The Broken Circle Breakdown (2012)

Didier, a Flemish banjo player in love with American bluegrass, meets Elise, a tattoo artist. Their romance is told out of sequence, cut against the band they perform in together. Elise becomes pregnant and they raise their daughter Maybelle at Didier's converted farm. Shortly after Maybelle turns six she is diagnosed with cancer. The film moves between the happy years before and the months of treatment: hospital corridors, chemotherapy, a shaved head, a hopeful remission, then relapse. Maybelle dies within about a year. Grief pulls the parents in opposite directions. Elise looks for meaning in an afterlife and in signs from her daughter, while Didier turns his loss into public rage, at one point breaking off a concert to denounce religious opposition to stem-cell research that he believes might have saved her. Elise changes her name, then takes an overdose. She is left brain-dead and Didier consents to withdrawing life support. The band plays around her bed as she dies.

Spoilers throughout. Discussing the cancer storyline means discussing how this ends.

The film is strong on the domestic texture of childhood cancer: the sudden collapse of ordinary routine, parents performing cheerfulness in front of the child, hair loss and the wig, isolation precautions and constant handwashing, and the fact that a child's treatment is months of unglamorous attrition rather than dramatic single operations. It captures the false summit of remission and the particular devastation of relapse. Above all it is honest that a child's death does not bond a couple. Bereaved parents often grieve on incompatible timetables and in incompatible languages, and many relationships do not survive it. Didier's fury at obstacles to research is a recognisable form of grief looking for somewhere to land.

Because the diagnosis is never named, the film works as a general portrait rather than an accurate account of any one disease. Treatment is compressed into montage. The stem-cell-research argument functions as political grievance more than clinical description: for the blood cancers where transplant applies, donor stem cells come from bone marrow, adult volunteer donors or umbilical cord blood, not from the embryonic research the monologue is about. The roughly one-year arc from diagnosis to death is also faster than the usual course of most childhood cancers, many of which are treated for two years or more.

Since the film names no diagnosis, the useful real-world subject is childhood cancer generally. Leukaemias are the most common cancers in children, followed by brain and other central nervous system tumours and lymphomas (NCI). The warning signs are ordinary-looking, which is exactly why they get missed. NCI lists fever, easy bruising or bleeding, flat pinpoint dark-red spots under the skin, unusual paleness, weakness or tiredness, bone or joint pain, painless lumps in the neck, underarm, stomach or groin, pain or fullness below the ribs, loss of appetite, weight loss, abdominal pain and frequent or persistent infections. For solid tumours, parents may notice a lump or swelling that does not settle, morning headaches with vomiting, changes in vision or balance, or an unexplained limp. The central fact for a family audience: there is no cancer screening programme for children at average risk. No test is recommended for healthy children, and childhood cancer is found because someone takes a persistent, unexplained symptom seriously. Surveillance exists only for children with specific inherited predisposition syndromes, arranged through genetics services. Symptoms lasting more than a couple of weeks, or any unexplained bruising or bleeding, warrant a doctor's assessment and usually a simple blood count.

A film is not a diagnosis, and a dramatised illness is not a guide to your own. What a story like this is genuinely good for is lowering the barrier to a conversation you might otherwise put off.

If something in your body has changed and stayed changed for a few weeks, that is worth raising with a doctor — not because it is likely to be cancer, but because most of the time it will not be, and finding that out is the point. Where screening exists for a cancer, it is the one thing you can do before anything is wrong at all. See screening and possible warning signs.

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The Broken Circle Breakdown is worth watching as a film. It is not a guide to the disease it portrays. The gap between the two is what this page is for — and the thing worth carrying away is that a change which persists is worth a conversation, whatever a story led you to expect.

This page describes a work of film or television for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email [email protected].