How to Act Sick for a Role

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Photo Source: “Big Fish” Courtesy Sony Pictures Releasing

Whether it’s Meg Ryan’s stuffed-up sniffles in “You’ve Got Mail,” Leonardo DiCaprio’s aggressive coughing inside a French prison in “Catch Me If You Can,” or Albert Finney battling a terminal cancer diagnosis in “Big Fish,” actors often have to portray illness onscreen. To be both convincing and respectful in your under-the-weather role, follow these tips and tricks.


How to prepare to play a sick character

Straight Outta Compton“Straight Outta Compton” Courtesy Universal Pictures

Identify the details

“Being sick” is not a one-size-fits-all description, so it’s important to ask detailed questions about the illness you plan to portray. Is it a life-threatening disease or merely the common cold? Is it just starting, or has your character been dealing with it for an extended period of time? Is your character taking medication or being treated? If so, does that treatment have any notable side effects? 

It’s also vital that you pin down the tone of the project. The post-restaurant food poisoning scene in “Bridesmaids” required much more over-the-top broad comedy than Kristen Stewart’s portrayal of a diabetic succumbing to seizure in “Panic Room.” Defining the parameters of your performance lets you see how big or small to go. 

Do your research

Serious diseases, in particular, will require more thorough research to present truthfully and sensitively onscreen. For example, Tom Hanks consulted with medical authorities and spoke to actual patients to play a lawyer diagnosed with AIDS in “Philadelphia.” Hanks’ prep work also involved losing 35 pounds, an arduous process the actor described as “very much dictated by the reality of the science” behind the disease. 

Go through the motions

To get an idea of what that sickness really feels like, try to (safely) recreate as many of the physical reactions as you can. Trigger sneezes and blow your nose to get the right nasal sensation. Gently put tissues up your nostrils to recreate the plugged-up sound of a sick voice. “When somebody is sick and they’re stuffy, they’re only going to sound stuffy on certain words—words with m’s, n’s, b’s,” notes Doug Fahl, a theater, film, and commercial actor and coach. “If you plug your nose and you say ‘muh’ or ‘nuh’ or ‘buh’ or ‘duh,’ most of your vowels are going to be fine until you try to mimic those letters.”

Fahl suggests sniffing a lot, coughing and clearing your throat, expressing the physical strain of a headache, and appearing fatigued and run down. “Does your character have any aches and pains? Is your neck sore? Be specific about those things.”

How to act sick

The Last of Us episode 3“The Last of Us” Credit: Liane Hentscher/HBO

Let the symptoms guide your decisions

Look up the most common physical symptoms of the sickness. Keep building on what you find and let each symptom inform part of your performance. Stuffiness, sore throat, or coughing will also affect your voice. Nausea can change how you sit in a chair. Back pain will alter the way you walk. 

Aaron Berjohn, a SAG-AFTRA actor with expertise in drama, comedy, and improv who has previously played a character who was dying, says, “I start with one specific part—maybe my head, maybe it’s my throat—and I work to get a sense of what the illness does to that area. I keep my attention in that area for a while, getting a sense for the illness there. I also try to move with the illness…again, seeing what it does to a certain area. Letting myself explore how much it restricts or inhabits an area of my body.”

Any illness, Berjohn says, affects the brain and mental state of a person. “We can experiment with how it affects our communication, or relationship with those around us. It’s a really rich exploration,” he says. “There are so many variables that can come into play, and each illness will affect one character differently than it would someone else.” 

Use your own memories

“I’d begin by revisiting any memories that relate to the illness—whether on my own or my memories of people I’ve known,” says Noa Graham, a SAG-AFTRA theater and film actor. To convert those memories into a performance, Graham suggests exploring the techniques of renowned acting teacher Uta Hagen. “[Hagen] gave great advice about the need for specificity with fatigue or feeling cold: localize it physically,” she says. “I would try to find where the illness is heaviest or most painful or most turbulent in me and carry it around.” 

To act sick, focus on two aspects of Hagen’s technique:

  • Substitution: This involves pinpointing a time in your life when your feelings or emotions overlapped with the character. In this case, that’s a moment you felt particularly sick or weary. 
  • Transference: This means finding your relationship to a character based on those overlapping perspectives. Based on how you reacted to being sick, how might your character respond? 

Fully embody the illness—and then hide it

An effective approach, Fahl says, is to play it as your character physically trying to overcome or hide their sickness. He challenges actors to “play the objective of trying to mask your symptoms. Indicating the symptoms is not acting, that’s going to come off as fake,” he says. “Feeling the physical sensations of those symptoms and then trying to mask them, clear them out, and then just carry on with the conversation” in a scene may come off as more authentic.

“We don’t need to see you play [all the symptoms], we just need to see you try to overcome it. You can still be stuffy and tired, but you showed up to work, and took a cough pill,” Fahl adds. “You’re trying not to express those symptoms. That’s the trick.”

Actors who played sick characters

Zoe Kazan in “The Big Sick” (2017)

In this critically lauded film, Zoe Kazan’s character is suddenly hospitalized for Still’s disease, an autoimmune disorder that places her in a medically induced coma. “Playing the scenes, I was surprised by how vulnerable I felt,” Kazan said in an interview with Gold Derby. “I think to have your body be physically weakened like that makes you feel things in a different way. It makes you feel your own mortality…and I found those scenes very painful to play.”

Meg Ryan in “You’ve Got Mail” (1998)

In this scene from the classic romantic comedy, Meg Ryan perfects a plugged-up, sinus-affected voice for an important back-and-forth, all while maintaining fatigue, drowsy eyes, and nose-blowing.

Linda Blair in “The Exorcist” (1973)

Being sick is hell, and nobody understood that more than 12-year-old Regan, played by Linda Blair, in “The Exorcist.” Not afflicted with the flu or bronchitis but Satan himself, Blair had the difficult task of conveying demonic possession in a grounded and believable way so that audiences were fully immersed in the film. She goes from an upbeat, excitable kid to someone full of malaise and, with the life gone out of her eyes, to a puking, thrashing entity.

Dustin Hoffman in “Midnight Cowboy” (1969)

Dustin Hoffman’s Ratso Rizzo is afflicted with coughing fits and gradually becomes more physically unraveled throughout the film. Rizzo insists on brushing it off. It adds a fascinating and sad dimension—and a lot of humanity—to his streetwise character. 

Tom Hanks in “Bridge of Spies” (2015)

In addition to “Philadelphia,” Tom Hanks gives a subtle sick performance in this Steven Spielberg thriller. Playing a lawyer sent to Berlin for a high-stakes negotiation, Hanks portrays his character with a rough cold that only adds stress and discomfort to his mission.

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