The Room Next Door (2024)

Ingrid is a novelist who has just published a book about her own fear of dying. She learns that her old friend Martha is in a Manhattan hospital with cancer. They had worked together at a magazine decades earlier, before Martha became a war correspondent.

Visiting, Ingrid finds her lucid, funny and unsentimental. An experimental treatment for Martha's stage 3 cervical cancer looks promising, then fails.

Martha then reveals she has bought a euthanasia pill online. She asks Ingrid to come with her to a rented house in Woodstock, New York. Not to help her die, but to be in the room next door when she does. The signal will be a closed bedroom door. After one false alarm, Ingrid finds Martha dead on a lounger outside. A devoutly religious detective treats her as a suspect. A lawyer defends her. Ingrid then contacts Martha's estranged daughter, Michelle, and brings her to the house.

Spoilers throughout. Martha's death and everything that follows it are discussed on this page.

Most films skip the aftermath. This one builds its third act out of it, and the distinction it draws is real.

In a US state without an assisted-dying law, being present when someone takes their own life is not itself a crime. Obtaining the drug for them, or giving it to them, is a different matter. That is exactly what the police interview turns on, and it is why Martha is so insistent that Ingrid stay next door rather than in the room.

The film also shows the bureaucratic aftermath and the suspicion that lands on the survivor. That part is usually left out entirely.

Martha is on a trial, and the film handles it well. A trial drug can produce a genuine remission and then stop working. That failure is often the moment a person shifts from fighting to planning.

Her reasoning is also plausible. She is not depressed, not yet in unbearable pain, and she is acting while she still has the capacity to act. That matches the pattern people describe when they seek an assisted death.

Cervical cancer is the strongest case in all of cancer screening, and the film says nothing about it. That silence is a large hole in a story about this particular disease.

Almost all cervical cancer is caused by lasting infection with high-risk human papillomavirus, or HPV. Screening does not just find cancer early. It finds cell changes years before a cancer forms, so they can be treated and the cancer never happens.

The US Preventive Services Task Force gives cervical screening a grade A, its strongest rating.

The Task Force sets it out by age:

• Ages 21 to 29: cervical cytology, the Pap test, every three years.
• Ages 30 to 65: cytology alone every three years, or high-risk HPV testing alone every five years, or HPV testing and cytology together every five years.

It recommends against screening before 21. It recommends against continuing after 65 for women who have had adequate prior screening and are not otherwise at high risk. And it recommends against screening women who have had a hysterectomy that removed the cervix, unless they have a history of a high-grade precancerous lesion or of cervical cancer.

This recommendation is currently under review, so the schedule may change.

HPV vaccination prevents most of the infections that cause cervical cancer. It does not cover every high-risk type, and it cannot clear an infection someone already has.

So a vaccinated person still follows the same screening schedule. This is one of the most common misunderstandings about the vaccine, and it is worth being clear on.

NCI says early cervical cancer usually causes no symptoms, and that symptoms usually begin once the cancer has spread. When they do appear, NCI lists bleeding after sex, bleeding after the menopause, bleeding between periods or heavier and longer periods, watery discharge with a strong odour or containing blood, and pelvic pain or pain during sex.

Advanced disease can add a dull backache, leg swelling, abdominal pain, fatigue, and pain or bleeding with bowel movements or urination.

Martha stays elegant, articulate and physically capable until the day she dies. Her hair, her wardrobe and her appetite for conversation are all intact.

Advanced cervical cancer that has stopped responding to treatment usually looks different. Pelvic and lower-back pain. Bleeding. Leg swelling. Kidney problems when the tubes from the kidneys get blocked. Marked weakness. Very little of that reaches the screen.

The route to the pill is frictionless too. It is ordered from the dark web and simply arrives. And nothing is ever said about how Martha's cancer was found, or whether she had ever been screened.

This page is free to read and always will be, with no adverts and nothing for sale. If the cervical screening schedule was useful, you can help keep it that way. Support our work.

The Room Next Door is careful about law and choice and vague about the body. It is the most legally literate film on this list and one of the least physically honest.

The gap it leaves is the important one. Cervical cancer is the cancer where screening genuinely prevents the disease rather than merely catching it. A film about a woman dying of it never mentions that once.

• https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening
• https://www.cancer.gov/types/cervical/symptoms

This page discusses The Room Next Door for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email corrections@cancerexplained.org.