhouette of how things might have been – how his family and friends could have given him the support he needed to endure his treatment.

Breaking Bad – A new iconography of death?

Breaking Bad develops a secular reimagining of the iconography of death around Walter White, which could help to meet the need for symbols in cancer care. Walt’s interactions with the world around him create ‘televisual moments’: ‘iconic images and sounds’ (Moylan, 2019: 308) comprising the kind of ‘symbol system’ which Jung believes can reconnect the ego with sources of truth, inspiration and social connection. Breaking Bad is an example of a series that could be used to recover elements of what was stripped from care practices when religious iconography lost its relevance, restoring the transformative potential of symbol to cancer care. Margaret Miles suggests there are similarities between the ‘visual training’ required for thoughtful ‘film spectatorship’ and that which is needed to enter into a ‘religiously momentous scene’. She likens the ‘new skill’ filmgoers (and now also television viewers!) must learn to the ‘explicit visual training that spectators underwent’ for religious devotional practices (Miles, 1996: 27–31, 205). The lengthy, committed viewing patterns longform serial drama demands of the viewer are like a ritualised practice, encouraging viewers to assimilate an iconographic language that invests images of death and cancer with new meanings. Like the Christian art which used to play a crucial role in spiritual care, Breaking Bad presents shocking images of suffering and violence, yet uses audiovisual cues to invite the audience to search for sources of consolation and hope concealed beneath Walt’s shadow. This section outlines three key examples of this imagery in Breaking Bad, describing how these iconic moments provide viewers with a symbolic language that could help them to speak more confidently and constructively about their own experiences of cancer.

Breaking Bad makes effective use of the symbolic significance of the tomb. In the final moments of season four, as Walt begins to realise that his life is collapsing into chaos, his predicament is captured by a shot of him lying in the hole in his basement where he keeps his money, laughing hysterically. The camera angle lets the audience look down on Walt, seeing him trapped within the grave he has created for himself in his hunt for wealth. Walt’s absurd, nihilistic laughter speaks of the meaninglessness of life under threat of sickness and death, but the audience sees this hopelessness as Walt’s own construction – a coffin he has built for himself (4: 11). The final shot of the entire series develops this iconography, showing Walt, bleeding to death, surrounded by walls of equipment in his meth laboratory. Again, a bird’s-eye camera angle gives the audience the distance and perspective required to recognise this as a tomb that Walt has trapped himself in – a ‘death of his own making’ (Thompson, 2015: 62) – while the lyrics of the accompanying soundtrack build on this meaning: ‘guess I got what I deserved’ (5: 16). Walt can only see the walls around him as mirrors reflecting his personal sense of fear and failure. Yet the camerawork gives the viewer a vantage point from which they can look on this vision of death as a transparent icon which conceals what might have been behind it. Walt’s fate functions both as a poetic representation of the consequences of his misdemeanours, and an iconic ‘silhouette’ of a better path not taken. Looked on as an icon, the sterile, amoral emptiness of the tightly controlled scientific environment Walt has confined himself in becomes a negative image of all the truly ‘special’ things he has disregarded and destroyed.

We are invited to see this vision of Walt’s self-perpetuated slide towards meaninglessness as a window onto an imaginative space in which alternative responses to cancer could be explored. The scene is comparable to traditional Christian depictions of the tomb because the form of the work possesses a transparency which leads beyond the morbidity of its immediate content towards light and life, shining through the gloom of human transience (Hart, 2014). Walt’s response to his diagnosis turns death into an idol which he has never been able to look past but cinematography, shot selection and sound give the audience chances to ‘think at deeper levels’ (Lewis, 2001: 182). The series shows how aesthetic tools particular to television can construct depths of spiritual meaning behind the superficial surface content of a narrative, reimagining the palliative, consolatory power of the iconography of death for a popular, accessible modern medium.

Another notable element of Breaking Bad’s iconography of death is the series’ use of the circular ‘zero’. The symbolism of an empty circle recurs throughout, its significance subtly shifting to accommodate different meanings and resonances. One of the first examples of this comes while Walt is shaving his head for the first time, as chemotherapy has started to cause hair loss. Rather than show Walt himself the camera focuses on the round, black plughole in the sink, as Walt’s hair disappears down it. The extent to which feelings of loss and nullity have started to take hold of Walt’s existence is conveyed through the reframing of a banal, everyday object as a dark, doom-laden nought (1: 6). Like the transformation of a plughole into an evocation of ‘absolute blackness’ in Psycho (1960) (Misek, 2008: 7), the shape becomes a sign in Breaking Bad’s ‘artistic language’: a means of ‘translating concrete reality’ which turns a domestic detail into a satire of the bitter hopelessness Walt is indulging in (Ouspensky and Gytheil, 1978: 451–494).

As this language evolves, the symbolism of the zero becomes crucial. When Walt’s actions result in Hank being murdered by a group of neo-Nazis, dramatic camerawork shows his immediate reaction to Hank’s death in slow-motion, leaving Walt almost frozen in a grief-stricken moment of realisation, with his mouth framed in a silent, agonised scream (5: 12). This devastating expression is reminiscent of the poignant, desperate ‘O, O, O’ uttered by King Lear at the death of his beloved Cordelia, in another artwork in which the symbolism of ‘nothing’ plays a central role. Walt’s own ‘O’ signifies the hole he has created in his life, reminding the viewer of the fatal consequences of the way he has chosen to fight his cancer while weaving this tragedy into a wider aesthetic language of meaninglessness. And when Walt is left alone to die in self-imposed exile, with the series nearing its finale, this language reaches its culmination. With cancer causing Walt’s body to shrink, his fingers become so emaciated and skeletal that his wedding ring falls off. The camera instantly homes in on the fallen ring and the empty circle it now frames, inviting the audience to see this space as full of the marriage and family that Walt has corrupted: an absence evoking those things which could have returned meaning to his existence (5: 15). The ring, like the plughole, takes on a ‘porous quality’ and ‘points beyond itself’ (Barnett, 2018: 188) towards the things which Walt should have cherished and protected.

The most important component of Breaking Bad’s televisual iconography is the screen itself. In 5:8, in the aftermath of one of Walt’s most reprehensible acts, the audience is shown an iconographic shot which holds death, desolation, and new life in paradoxical tension. In the foreground, Walt is playing happily and tenderly with his infant daughter. Yet in the background, behind the father and daughter, is a television showing news coverage of a series of carefully coordinated prison murders Walt has organised and paid for. Though Walt is oblivious to the screen, the viewer sees and hears the horrifying reports of 10 brutal killings set against a picture of peaceful, innocent new life. Appropriately, the on-screen television adds layers of meaning to the scene that Walt is unaware of, allowing the viewer to attain a deeper understanding of his situation. Real cancer patients talk about the importance of appreciating the ‘inextricability of life and death’ and the need to recognise how ‘cancer teaches you to live’ (Brown, 1999: 13), but this is only revealed to the audience as a suggestive silhouette of the life Walt might have embraced. The tenderness and tranquillity of the father and child together is rendered superficial and hollow by the deeper meanings created by the screen lurking in the background. For a patient experiencing the fear, anger and isolation which has consumed Walt, the morbid symbolism of this scene might alert them to the need to search for new ways of relating to their condition that preserve the promise of life.

In a revealing reworking of this symbolism a few episodes later, Walt finds himself watching an old friend in a television interview describing how Walt is no longer the ‘sweet, kind, innocent man’ he used to be, but a dangerous, brutal drug lord (5: 15). The fury on Walt’s face is unmistakable as the screen becomes a mirror in which he sees himself as a misunderstood, mistreated victim. For Walt, the television itself is what Jean-Luc Marion would deem an ‘idol’: an ‘invisible mirror’ highlighting the ‘shortcoming of his gaze’ and his inability to see past bitter, consuming feelings of injustice and despair (Marion and Carlson, 1995: 7–20). But for the viewer the screen takes on iconic qualities, which point beyond the interview towards the ‘innocent’ life which could have been lived despite, and because of, his prognosis. The Self which was once Walt’s ‘true life’ of sweetness and compassion has been eclipsed by Heisenberg, but the series still pulls viewers’ attention back to everything that Walt has left behind.

What makes Breaking Bad a particularly promising resource for spiritual care is the way in which it balances brutal honesty with an awareness of how ‘the prospect of death…wonderfully concentrates the mind’ (Becker, 1973: ix), introducing audiences to the paradoxical idea that something which threatens to take you out of the world can bring you more deeply into it. Cancer patients frequently refer to the pain and hopelessness their condition causes, and the terror death holds for them. Yet their testimonies also often point to this paradox, describing feelings of relief and renewal when the illusion of impermanence is lifted, and death becomes closer and more familiar. Breaking Bad holds these two kinds of responses together in the same space, using Walt to examine the anger, isolation and resentment cancer causes, while employing sophisticated aesthetics and dialogue to introduce more hopeful perspectives emphasising interdependence, life and love. Unlike Heisenberg himself, a critical viewer will be able to see Walt’s ego-life as a shadow of something greater: an absence evoking the different life he could have lived.