Saturday Night Live Skit Met With Criticism for Tone-Deaf Take on Sickle Cell Disease

A skit from the December 16 episode of Saturday Night Live (SNL) that poked fun at sickle cell disease and presented a narrow view of the patient population has drawn criticism from members of the sickle cell community.

What’s the Issue?

Aired on the heels of the breakthrough FDA approvals of the first cell-based gene therapies indicated for treatment of sickle cell disease, the skit depicts a white elephant gift exchange held at a corporate holiday party. As a Black employee, portrayed by Kenan Thompson, goes to select his gift from the available pool, his White colleague, portrayed by Kate McKinnon, suggests that he choose to open the envelope in her hand instead.

As he reads the letter announcing that McKinnon’s character has secured him a spot in “Vertex Pharmaceutical and CRISPR Therapeutics’ exa-cel program for sickle cell anemia,” McKinnon places a comforting hand on his shoulder in a move that communicates, “You wouldn’t have had this opportunity if it weren’t for me.”

And in typical SNL fashion, there’s a twist: Thompson’s character swaps his letter of enrollment for a Boogie-Woogie Santa, a Santa figurine that delights employees with his singing and trumpet-playing, opened earlier in the gift exchange by another employee. The colleague that receives the letter in the swap expresses disappointment that the members of his family won't be able to "use it," because like himself, they're all White.

The last colleague to open a gift receives a blanket but announces that she’d like to make a trade. She, a Black woman, begins to talk about the struggles that her mother, who has sickle cell disease, faces—including chronic pain and kidney problems—and says that she is grateful to have finally found something to make her smile. But rather than choose the letter of enrollment for the curative program, the employee swaps her gift for the Boogie-Woogie Santa. By doing so, she frames her mother’s struggles as a point of humor.

Why It Matters

Individuals with sickle cell disease and disease advocates have criticized the skit for both its caricatured portrayal of the patient population and the struggles they face, especially as the timing of its airing casts a dark shadow over the recent breakthrough FDA treatment approvals.

• Despite it being the most common inherited red blood cell disorder in the United States, sickle cell disease has been historically overlooked and underfunded.¹
• Approximately 90% of patients with sickle cell disease in the United States are Black or African American, but persons of Hispanic, Mediterranean, Middle Eastern, and Indian descent are also affected.²
• According to recent research, the median age of death of patients living with sickle cell disease complications is 43 years old.³

Expert Commentary

In a statement titled “Sickle Cell Disease is Not a Joke,” the Sickle Cell Disease Association of America denounced SNL for the skit.⁴

• “We are disappointed that Saturday Night Live chose to trivialize this landmark moment in history during their program. More than 100,000 people in the United States and millions globally are impacted by this devastating disease, and yet it is one of the few debilitating conditions that you will find people joking about on television.”
• “Part of the ‘humor’ revolves around the common myth that only Black people can have sickle cell disease…[but] people of all ethnic backgrounds can inherit the disease. In the United States, Hispanic and Latino Populations have the second highest incidence, but Asian, Indian, Native American and–yes–White people, can all be born with the disease.”
• “Many people don’t understand the devastating reality of [sickle cell disease]. The onset of sickle cell pain is sudden and debilitating. [The pain] has been described as feeling like you are walking on hot coals or like shards of glass are traveling through your veins.”

In-Depth Insights

• Illustrating the impact of the FDA-approved therapies to address the significant unmet need for treatment of sickle cell disease, Nicole Verdun, MD, director of the Office of Therapeutic Products within the FDA’s center for Biologics and Research said, “Gene therapy holds the promise of delivering more targeted and effective treatments, especially for individuals with rare diseases where the current treatment options are limited.”¹
• Members from Sick Cell, another sickle cell disease advocacy group, asked SNL to “correct the inaccurate information” spread on its platform and “amplify facts about the newly approved gene therapies, the realities of the painful and irreversible complications of sickle cell disease, the stigma tied to sickle cell disease, and the work that the population is tirelessly executing to improve the lives of those living with sickle cell disease.”⁵

Extra Reading

For more on this issue, check out these articles.

• https://www.sicklecelldisease.org/2023/12/18/sickle-cell-disease-is-not-a-joke/ (Sickle Cell Disease Association of America)
• https://sickcells.org/wp-content/uploads/2023/12/2023.12.18-SNL-Response-Letter.pdf (Sick Cells)
• https://www.fda.gov/news-events/press-announcements/fda-approves-first-gene-therapies-treat-patients-sickle-cell-disease (FDA)

References

1. FDA approves first gene therapies to treat patients with sickle cell disease. News release. FDA. December 8, 2023. Accessed December 21, 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-first-gene-therapies-treat-patients-sickle-cell-disease

2. Lee L, Smith-Whitley K, Banks S, Puckrein G. Reducing health care disparities in sickle cell disease: A review. Public Health Rep. 2019;134(6):599-607. doi:10.1177/0033354919881438

3. Payne AB, Mehal JM, Chapman C, et al. Trends in sickle cell disease-related mortality in the United States, 1979 to 2017. Ann Emerg Med. 2020;76(3S):S28-S36. doi:10.1016/j.annemergmed.2020.08.009

4. Sickle cell disease is not a joke. Statement. Sickle Cell Disease Association of America. December 18, 2023. Accessed December 21, 2023. https://www.sicklecelldisease.org/2023/12/18/sickle-cell-disease-is-not-a-joke/

5. SNL response. Statement. Sick Cells. December 18, 2023. Accessed December 21, 2023. https://sickcells.org/wp-content/uploads/2023/12/2023.12.18-SNL-Response-Letter.pdf