Neurocinema—The Sequel

A History of Neurology on Screen

Eelco F. M. Wijdicks

• Publisher: CRC Press
• Year: 2022
• ISBN:
  9781000549164
• Edition: 1
• Topic: Medicine
• Subtopic: Neurology

The history of neurology as seen through the lens of the filmmaker is fascinating and extraordinary. Neurocinema-The Sequel is a review of the history of neurology as seen in film, starting with the early days of cinema and concluding with contemporary films now available in theaters and on streaming sites. The major themes of this book encompass how neurology has been represented in the history of cinema and how neurologic topics emerged and then disappeared, with some staging a comeback in more recent films. 180 films are assessed and rated, and many of these are exemplary depictions of neurological disorders. The author examines whether film, from a neurologic perspective, can provide insight and even debate. Each of the films discussed in this book demands serious attention by those who see and manage neurologic patients and support their families. Neurocinema - The Sequel chronicles this archive of neurologic representation, drawing readers in a rich collection of cinematic wonders of permanent cultural and historical value.

1Introducing the History of Medicine in Film

DOI: 10.1201/9781003270874-1

Cinema is a great way to explain the past.

Martin Scorsese (2012)¹

In cinema, every thematic component and motif can be subject to scholarly criticism. At the heart of the matter is whether the history of social science in medicine could include an exploration of medicine in cinema. I think it should. I assume few would dispute that, viewed in the right way, the story of medical professionals treating diseases in and out of the hospital and over decades, the manifestations of acute and chronic medical and neurologic disease, and how they affect the patient, family, and public health, can be told in a cinematic language. Moving between fact and fiction, screenwriters and directors are common proselytizers for social change, and pointing out disgrace or scandal may easily extend to medical institutions and their workers. You might think, therefore, that cinema can recreate disease and, in neurocinema specifically, make us understand how damaged brains work—or rather do not work. We can look at a frame of reference and examine how films incorporating the practice of medicine create meaning.

The preservation of early film and the recently achieved, widespread availability to view film over various social media platforms have allowed us to look at a number of themes—the changing persona and status of the physician and the shifting patterns of disease. Medical bioethics entered the fray in the mid-1970s, but neurologic disease-related themes as a provocation for controversial decision-making were preferentially used in film as early as the 1940s; later, they surfaced occasionally as part of a biopic but always to advance the cause of self-determination. Trying to understand another human being with a medical death sentence was (and still is) a topic of morbid curiosity for serious filmmakers. Other common dramatic themes included the perceived “atrocities” perpetrated in psychiatric institutions, the consequences of major addictions, medical violations, medical monsters and “freaks of nature,” and the all-too-common health disparities and lack of health equity. Historically, film may remind us that people can change (and societies with them).

No one enjoys going to the hospital, and we all fear bad news. In film, illness is often unexpected and accidental. 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—for example, suddenly diagnosed terminal cancer—into the story to unnerve the audience and create tension in the narrative. Doctors in their white coats or surgical scrubs appear when the leading character in the film becomes ill. Over many years, their portrayal has evolved from the general family doctor to medical specialists, in parallel with the subspecialization of medicine itself. Currently, the medical specialties most preferred by screenwriters are surgeons, psychiatrists, and pediatricians.

¹ Queenan J. Interview: Good fellows: Martin Scorsese and Colonel Blimp. The Guardian. London: Guardian News & Media Limited; 2012.

Filmmakers also favor panic-causing epidemics and dystopian viral outbreaks. The social anguish and fury of these rapidly spreading diseases triggered filmmakers to tell a story. Before the onset of the COVID-19 with its devastating loss of life, these films were often belittled as scary mainstream movie entertainment with little or no scientific basis. We all believed that great epidemics belonged to the distant past.² Pandemics are serious, and initial disbelief and later persistent denial are always rampant with public health officials desperately trying to convey the real danger to the public and our leaders. This pandemic certainly caused us to feel like we were in a movie, and movies seem to mimic reality, although not quite.

Medicine can also serve as a topic of comedy, making fun of medical decisions and physicians. The silent era in cinema was particularly dominated by burlesques (using escaped “lunatics”) outwitting dull (and incompetent) doctors. More recent films satirize the medical health system and the health insurance industry. Filmmakers are at pains to stress that a system and a process, rather than the individual, are to blame. In Critical Condition (1987), Richard Pryor impersonates a doctor; after being discovered, he decides that his only chance of avoiding prison is to plead insanity, which leads to a comical courtroom display of schizophrenia.

Medicine in film crosses all genres and is everywhere3. Yet, in the end, and in the bigger picture, medical diseases are rarely lauded. There are only 3 in Roger Ebert’s 4-volume set of books on The Great Movies, comprising 300 reviews, and no entries in the magazine Sight and Sound’s Top 50 poll of major international film critics. Cahiers du Cinéma, a film magazine posting the longest yearly best of listing, noted only three films. Not surprisingly, these focused on psychiatry.³

For medical professionals, the representation of medicine—particularly in films of import—must be intriguing at the least. There are actors ready to take risks in roles that others would have avoided.⁴ Here, we glimpse into the vast cinematic portrayal of diseases, doctors, and hospitals as a lead-in to the main topic of this book.

Portrayal of Hospitals: From Caring Nursing Sisters to Dilapidation and Disarray

For many decades, the hospital was for the impoverished and immobilized bedridden.⁵ When the well-to-do fell ill, they typically were treated in their own homes and cared for by a trained physician. For those less privileged, a bed among strangers in a hospital ward was to be avoided and was a last resort. Hospitals were better known as charitable guest houses (almshouses) and evolved to organized institutions with some centers of excellence and scientific progress. The professionalization of nursing reshaped and refashioned hospital care. Some films depicted a caring environment with Catholic sisters serving the poor, as in Umberto D. In contrast, The Hospital is a place of mayhem where just about everything goes wrong (Figure 1.1).⁶ Interior scenes are on soundstages, but the outside shots can feature known (albeit renamed) hospitals.

FIGURE 1.1 (a) The solemn hospital in Umberto D (Rizzoli Film, Alamy Stock Photo). (b) The pandemonium in a modern setting in The Hospital (Photofest).

² Cases of AIDS peaked in the mid-1980s; indie films on AIDS came quickly with Buddies in 1985. However, it took Hollywood much longer to recognize the AIDS global epidemic (Philadelphia, 1993) than it took to seize on the storytelling potential of the COVID pandemic. Corona (Mostafa Keshvari, Level 33 entertainment 2020) was the first movie shown at film festivals. Locked Down (Liman D. Warner Bros. Pictures. January 14, 2021) focuses on how the lockdown altered people’s daily lives including their livelihood and capacity for in-person socialization. A number of horror films have appeared and are planned (Songbird; Covid-21). ³ See Wijdicks EFM. Cinema, MD. New York: Oxford University Press; 2020. The chapter titles reflect the most common themes screenwriters use when the practice of medicine becomes a large part of the narrative. ⁴ Boris Karloff (the creature of Dr. Frankenstein) played a number of “mad doctors” in other horror films and most famously Dr. Savaard in The Man They Could Not Hang (1939) experimenting with bringing back the dead using an artificial heart and lung machine. ⁵ See Risse GB. Mending Bodies, Saving Souls: A History of Hospitals. 1st ed. New York: Oxford University Press; 1999 and Rosenberg CE. The Care of Strangers: The Rise of America’s Hospitals. Baltimore, MD: The Johns Hopkins University Press; 1987. ⁶ De Sica V. Umberto D. Dear Film. January 20, 1952; Hiller A. The Hospital. United Artists. December 14, 1971.

In documentaries, the camera enters with the (presumed) permission of leadership and consent of patients and families. Between the late 1960s and early 1980s, Frederick Wiseman filmed hundreds of hours in an emergency department, an intensive ...