In the first scene of Scott McPherson's 1990 play, "Marvin's Room," 40-year-old Bessie sits in a medical lab awaiting a blood test.
As she tries to mask her mounting discomfort, an inept doctor stabs at her arm in search of a cooperative vein, and cheerfully hints that her test results may be upsetting.
He's right. Bessie, we soon learn, has leukemia. She also has responsibility for two elderly relatives with their own medical problems: her bedridden, stroke-victim father Marvin, and her dotty Aunt Ruth, whose brain is wired with electrodes to relieve a spinal condition.
"Marvin's Room" also deals unblinkingly with bone-marrow transplants, respirators and the violently dysfunctional mother-son relationship between Lee, Bessie's sister, and her ballistic teenage offspring, Hank.
Yet, believe it or not, McPherson's script - which premieres locally tomorrow night at the Seattle Repertory Theatre - is not a downer.
This portrait of a family under extreme pressure is a warm, perceptive comedy - or, more to the point, a serious play laced with giddily comic moments. In his rave review, New York Times critic Frank Rich termed it "one of the best plays of the year as well as one of the wisest and most moving."
Is the theater-going public ready, though, for a comedy that laughs squarely in the face of incurable illness and imminent mortality? One that jokes around about giving blood? One that reveals the splotchy scalp of a woman losing her hair to chemotherapy?
So far, yes.
"Marvin's Room" has had successful runs in Chicago and Hartford, Conn., and is selling out currently at Playwrights Horizon in New York. The Rep's version, part of the Stage 2 series in the Poncho Forum, is directed by Robin Lynn Smith, with a cast featuring Julie White, Todd Jefferson Moore and writer-comedienne Susy Schneider.
Though "Marvin's Room" explores incurable disease with extraordinary candor, it is only the latest in a steady stream of modern American plays, ("The Shadow Box," "Whose Life Is It Anyway?"), films ("Love Story," Terms of Endearment"), and TV movies (`"unshine," `"n Early Frost") to address the subject.
Some cancer stories, like the 1990 film "Dying Young" starring Julia Roberts, are basically updated romantic melodramas - modern versions of "Camille," with attractive central characters who die gracefully, looking none the worse for wear.
Numerous other disease-of-the-week sagas have spotlighted less glamorous characters, but turned them into sanctified heroes. In this formula, looming death heals estranged families, wipes out past sins, and has little to do with mundane horrors like huge hospital bills, medical neglect and finding round-the-clock nursing.
But with cancer rates rising, more and more people are having direct contact with incurable disease - either first-hand, or through the experience of a loved one or relative. No longer considered shameful or hidden, cancer is cutting across socio-economic lines and personality types. And it is not so easily romanticized.
The AIDS epidemic is also profoundly changing our images of grave illness. The vast majority of those who have contracted the disease or tested HIV-positive have been in the prime of life, including well-known writers, actors and other public figures (Magic Johnson being the prime example).
Rather than suffer in silence, some of these people and those close to them are eloquently sharing what they've learned about living with AIDS. In the entertainment realm, this has resulted in honest, even angry plays such as "As Is" and "The Normal Heart," and in the moving film, "Longtime Companion."
McPherson, the 32-year-old, Chicago-based author of "Marvin's Room," is battling AIDS. But the work that is bringing him to national attention was written before the onset of his illness. And it was not inspired by his own struggle, but by that of his widowed mother to raise three children and care for her own cancer-ridden mother.
"At times," wrote McPherson in a program note for the play, "an unbelievably harsh fate is transcended by a simple act of love, by caring for another."
In its affirmation of life and love, its gritty detail and its absurdist dark humor, "Marvin's Room" doesn't flinch at harsh fate. Some may consider its subject matter morbid, and its humor in questionable taste.
But the play demonstrates just how far the theater has come in dealing honestly - and artfully - with a subject few of us can afford to ignore.