When neurointensivist Dr. Eelco Wijdicks published the original Neurocinema: When Film Meets Neurology in 2014, his collection of film essays summarizing the portrayal of major neurologic syndromes and clinical signs in cinema served to underscore the field’s existence by being its premier textbook. Therein the medically-inclined movie buff or the film-frenzied clinician could explore medicine as it appeared on the big screen and better understand what the effects of medicine on film have played in our cultural milieu over time. After reading its sequel, Neurocinema — The Sequel: A History of Neurology on Screen published this Spring, I interviewed the author about how he ended up in the director’s seat of the discipline. No, I didn’t ask him any of the Inside the Actors Studios questions!
Michael Stanley: How did Neurocinema come to be?
Eelco Wijdicks
Eelco F.M. Wijdicks MD, PhD is Professor of Neurology, College of Medicine, Mayo Clinic. He established Neurocritical Care at Mayo Clinic and is consultant neurointensivist in the Neurosciences Intensive Care Unit at Saint Marys Hospital (Mayo Clinic Campus Rochester). He has published commentary and criticism on medical and neurologic portrayal in film, including Neurocinema: When Film Meets Neurology (CRC Press 2014) and Cinema, MD: A History of Medicine on Screen (OUP 2020). He lives with his wife
Barbara-Jane in Rochester (MN) and Bonita Springs (FL).
Eelco Wijdicks: I love film, and over the last fifteen years or so I’ve kept notes on the ones I thought were great and why. Every once in a while that would include something neurological. The interest and inspiration I guess had always been there. But the spark towards a serious endeavor began when I was working on a book about coma at the time and putting together a chapter on how the public sees coma. I became interested in how depictions of comatose patients in film influenced medical decisions of patients and family—about one-third of well-educated viewers could not recognize the Sleeping Beauty-like depictions as inaccurate. We wrote a paper about in Neurology, but by then I knew I was in trouble because I was so interested in the subject I had to write the book.
Stanley: What did you observe in curating these films?
Wijdicks: In the days of early film it was for “neurological monsters,” with silent movies exploiting the dysmorphism of people suffering from neurological disease for spectacle. The physicality of neurological diseases—like seizures or paralysis—and later the psychiatric qualities like hallucinations, manias, psychosis, amnesias, were often pejorative and stoked myths about these patients being dangerous. But as I continued onward in the history of film into the ‘80s, we see a shift to deeper and more nuanced ethical conundrums brought on by neurological conditions, or how succumbing to or overcoming neurological disease plays a central role in character development. Lately, and I wouldn’t doubt its because of how common dementia is becoming, films like Iris, Still Alice, and more recently The Father, have focused on dementia affecting highly intelligent minds decompensating. The Father, which won awards, was particularly good for its attempt to dramatize the disorientation someone with dementia might be undergoing and conveying that to the audience. The point is not necessarily that what is being depicted is precisely how a person developing dementia experiences disorientation—we would have no real idea of that. But we can be through skillful filmmaking become disoriented—and induced to feel upset by this disorientation. That is a kind of sympathy that can be achieved. The nitty-gritty of how dementia is affecting lives is becoming more the topic than genius professors or writers losing the thing that made them special—which was the more common theme. Perhaps we as a society are ready for the nitty-gritty in a way we weren’t before, now that more people are living with dementia or a loved one with dementia.
Stanley: In The Sequel you ponder just how the audience neuro-dynamically engages with the medium.
Wijdicks: I’ve added a section musing about this. The amygdala, involved in emotion, is activated especially when the music turns happy or sad. Then there’s the quality of narrative transportation, where you get engrossed in the film. This is facilitated by the editing and pacing. Then there’s the empathy of seeing a character in a pain and your own bodily self-monitoring pathways in the insula of the brain goes off, too. It’s like what Kael said: I go into the movie, I watch it, and I ask myself what happened to me.
Stanley: What is generally your approach to the book?
Wijdicks: It’s closer to a history book. It’s not a film criticism book. I’m not trying to teach film-makers how to write neurology, and I am not trying to snicker or criticize film-makers’ efforts. Film makers turn to neurology many reasons—and these are not B films. Many of these 118 film where neurology plays a significant role are award-winning, classics even. I’m trying to understand what those roles are and their impact.
Stanley: How else might someone use Neurocinema: The Sequel?
Wijdicks: The Sequel is more academic and more analytical in its perspective than the original. Aside from providing an update on more neurology in cinema and bringing them into context, there are new chapters delving into the history specifically, on celebrities with neurological diseases on film or depicted on film, neuro-ethical questions raised in film. These additions make the book a practical reference for so-called cinemeducation, using film as a means of engaging medical students in important and formative elements of doctoring. Public views on institutions like the VA, Socialized Medicine, VA Medicine—we can learn something about those attitudes through how representations of these institutions change over time.
Stanley: But you do provide your Ebert and Roeper like ratings?
Wijdicks: The Reflex Hammer rating scale from the original is still there, with one hammer indicating an incorrect depiction and four hammers indicating mandatory viewing. The Sequel includes a ‘neurofollies section, with one safety-pin for a preposterous depiction and three safety-pins as a kind of kudos, to put it kindly, to the imagination of the film-makers. Although these ratings accompany reference to the film, this not a Rotten Tomatoes of Medicine kind of book. I’m providing some guidance to those who see the 118 films (both American and, importantly, international films so often neglected) referenced and think to themselves, “Where do I begin?!”
Stanley: I’d begin by telling clinicians and medical trainees to read your book. It’s a great way to build a film club in your medical school or department.
Wijdicks: That’s kind. Just start paying attention to what attracts you to a film and how you respond to it. That’s a good place to start.
Michael P.H. Stanley, MD is a senior resident of the Mass General Brigham Neurology Program. He currently serves as the director of outreach and engagement for the Boston Society of Neurology, Neurosurgery, and Psychiatry as well as the director of the Young Oslerian Group within the American Osler Society. In addition to his clinical duties, he is a frequent contributor of essays and articles on the intersection of medicine and society, writing for the Wall Street Journal, National Review and Portland Press Herald, among others. Follow him @Mphstanley on Twitter.