2022/Jul/18 "Neurocinema--The Sequel" is out! Dr. Margo Peyton rewinds the tape to review Dr. Eelco Wijdick's original.

Neurocinema--The Sequel: A History of Neurology On Screen was published this Spring. Like any sequel, it's important to watch or read the original. We asked Dr. Margo Peyton for her take on this foundational text on the subject.

Dr. Margo Peyton

Margo is a neurology resident at Mass General Brigham. Prior to medical school, she worked in film and television story development for DreamWorks Animation. Follow her on Twitter @margopeyton

Lights, Camera, ACTION!

Neurocinema cover

Swedish director and producer Ingmar Bergman said that “No form of art goes beyond ordinary consciousness as film does, straight to our emotions, deep into the twilight room of the soul.” Professor of Neurology Eelco F.M. Wijdicks, in his 2015 book Neurocinema, seizes on Bergman’s perspective to show the impact of neurologic disease through the medium of film. Neurology, with its indivisibility from ethics and psychology, provides excellent cinematic content and, as a physician of neurocritical care and a cinephile, Wijdicks provides an excellent perspective to guide us through it. As a neurology resident who worked in story development for DreamWorks Animation before medical school, I appreciate Neurocinema as a melding of my two worlds as well, curated by an expert neurologist and “neurocinema critic.”

Dr Eelco Wijdicks

In Neurocinema: When Film Meets Neurology, Wijdicks analyzes over 100 films from 1920-2014 to chronicle and critique the cinematic portrayal of neurologic disease. The book is a product of Wijdicks’ professional and personal interests, with many of the reviewed films coming from a personal file he has maintained. Beyond an appreciation for the films’ entertainment value, however, Wijdicks uses his dual interests to advance neurologic education for physicians and nonmedical audiences alike.

In two introductory chapters on medicine and neurologists in film, Wijdicks explains how neurologists have found some fame through portrayals of Oliver Sacks: Robin Williams in Awakenings (1990) and Bill Murray as a satirical Sacks in The Royal Tenenbaums (2001). Also notable is the portrayal of Jean-Martin Charcot and his study of hysteria in Augustine (2012). Overall, the depictions of neurologists, Wijdicks concludes, tend towards aloof, bowtie wearing individuals lacking in compassion and diagnostic certainty.

The analytical heft of the book lies in the chapter on neurological disorders in film, in which Wijdicks discusses the representation of coma, seizure, stroke, and many other conditions in American and international cinema. While he recognizes the primacy of story, Wijdicks holds the films to a higher standard than entertainment alone because of the potential impact of medical misinformation. In focus groups, Wijdicks has found that people cannot identify medical inaccuracies in film and that medical film scenes influence their medical decisions. Wijdicks’ discussion of several of his “Top Ten Neurocinema” highlight how film can both captivate with story and advance accurate portrayals of neurologic disease.

In the French film Amour (2012), an octogenarian has a stroke that requires her octogenarian husband to provide full-time care at home. Wijdicks analyzes how Amour captures the “often unrecognized” demands on caregivers, the unmet need for neuropalliation, and the impact of disease on relationships. It forces us to confront, Widjicks argues, the threat to dignity for stroke patients. Next is My Left Foot (1989), a film about Christy Brown, a man with cerebral palsy who became a famous author and painter. Wijdicks applauds Daniel Day-Lewis’ “incomparable” portrayal of pseudobulbar signs and dystonic postures. A method actor, Day-Lewis remained in character for the shoot, using a wheelchair and modeling his mobility from footage of Brown, and won an Academy Award for his performance. And last is the French film The Diving Bell and the Butterfly (2007) about Jean-Dominique Bauby, the former Elle editor-in-chief who had a basilar artery occlusion leading to “locked-in” syndrome. Here Wijdicks assigns the film as required viewing for its lessons in communication (Bauby dictated an entire book through blinking) and the importance of working with colleagues in respiratory therapy and rehabilitation.

In addition to these exceptional examples, Wijdicks acknowledges the influence Hollywood’s own proclivities have on the portrayal of neurologic disease. He names the cinematic depiction of coma the “Sleeping beauty phenomenon” because patients often lack the condition’s contractures, decubitus, and changes in facial features in favor of the screen’s preference for physical attractiveness. Films often depict people with epilepsy as dangerous and mentally unstable for dramatic effect, reinforcing the false connection between epilepsy and psychiatric disorders. Perpetually creating films about the movie-making industry itself, Hollywood demonstrates a fascination with neurologic disease in artists. Parkinson’s disease in musicians (A Late Quartet, 2012), dementia in writers (Iris, 2001) and musicians (A Song for Martin, 2002) – Hollywood strives to know how neurologic disease affects the production of creativity.

Given the impact of representation in film and TV on young audiences, and given my background in animation, I would be curious for Wijdicks to explore neurologic disease in children’s entertainment. Animation, without the reliance on human actors, offers unique opportunities for the physical depiction of neurologic disease. Several of Pixar films have showcased the themes explored in Neurocinema. In Up (2009), the devastating opening sequence sets up a conflict between institutionalization and independence in older age. In Finding Nemo (2003), blue tang Dory has short term memory loss that adds complexity to the trans-oceanic adventure. And of course, there is Inside Out (2015), which tackles affective neuroscience on a (personified) molecular level.

Neurocinema is an entertaining and educational book that guides readers through topics like localization and pathology as well as the Hollywood stories behind and in front of the camera. Wijdicks suggests that readers form a film club and provides prompts for discussion, including “discuss an inaccuracy and use to as a teaching advantage.” It will no doubt be the most well-attended journal club.

 

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