José Elías García Sánchez and Enrique García Sánchez
Departamento de Medicina Preventiva, Salud Pública y Microbiología Médica. Facultad de Medicina. Universidad de Salamanca (Spain).
Correspondence:José Elías García Sánchez. Facultad de Medicina. Alfonso X El Sabio s/n. 37007 Salamanca (Spain).
Received 20 October 2007; accepted 26 October 2007
As spectators, as mere observers (since we are not critics) in many current films we see a trend towards explicitness -realism and even hyperrealism- and as Editors of this Journal we believe than many cinema lovers will agree with us. When portrayed in films, sex scenes tend to be as explicit as possible; violence also leaves no doubts and often becomes so extreme that we sometimes worry about the blood and guts splashing out from the screen and hitting our faces. Regarding language (and what language!), what we now hear on the screen ranges from the most refined to the lowliest of the low. And we could indeed follow on in this vein up to the actual physical setting of the film, which is usually addressed in great detail.
Despite all this, in respect of the aims of this journal we cannot deny that in today’s films medical issues, when present, are usually extremely well reflected and are not portrayed for with any morbid purpose in mind, as is -in contrast- frequently the case of TV series attempting to do the same. This is because films today tell us more; they dare go further, and indeed do so explicitly. Within the sphere of the purely visual, this is reinforced by today’s technological advances and their applications in the cinema, bolstered by makeup and imagination.
This brief introduction is necessary if we are to offer any comment on the films explored in the present issue of our Journal, which are very diverse in their content and in the plots therein. Nevertheless, they all share a common feature in that they are cinematographic productions that contain elements of reality, realism and even hyperrealism in the different ways that producers have dealt with medical issues. Also, many of the films discussed previously in this Journal exhibit this characteristic as from the very start of the plot.
One of the definitions of the Compact Oxford English Dictionary of Current English for the word reality is the state of things as they actually exist, as opposed to an idealistic or notional idea of them1 (truth; what really occurs). There is no doubt that the medical issues of the plots we are talking about are real, and they really happen today, or have happened in the past. Is medicine important in humanitarian care in fratricidal wars? Is Alzheimer’s disease not important? What are we to say about the advances made in cardiology? How are we to judge the physician-patient relationship? When physicians get ill, are they too not subject to what the health care system can offer? These are the topics underlying Beyond borders (2003), by Martin Campbell, Y tú quién eres? [And who are you?] (2007), by Antonio Mercero, Iris, by Richard Eyre, Son of the bride/ El hijo de la novia (2001) by Juan José Campanella, Something the Lord made (2004) by Joseph Sargent, Sachs' Disease/ La maladie de Sachs (1999) by Michel deville, The doctor (1991) by Randa Haines, Venus (2006) by Roger Michel and The painted veil (2006) by John Curran.
On defining the word realism, the Compact Oxford English Dictionary of Current English state that this is the representation of things in a way that is accurate and true to life1. The film Beyond borders is a reflection on the raw, high-impact images of starvation, misery, lack of health care and resources, and violence and corruption of the fratricidal horrors in Ethiopia, Cambodia and Chechnya, portrayed in highly realistic scenes, and the efforts of NGO’s to palliate such affairs2.
Alzheimer’s disease is a sword of Damocles swaying above the heads of the elderly. The film Y tú quién eres? completes the realistic view previously seen in Iris and Son of the bride. Hyperrealism is related to Photorealism, a style of art and sculpture characterized by the highly detailed depiction of ordinary life with the impersonality of a photograph1. There surely cannot be anything more real than what we see in the films about Alzheimer’s patients and the impact of this devastating disease on family and carers a like3.
Something the Lord made is packed with interesting ideas. First, we are offered a biographic view of Dr. Alfred Blalock and Vivien Thomas, who both revolutionised cardiac surgery. Second, we become privy to the racist reality of the American population. Joseph Sargent previously addressed this in The Tuskeegee experiment (1997). Third, we are allowed to explore the relationships between mentor and disciple4. This is certainly an interesting film from which we can draw strength to refute James Watson’s recent “statements” about the black population.
Physician-patient relationships are very complicated in the public health system. Sachs' Disease portrays a humane way of practising medicine, and how this can become a “disease” for the treating physician. This film is replete with reality, realism and hyperrealism. In these latter two fields, we witness the abortion performed by Dr. Sachs5 and are offered a poster in his office saying Un medicament, ça ne se prend pas à la légière (A drug cannot be taken lightly), a poster published in France with a view to fostering awareness about the dangers of self-medication. The doctor is full of different issues, but does place stress on something fairly common: the fact that the population tends forget that physicians also fall ill and that despite the possibly corporate nature of their profession they too are subject to the positive and negative of the health system5. There is not always a doctor who is a friend, and the most brilliant practitioner is not always the best doctor.
Venus also tackles ageing, not as regards its effects on the intellectual sphere but on other no less important aspects, such as the frequent appearance of tumours in later life. In particular the film focuses on prostate cancer, a disease that is almost a constant within the elderly male population. The film includes scenes of medical examinations and mentions the usefulness of rectal explorations, all shown with great realism6.
Finally, The painted veil, in its 2006 version, portrays the fundamental symptoms of cholera with great hyperrealism: diarrhoea. It is here when imagination is brought into play; this is the first time, to our knowledge, that diarrhoea is shown in an elegant and not crude way, and the images show that in cholera outbreaks the diarrhoea is intense and watery. All this we see in a film made in natural surroundings (China), for greater neorealism, and the images are diametrically opposed to the cholera portrayed in the earlier version of 19347.
In conclusion, therefore, we certainly feel that all these films are a “must” for our readers.