From Romeo and Juliet to Titanic, we’re drawn again and again to tales of love that end in heart-wrenching loss. Our morbid fascination with doomed love has even given rise to an entire archetype, dedicated to the romance of dying: The Sick Girl. Other characters inevitably fall for her, and usually, so does the audience. But while the Sick Girl seems to bring positive representation to people living with illness, it’s a trope that often traffics in cliches, and it creates unrealistic expectations that can be harmful. Here’s our Take on the Sick Girl, and whether it may be time to let her go.

The Sick Girl Trope, Explained

TRANSCRIPT

Romance and tragedy have been intertwined from the very beginning of storytelling. From Romeo and Juliet to Titanic, we’re drawn again and again to tales of love that end in heart-wrenching loss. Our morbid fascination with doomed love has even given rise to an entire archetype, dedicated to the romance of dying: The Sick Girl.

On-screen, this ill-fated young woman can be identified not just by the fact that she’s ill, but by a set of recognizable characteristics: First and foremost, her life is defined by her sickness. She may have other interests and an outgoing personality, but her ailments make them difficult to pursue.

• The Sick Girl is usually bursting with positivity: she’s likable, outgoing, and nearly flawless — which makes her affliction all the more tragic.
• She’s also unusual: facing death has made her unapologetic about who she is. She can be unflinchingly candid or dreamy and whimsical.
• Even at the height of her illness, she’s usually gorgeous — though she might not always be aware of it.
• She’s also wise beyond her years, full of pithy observations born from her unique perspective on life.
• And she often exists solely to pass this wisdom on to a man, inspiring him to live his life to the fullest, before she surrenders hers.

Other characters inevitably fall for the Sick Girl — and usually, so does the audience. And this makes saying goodbye to her all the more painful. Yet while the Sick Girl seems to bring positive representation to people living with illness, it’s a trope that often traffics in cliches, and it creates unrealistic expectations that can be harmful. Here’s our take on the Sick Girl and the role she plays, and whether it may be time to let her go.

Romanticizing Illness

The idea of a woman who’s made all the more beautiful by illness dates back to the 18th century when tuberculosis was rampant. The disease — also known as consumption — was known for giving its victims a small waist, rosy lips and cheeks, pale skin, and silky hair, making it an unlikely ideal for Victorian beauty. After the title character of Samuel Richardson’s 1748 novel Clarissa succumbs to tuberculosis, he writes of the admirers crowded around her deathbed: “We could not help taking a view of the lovely corpse… The women declared, they never saw death so lovely before.”

Meanwhile, artistic works from the opera La Bohème to Moulin Rouge! propagated the idea that illness—and tuberculosis in particular—was an especially romantic way to die. Though we’ve largely left tuberculosis behind, we still seem to find something romantic and beautiful about the Sick Girl. In the 2014 hit The Fault in Our Stars, Hazel is living with cancer, yet you’d hardly know it by looking at her. As cancer survivor Lauren Sczudlo wrote in The Washington Post, the film languishes in Hazel’s “fantastic figure and luscious hair”. “How did Hazel maintain that bodacious body?” she writes. “Her daily prescription drug cocktail would almost definitely have included steroids, meaning Hazel would’ve been a marshmallow waddling on two sticks.” As Sczudio notes, it’s a portrayal that omits all the ugly realities of terminal illness, offering an impossible fantasy version that only “proves that real dying is too truthful for even a professional Hollywood film to depict, so it doesn’t even try.

Our modern romantic notions of the Sick Girl can be traced to 1970’s Love Story, an Oscar-nominated box-office smash starring Ali Macgraw as a vivacious young woman whose life is cut short by a terminal illness. The film is told in flashback, which gives everything an air of melancholy and significance. And Jenny’s death marks a heartbreaking yet romantic end to a relationship that remains untroubled by honest depictions of her illness — which is never named — or the physical toll it would take. As Roger Ebert once put it, Jenny seems to be afflicted with “Ali MacGraw’s Disease… where the only symptom is that the patient grows more beautiful until finally dying.”

Reviewing the film for The New York Times, Vincent Canby said that “The only really depressing thing about Love Story is the thought of all of the terrible imitations that will inevitably follow it.” He was proven correct: movies and TV shows have continued to see young women suffering from Ali MacGraw’s Disease, in films that often turn them into morbid Manic Pixie Dream Girls. These women will similarly meet a man in serious need of enlivening or improving, teach him that every moment is precious, and then pass away. In this, we can see one of the main problems with the trope: The Sick Girl is defined not only by her sickness but by what she means to a man.

Sara Deever: “I can help you, Nelson. I have a gift. A special ability to help men with… problems.” - Sweet November

In 2011’s Restless, the upbeat Annabel seems especially undaunted by the fact that she has cancer, and the film largely concerns itself with her love interest, Enoch, and his emotions. Even Annabel’s death is oriented around Enoch — so much so that she asks his permission to die. In A Walk to Remember, Mandy Moore’s Jamie helps Shane West’s popular, superficial Landon become a more sensitive, mature guy before she dies, inspiring him to find both faith and direction. It’s a role she performs by offering him — and us — a sort of cautionary tale about our own mortality. The Sick Girl is there to remind us to live life like there’s no tomorrow — because, for them, there isn’t. It’s a patronizing narrative that suggests sick people exist solely as an object of there-but-for-the-grace-of-God inspiration, As Elsie Tellier writes, “Terminally ill people are not alive just to make healthy people ‘appreciate their lives’ more.”

Often, the Sick Girl is also portrayed as simply too good for this world: she lives as an angel and dies a martyr, her illness made all the more tragic by how otherwise pure she is. And this leads to her having no real complexities or character arc of her own. She’s so perfect that she can’t really grow — and there’s likewise no room for her to be anything less than heroic about the struggle she faces.

And because her time is so fleeting, the Sick Girl is also used as an object of forbidden love. In this, it’s easy to see why the Sick Girl is so often romanticized: her illness creates the essential conflict keeping young lovers apart that we see so often in our most successful romantic stories. In addition to being beautiful and perfect, she is unattainable, and her looming death creates an urgency to the relationship that gives everything extra passion and meaning. By denying those lovers the ability to be together, the Sick Girl trope perpetuates the narrative that the most romantic love is the one that’s never totally fulfilled.

Villainizing Illness

In order for the Sick Girl’s illness to be romantic, it has to become an antagonist — the one thing keeping these lovers apart and standing in the way of their happiness. In 2019’s Five Feet Apart, the characters’ cystic fibrosis becomes an invisible physical presence between Stella and Will, forcing them to stay separated because of the risk of cross-infection. Throughout the film, their shared illness hangs menacingly over their every interaction as they draw closer together — and eventually risk their lives. It’s a film that’s drawn considerable backlash from the cystic fibrosis community, for the way it romanticizes the disease and, in the words of one “CFer,” exploits “a life-and-death situation, which the movie reduces to a plot device to make teenagers horny.” But it’s also been criticized for reducing them to pitiable victims. As another CFer observed, “This is very much what we all would call ‘pity porn’.”

There are obvious reasons to feel sympathetic toward anyone with an illness, to be sure. Besides suffering through symptoms, many have feelings of isolation or depression, experience issues with body image, and struggle with independence and maintaining their friendships. But films that languish in eliciting pity for people with illness only contribute to the stigmas around it. 2017’s Everything Everything earned considerable backlash for its depiction of a teenager, Maddy, who’s been told she has an immune disorder, and whose mother forbids her to go outside. Naturally, Maddy eventually decides to risk everything when she falls for her handsome neighbor. The film paints Maddy as imprisoned by her disease — and it earned the swift ire of advocacy groups who criticized its exaggerated and “completely false” representation of the restrictions she would face. It also sparked criticism from those who live with immune disorders themselves, who decried the film’s suggestion that they’re incapable of living a full life — or that disregarding their safety is the only way they could “truly live”.

These stories — where illness not only prevents the Sick Girl from fully realizing love but from enjoying life at all — don’t just evoke pity. They stoke fear, suggesting that a character’s illness will ruin not only their lives but the lives of those close to them. In the 2009 drama My Sister’s Keeper, we meet Abigail Breslin’s Anna, who’s been conceived as a so-called “savior sister” for Kate, who has leukemia. Anna is born expressly for the purpose of donating her blood, organs, and tissue to Kate, whose illness takes a mental and physical toll on her sister. This eventually drives Anna to seek emancipation for the rights to govern her own body, and it almost tears their family apart over what Kate really wants.

This same kind of melodrama erupts in both My Sister’s Keeper and Everything Everything, where it’s expressed through the mothers, who become villains themselves: protective of the Sick Girl to the point of being constantly terrified — and occasionally tyrannical. The Sick Girl’s mother is usually there to remind her daughter of the impossibility of ever living a normal life. Everything Everything takes this to an unusual extreme, revealing that Maddy’s mother suffers from Munchausen syndrome by proxy, and has been lying to her daughter about her disease. The film garnered controversy for this as well — not only for furthering harmful stereotypes of people with immune disorders as simply hypochondriacs but for making the mentally ill mother into the antagonist.

Occasionally we’ll see the Sick Girl’s illness presented as a sort of karmic punishment for living her life a little too freely. Both the tragic heroines of Alexandre Dumas’s Camille and Moulin Rouge’s Satine are courtesans who spend their time flitting through the Parisian demimonde, engaging in hedonistic pleasures that are finally brought to an end by a fatal bout with consumption In Rent, the HIV-positive Mimi sees her illness rapidly progress after she relapses with drugs — the spread of her disease is implicitly tied to her own, self-destructive behavior. A similar scenario plays out in Forrest Gump’s Jenny, who spends years living a bohemian lifestyle, partying, and indulging her own vices. When she falls ill with a disease that is likely but never explicitly identified as AIDS, the film suggests that even her rehabilitation as a traditional wife and mother isn’t enough to save her. This reflects some unfortunate real-world misconceptions: In 2018, one in ten Americans said they believed that people with chronic illnesses only have themselves to blame.

Much as the Sick Girl trope can often portray the Sick Girl as angelically pure, it can also exaggerate her illness as a form of retribution — a curse that makes life agonizing and unbearable. But there are millions of people living with illness, most of them leading everyday existences that aren’t marked by this kind of melodrama. So why is it so difficult to tell their stories?

Getting Better About Illness

Stories about the Sick Girl often focus on what she represents rather than what she’s actually going through — and this makes a certain sense. Illness can be difficult and painful to watch. It’s messy and complicated, and it doesn’t adhere to our need for tidy storytelling. But it’s notable that this often doesn’t seem to be the problem for the Sick Man. Movies about men with disease or disability tend to be warts-and-all in their approach, encompassing love and hardship, dealing head-on with their frustrations and physical deteriorations. More importantly, they don’t always die. Instead, they’re left changed by their illness and, in many ways, having grown from it.

Stephen Hawking: “However bad life may seem, there is always something you can do, and succeed at. While there’s life, there is hope.” - Theory of Everything.

Similarly nuanced, realistic depictions of the Sick Girl are rare, although they do exist. 1983’s Terms of Endearment finds considerable heartache in the story of the terminal cancer patient Emma, played by Debra Winger. But the film balances this with humor, never romanticizing Emma or reducing her to a symbol; she squabbles with her overbearing mother, played by Shirley Maclaine, right up until the end. The film finds its central drama not in a romantic love story but in this mother/daughter bond, as well as in Emma’s relationship with her own sons. And it leaves us with a fuller portrait of what it means to lose someone to illness — someone who’s real, rather than a symbol, which makes it all the more devastating.

Although 2015’s Me and Earl and the Dying Girl does revolve around a love story, it openly tries to subvert the usual Sick Girl cliches. It doesn’t glamorize or romanticize Rachel’s leukemia, nor does it have her risking her life just to truly live. It confronts Rachel’s physical condition honestly and delves into her insecurities about it.

Rachel Kushner: “I’m so ugly. Everyone feels like they have to lie to me and no one realizes how insulting that is.” - Me and Earl and the Dying Girl

Most importantly, it presents her as in control of her own story, right up until the end. It finds a welcome balance between the difficulty of living with a serious illness and the strength that people find to endure anyway.

Promisingly, we’ve begun to see films where the Sick Girl is actually allowed to get better—and completely upend our own prognosis for how her story turns out. At first, 2017’s The Big Sick seems to be setting us up for a classic Sick Girl story: Kumail falls for Emily, just before a lung infection leaves her in a medically induced coma. As Emily lies there, Kumail’s feelings for her only intensify. The film suggests that this will be another story of an idealized love that can never be fulfilled, making it all the more romantic. But then, Emily not only wakes up; she wakes up and rejects Kumail. She becomes a real, complicated person again — and also, she’s not entirely cured. Emily is told she will live the rest of her life with a serious, yet treatable disease. And it’s into this uncertain, yet certainly surmountable future that she and Kumail are able to rekindle their romance, one where her illness will play a part but doesn’t rule her life.

The Big Sick is based on a true story, so it’s not surprising that it deals with illness more honestly than the countless, weepy romances we’ve seen over the centuries. Yet there’s every reason to demand a similar sensitivity from our fictional depictions. We’ve seen small, yet significant inroads toward more nuanced representations of the disabled community in recent years, in stories that don’t reduce them to mere symbols or stereotypes.

Ryan O’Connell: “When you don’t see yourself being reflected back at you onscreen you’re implicitly told that you don’t matter, that your story’s not worth being told.” - “The Cast of Netflix’s Special Talk LGBT, Disability and Minority Representation”, Netflix UK & Ireland

We can certainly do the same for those who find themselves battling serious diseases — whether they’re overcoming them, or even just accepting them. After all, this is really what the Sick Girl can teach us: not how to be better people, to love more deeply, or to make the most of every moment, but how to live with that uncertainty, to find strength even at our weakest, and above all, to carry on.

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