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Cerebral Palsy in Cinema

María Lucila Merino Marcos

Departamento de Pediatría del Hospital Universitario de Salamanca (Spain).

Correspondencia: María Lucila Merino Marcos. Hospital Universitario. Paseo de S. Vicente s/n. 37007. Salamanca (Spain).

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Received 28 may 2005; accepted 22 june 2005


Summary

In the last twenty-five years, a number of important films have been made in which the protagonist or supporting actor has had, or simulated having, cerebral palsy. On occasion, these characters have been played by people with disabilities. In the course of this field’s history, films have portrayed many diverse aspects of cerebral palsy such as healthcare and social and familial obligations.

Keywords: Cerebral palsy, Disability, Handicap, Cinema.


Cerebral Palsy in Cinema

Cerebral palsy is a group of non-progressive, chronic disorders owed to alterations produced in the brain in the first stages of life. These are characterized by disorder of posture, movements, and equilibrium and are frequently associated with seizures as well as sensorial alterations and mental retardation.

Cerebral palsy is considered a syndrome since it can be a consequence of many triggers each of which occurs either prenatally, at the time of delivery or in the first years of life. The prenatal causes include, among others, intrauterine infections, multiple pregnancy, cardiac malformations, exposure to toxins, and some illnesses from pregnancy. Among peri- and neonatal etiologies, there are causes such as premature births, low birth weight, hypoxia, hyperbilirubinemia, birth trauma, infections during birth, and cerebral hemorrhage. Postnatal etiologies include central nervous system infection, head trauma and hemorrhages. Depending on the cerebral structural alterations produced, there exist various types of cerebral palsy which are grouped into four basic forms: spastic (with stiff and difficult movement), athetoid (with abnormal, slow, uncoordinated, and uncontrolled movements), ataxic (with disturbed sense of balance), and mixed cerebral palsy. The body parts involved determines if there is hemiplegia, diplegia, or quadriplegia. If there is not total paralysis there could be paresis.

Despite the advances in obstetric and pediatric care, the prevalence of cerebral palsy has not lessened in industrialized countries and continues to be a subject of great medical and social interest1-3.

Cerebral palsy is not an exclusively medical topic, rather it has implications in many different professions such as: occupational therapy, psychomotoricity, psychotherapy, psychology, speech therapy, the world of caretakers, social workers, and educators. The functions of the medical specialists usually are limited to diagnosis; treatment of some manifestations, complications, and associated pathologies; and the control of physical rehabilitation and speech therapy. Their role is crucial in the establishment of preventive measures.

The patient with cerebral palsy is not a single isolated person conditioned by his situation, rather he is part of a family and society which will have an influence on him and vice versa. Disabilities and the handicapped are topics and characters in many movies, cerebral palsy and those afflicted, among them. In many cases, cinema can play a part which is informative, used for training and informing, as is the case with these movies. For these reasons, its analysis has clear social interest.

Putting aside the exceptions, movies with cerebral palsy can be separated into three groups: those in which the protagonist has cerebral palsy, those in which a secondary character has it, and those in which cerebral palsy is simulated.


Movies in which the lead has cerebral palsy

Touched by Love (1980) by Gus Trikonis, shows how cerebral palsy can be associated with other clinical conditions, in this case autism. Lena Canada (Deborah Raffin) is a nurse who cares for Karen Brown (Diane Lane), a girl with cerebral palsy and autism who, abandoned by her mother, is in a center for the handicapped. Karen needs a wheelchair and does not speak. To stimulate her and get her to interact with her outside world, Lena gets the girl to write letters to Elvis Presley. The movie is based on the book by Lena Canada To Elvis, With Love.

Annie's Coming Out (1984) by Gil Brealey, is an Australian movie based on the non-fiction novel Annie's Coming Out, by Rosemary Crossley and Anne McDonald. When Annie was three-years-old (October 12, 1964) her parents entered her into Melbourne's Brentwood Hospital, a hospital for mentally impaired children. Annie suffered from athetoid cerebral palsy, which impeded her speech. For this reason, during eleven long years she was categorized as profoundly mentally impaired, when in reality, she had a brilliant mind. The situation changed when Jessica Hathaway (Angela Punch McGregor) was contracted as a therapist at the center. Jessica, in addition to change in children care at the center, discovered Annie was of normal intellect. Neither the center nor her parents accepted this. The issue went to court where Annie’s civic rights were recognized.

The movie brings many important themes about cerebral palsy to the table. The first topic it brings up is that of parents who love their children very much…but from a distance and without opinions. It also brings up the right of the handicapped to receive dignified care. This has probably been achieved in western countries but not in others, since care is very costly. Annie’s center had improved with respect to previous times, but only provided basic supported living services, bad-feeding, because a great number of children have difficulty swallowing, thus Annie showed signs of malnutrition, bowel control and spend the majority of the time in their jail- cradles. Most of the personnel lacked the affection and failed to give the personalized attention their patients needed. The need for multidiciplinarian teams remains evident to establish the degree of handicap and search for appropriate methods of communication and artistic expression. Jessica gets Annie to communicate first with the position of her tongue and later using a personal blackboard with which she eventually writes her book. In the movie, some of the complications of cerebral palsy arise that can cause death, specifically pneumonia. The film puts forth the usefulness of speech therapy, occupational therapy, music therapy, and the importance of the integration of quadriplegics in their homes or in those of others, as Annie goes to live with Jessica. Lastly, the film shows the importance of the defense of the civil rights of the handicapped when they have the intellectual capacity which permits them such. The film won three awards from the Australian Film Festival in 1984: Best Movie, Adapted Script, and Leading Actress (Angela Punch McGregor). In addition, it had four more nominations for: Best Leading Actor (Drew Forsythe), Supporting Actress (Monica Maughan), Director (Gil Brealey), and Music. At the Montreal Film Festival it won the Prize of Ecumenical Jury. In the United States it debuted with the title Test of Love in English and Una razón para vivir in Spanish.

Gaby, a True Story(1987), by Luis Mandoki, is also based on a true story. This film, a co-production between Mexico and the United States, is the cinematographic adaptation of the life of the Mexican writer Gabriela Brimmer of Jewish decent. Gaby (Paulina Gómez, in infancy, and Rachel Chagall) was born in 1947. This poet had severe perinatal quadriplegic cerebral palsy. All her life, she was in a wheelchair with a speech impediment and had mobility in only her left foot. This is the case of a highly intelligent person with cerebral palsy; so smart in fact, that in addition to her works, Gaby graduated from college. The film defends the social and educational integration of the disabled – the importance of their ability to communicate and the search for resources and systems permitting them such things. In the case of Gaby, this was thanks to the mobility in her left foot. This accomplishment, which is present in other movies as well, is elevated to the category of artistic expression, just as in My Left Foot. In both films the protagonists use machines manipulated with their toes to write their works. Advancement in technology has substantially improved the possibilities for communication, expression, and training for many of the handicapped. The problems of the sexuality of the handicapped are issues also brought to the table. As in many cases, the love and care for Gabriela’s surroundings were determining factors in her growth. Thanks to her grandma, Florencia (Norma Aleandro), Gabriela learned to read – better put, they learned to read, since Florencia was illiterate. The method used was the only one possible, a blackboard and her left foot. Florencia not only took care of Gaby, but did so all her life. Gaby meets Fernando (Lawrence Monoson), a central character suffering from cerebral palsy as well, in the rehabilitation center. The boy had less severe paralysis than she and was not only a friend, but also her first love and someone with whom she had sexual relations. The social integration of Gaby allowed her to adopt a daughter. Norma Aleandro was nominated for an Oscar in 1987, as Best Supporting Actress for her part as Florencia.

My Left Foot (1989), by Jim Sheridan, is a co-production between Ireland and Great Britain. It narrates the life of the Irish painter and writer Christy Brown and is based on his autobiography. In this dramatic piece, the protagonist suffers from a form of cerebral palsy that does not affect his intelligence, but that only allows him to coordinately move his left foot, hence the title. As a result, he was able to write his autobiography and paint pictures, managing to create a doorway to the outside world. The role of his mother in his care and in the achievement of his successes was crucial. The plot takes place in Dublin, in a working-class neighborhood and within a Catholic family of lower economic status. The painter was the tenth of twenty-two siblings, of which only thirteen survived. The role of Christy Brown was interpreted by Hugh O'Conor and by Daniel Day-Lewis, in his infant and adult years respectively, and that of his mother, Mrs. Brown, by Brenda Fricker. Daniel Day-Lewis won the Oscar for Best Actor in 1989, and Brenda Fricker, Best Supporting Actress. The film received three more nominations, Best Film, Adapted Script, and Directing. In this case the awards are a true reflection of the quality of the film and script in general, and the interpretation, in particular. The protagonist was born in 1932, with athetoid cerebral palsy of perinatal origins. Although he only had control of his left foot, he had a fully functioning mind. He required total help for basic needs and a wheelchair for mobility. He was late in speaking and in the end finally succeeded with difficulty. The film demonstrates the fundamentals of dealing with cerebral palsy, such as familial acceptance, social integration, the need for encouragement for the development of self-esteem, especially by the mother, or the physical rehabilitation and speech therapy. Psychological, affective, and sexual issues are raised, exemplified by Christy’s lack of control and his refuge in alcohol. Three things to take into account: Christy rejects the center where they are going to rehabilitate him because the other patients are children, this Dublin center was free, and lastly it is important to have an adequate wheelchair.

Skallagrigg (1994), by Richard Spence, is a production the BBC based on the novel of the same name by William Horwood. It calls attention to the mistreatment and lack of consideration that in the past the disabled received in some centers or from their caretakers - it is hoped this does not occur today. This movie tells two distinct stories, both come together at the end of the movie. The first is of Esther (Kerry Noble), a 16-year-old girl with cerebral palsy who, since the death of her mother, has lived in a center for the disabled. She convinces her father, along with some of the others in the institution, to find Skallarigg, a mythical character who protected the disabled. The other story is about Tom (Adam Walker and Richard Briers), also with cerebral palsy, who in his thirties was institutionalized in a place where he received bad treatment. The first story analyzes an interesting topic, the relationship of a father with your disabled child, who has kept in a Center for Handicapped Children. In this film, the majority of the actors who interpret characters with disabilities are indeed handicapped.

Dance Me to My Song (1998) by Rolf de Heer. This Australian film, whose plot takes place in Adelaide, occurs like many others, an intelligent person with cerebral palsy is confined to a wheelchair. In this case it is a woman, Julia (Heather Rose), totally impeded and deformed by her spastic cerebral palsy, who depends on others to live and communicates thanks to a speaking machine connected to a computer, reminiscent of Stephen Hawking. Julia is cared for, or better put poorly cared for, by Madelaine (Joey Kennedy), a woman of questionable character and to a certain extent evil, but who keeps her from ending up in an institution. The movie puts forth the problem in the quality of the caregivers, the abuses, and the mistreatments. Madelaine’s inappropriateness is such that Julia witnesses the sexual relations she has with her boyfriend. The central plot closes when Eddie (John Brumpton) appears and falls in love with Julia and robs Madelaine, even though the protagonist will achieve to have sexual relations with him. Here they put forth the important problems associated with cerebral palsy: frustration and sexuality. The actress portraying the protagonist, Heather Rose, who was also co-scriptwriter, suffered from a severe case of cerebral palsy and needed a speaking machine, all examples of her strong character. She died on October 5, 2002, at the age of 36.

Door to Door (2002) by Steven Schachter, is a North American made-for-television movie. The script is based on real accounts. It deals with an important issue for people with cerebral palsy and for others with disabilities – their social integration which unfailingly leads to integration in the workforce. The film shows the discrimination suffered by the disabled when finding work and how they can triumph in doing so. Those with cerebral palsy are not always affected mentally and the physical limitations, which could limit their capacities for work, can be overcome with adequate jobs and using systems and procedures adapted to their deficiencies. States with elevated systems of social security create laws which favor their integration. The protagonist gets a job and triumphs thanks to his strength, tenacity, and character, overcoming the initial limitations derived from its cerebral damage. The plot covers forty years in the life of Bill Porter (William H. Macy) in Portland, Oregon. In addition to his physical problems, Bill’s cerebral palsy affected his speech. In 1955, he tried to work for the Fuller Company as a door-to-door salesman just as his father had. Against the wishes of the company, and thanks to the persistence of his mother, he finally got the job with a competing company, The Watkins Company. With Watkins, he triumphed, not only in his state but comparatively in his country. His mother, who fought so much for him in the end, developed Alzheimer’s. William H. Macy magistrately played the main role and the movie was awarded 6 Emmys and 6 nominations.

Oasis (2002) by the South Korean Lee Chang-dong, focuses on the love between two handicapped people, Jong-du Hong (Sol Kyung-gu) and Gong-ju Han (Moon So-ri). The first is a mentally handicapped delinquent who, in this case, is released from jail for a crime he did not commit, a drunk driving accident. The real culprit was his brother, Jong-Il Hong (Nae-sang Ahn). Jong-du goes to the accident victim’s house and there he finds Gong-ju Han, a girl with cerebral palsy who is confined in her home by her brother and sister-in-law. Infatuated with her, he returns and attempts to rape her, but after various encounters they end up falling madly in love. The girl has ataxic cerebral palsy and is quadriplegic and as a result, she is in a wheelchair and cannot speak. Both suffer from abandonment, embarrassment, and the lack of understanding from their families. People do not understand them nor understand your love; they are strange and thus excluded from society. The movie denounces the lack of family and social acceptance of the impaired as well as the love between them. The scriptwriter is also the director, who in 2003 was named the South Korean Minister of Culture. In the 59th annual Film Festival of Venice, he received the award for Best Director; Moon So-ri received the award for Best Actress, the Marcello Mastroianni award. It is a tender and excellent movie, a beautiful love story.

Inside I'm Dancing (2004) by Damien O'Donnell, is an Irish dramedy. Its two protagonists are handicapped people with completely distinct outlooks on life. Michael Connolly (Steven Robertson) at age 24 lives in the Carrigmore Home, an institution for the handicapped in Dublin. His cerebral palsy dictates he use a wheelchair. He suffers from diplegia, which affects his gestures, his positions, makes it so speech is almost unintelligible, and causes him to be frustrated. The arrival of Rory O’Shea (James McAvoy), a boy of the same age, changes his life. Rory suffers from Duchenne Muscular Dystrophy which confines him to a wheelchair and only permits him to move the fingers of his right hand; yet, he is active, a rebel, and loquacious. What’s more, he is understood when he speaks. He convinces Michael and the Disabilities Rights Commission members, that the two boys can live in an apartment and have a complete and independent life. Of course, to accomplish this, they would need someone to take care of them and both pick Siobhan (Romola Garai), a blonde, beautiful young woman. The plot of the movie tells of a person with severe cerebral palsy with notable disabilities and affected speech, who needs help to live in a center or in his own home. It puts forth that complete integration can only be achieved in one’s own home with help and company, which is something to be tried in some rich societies with assisted living facilities. Once again, it addresses an important idea, relations and sexuality of the impaired, with one catch, the competition between them. In the United States it was titled, Rory O'Shea Was Here. Jeffrey Caine created the script from a plot by Christian O'Reilly, which he based on his experiences from his work in the Centre for Independent Living of Dublin.

Le chiavi di casa/The Keys to the House (2004), by Gianni Amelio, is an Italian-French-German production.It centers on the meeting of a disabled boy with his father, whom he does not know. Paolo (Andrea Rossi) is a 15-year-old boy who suffers from cerebral palsy stemming from a complicated birth which killed his mother. After being rejected by his father, he lived with his aunt and uncle. For many years, he had been going to Berlin to receive specialized treatment in a hospital. For the first time, and mediated by his aunt and uncle, his father Gianni (Kim Rossi Stuart), accompanies him to the Berlin hospital.Their meeting occurs on the train. The counterpoint to the plot puts Nicole, (Charlotte Rampling) the mother of a handicapped girl, crossing paths with Gianni in Berlin. In the conversations between Gianni and Nicole important things are discussed, such as the feelings the disability of a child can produce in the parents, the life goals, the pressure, the embarrassment or the sadness, and how this permanent attention which in many cases is needed, falls on the mothers. Paolo’s cerebral palsy is shown through physical limitations and difficulties in speech, the character is interpreted by Paralympian Andrea Rossi. In the Berlin hospital, procedures used to evaluate and control the disability are shown. The movie is based on the novel by the same titles written by Giuseppe Pontiggia. It is a family drama with psychological aspects.


Films with a character who suffers from cerebral palsy

A Day in the Death of Joe Egg (1972) by Peter Medak, is a British film based on a Peter Nichols play by the same title. This dramedy includes issues which can present themselves to parents of children with the worst cases of cerebral palsy. Bri (Alan Bates) and Sheila (Janet Suzman) have a daughter with a neurological affectation, of such a degree that since birth she has been in a vegetative state. Sheila is confident in her recuperation while Bri thinks death is the solution and considers euthanasia.

An Ark Shell On the Ground/ Pijogae mute oreda / An Ark Shell on the Ground, by Byeong-gan Yang, is a South Korean film. When her mother dies, Mi-yeong is left in charge of her siblings, the oldest who has cerebral palsy and the youngest who is very sick. She leaves the first in an asylum and prostitutes herself to afford the medicine for the other4.

Orphans (1997), by Peter Mullan, contains British humor in its purest state. The title stems from the question: “What do four siblings do on the eve of the burial of their mother in Glasgow?”. The only sister, Sheila (Rosemarie Stevenson), suffers from cerebral palsy and remains confined to a wheelchair.

How To Kill Your Neighbor's Dog (2000), by Michael Kalesniko, is a German-American production. In this film, creativity, family, and surroundings seem to have turned their back on dramatist Peter McGowan (Kenneth Branagh). All problems! That is, until Amy Walsh (Suzi Hofrichter), appears in his house accompanied by her mother. Amy is eight-years-old and suffers from a moderate form of cerebral palsy.

In Once in a Lifetime/ Livet är en schlager (2000), by Susanne Bier, Mona (Helena Bergström), a pop music fanatic, sees to the necessities of her family, husband, four children, and brother working in a center for the handicapped. There, she cares for David (Jonas Karlsson), whose cerebral palsy has him confined to a wheelchair. He is admitted because his parents are not accepting of him. David composes music on a computer with the goal of getting the attention of his parents. Mona likes one of his works so much she sends it to a festival without his permission. The film is a Swedish and Danish co-production.

In the first story of the American film, Storytelling (2001), by Todd Solondz, Marcus (Leo Fitzpatrick), the boyfriend of the protagonist Vi (Selma Blair), has cerebral palsy and wants to be a writer. Moreover the film treats Marcus’ sexual relations with Vi, the understanding of his friends, and the contempt for his professor.

The Indian film Tera Mera Saath Rahen (2001) by Mahesh Manjrekar, has a simple nuclear plot: Raj Dixit (Ajay Devgan) lives only for his brother Rahul (Dushyant). Rahul is a 14-year-old boy who has a type of cerebral palsy which affects him physically and mentally, making him completely dependent on his brother. The situation gets more complicated, if that is possible, when Raj falls in love with Madhuri (Sonali Bendre), who will only marry him if he enters his brother into a disability center.

Take Care of my Cat/ Goyangileul butaghae (2001) is a South Korean drama directed by Jae-eun Jeong. It narrates the efforts of five friends to stay connected after graduating. One, Tae-hee (Don-na Bae), helps to type the works of a young poet with cerebral palsy.

In the Spanish film Piedras/ Stones (2002), Ramón Salazar introduces Anita (Mónica Cervera), the daughter of Adela (Antonia San Juan), the madam of a brothel. Anita has cerebral palsy with a mental disability. She spends her time at home drawing with paints, only leaving to walk the dog and watch airplanes.

Magnífico (2003) by Maryo J. de los Reyes, is a Filipino film in which a nine-year-old boy, Magnífico (Jiro Manio), tries to help his underprivileged family. His father has work problems, his grandmother dies of cancer, his brother has lost his scholarship, and his sister has cerebral palsy. The little girl, Helen (Isabella de Leon), does not speak and needs constant help. Magnifico takes care of her, feeding and carrying her.


Films in which cerebral palsy is imitated

The Usual Suspects (1995) by Bryan Singer, is a thriller where the police search for the creator of an explosion in the port of New York. Roger 'Verbal' Kint (Kevin Spacey) is one of the five usual suspects interrogated and presents a physical disability (a spastic left hemi-paresis, as can be seen in the movie poster) as well as a mental disability owed to a case of dehydration suffered as a child. Kevin Spacey won the Oscar for Best Supporting Actor in 1995, for his interpretation in the film. This film was co-produced by the United States and Germany and was also awarded the Oscar for Best Screenplay.

In The Score (2001), by Frank Oz, Jackie (Edward Norton) infiltrates Montreal Customs as a maintenance worker pretending to have a type of cerebral palsy and be mentally slow. In this way, he contributes in preparing the robbery Nick Wells (Robert De Niro) has planned, which is the center of the plot.

In the last 25 years, the film industry has produced a sufficient number of movies about cerebral palsy to bring information relating to its diagnosis and care in the medical, psychological, and social fields. The films have also been beneficial to parents and in changing the views of society with regard to this syndrome. The themes of the movies have been incredibly varied. The movies have been made in many countries and, on occasion, using disabled actors, contributing in this way toward their job integration. In the majority of films where the protagonist has a form of cerebral palsy which it does not affect the mind, thus the cinematographic narration is more easy. On occasion, the scripts have been based on real stories and on works created by the very same handicapped person.

People with cerebral palsy are neither “weirdos, nor stupid” (The Score 2001), they possess all the human rights and more. They have the right to be treated with love and receive the attention they need (Annie's Coming Out, 1984; Gaby, a True Store, 1987), although it is also necessary to encourage them to develop and show all their potential (My Left Foot 1989). Society should provide them with the means to be as integrated and independent as possible (Inside I'm Dancing, 2004), give them labor possibilities (Door to Door, 2002), and permit their affective growth (My Left Foot 1989). As such, the message is that Christy Brown “is not a great disabled painter but a great painter” (My Left Foot 1989).


References

  1. Nelson KB. Can we prevent cerebral palsy? N Engl J Med. 2003; 349:1765-1769.
  2. CDC. National Center on Birth Defects and Developmental Disabilities. [Database on the Internet]. Cerebral palsy 2004[cited 2005 May 20]. Available from: http://www.cdc.gov/ncbddd/dd/ddcp.htm
  3. Bringas-Grande A, Fernandez-Luque A, Garcia-Alfaro C, Barrera-Chacon M, Toledo-Gonzalez M, Dominguez-Rolda JM. Parálisis cerebral infantil: estudio de 250 casos. Rev Neurol. 2002; 35: 812-817.
  4. The Internet movie database [database on the Internet]. Pijogae mute oreda (1985) [cited 2005 May 20]. Available from: link

?Acknowledgment

International Studies Abroad (I.S.A.)

link


Translated by: April Kelly

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