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The shared experience of disease: Public health and cinema

Carlos Tabernero Holgado

Centro de Historia de la Ciencia (CEHIC). Universidad Autónoma de Barcelona (Spain).

Correspondencia: Carlos Tabernero Holgado. Centro de Historia de la Ciencia (CEHIC). Unidad de Historia de la Medicina. Facultad de Medicina. Universidad Autónoma de Barcelona. 08193 Bellaterra (Barcelona) (Spain).

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Received 13 March 2011; accepted 21 April 2011

Public Health, assumed as a set of institutionalized medical/health practices and discourses, is an ever present element of our daily lives, as well as an essential part of the different societies we live in. Collective strategies concerning disease management are built upon health systems and their policies, which means that so are individual relationships between doctors and patients. All of this helps to shape our view of the daily experience of disease (and of health) and, therefore, it also has influences our position towards it, at a private and individual level, and also at a collective one.

Health and disease are made visible to the community through Public Health, which in this way plays a decisive role in the construction of our identity (individual, physical, social and cultural). For this purpose, and among other aspects, it relies on another crucial set of practices and fundamental discourses that has become a part of the structure of our societies: the mass media. During the last century these media, especially cinema (and television), have become the source of wide-ranging representations and interpretations of the values, projects and expectations of each community, thus contributing to the formulation of both the symbolic framework on which social, economic, political and cultural life is built and sustained, and of spatial organization and timing, especially as the presence of the media becomes an integral part of our daily lives. Taking Public Health, on the one hand, and the media, on the other hand, in a deliberately broad sense as sets of "practices and discourses" implies explicitly acknowledging a relation, in both cases, to multiple forms of everyday action and interaction among people, groups and institutions, as well as to mechanisms of creation, circulation and management of knowledge in general - medical/health-related in our case - that are fundamental to the processes of construction and functioning of contemporary societies. Within this context, our perception and experience of health and disease is individually, socially and culturally built, fuelled and modified within the framework of these interrelated structures1.

Based on these premises, in September 2009, the Universidad Internacional Menéndez Pelayo (Menéndez Pelayo International University), in collaboration with the Institut Menorquí d'Estudis, organized a symposium on cinema and Public Health within the framework of the 20th Escuela de Salud Pública de Menorca (School of Public Health of Menorca), with the purpose of analysing the multidimensional relationship between Public Health and cinema. Taking into account several of the aspects involved in the impact of Public Health on the daily lives of people, either as collusion or as resistance, and its links to social, political, economic, cultural and ethical issues, a series of cinema projections were organized around three main topics: the relationship between Public Health and people pertaining to the way occupational and environmental risks are presented in films, with the screening of Alice - A fight for life (1982) by John Willis and Erin Brockovich (2000) by Steven Soderbergh; the relationship between Public Health and gender, particularly focusing on cinematographic representations of abortion, with the screening of Une affaire de femmes (1988) by Claude Chabrol and Vera Drake (2004) by Mike Leigh; and the way cinema presents addictions, especially drug addiction, with the screening of Near dark (1987) by Kathryn Bigelow and The addiction (1995) by Abel Ferrara.

The four articles that follow in the present issue of the Journal of Medicine and Movies summarize and analyze the aforementioned symposium on cinema and Public Health. In the first one, Cinema and the Collective Dimensions of Disease, Carlos Tabernero and Enrique Perdiguero, members of the symposium's coordination team, suggest an approach to understanding the role cinema plays in the mechanisms involved in the socio-cultural construction of health and disease2. For this purpose they perform an analysis of the main types of representation of epidemics in films, using them as examples of diseases that go beyond the limits of people's private lives, thus becoming the epitome of disease as an all-out threat to human communities. The frequency, relevance and characteristics of epidemics in cinema, mainly related to criteria of proximity in space and time to the contexts of production and distribution of the films, to their levels of morbidity, mortality and stigmatization, and to their degree of persistence in collective imagination, conform our way of understanding, experiencing and managing disease through the everyday reality of cinema as media practice and as an active means for individual and collective (self-) reflection.

In the second article, The Vindication of Non-expert Knowledge in the Defence of Public Health: Erin Brockovich, Alfredo Menéndez Navarro uses this well-known film to explore the complex work-health-environment relationships and the limitations of experts in the identification and management of occupational and environmental risks3. To complete his study of the documentary Alice - A fight for life (1982) by John Willis, published in this journal4, Menéndez Navarro explores the main features of toxic torts, analyzing the mechanisms followed by citizens to play an actual part in the construction and management of occupational and environmental risks. Soderbergh's film, based on true facts, allows us to identify the access to expert knowledge and its combination with locally contextualized knowledge, as well as the visibility of the daily experience of disease, as key elements for empowerment and resistance, in this case regarding the collective dimension of medical/health practices and discourses and their impact at the individual level.

Likewise, Isabel Jiménez Lucena, in her article Differences, Paradoxes and Exclusions regarding Abortion. A Possible Interpretation of Une affaire de femmes and Vera Drake, delves into the role of women as active agents in abortions and their influence in the associated processes of medicalization. By carrying out a comparative analysis of Une affaire de femmes (1988) by Claude Chabrol and of Vera Drake (2004) by Mike Leigh5, Jiménez Lucena shows, on the one hand, the subtle differences between the presentation and questioning of the "performative" contradictions introduced in Chabrol's film regarding the particularized experience and collective management of abortion and, on the other hand, the presentation in Leigh's film of the medicalization of women as an effective public health strategy. The comparative study of these two films reveals how abortion is interpreted as an instrument of power over women's bodies.

Finally, in his article Vampirism as a Metaphor for Addiction in the Cinema of the Eighties (1987-1995)6, Juan Antonio Rodríguez Sánchez provides a review of vampire films made through last century's 80s and 90s. Focusing on vampirism as a metaphor for epidemics (see 2), Rodríguez Sánchez analyses the figure of the vampire as a metaphor for addiction, studying how this figure is used in the cinematographic context of the time to create a stereotype of drugs and its users. The collective threat, in this case, is expressed in terms of family breakdown, so that, with an essentially conservative attitude, the traditional values of family and religion are presented as an antidote.

Taken together, these four articles cannot thoroughly analyse the multiple representations of the collective experience of disease (and health) in the mass media. Nevertheless, they provide a detailed approach to the complex and multidimensional relationship between Public Health and cinema, revealing certain main features of the mechanisms for the construction and management of the collective dimensions of disease and, therefore, also of the knowledge and medical/health practices and discourses that are involved, as well as their impact at the individual and collective levels.


References

  1. Tabernero Holgado C. Discursos y representaciones médico-sanitarias en el cine documental colonial español de la posguerra (1939-1950). Barcelona: Centro de Historia de la Ciencia (CEHIC) / Universidad Autónoma de Barcelona, 2010. Available from: link
  2. Tabernero Holgado C, Perdiguero-Gil E. Cinema and the collective dimensions of disease. J Med Mov [Internet]. 2011; 7(2):44-53. Available from: link
  3. Menéndez Navarro A. The vindication of non-expert knowledge in the defence of public health: Erin Brockovich. J Med Mov [Internet]. 2011; 7(2):54-60. Available from: link
  4. Menéndez Navarro A. Alice - Alice-A Fight for Life (1982) and the public perception of the occupational risks of asbestos. J Med Mov [Internet]. 2007; 3: 49-56. Available from: link
  5. Jiménez Lucena I. Differences, paradoxes and exclusions regarding abortion. A possible Interpretation of Une affaire de femmes and Vera Drake. J Med Mov [Internet]. 2011; 7(2):61-68. Available from: link
  6. Rodríguez Sánchez JA. Vampirism as a metaphor for addiction in the cinema of the eighties (1987-1995). J Med Mov [Internet]. 2011; 7(2):69-79. Available from: link