Neurocinema

When Film Meets Neurology

Eelco F. M. Wijdicks

• Publisher: CRC Press
• Year: 2014
• ISBN:
  9780429586217
• Edition: 1
• Topic: Medicina
• Subtopic: Teoria, pratica e riferimenti medici

Film directors recognize that neurologic disease impacts mind and motility and often use it in a plot or defining scene. It should be informative and educational to deconstruct neurologic representation in film. Neurocinema: When Film Meets Neurology is acollection of film essays that summarize the portrayal of major neurologic syndromes and

CHAPTER 1

Medicine in Film

You know the secret of being a good doctor, don’t you?… You act like one.

The Good Doctor (2011)

In film and in reality, illness is often unexpected and accidental. Using serious illness as a plot device brings melodrama to the narrative arc. Filmmakers often perceive medicine as health interrupted by illness followed by disability or death, and this topic is an endless source of ideas and fictional inventions. Screenwriters have inserted life-threatening disorders—often suddenly diagnosed terminal cancer and more recently AIDS—into the story because they are unnerving to the audience and create tension in the narrative. Doctors often appear when the leading character in the film becomes sick, and over many years their portrayal has evolved from the general family doctor to medical specialists, parallel with subspecialization of medicine as a whole.

The medical specialties that screenwriters prefer the most are surgeons, psychiatrists, and pediatricians. Themes may be specific to the type of specialty, and of course, we have all seen the heroic lifesaving surgeon.

Filmmakers are very good at creating panicky epidemics. Dystopian viral outbreaks such as the avian flu have attracted filmmakers. Each of these films can be easily liable to the charge that it is nothing but scary mainstream movie entertainment. Medicine is also a topic of comedy, making fun of medical decisions and physicians. There is also a surplus of psychiatric disorders, mostly involving neuroses and addictions. There are numerous screwball comedies involving psychiatrists. Yet, in the end, medical diseases are rarely depicted in the major films (only three in Roger Ebert’s book The Great Movies, comprising 300 reviews, and no entries in the magazine Sight and Sound’s Top 50 poll).

Medicine in film has been researched well, and the reader is referred to several texts, listed at the end of this chapter. For physicians, the representation of medicine—particularly in films of import—is always interesting, commonly fascinating, and sometimes laughable. Here we glimpse into the cinematic portrayal of hospitals, doctors, and diseases as a lead-in to the main topic of this book.

PORTRAYAL OF HOSPITALS

The depiction of medicine often starts outside the hospital and in ambulance runs (Bringing Out the Dead [1999]). Most of the time ambulances are presented as being in a state of chaos, with physicians questioning who is in charge. And of course we have the emergency department, where patients are rushed in with yelling and screaming staff and often a bloody mess. Because medical illness often involves trauma or a gunshot wound, we may get to see the operating room and the intensive care area. For dramatic purposes and to create further tension, a surgeon may be seen rushing out of the operating room to tell distressing news to family members (Miami Vice [2006]). In the recent film Fruitvale Station (2013), a surgeon enters the waiting room and tells an anxiously waiting family, “He did not make it.”

Intensive care units (ICUs) or surgical trauma units usually show the actor after polytrauma—packed in and in traction. Most remarkable is that sometimes the sound of the patient’s heartbeat is heard—as it is in the operating room—becoming fast when the patient is in distress. (Note that ICUs do have alarms, but no audible heartbeat can be heard from the equipment used.) The ventilator shown in the ICU often looks similar to the one used in the operating room (bellows included).

Medical institutions are not always depicted accurately. Veterans Affairs (VA) hospitals are commonly shown, usually in the war-film genre. VA hospitals are either appalling places (Coming Home [1978], Born on the Fourth of July [1989]) or places where bureaucracy leads to nothing but frustration (Article 99 [1992]).

The most shocking institution is the psychiatric hospital. In 1975, the movie One Flew over the Cuckoo’s Nest cemented a dramatic negative depiction of the psychiatrist and psychiatric nursing staff, and Shutter Island (2003) was a film noir, with the criminally insane in shackles. Hospital drama continues to interest filmmakers, and atrocious treatment predominates.

PORTRAYAL OF PHYSICIANS

Films released in the 1930s and 1940s showed physicians as fine country doctors who were simple and compassionate, inserting their lives into the tragedies of patients. Over time, the portrayal dramatically changed, with film also introducing major medical ethical issues such as mercy killing and abortion.

Many directors have used physicians in film—most of them male, attractive, and witty, although the sympathetic portrayal of the character varies depending on the needs of the script. When the doctor enters the scene, he is usually meticulously dressed in a crisp white coat.

In the United States, the Doctor Kildare TV and movie series became a classic in the depiction of physicians, nurses, and administrators, showing a virtually perfect world of medicine. The series included Dr. Kildare’s Crisis (1940) and Dr. Kildare’s Wedding Day (1941) with the classic line of dialogue, “Doctors doctor for 24 hours a day. The rest of the time he can’t be a husband.” A world where physicians could not combine their profession with marriage was portrayed, and full commitment to the profession was necessary. There were very few female doctors in early feature films (e.g., The Girl in White [1952]). Female doctors appear in numerous later films, often to show some gentle flirtation or even marriage (Erika Marozsan in Feast of Love [2007]).

There were many other problematic portrayals of the medical profession. One of the most notorious is The Interns (1962), where a group of young doctors is moving into practice. The nursing staff is told, “Never talk to the interns. They are all sex maniacs.”

The portrayal of doctors has evolved from the dedicated solo general practitioner to a character study of the arrogant, intimidating hotshot surgeon. In Doc Hollywood (1991), Michael J. Fox stated, “Beverly Hills, plastic surgery, the most beautiful women in the world. What do these three things have in common? Answer: Me in one week.”

Gynecologists occasionally appear, even as the main actor in one movie—Richard Gere in Robert Altman’s Dr. T and the Women (2000). Gynecologists are also involved with birth traumas. Rosemary’s Baby (1968) is the major representation of hysterical pregnancy, rape fantasies, and other absurdities such as germinating a devil child. All of this has one theme, which is to shock and create a troubling feeling for the moviegoer.

Because there are many films portraying people with psychiatric disorders, the portrayal of psychiatrists has been well analyzed. They have been categorized as competent and caring (Dr. Bergen, played by Judd Hirsch in Ordinary People [1980]), neurotic and comical (Richard Dreyfuss as Dr. Marvin in What About Bob? [1991]), and evil experimenters (Dr. Hannibal Lecter, played by Anthony Hopkins in Silence of the Lambs [1991]).

The social and professional status of physicians is high, and their offices are typically shown as being large, with large cluttered desks. There are quite a few surgeons who drive sports cars and live in lush country homes. Some films discuss the salaries of specialists, most notably in Crisis (1950), where the neurosurgeon (played by Cary Grant) says “My fee? I usually charge 10% of the patient’s income.” In Drunken Angel (1948), the physician says to his patient, “I warn you, my fees are very high—I always overcharge people who eat and drink too much.” But there are more peculiarities. Some films emphasize addictions by physicians, or physicians practicing while intoxicated, such as the general surgeon (Alec Baldwin) in Malice (1993) and the heart surgeon (Kirk Harris) stealing drugs from the hospital to trade for cocaine in Intoxicating (2003).

Screenwriters have toiled carefully over portrayals of specialists, and a summary of their specialty characterizations is shown in Table 1.1.

Nurses in film were in a role of servitude for many decades. Often in the nurse–physician relationship, the nurse played a lesser role and endured harassment and verbal abuse. Nurses were typically in awe of the doctors, because “they always know best.” Doctors were also seen as major marriage material and incited jealousy among the nurses.

The relationship of physicians and nursing staff is also often confrontational. In Critical Care (1979), there is an important dialogue where the nurse questions whether the care of a patient in a persistent vegetative state needs continuation. The physician answers, “It’s important that we say that we did everything,” to which the nurse replies, “That’s doctor-speak for ‘we put this patient through hell before he died.’”

Exploitive relationships are common in the movies, and loss of physician boundaries is so...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Preface
• Acknowledgments
• Neurofilm Collection
• CHAPTER 1 ■ Medicine in Film
• CHAPTER 2 ■ The Neurologist in Film
• CHAPTER 3 ■ Neurologic Disorders in Film
• CHAPTER 4 ■ Neuroethics in Film
• CHAPTER 5 ■ Neurologic Disorders in Documentary Film
• CHAPTER 6 ■ Neurofollies in Film
• CHAPTER 7 ■ Epilogue: The Neurology of Cinema
• APPENDIX: NEUROFILMOGRAPHY