Big Screen Prognosis: Big B’s ‘Paa’ Offers A Powerful Portrayal Of A Child Suffering From Progeria; Doctor Explains How Common It Is

In 2009, a landmark film featuring Amitabh Bachchan, Abhishek Bachchan, and Vidya Balan was released and quickly became a favourite of critics and film enthusiasts for many reasons, but significantly for its sensitive portrayal of a child struggling to cling to a few moments of life from Progeria, a rare genetic disease.

Director R. Balki defied expectations by presenting Big B as a 12-year-old child named Auro living with the life-threatening disease, and Abhishek Bachchan as his father. Soon after hitting the theatres, the film highlighted a much-needed conversation about the mental, physical, and emotional suffering of Progeria patients and their families, too. Dr Sujatha Thyagarajan, Lead & HOD - Paediatric Intensive Care and Paediatric Emergency at Aster Whitefield Hospital, Bengaluru, shares that Progeria is a rare disorder, with 1 case per 20 million births.

Paa: A Sensitive Portrayal Of Progeria

Speaking about the disease, Dr Sujatha Thyagarajan explains that Progeria is commonly known as Hutchinson-Gilford Progeria Syndrome (HGPS) and is caused by a mutation in the LMNA gene, which results in the production of a defective protein called progerin. Reports suggest that worldwide, only a small number of children are known to have classic HGPS.

In the film ‘Paa’, Auro is shown as a fun-loving and witty child who copes with the consequences of the disease, whether it is a medical condition or social humiliation. Auro faces mocking at school, nobody wants to be his friend or even sit with him, being afraid of his strange appearance. However, his mother, Vidya (Vidya Balan), being a single parent, tries quite hard to provide her son a normal, well-educated, and fulfilling life - but it is not easy to live with Progeria.

The plot turns at the moment Amol (Abhishek Bachchan) enters the scene at Auro’s school event, attending as a chief guest, and feels touched by the child's condition. Feeling a compelling attachment to Auro, Amol intervenes to help Vidya manage the resulting media attention and his treatment. Following a series of events, both Amol and Auro become aware of the fact that Amol is actually Auro's biological father.

The film brilliantly exhibits how Auro’s physical condition is rapidly changing due to the disease, causing him to resemble someone much older than his actual age. His head becomes disproportionately large compared to his face, and the veins become prominently visible, making him look like an older person. The movie gives you a glimpse of what individuals with Progeria suffer in performing daily tasks, such as waking up from bed, eating, walking, or even speaking.

As the film reaches its last stage, Auro's condition begins to deteriorate rapidly, and due to the lack of a known cure, doctors also struggle with the right and effective treatment. Despite every effort, Auro takes the last breath at this young age and leaves viewers with an unsettling feeling.

The film ultimately illustrates how such rare diseases often do not receive the visible support, research, and social attention required to deal with the condition at both the medical and societal levels.

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Living With Progeria

According to a Cleveland Clinic report, newborns affected by the disorder typically appear healthy at birth but usually begin to show distinct signs of premature ageing during their first one to two years of life. Dr Thyagarajan says that children with HGPS typically appear small for their age and exhibit slow growth, but their bodies become like that of someone in their 70s or 80s, which was the condition with Auro.

The disease not just makes them visibly distinct from other children of their age, but can also cause, in some cases, failure to thrive. Children fighting from Progeria possibly lose their lives to cardiovascular disease, such as a heart attack. However, in most cases, the first visible symptoms are loss of body fat, baldness, stiff joints, thin, wrinkled skin, and a distinctive facial appearance.

While watching the film, it makes you feel how Auro tried to handle his pain with maturity because he understands how hard his mother is trying to give him a protected yet supportive environment. The moments when Auro uses his humour to share his pain in a light manner in front of his mother give you wet eyes and a sense of his emotional maturity. Auro going to school and visiting the other public areas gives a social statement about living a relatively normal life; however, this is not the case for most patients in real life.

Progeria Cases In India

According to the Progeria Research Foundation (PRF), a global organisation with the vision to find treatments and a cure for Progeria, India had 7 reported and around 66 unreported cases of HGPS in 2016. The non-profit organisation and PRF are looking for these unreported cases to provide the much-needed assistance children need to survive.

According to some reports, in December 2023, a 14-year-old boy from Madhya Pradesh was detected living with a variant of Progeria, Mandibuloacral Dysplasia, which is the first-ever case of this variant as of now.

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Treatment Of Progeria: 2009 Vs 2025

There is currently no cure for this disease, but medications are available to manage the condition and slow the disease progression. However, the landscape of Progeria treatment and management has drastically changed since 2009 in a positive way. In the year of ‘Paa’, there was no targeted and approved drug therapy directly treating this rare genetic disorder. The medication was only supportive in managing the symptoms of ageing, heart diseases, and other health conditions resulting from Progeria.

However, today, there is not just a surge in social awareness but also a targeted drug. Lonafarnib is the first and only FDA-approved drug (approved in 2020) that has been shown to slow disease progression and improve longevity.

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Dr Thyagarajan notes, "There is no cure, but the focus of care is symptomatic management, mainly related to the heart. Medications such as statins, low-dose aspirin, and anticoagulants are administered, and physiotherapy and nutrition serve as key supportive treatments."

According to reports, without treatment, most people with classic HGPS historically lived into their early teens (often around age 13 to 15), as there are rare cases of patients living longer.

Bottomline

Like any other severe illness, Progeria comes with physical, emotional, and financial torment for both the child and the family. The powerful message of ‘Paa’ underscores the importance of a family’s emotional support and social awareness about the disease, including the right medical treatment.