The neurologist in film: from Sacks to Charcot
2013; Elsevier BV; Volume: 13; Issue: 1 Linguagem: Inglês
10.1016/s1474-4422(13)70243-6
ISSN1474-4465
Autores Tópico(s)Neurology and Historical Studies
Resumo“Those damn neurologists, they think they can run the world ” EDtv, 1999 Neurologists are rarely plot protagonists. Rather, our appearance in films is often brief, with screenwriters preferring surgeons, psychiatrists, and family doctors. The neurologist portrayed in film is a caricature: the aloof neuroscientist studying a rare neurological disease (Bill Murray in The Royal Tenenbaums), the strictly business and cynical physician (Patrick Chesnais in Le Scaphandre et le Papillon), the glib researcher undertaking highly unethical human experiments (Gene Hackman in Extreme Measures), the false prognosticator telling the family of a patient in a persistent vegetative state to keep hoping for a miracle (Roberto Álvarez in Hable con Ella), and the flustered physician desperately calling for an emergent EEG in diabetic coma and, even more strangely so, during a fundoscopy (Dess Philpot in Reversal of Fortune). In the USA, the film Awakenings introduced the neurologist to cinemagoers, with Robin Williams as the fictional Dr Sayer portraying real-life Oliver Sacks. Williams played a bearded, spectacled, coy neurologist discovering a treatment for encephalitis lethargica. In The Royal Tenenbaums, the far nerdier Raleigh St Clair (Bill Murray) is also modelled on Oliver Sacks. In the film, Dr St Clair writes a book entitled The Peculiar Neurodegenerative Inhabitants of the Kazawa Atoll and is seen studying a rare disorder of amnesia, dyslexia, and colour blindness combined with a highly acute sense of hearing. After a patient is subjected to a block design test (which shows a notably discongruent result), the neurologist chuckles, “My goodness, how interesting, how bizarre.” In Europe, the neurologist is treated like any other physician, with sympathetic depictions few and far between. In La Guerre est Déclareé, the parents of a child with a brainstem tumour are approached by a crass paediatric neurologist. She barges into the room with her entourage, looks at the child and tells the parents that he needs a CT scan, rushes away, and leaves an assistant to explain the details. What follows is a pompous display of inexplicable medical jargon that totally confuses the distraught parents. In Go Now, the neurologist of a patient with highly suspicious signs of multiple sclerosis shuffles papers while eating a sandwich, but cannot find test results—“no results here…bit of a cock up.” He simply asks the patient to return to the office in a month because “I am on holiday”. However there is some good out there. In A Song for Martin, the neurologist compassionately explains the consequences of the early diagnosis of Alzheimer's disease in an orchestral director and composer. The patient was tested after he embarrassingly lost the ability to follow the score during a major performance. She advises him to “try to live normally. Do what you have always done as best as you can, Mr Fisher. Work and spend time with your loved ones. Love and mental gymnastics are the best treatments.” Now, for the first time, a feature film—the César-nominated Augustine—is devoted fully to neurologist Jean-Martin Charcot. If any neurologist seemed to have “run the world”, it must have been Charcot. He was widely consulted as the chair of the Clinique des Maladies du Système Nerveux at La Salpêtrière in 19th century Paris. Charcot's studies of female hysteria cemented his international fame. He was well known for his clinical demonstrations showing the effects of touching “hysterogenic zones” that would induce a hysterical attack. His treatment of young afflicted women (and also men) included hypnosis and, most memorably and shockingly, and shown in this movie, the “compresseur ovarien” (an abdominal vice with a knob that applied pressure to the ovary), both of which could abort the spells. In the film, Charcot is played by Vincent Lindon, but he has little of Charcot's imposing austere stature, which has been called Napoleonic. The role would have been perfect for Marlon Brando. Nonetheless, the film recreates the atmosphere at La Salpêtrière and Charcot's associates reasonably well. Désiré-Magloire Bourneville has an insignificant cameo, but the film does not identify other famous neurologists of the time. Some aspects of neurological examination, the major discrepancies, and rapid changes in symptomatology are shown and generally correct. The manifestations of “la grande hystérie” are exhibited by Augustine, played smartly by Stéphanie Sokolinski (Soko), and the audience gets quite a show, including the well-known “arc-en-cercle” position of a hysterical patient. Dark and shadowy cinematography creates a gothic and exotic effect that will cause some viewers to label Augustine as nothing more than a psycho-erotic thriller. The director's goal might have been to show a chauvinistic doctor's behaviour and sexual desire evoked by lusty women—and indeed, in the culminating scene, Charcot fornicates with her in his office. Just because La Salpêtrière was a public women's hospital staffed entirely by male, often authoritarian, physicians (including Charcot), one should not conclude such a discreditable connection. A feature film rarely provides useful insights into the practices of a neurologist. Now it is suggested that one of the fathers of neurology was a victim of erotic transference. We deserve better. For more on the film see http://www.musicboxfilms.com/augustine-movies-66.php For more on the film see http://www.musicboxfilms.com/augustine-movies-66.php
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