Summary:

This is an imaginative documentary film by director-producer Su Friedrich, of her experiences with health problems, physicians, the health-care system, and how these affected her relationship with her female partner over a period of more than two decades. The narrator-subject takes us through her numerous surgeries, hormonal (prolactin) imbalance, and her growing disenchantment with the traditional health-care system.

She films herself: getting dressed into the "humiliating" paper garb prior to being examined by her physician; in exchanges with her various physicians; reading from medical texts and self-help books as she tries to understand her condition(s); taking t'ai chi classes and preparing herbal potions; gardening and doing needle work. As the film ends, she is grappling with the prospect of menopause, but she feels that she has taken charge of her body and of her own care, that she tends herself as she tends her garden.

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This is a collection of four stories and a novella with pervasive themes of death, loss, grieving, mourning, and anger; the characters live in rural parts of the upper midwest, and there is much unhappiness in their lives.

In "Catch and Release," we accompany Danny, a talented fishing guide "not quite thirty," as he floats down a stream he knows well. He and his siblings have divided his father's ashes, his portion now in a thermos. His father died suddenly, absurdly on a bathroom floor. Although Danny knows nature well (and loves it), he is angry and heartsick. Nor is religion a comfort. Bit by bit he scatters the ashes, but there is no healing ritual.

In "Bloodsport" a young man murders is wife and then kills himself. The town funeral director feels this is "utterly incomprehensible" but provides his professional services to the family and all who  come to the service and burial. He knew the young woman, Elena, and found her attractive; now he embalms her. Twenty years later he feels a "sense of shame" that men "let her down badly."

"Hunter's Moon" presents Harold, a casket salesman. Retired, he goes on long walks, trying to make sense of is life and loves. He likes naming things. His first wife left him for another woman. His daughter (pregnant and drunk) was killed by a train. His second wife left him. His third wife died of cancer. He abuses antidepressants and liquor. Sitting on his front porch, he slumps over. All night a dog keeps watch over, we assume, his dead body.

In "Matineé de Septembre" we find a reworking of Thomas Mann's "Death in Venice." In both stories, a literary figure escapes ordinary time, falling in love with a young person of the opposite sex, and falling into decadent gestures in the hope of recapturing youth. Both efforts end in failure and death. In Mann's story, the person is an older man of much literary accomplishment. In Lynch's retelling, the person is a professor and "poet of note," although not really of international fame. Actually she's a woman of inherited wealth, a wealthy snob, a narcissist, a survivor of a "perfectly bargained marriage." Her one child was stillborn. A dozen hints at her headaches suggest that she is doomed, and she dies in the last paragraph, without (as in the Mann story) the notice of the literary world.

After these grim tales comes the satiric (and also grim) novella, "Apparition." We follow one Adrian Littlefield (the last name is symbolic) who was a strait-laced pastor, then (after his wife left him) a self-help author who urged post-divorce people to live it up. The satire is trenchant. Adrian's big book is "Good Riddance." A church fundraiser with gambling allows "otherwise devout people to wallow in sin for a worthy cause." Adrian has girlfriends and one-nighters. He's an expensive speaker. Fortunately one Mary De Dona provides him with gratuitous sex, and he is saved. Now 50+, he visits the empty house where his wife once lived, learning little; his tour guide, one "Gloria" is in her 70s, married for 58 years, with grandchildren and great-grandchildren. He wishes he could have had such a life and feels "a wave of sadness." 

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Séraphine (Yolande Moreau) is a housekeeper, ill-treated by her employers, but she finds solace in painting naïve images of flowers, fruit, and birds, using vivid colours that she makes herself from plants and animals. Her mistress rejects the art as junk.

Séraphine sympathizes with the apparent loneliness of the German tenant Uhde (Ulrich Tukur) who is a connaisseur of art. He admires one of her tableaux and is astonished to discover that the artist is his housekeeper. He encourages her and buys some paintings.  But war in 1914 forces him to return to Germany.

Spiralling downward deeper into poverty and mental alienation, Séraphine continues to paint works that grow larger, bolder, and more colorful. Finally her bizarre behavior leads to her arrest and commital in an insane asylum, and her painting ceases.

Uhde eventually returns to France and organizes the first Naïve Art exhibition featuring work by Henri Rousseau and Séraphine. But only years later does he bother to look for her. She is miserable. He arranges for her to be given a more comfortable room, but he doesn’t speak to her and she never paints again.

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The film opens on the Coeur d'Alene Indian Reservation -- called "the rez" by its inhabitants -- in 1998. Immediately there is a flashback to July 4, 1976 when the community was celebrating "white man's Independence Day" in drunken abandon. Accidentally Arnold Joseph (Gary Farmer) sets an uncontrollable fire to his neighbor's house, killing the couple who live there. But Joseph catches the baby, Thomas, when he is thrown out of a second story window from the burning house. The rescued Thomas (Evan Adams) is brought up by his grandmother and along side of Victor (Adam Beach), Arnold Joseph's son of about the same age. Joseph keeps on drinking but is in despair about the conflagration and its consequences.

12-year-old Victor watches sullenly while his parents drink until one night he smashes all their beer bottles. This action is a wake-up call for Victor's mother, Arlene (Tantoo Cardinal), who insists that she and Arnold both stop drinking. She chases Arnold out of the house; he leaves, never to return, while Victor watches, sobbing. These elements of the story occur in flashbacks while the 20-year-old Victor and Thomas travel by bus to retrieve whatever they can of Arnold Joseph, who has died outside of Phoenix. The remaining story unfolds in that forsaken spot where Joseph lived in a trailer and befriended Suzy Song, a young Indian woman originally from New York.

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The title recalls Clotho, the Fate charged with spinning the thread of life which would someday be clipped by her sister, Atropos. The two-stanza poem describes the circumstances of illness within a hospital setting. In stanza one, with a patient unable to urinate on his own, the poet employs desert images to suggest the dryness felt by the incapacitated sufferer ("throat-filling Gobi," "dry as Arabia," sunburnt cage of bone," "shekel," "rugs," "camel," etc.).

Stanza two begins with the riddle of the sphinx, another reiteration of desert imagery, but moves quickly to modern medical intervention by substituting the cane, the third leg of the elderly, with an IV pole for liquid sustenance and the "snake-handlers fist of catheters," ridding the body of its wastes. Clotho's role has been usurped by technology's miracles, and an appeal is made for the "kind, withdrawn face trained in the arts of love."

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The title refers to a Veteran’s Administration hospital regulation concerning the withholding of full medical benefits if an ailment is not specifically related to military service. In an oftentimes comic battle between the forces of good--physicians and vulnerable patients--and those of evil--the administrators and their minions--the story has currency and direct appeal to viewers.

The Darth-Vader-like administrators are self-serving, inhumane bureaucrats with emotions that run the gamut "from A to B" (Dorothy Parker). Physicians, especially the character played by Ray Liotta, but also his dedicated colleagues, are imaginative and non-rule abiding in their central concerns: the patients. They listen to stories and sympathize; in addition, they turf, lie, steal, and do whatever is necessary to protect, serve, and treat their patients. When the government denies a heart bypass, for example, the docs schedule prostate surgery for the official record and do, instead, the needed heart surgery.

At times, it’s as if the Marx Brothers or the Keystone Cops have donned white coats to sneak around the hospital with patient-centered antics. In the absurd bureaucracy, viewers, perforce, must cheer enthusiastically for the merry band of renegade docs.

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Rob Morrow of "Northern Exposure" fame portrays Lyle Maze, a very sweet artist/sculptor with Tourette's syndrome. Even though early scenes demonstrate the challenges presented by involuntary shoulder shrugs, arm twitches, popping sounds, and vocalizations associated with Tourette's, the story quickly evolves into a fairly predictable tale of love. Mike (Craig Sheffer) is engaged to Callie (Laura Linney), but spends months of time incommunicado--practicing medicine in Burundi and other remote locations.

For different reasons, both Lyle and Callie are cast into lives defined by isolation and loneliness. Shortly after Mike has left for his most recent assignment, Callie learns that she is pregnant. Alone and confused by Mike's long absences, she turns increasingly to Lyle for friendship and support. Not surprisingly, they fall in love.

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This unusual story, beautiful and overwhelmingly sad, is set in Sicily on the craggy and barren island of Lampadusa surrounded by the bluest of seas. Everyone in the small fishing and canning village may be related; certainly, this is a place where secrets are not possible. Grazia (Varria Golino) appears to be the loveliest and most loving mother and wife, although her carefree, even childlike behavior is foreboding. The camera loves her and so do viewers who are ravished by her beauty and innocence.

With children positioned on the back of her Vespa, she and they escape to a deserted beach where she swims topless with her children; later, she releases hundreds of howling stray dogs from their inhumane confinement. Not surprisingly, spied-upon actions such as these produce critical response from more conservative neighbors whose norms are less capricious.

When signs of instability and manic depression become apparent, the community joins together to suggest hospitalization to her very supportive and heart-broken husband (Vincenzo Amato). She, like the caged-up dogs, seems to deserve the kind of freedom epitomized by her trips to the beach and will not, we sense, survive medical "imprisonment."

At this juncture, just as her wings are to be clipped, the story’s unexpected turn forces the mourning village to wonder about human frailty and reality. The ending, ultimately unclear and haunting, is a celebration of imaginative madness and ephemeral beauty. Visually stunning.

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Oscar, the narrator of this fresh fictional gem, is ten years old. Because his form of leukemia has not responded to treatment, he has been living in a French hospital for a very long time. His parents, who bring him gifts and surely love him, are uncomfortable during their infrequent visits. Dr. Dusseldorf and the nurses are kind, but indirect and distant in their communications with him. Because no one talks to him about his illness or what is likely to happen, he feels isolated, alone, and miserable.

When Mamie-Rose, a very elderly hospital "pink lady" (hospital volunteer) with an exotic past, enters Oscar's life, she brings honesty, warmth, and comfort to the lost child known as Bald Egg. Guided by this incredible person--a blunt-spoken, irreverent woman who touches him, kisses him, and tells him wondrous stories of her wrestling feats--the boy grows stronger. Who wouldn't under the influence of the Strangler of Languedoc?

Of course Oscar is going to die. In addition to her generous companionship and her introductions of him to other children in the hospital, Mamie-Rose suggests letters to God as a way of feeling less lonely. "So God, on the occasion of this first letter I've shown you a little of what my life in the hospital is like here, where they now see me as an obstacle to medicine, and I'd like to ask you for clarification on one point: Am I going to get better? Just answer yes or no. It's not very complicated. Yes or no. All you have to do is cross out the wrong answer. More tomorrow, kisses. P.S. I don't have your address: what do I do" (65).

With Mamie-Rose treating him like a real kid, "move your but . . . we're not ambling along like snails" and Oscar scripting very candid letters to God, the first-person story about loneliness, love, and compassion is presented with spirited imagination. Oscar's story is quite extraordinary--and unforgettable.

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Summary:

Because this lucid, rich, and incisive book has not, as yet, been published in the United States, it has not acquired the readership it deserves. For those teaching Medical Humanities or those interested in broader or more global stories and perspectives about physician training, practice, and experiences, Helman’s most recent publication should be considered.

Part One (“Setting Out”) begins in South Africa where Helman’s family, comprised of a dozen doctors, has lived for generations and where his own medical studies occurred. As a child, he accompanied his father on rounds while other children spent holidays at the beach. Before long he discovered how hospitals, during the madness of Apartheid, were to “some extent a distorted mirror-image of the world outside” (3). Appalled by the differences in care and treatment, the keenly aware young man kept notes. His vivid observations of the harsh context of social injustices provide an unequivocal, eloquent, and disturbing critique of medicine then and there. His acute observations of physician behaviors and indigent populations in the city and in the bush contribute, as readers discover in later chapters, to the author’s expanded and compelling interests in cultural anthropology.

Part Two (“The Family Doctor”) leads to London. “After all the heat and light and space of Africa, London—with its low leaden sky and constant drizzle—was like living inside a Tupperware box, one stored deep inside a refrigerator” (47). In the 60s Helman’s migration required an adjustment to a world of technology and order, where as a family practitioner, he had become, in fact, a suburban shaman. In any society, patients wanted “relief from discomfort, relief from anxiety, a relationship of compassion and care, some explanation of what has gone wrong, and why, and a sense of order or meaning imposed on the apparent chaos of their personal suffering to help them make sense of it and to cope with it” (xvi).

Gradually Helman saw connections between the role of family physician and traditional healer: both involved an understanding of “not only a body’s internal equilibrium but also the equilibrium of the patient’s relationships with the world he or she lives in and how treatment should aim not only to treat the diseased organ but also to restore the patient’s life that equilibrium of relationships” (xvii). His encounters with patients and the stories they reveal suggest how important these often overlooked connections are and why they ought to be included in medical training and practice.

By the time readers reach Part Three ("States of the Art”), the author has moved into broader realms of thinking, in which medicine and illnesses are examined anthropologically. After 27 years of clinical practice Helman’s white coat and stethoscope are placed on a hook. Now, as a credentialed anthropologist at University College London, his larger lens allows for sustained scrutiny of the complexities, ambiguities, and nuances in such chapters as “Grand Rounds,” “Hospitals,” “Placebos,” “Third Worlds.” Helman’s range of experiences, multi-disciplinary training, intellectual conclusions, and abundant common sense argues for techno-doctors to learn from holistic practitioners. Whether devastating or humorous, the critiques reflect not just care provision but shared human capacities: the insights are thoughtful and fresh and very worthwhile.

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