15/02/12 Film Essay # , , ,

Talk to Her (2002)

Talk to Her (2002)
Director: Pedro Almodóvar
Writer: Pedro Almodóvar
Stars: Rosario Flores, Javier Cámara, Darío Grandinetti


In the midst of planning a trip to Spain and having just seen Pina, a splendid 2011 documentary tribute to Pina Bausch by Wim Wenders, I was eager to return to Almodovar’s 2002 Talk to Her. I remembered the film’s opening scenes of Café Muller as an archetypal dance. And in anticipation of our upcoming travel in Spain, I was also sure Pedro Almodovar would stir up excitement with his deft flair for embellishing patriarchal symbolism with spicy feminine images.

If Almodovar had called his film “Talk to Him”, I could’ve imagined I was going to be urged to discover the rewards of expressing my deepest longings to the designated immanent being of mankind – the usual, God in male persona. But, instead, he was urging, Talk to Her? Her? Well, of course, this was going to be a film urging men to talk to women, but then, I found it went bit further. It urges us viewers to wonder about a strange world, an unusual one, the divine one where miracles happen. At the center of Talk to Her is a “coming back to life” story calling us to the mysteries of the feminine.

Talk to Her opens non-verbally in dance, the body expressing more emotion in a gesture than words could conjure. In one of the most famous of Pina Bausch’s dance performances, Café Muller, men dash quickly to remove chairs from women dancing blindly with abandon without seeing where they are going. Men removing obstacles from the beauty of women’s free flight is a metaphor so powerful, it brings tears to the eyes. Two men – strangers – sit next to each other in the audience watching Café Muller. In fact, one does cry. The other looks at him, touched by his tears but saying nothing. They will meet again.

Talk to Her brings these two men together to break a silence that so often covers up feelings and separates people, reinforcing a painful aloneness. Talk, as we all know, is the province of women. Hence, entering the province, men enter the mysteries of the feminine and find what they’re missing – feelings for one another and for the ‘other’, a woman.

The man who cries, Marco, is a freelance writer, a traveler of the world, macho strong in looks and suffering silently from a lost love fifteen years past. He’s smitten with a famous female bullfighter, Lydia, whose husband has left her, leaving her embarrassed in public and vulnerable to the press. He reaches out to her, offering to do a story that will rescue her from hostile publicity. The plot thickens as the two ride a rocky road of sexual attraction that could, perhaps, become something more if they were not both plagued by attachments to their previous relationships. He attempts to overcome his own doubts with declarative statements of love for her but she demurs, saying, “We’ve got to talk”, alluding to unspoken assumptions.

The man seated next to Marco is Benigno, an odd voyeuristic fellow for sure. He is a highly sensitive male nurse who lives alone in the apartment where he grew up with his mother, cared for her until she died. He’s fallen in love with a dancer, Alicia who he’s never met, only watched practicing in a studio across from his apartment window. He slowly begins to act on his fascination, returning a purse she’s dropped on the street, making an appointment with her psychiatrist father and spiriting a comb out of her apartment. And then, going beyond Benigno’s wildest dreams, Alicia is in a car accident and ends up in his almost 24-hour care at the local hospital — his sleeping beauty, the love of his life and a woman for whom he will die. While she lies silent in a coma, he keeps up a flow of talk, indulging himself as if she were an eager participant.

With all the magical allusions synchronicity conjures up, the female matador also meets with an accident that renders her unconscious in the same hospital down the hall from Benigno and the dancer. The two men are thrown together one more time and, as different as they are, this time they become close friends. Benigno, who talks endlessly to Alicia, tries to get Marco to open his heart to Lydia. Marco tries to get Benigno to see the futility of one-sided love. Fantasy driven Benigno and reality bound Marco are like two sides of one coin, forming a strong albeit not well explored emotional bond.

Benigno enters into an ever-expanding world of make-believe with Alicia, developing an arguably closer relationship with this woman in a coma than would ever be likely in his ordinary life. Benigno’s love of Alicia may be pure. No one questions it. He doesn’t seem sexually mature to anyone. His being moved by an unconscious woman’s passivity as if she were alive is never taken as anything more than devoted caretaking. When Alicia is discovered pregnant and Benigno is accused of impregnating the unconscious dancer, he neither confirms nor denies. But the facts (and Almodovar’s suggestive animated imagery) say it’s so.

When Benigno announces his intentions to marry Alicia, saying to Marco, “I want to marry her”, Marco thinks he’s kidding and gets annoyed. Nothing could be more absurd to Marco. “You can’t marry her, she can’t say ‘yes’.” But Marco, who has charged ahead with his own plans for marrying Lydia is also guilty of never having asked her and listened for an answer. In fact, he’s edged out of Lydia’s life by her husband’s return to her bedside in the hospital, finding out from him that they were on the verge of reconciliation when the accident occurred. Neither man in either world considers talking to a woman as meaning that a woman talks back.

Benigno, jailed for his offense, slips further and further into oblivion. Marco, by contrast, does the ‘manly’ thing. He throws himself into work, signing up for farflung travel assignments – until he hears that Benigno is in jail. Marco feels compelled to return and see what he can do for Benigno. Unconcerned about imprisonment, Benigno simply wants to know how Alicia is, when he can see her. Marco discovers the ill-begotten pregnancy ended in a stillbirth for the child but a full recovery for the mother! He’s determined to get Benigno released from jail but he has agreed to silence about Alicia’s condition. Benigno, deprived of information and believing Alicia died in childbirth, commits suicide.

In another one of those great Almodovar synchronous storytelling events that evolve culture as well as character, Marco and the recovered Alicia, meet at yet another performance of Pina Bausch. Marco, a changed man, is openly eager to talk to this woman who looks with open eyes and talks back. Keeping silent has not gone well for him and he has the legacy of his friendship with Benigno still fresh in his mind. He may even wonder whether Benigno talking to Alicia in a coma enlivened her, contributing to her recovery. Since science is still looking for the mind, it’s not so far fetched to believe that talking stimulates a process that leads to an awakening from a coma. I go back to my beginning of seeking the divine ‘Her’ in “Talk to Her”. We may get our fondest longings met talking to “Her”.

When Marco turns around in his seat to talk to Alicia, their talk must go across an empty chair in the row between them, suggestive of a silence not of their own making but with an invisible, miracle-making Benigno present, encouraging them to cross it.

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03/01/09 Other Writing # , , , , , ,

Missed Diagnosis

This is my story. It could save your life.

My story begins late one night in December 2008. I’d just come home from a long and wonderful trip to Bhutan, Nepal and India and was in the midst of moving in with a man I’d met and fallen in love with two summers before. We’re both in good health, exercise regularly and keep our diet on the light side. But this night we’d been out to a fancy restaurant. We were in a high mood, planning a celebration for our 70 and 75th birthdays as one big party in February. A few hours after I’d gone to sleep, an intense cramping in my lower left side awakened me. My abdomen was bloated. My stomach felt hard as a rock. I couldn’t lie still so I stood up. I immediately bent over in pain. Feeling pretty weak I supported myself with the back of a bedroom chair. Sitting or lying down felt worse. That night, I walked around and around and around the living room wondering what was wrong and what to do. I’d suffered digestive discomfort for years but never anything like this. It was logical to believe I’d picked up a bug in India. As I walked, I took GasX. About ten minutes later, I felt better and was able to go back to sleep. I thought that was the end of it but it was just the beginning.

I’m a psychologist who hears many clients describe digestive discomfort, especially after a meal out in a restaurant. I’ve listened to many women describe similar nightly walkabouts in which all they could do was wait for gastrointestinal pain to subside. One woman told me her mother had been having attacks for years and tried every home remedy and medical prescription in the book with no sustainable relief. It’s common to hear people report getting so frightened by the pain that they believe they’re having a heart attack. They go to an ER, lay around on a gurney for hours and come home with a diagnosis of indigestion. Still, since the pain was extreme, I called my internist the next day and got an appointment a few days later. He sent me for scans of my liver, kidneys, gall bladder and esophagus, gave me an ECG in his office and prescribed Prevacid for indigestion. All the tests came back normal.

But nothing was normal. I continued to have severe digestive discomfort and painful spasms every few nights. I searched the Internet hoping to understand my symptoms better. I kept coming up with GERD (gastro esophageal reflux disease) and IBS (irritable bowel syndrome). Each search described many of my symptoms but there was little mention of the pressure from gas that I was experiencing or the pain. I saw a nutritionist who was convinced that my gall bladder was malfunctioning. Her dietary recommendations didn’t work but she heightened my awareness of the importance of diet. In particular, I learned that carbohydrates produce gas and overeating at any particular meal puts extra stress on the stomach. I started a low carb diet and ate small frequent meals. I also stopped eating anything after six pm. Even though my alcohol habit consisted of little more than a glass of wine with dinner, I stopped drinking any alcohol. A glass of wine seemed to set off a spasm. Same with my morning cup of coffee. Taking these measures slowed down how often I experienced these episodes of intense pain but did not affect the intensity once one got rolling. Modifying my eating habits certainly helped but didn’t solve the problem.

Next I saw a gastroenterologist who was convinced I had SIBO (small intestinal bacterial overgrowth). He prescribed Xyfaxan, an antibiotic that targets bacteria in the intestine in order to restore proper balance and cease pain caused by spasms of the gut. I did several series of this antibiotic over the next months. The third, pulling out all stops, was for three weeks. He also prescribed Levsin, an antispasmodic medication. The antibiotics seemed to lessen the frequency of occurrences and the Levsin was a godsend. My symptoms were increasing and the episodes becoming more frequent, more unpredictable. It’s hard to describe how disturbing it was to be clueless about when an episode might occur. If I had an afternoon of clients, I ate a light breakfast with no carbs and skipped lunch. It was the only way I could be sure I wouldn’t crash in the middle of a session with a client. With Levsin in my pocket, I felt more in control but when I wanted to be sure I wouldn’t get an attack I just didn’t eat.

Oddly, when I was fine, I was fine and that was most of the time. Difficult to predict, symptoms often came out of the blue and while very intense, passed within minutes. I learned that I could avert an episode by taking Levsin at the first sign of symptoms and even stop a rising spasm on its way to full bloom if I acted quickly. Because Levsin worked and because the antibiotics seemed to be working, I had confidence that the GI doctor knew what he was doing and felt confident he would solve the problem. I began to keep a journal of what I was eating and when I had symptoms. Eating carbs and eating too much at one meal continued to be major culprits. They led to gas, bloating, abdominal cramping, heartburn and scratchy throat. As months passed, I sometimes felt an intense pressure pushing on my diaphragm and rising to the center of my chest. I sometimes felt a hot spot behind my sternum, pain in one or both arms and soreness under my ears. I took Levsin everywhere with me. On a walk, to the movies, to bed.

Adding to my difficulties, I felt depressed, tired and annoyed. So many interactions in life revolve around food. “Let’s get together for lunch” became a challenge. Not being able to eat freely meant playing a game when we went out with friends. I began a blind man’s game of not seeing food on the table, on my plate or on a menu in order to enjoy myself. At least in California where I live, restaurants are used to people customizing their meals but I only had one diet I knew worked. When it didn’t fit the occasion, I cancelled. It’s an education to notice how central food is to so many ordinary things we do in a day. Being so restricted often secretly stole the fun out of a get together for me but I couldn’t risk a build-up of pressure.

On occasion, symptoms got started and subsided on their own. But mostly, the only thing that made a spasm bearable was Levsin. GasX always helped. Sometimes Gaviscon or Prevacid helped. I tried PPI acid suppressors (proto pump inhibitors) but with little reliable effect. On my low carb diet, I lost weight, 20 lbs from 138 to 118 in eight months. In a society where “one is never too thin”, I was looking good and getting lots of compliments but I did not feel good. It’s one thing to modify life to live around symptoms, another to think of living with an imposed restriction day in and day out for the rest of my life. As time wore on without a diagnosis, I began to think the painful episodes were here to stay.

My spasms felt like contractions in childbirth, horribly intense but subsiding in minutes. Resolved to their intrusion, at least I knew they would end. Like a woman giving birth, I went with the pain, breathed as rhythmically as I could and held the faith that I could get through it. I leaned against a couch, a fence or a wall depending on where I was when they happened. Since I felt like a pregnant woman with too much pressure on her stomach, I slept on a wedge to keep my head elevated to alleviate weight on my digestive tract. Keeping my upper body elevated while I slept helped me feel better but it didn’t prevent pressure from building up. Sometimes I woke up in the middle of a nightmare dreaming that I was being strangled or crushed or worse. To combat this invisible foe, I did everything I could, but to no avail.

Since I believed my symptoms were clues, I described them numerous times to numerous doctors, each with a different specialty, hoping one of them – internist, nutritionist, cardiologist, gastroenterologist and holistic md – would recognize what I could only sense. I kept asking questions, kept looking to them for answers. What’s causing all this? Where’s all the gas coming from? If it’s acid reflux, GERD and/or IBS, why doesn’t elimination of the usual culprits – gluten, dairy products, chocolate, wheat, red meat and alcohol – make a difference? If it’s SIBO (small intestinal bacterial overgrowth), why aren’t the antibiotics working? And, bottom-line, how does pressure from intestinal gas cause a cramp in my chest? Since my problems started the week after I came back from a trip to India, doctors and friends joined me in speculating that I’d brought back an obscure bug. That added to the mystery but it still didn’t explain how indigestion was related to spasms.

Did I take tests? Of course. Blood tests, electrocardiograms (ECG), scans and scopes of the upper and lower GI tract. They ruled out esophageal problems, gall bladder, liver and kidney problems, heart problems – or so I thought. Did I follow doctor’s instructions? Of course. Three rounds of intestinal antibiotics. Did I talk to people? Of course. Smartest friends in the room. Everyone had their own experience and/or someone close to them who had similar symptoms. They also had lots of advice. Apparently, there are millions of Americans suffering from chronic bouts of indigestion that they’re treating with billions of dollars of digestive aids. But no one pieced together the combination of symptoms I was describing into a diagnosis.

To add to my confusion about what was happening and, in hindsight, to the hidden danger of a missed diagnosis, I had a para-thyroidectomy in December 2008. I had been diagnosed with parathyroid dysfunction during an annual checkup with my internist before my trip to India. There was some speculation about whether it could be a cause of my digestive discomfort. Not likely but a possibility. Apparently faulty calcium regulation can contribute to digestive problems. The surgery required – of course – blood tests and another ECG. Fortunately (especially in hindsight), I flew through the surgery with flying colors. But it further confused the picture. After my calcium levels were restored, I enjoyed an upsurge of energy. When I was not actually experiencing an episode or its aftermath the next day, I felt better than I had in years.

Incidentally, in January 2009, I saw a cardiologist. It was a routine visit, like seeing a gynecologist. It was simply part of my overall pursuit of greater health appropriate to my age. My cholesterol levels were a bit high (LDL 120) and I was considering statins. I did, of course, describe my symptoms to him, including the fact that I was seeing a GI doctor. During the exam, he thought he noticed a murmur and recommended I get a stress-echo test to complete my work up. “Nothing urgent”, he assured me. Nothing that couldn’t wait until after a spring trip my partner and I were planning to Paris. In fact, none of my doctors expressed any caution about traveling for six weeks out of the country or any urgency regarding any other tests.

In August 2009 – after eight months of mind-numbing episodes of pain — I did find the answer. Persistent questioning – and, I believe, lady luck was on my side. We came home from Paris mid-June and I made an appointment to complete my cardiology workup with a stress echo test at the first opportunity. That would be August 7. By this time I was afraid my digestive difficulties were burdening my heart. I thought I might not be able to complete the stress echo well enough for accurate results. But by August, I was a pro at dealing with my attacks and felt confident I could get through it even if I felt one coming on. Exertion at this time was the least of my concerns.

Even though I knew that going up a steep sidewalk, swimming 4 short laps in a row or spending ten minutes on the elliptical trainer could arouse symptoms signaling the likelihood of an attack, I could work around it. I’d learned to pace my walking, slow down my exercising and not lift anything heavy. On the stress echo treadmill, it didn’t surprise me that I was fine for 4 minutes, 134 heartbeats. At that point I began to feel the usual pressure in my stomach, a light-headedness, pain behind my ears and a desperate need to rest. I’d been told 138 heartbeats was the target so when the monitor flashed a red 141, I figured I’d more than accomplished the target. I gasped for breath and asked the nurse, “Is that it? Can I stop now?” And she answered, “Only if you want to.” She didn’t bat an eyelash at my obvious distress. I’ve since discovered that people like to challenge the treadmill when they take the test so I guess that’s what she was used to. Then I did what I usually did when I was faced with an imminent attack. I calmed myself down. I breathed, meditated and thought pleasant thoughts while the nurse scurried around getting her numbers.

I was completely unaware of what had just happened. Customary for me, by the time I got to the waiting room, I felt fine. In this case, I felt pleased that I’d recovered without taking a Levsin. As I waited for the cardiologist, I was in a good mood, sure that – one more time – the test showed nothing definitive. My blood test numbers looked better than ever. They had all dropped dramatically from the year before. Total Cholesterol — 202 (from 247), Triglycerides — 61 (from 95), HDL 79 (108), LDL 111 (from 120). Clear proof that diet can affect your cholesterol — in case you had any doubt!

This was Friday afternoon. I was reading these results when the cardiologist came in. I was fully expecting a smile on his face. Instead, the look on his face was dead serious. He was very careful with his words. His words. “You have angina. Your reaction to the stress echo test is one of the most extreme we’ve had here in quite awhile.” My brain. “Is this something new, different or related to my problem?” He wanted to schedule me for an angioplasty as soon as possible. He asked me “Were you frightened while you were taking the stress-echo?” Wryly I answered, “No, I’ve felt similar spasms hundreds of times since December.” I had no idea what he was talking about. He was the first person to mention the word ‘angina’. First to indicate that I should be very concerned, even alarmed. He scheduled an angioplasty for Monday. I had a vague idea of what an angioplasty was but I had no grasp on angina. I certainly wasn’t thinking what I should’ve been thinking. ‘Good grief, I’m lucky I’m not dead.’

The cardiologist knew, of course, what I didn’t know – that the angina I had experienced on the treadmill was a life threatening aspect of blockage of the arteries in my heart. He continued to talk while I continued to blur. He assured me that the beta-blockers and nitroglycerin he was prescribing would, as he put it, “make sure I got through the weekend without an incident”. After not worrying for months, I now had to fret the weekend? Blur. As it turned out (and as usual), I had attacks both nights. And I used the nitroglycerin both times and it worked very quickly. I guess the good and the bad of the nitroglycerin was that it worked. It was evidence that the condition of my heart was the root cause of my painful episodes.

Fear blocked the big picture, distracting me from the warning my body was giving me that something very serious was wrong. Pain swept me off, like Dorothy in the Wizard of Oz, into a foreign land of medical expertise desperately in search of an answer to my symptoms. For eight long months, I had been swept away by a tornado of puzzling pain into the medical specialty of gastroenterology. As much trust as I’d put in the wizards of medicine, as conscientiously as I’d sought answers from them to show me the way home to health, the man behind the curtain didn’t have the answers.

Now, after the fact, I’ve learned that the information my doctors needed for a differential diagnosis for a woman has been all but excluded from medical research until recently. According to Harvard Health Letter (Vol. 34, 9/09), medical research on heart disease has steadfastly overlooked women because maleness has been considered the top risk factor. There is precious little published, even for doctors, indicating that gastrointestinal distress is a possible much less definitive symptom of heart disease in women. Furthermore, according to the same Harvard Health Letter, even when diagnosed, a woman still must be “a little more aggressive in getting the care” she needs. I can attest that I passed from doctor to doctor in Los Angeles, seeing some of the best doctors in the country without arousing the slightest expression of urgency about what they were seeing and hearing.

Medically speaking, I had angina pectoris. The spasms radiating to my arms finally made sense. After the fact, everyone seemed to know that angina causes pain when the heart experiences competition for its oxygen from digestion. I can’t imagine what would’ve been required to alert anyone of my doctors to imminent danger while I was traveling the yellow brick road of doctor’s appointments. What more could I have done? I even had an attack during an appointment with the GI doctor. As it was, the diagnosis did not get made until after I nearly set off a heart attack during a routine stress echocardiogram. Who were these doctors seeing in their examination room?

Angina is dangerous. It typically sets in motion a quadruple by-pass. I was diagnosed on a Friday, went in for angioplasty on Monday. In an extraordinary procedure that is now so standard it takes your breath away, a surgeon weaved a little camera up through an artery in my groin to my heart and discovered a 90% blockage. Instantly, he inserted a stent. Saved my life. That’s the only way to say it. I was very very lucky. Any untoward event. Any slight fender bender. A heated argument. Sudden anxiety. Traumatic surprise event – to me, a member of my family or one of my friends. Any unexpected stress that would’ve demanded more than 10% flow to my heart and I’d be dead. It’s a humbling thought.

The first thing my friends say when they hear my story is “That’s great. You’re going to be fine now.” And then there’s a pause, a second take. The next thing they say is ‘Ohmigawd, 90% blockage, you could be dead. That’s weird. How could your doctors miss that?’

I know I tell a harrowing truth that’s hard to believe. No one, not one doctor, friend or family member ever mentioned the word ‘angina’ to me in eight months of suffering. Angina was not in anyone’s vocabulary. Angina was never mentioned until my cardiologist said the word to me after the stress echocardiogram, a test ordered because he’d thought he heard a slight murmur in my earlier exam. Maybe my heart was murmuring to him, telling us to check out my heart and discover the angina behind my digestive distress.

Further in the ‘believe it or not’ department and to my complete delight, I’ve experienced a complete erasure of digestive distress since my angioplasty. All of my digestive problems have cleared up. I can eat anything I want. Drink wine and indulge in desert. My choice for the first time in almost a year.

But more important. Missing the diagnosis was extremely dangerous. Angina is as close as you can come to having a heart attack without having one. Angina is a build-up of plague in an artery of the heart – called atherosclerosis – that interferes with blood flow. Angina attacks don’t kill heart muscle but angina is a ticking bomb, ready to set off a heart attack with just the right amount of pressure – from stress, exertion, excitement. I’ve run across an impressive anecdote about angina written in 1790. Before the tests of modern medicine, Dr. John Hunter showed himself to be an astute observer of his own angina pectoris when he wrote, “My life is in the hands of any rascal who chooses to annoy or tease me.” What he knew is that an imbalance between the metabolic demands of the heart and the adequacy of one’s coronary circulation to provide oxygen causes pain. I wish I had had his insight. I experienced surges of physical symptoms when I got angry, upset or frightened or ate too much but I had no inkling what it meant. Now I know, angina interferes with the flow of blood when we need it the most. Not during an ECG when the heart’s at rest. If my heart had needed more than 10% blood flow to deal with a sudden jolt of fear, heavy lifting or – as with the stress echo – running, I’d have had a heart attack.

Time to ask the big question. But before I do, I’d like to make a qualifying statement. Even though it’s clear to me, after the fact, that my doctor’s lack of insight endangered my life, I’d like to make it clear that I’m not blaming my doctors for missing my diagnosis. I’m grateful for their continued concern and, ultimately, thankful for to their expertise. As I said, they saved my life. But why didn’t the absence of a source for the relentless distress I was experiencing arouse a sense of urgency in my doctors?

Recent news headlines about being in charge of your own health care have taken on new meaning for me. Here are some thoughts to ponder, more frightening than they seem when one’s life is at stake.

1) It’s no secret that there’s a breakdown in the health system that doesn’t encourage communication between specialties. I don’t have statistics but, as in my case, it could be critical if lady luck isn’t on your side. My cardiologist believed I was in good hands for digestive distress and stayed his course until a stress echo that put me squarely in his ballpark. When my GI doctor tapped the bottom of his bag of tricks, he didn’t have a policy directive to pick up the phone and call my cardiologist even though he was seeing symptoms indicating a crossover. My internist, persistent and conscientious, is not a coordinator of services.

2) Medical training is not oriented to educate patients as partners in finding a diagnosis. Yet patients need help now. We need to know how to go beyond the walls of a particular specialty. Even my ability to ask in-depth relevant ‘doctor to doctor’ questions did not uncover my diagnosis. Not one of my doctors expressed the need for a stress echocardiogram. Though I’d seen the cardiologist initially in January, his response was routine. My internist, who I saw often, first in December and last in June, mentioned in passing “if you’d like to move your appointment (for the stress echo) up from August, you probably could.” I took that to mean the stress-echo was one more elimination test.

3) Where does the fabric of integrity underlying the medical field as a whole come into action? My GI doctor, with whom I was in continuous contact, agreed with my plan to finish up my cardiac workup after I got back from France. But he expressed no sense of urgency and no possible explanation of how my heart might be related to my digestive problems. Is that an appropriate end to his responsibility? Did he suspect a connection between digestion and the heart and not say so? Or if not, why not? If the patient is the lynch pin, the only one carrying information from specialty to specialty, they need education as much as elimination to find a diagnosis.

True, I didn’t fit the picture for Coronary Heart Disease (CHD). I had no markers, as they call the signs of CHD in medical circles. My numbers are good. I’m a happy 70 year old in a relationship, slim and in general good health. I stretch, walk, and workout daily. I’ve followed a fairly good diet for years. And I had my heart checked. I’d had two ECG’s. I’d had surgery, a high heart stressor. And I’d seen a cardiologist. I also felt fine when I wasn’t having an attack. No doctor objected to my taking a long trip out of the country even though we didn’t know what was causing my problem. No one explained I might need more than an ECG – or insist on a stress echocardiogram or a nuclear cardiogram, the tests that take pictures of your heart in action and when increased blood flow is needed – to determine whether my heart was okay. Even the idea that blood flow might be related to my spasms and/or digestive problems did not enter the equation until after the fact.

It seems more important than ever to see oneself as a detective hot on the trail of your own case. Or, a Dorothy who has pulled back the curtain and knows a doctor is just a person, not a god. It’s pretty much a medical fact these days that each doctor who sees you looks from their own particular specialty and that there’s little crossover from one specialty to another. As I heard one cardiologist put it “When you’re a hammer, everything you see is a nail”. Makes it not only good but necessary, I believe, to track your own clues. As if you were finding fingerprints, you can identify a pattern running through one appointment after another even when logic is missing and everyone is looking in the wrong direction. As hidden as it may be, a magical through line exists. On the road, a tin man without a heart, a scarecrow without a brain, a lion without courage all became more than when they started. Even though nothing made sense, I persisted, never lost my curiosity and, in the end, I found the answer. Like a murder mystery without the murder, my tale would make a captivating adaptation of the Wizard of Oz.

The moral of my story? Don’t hand over your ruby red shoes. Doctors are ordinary people. It has to make sense to you before it makes any sense at all. Put angina in your vocabulary alongside heart attack and stroke. No reason to wait and wonder if your heart might be the heart of the matter. Check it out. Don’t wait for your doctor to tell you it’s urgent. And don’t settle for a test that won’t give you the full picture of your heart at work. It’s when it has to go to work that your life depends on it.

I’ve lived my life citing a couple mantras. One from Bob Dylan — “Those not busy being born are busy dyin’.” Another from Yevgeny Yevtusheko — ‘Don’t die before you’re dead’. I’ve never had my life saved before. Now death is more than a metaphor. Perhaps old age is the age of miracles. Or at least the profound realization of life as miracle. Take it to heart. Literally.

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08/02/02 Film Essay # , , ,

Amelie (2001)

Amelie (2001)
Director: Jean-Pierre Jeunet
Writers: Jean-Pierre JeunetGuillaume Laurant
Stars: Audrey Tautou, Mathieu Kassovitz, Rufus


“Honey, take your honey. Amelie is a four star date movie.”

Amelie was already buzzing after its premier at the Telluride Film Festival. Now it’s sweeping up awards, gaining momentum and heading straight for an Oscar nomination. Everyone comes out of Amelie with a smile. Amelie is a “feel good” movie that makes every girl wish she’d started out as a wallflower and leaves every guy wishing he’d have the good fortune to have an Amelie fall in love with him. But Amelie also takes on some very hard questions of life and gives them a fresh spin.

For those of you wondering whether you are a prisoner of a dull or crazy childhood, Amelie sets you free. Whoever came together to put you on this earth, Amelie makes it clear that you were born to blossom. You are first and foremost a child of your imagination, free to make yourself up while eating raspberries off your fingers, skipping rocks across puddles and photographing cloud animals. Amelie’s very neurotic mother dies in a bizarre accident and you wonder – would it have been any better if her mother had lived? Probably not. Left alone to grow up with a reclusive father, not a bad man but one seriously out to lunch, you wonder – did he notice when she turned seventeen and walked out the door? Probably not. But you do.

Amelie may begin with the accident of birth – yes, a sperm literally swims across the screen to meet an egg, an awesome accident to be sure. But to be sure you don’t miss the point, Amelie’s life really begins with Princess Di’s car accident. Well, not really. That’s just the accident that causes the accident of finding a box hidden behind the tiles of her bathroom wall that sets Amelie off on a path of do-gooding that transforms her from a wallflower stuck inside her imagination into a young woman flying along on the back seat of a handsome young man’s motorbike. Amelie is a dream come true. She dreams herself from nobody to somebody.

Amelie celebrates the small, the silly and the insignificant. When you identify with this young woman who tends tables at The Twin Windmills Café wearing clothes so wildly colorful she’s part of her own technicolor background, you fall down a rabbit hole. Suddenly, you are as large as the girl on the screen. You give a man back a box he hid when he was a boy, feel the joy of his recovering long lost memories and you’re magical. You get bright ideas. You scheme to get people what they long for. You start a gossip chain that brings two lonely, nutty people together. You’re a matchmaker. You gaslight the grocer who ridicules his retarded helper, tricking him into believing that he’s losing his mind. He turns from mean to meek. You’re a savior. You befriend an old painter nicknamed The Glass Man with bones so brittle he has to pad his furniture. The video you send of a man with a peg leg dancing on his padded TV is a sight to behold. You even figure out a way to get your father out of the house and travel the world.

And then Amelie falls in love with a man after her own heart, a heart that (with a little help from special effects) visibly thumps and flashes in her chest when their eyes meet. He’s fishing torn photos out from under a photo booth in a train station. He puts people back together again after they’ve torn themselves apart. He collects these patched personas in a big notebook but he’s obsessed by a search for one man who regularly visits all the booths in all the train stations tearing himself up over and over again. Why would a man do such a thing? Is he a man afraid of death, seeking immortality in photographs? Is he trying to come into being, a ghost without an image until he sees himself? Amelie sets her mind to the quest. Who she finds will make you laugh.

But, now what? Amelie is a figment of her imagination and she’s fallen in love with a real man. He has a job. He has a hobby. He has a motorbike. He even has a name. Nino. But, does he have a girlfriend? Is he going to like her? Will he feel about her the same way she feels about him? Either she will have to cross the line, get out of her fantasy or lure him in. She does both. Just like a woman. She seeks him out. Then she retreats. She’s bold. She wears big black boots and photographs herself dressed up like Zorro. But she’s shy. She doesn’t confront. She draws blue arrows, slips him secret notes and gives him directions that bring him to her door. Then she doesn’t answer. If you didn’t love her so much by this time, you’d tear your hair out. Finally, The Glass Man socks it to her. Well, as much as an old man with brittle bones can. He sends her a video of himself saying, “It’s time for you to take a real risk. Of course, you can choose to live in a dream if you want to. You have a perfect right to mess up your own life.”

You know the end. All romantic comedies end the same way. First, one fantasy accidentally bumps into another. Then they get together. And then, since no two fantasies are ever the same, only the photo booth knows what will develop.

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14/12/01 Film Essay # , , ,

Vanilla Sky (2001)

Vanilla Sky (2001)
Director: Cameron Crowe
Writers: Cameron Crowe (screenplay), Alejandro Amenábar (film “Abre Los Ojos”), Mateo Gil (film “Abre Los Ojos”)
Stars: Tom Cruise, Penélope Cruz, Cameron Diaz


“Forget the critics, VANILLA SKY is a wake up call you don’t want to miss.”

It’s no secret. Tom Cruise lives in a dream world. So when Tom wakes up in a chic Central Park apartment, plucks a stray grey from his fine head of hair and roars downtown in a Ferrari to find the streets of Manhattan completely empty, we know we’re in for a wild ride. Just how wild is a surprise I won’t give away but trust me, you’re going to feel like that guy sitting in front of a TV getting your hair blown back by the force of possibility.

In Vanilla Sky, we never get far from Tom being Tom; he’s an icon of American life, living the American dream —— in life and in the

movies. When Tom keeps getting asked the question, “What makes you happy?” Vanilla Sky pushes a commonplace question onto a mythic plane. Tom embodies the “puer eternus” archetype, the eternal golden boy who never grows up, always on the lookout for the perfect woman. However, the character in this film is getting older, turning a critical thirty-three —— and even though Tom’s surely forty, he looks thirty, doesn’t he? With Tom in the lead, Vanilla Sky has no trouble conjuring up a confrontation with immortality worthy of a god. Heir to the American dream of happy endings and having it all, Tom as David Aames explores a brand new solution for beating the odds that goes beyond meeting the perfect woman.

David Aames burns bright as a familiar stereotype of the spoiled rich kid. In spite of his charm, good looks and his father’s billion dollar publishing empire, he hasn’t found love. David’s father and mother perished simultaneously in a car accident, leaving him at twenty-three with only a corporate board of old fogies to oversee his fun-loving approach to running the company. He treats the whole publishing world as a joke, preferring to play tennis or romp in the sack than attend board meetings. His current girlfriend, Julie Gianni (Cameron Diaz) tops the charts as the quintessentially beautiful, blue-eyed blonde. And, though clearly one of long list, she’s seemingly a good match for David’s cavalier attitude about love. She plays his game. We don’t have to reach far for this fantasy. Julie epitomizes a guy’s dream girl, one who makes love like she’s in love —— with no strings attached. We’ve seen that male fantasy hit the dust in other movies but not quite like it does in this one. Even Fatal Attraction might stand aside.

At his birthday bash, David does what David does. He’s single, unattached and looking for love so he doesn’t invite Julie to the party. But she shows up anyway for a little tete-a-tete in the bedroom. Then David’s best friend walks in with an exotic cutie from the other side of the tracks. David meets her eyes across a crowded room and old-fashioned love is in the air. Sofia (Penelope Cruz) has two jobs and a dream of her own. She wants to be a dancer. David’s fascination with Sofia is not lost on Julie. Dressed like a siren in a red dress, Julie’s eyes bore into David’s back as he lights Sofia’s fire. David ignores Julie and takes Sofia home, spending an exquisite night with her doing everything but making love. David deftly avoids sex, which we learn when we discover that all of our viewing of David from the moment he woke up in a dream that morning is a flashback.

David is on trial for murder, incarcerated and wearing an eerie latex mask. He’s answering questions posed by a court-appointed psychologist to determine his sanity. Our perspective shifts. We’re no longer spectators. We’re inside David’s experience. David explains to Dr. McCabe (Kurt Russell) that he was savoring an exquisite edge of tension while he spent the night with Sophia. Even as he ran his thumb along the big question, “is she the one?” he was drawing out the sensual pleasure of the moment. He’s seen the end of love too often, preferring the intensity of anticipation to culmination. As he saunters out of Sofia’s warehouse loft the next morning, Julie drives up. She has an invitation for him. Would he like to hop in the sack with her one more time, satisfy that urge that she knows he’s been building up all night —— one last freebie for old time’s sake before he moves on?

David gives us several delicious moments of deliberation as testosterone struggles with good sense. Men lashed themselves to the mast for a good reason when the sirens sang. But, stereotypes reign. David, in spite of his millions, believes his true power lies in his charm. He can’t resist Julie’s ‘too good to believe’ offer. Imagine, she wants him even though he’s moving on to another woman. Imagine, she’s not judging him. And Julie, in spite of her brains and beauty, can’t stand a smalltime ‘moth’ woman getting her man. She’s played the game; she deserves the prize. She plies all her wiles to draw David into the car with her.

He makes the choice, takes the ride. But then Julie snaps. She gives him a brief peek in what lies beneath the surface when a woman gives her all to a man. She tells him she loves him. But caught up in an egoistic storm of jealousy, her love takes a turn as old as the hills. Julie would rather die than live without him. And, sadly, she does. She drives them off a bridge at eighty miles an hour into a wall of tragedy. David survives, but his face is disfigured, his body broken, his spirit crushed. It’s tough enough to see anyone disfigured but when the victim is an icon of male youth and beauty, a contagion of deep grief invades the heart. Even knowing it’s just a movie didn’t prevent my longing for a restoration of the joy that had just disappeared with that face. Later, Sofia, speaking from a soft voice of wisdom, will say to him, “I wish you hadn’t gone with her.”

David’s down. And we’re only a third into the story.

If you had a billion dollars, would you go to the moon? What makes you happy? How do you get across the line from youth to the long life that lies ahead after you sprout grey hairs, can’t charm the pants off the most beautiful woman in the room and realize money buys everything but love? When we lose the illusion of immortality, we discover an awesome crosshatching of past, present and future realities in our minds that film can allude to even if not capture entirely.

Vanilla Sky crosshatches David’s moment of decision facing that mythic question, “what makes you happy?” with the real, the surreal and just plain vanilla fantasy. We see the good, the bad and the ugly. We respond to visual tricks showing how we make life up out of images that stir our emotions. I myself have walked New York streets feeling the pleasure of a cold morning moment, imagining myself holding Bob Dylan’s arm. I’ve danced at parties feeling Coltrane’s magical presence in the room. I’ve felt childhood needs override good sense. And I’ve dreamt nightmares that woke me up. David tells the psychologist he’ll think he’s crazy if he tells him what happened. Yet, in movies, we accept slipping from one reality to another as perfectly normal. Vanilla Sky offers its fair share of realities.

Sofia’s softly spoken oracle speaks volumes, “Every passing moment is another moment to start over again.” I think Vanilla Sky has something like this in mind when it likens the sky above New York to the sky that Monet painted one day many days ago. It’s a sky full of dreams —— if we open our eyes.

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21/02/97 Film Essay # , , , , ,

Lost Highway (1997)

Lost Highway (1997)
Director: David Lynch
Writers: David Lynch, Barry Gifford
Stars: Bill Pullman, Patricia Arquette, John Roselius


(Published in C.G. Jung Library Journal, Vol. 16, No. 1, 1997)

Not for a moment in his latest film does David Lynch allow us the relief of believing that his primary characters, Fred (played poignantly by an edgy Bill Pullman) and Renee (portrayed by a sexy-perfect Patricia Arquette) are in a real marriage, saying daily good-byes, having a real life. Not even in the opening moments of the film when Fred and Renee are agreeing that it’s okay for her to stay home rather than accompany him to the club where he plays tenor sax, does Lynch allow us to believe that we are going to see only another noir narrative about a man obsessed with a woman he can’t possess. Nor will Lost Highwaybe another Fatal Attraction,” a movie that ultimately relieves its male watchers of their responsibility for the entanglements that ensue from their own voyeuristic flirtations. Lynch isn’t telling an everyday story; he’s linking a man’s loss of control over a woman’s sexual desire to feelings of murderous rage and going for the jugular of our present-day sexual anxiety.

Lost Highway is a long, drawn out film about entering and, maybe not fully, re-emerging from the dark shadows that contain the feelings of men in our culture. Lynch attempts to do justice to the inner sanctum of Fred’s self-torture aroused by the fear — old as Homer’s Paris losing Helen back to the Trojan king Menelaos — of losing the prize of his woman’s love. Much of America’s vision of masculinity still naively equates itself with a man’s ability to capture and keep a woman who carries the “right image” to the eyes of his fellow men. This is a private agony that has been sanctioned by the culture as a key cornerstone of initiation into manhood. When the manly task is nothing less than to compel the suitable woman to be perpetually desirous of nothing and no one else but him, the test of being a real man becomes the ability to possess the woman body and soul.

To link up, in a convincing way, the rhythms of extreme emotional fragmentation and impulsive acts of violence with what the American male has to go through when he feels he is not “man enough” to keep his woman with him is the affective brilliance of Lost Highway. The paranoia that tortures Fred and transports him into his own nightmare is tightly tied to the notion that masculine control is essential to survival. It wrenches us with the suggestion that if men do not break with this relentless pressure on them to be “real” men, men in cool control, masculinity itself will have a mental breakdown. Lost Highway is a man’s scream of anguish over his inability to escape from the ubiquitous cultural fantasy that possession of a woman is the only way for him to keep it together.

Lost Highway taps a world of dream reality and opens up a window onto an emerging male awareness of the internal cost of carrying such a burden. After Fred leaves Renee at home to read a book that they both know she will never open, he blows a frenzied stretch of jazz saxophone in his club that skims the rim of a scream. For a man filled with searing doubt, the wail of a tenor sax can easily sound like the inner pain of an injured anima. His access to soul is being cut off. And in a country headed by a saxophone-playing President who is being sued for sexual harassment, the film images of a man losing his grip take on a broader resonance. When Fred calls home between sets, we hear three different phones ring, with no response, in three different empty rooms; their staccato tones hollowly echo the repetitive anguished solo he has just delivered. We expect the worst when Fred arrives home. But there is Renee, fast asleep. The agony deepens; did she sleep through the call or did she merely get home in time (from whatever secret life she is leading) to carry off the ruse that she has been home all evening. Is Fred being paranoid or is he the classic symbol of a man emasculated, cuckolded even in his own house? The dark music rises from deep from within Fred’s fear of losing Renee, which means losing control, sanity, and identity all in one raw crescendo.

Lynch sets us up much in the same way he presents Renee to Fred, playfully spinning us around, letting us have the roller coaster experience of yielding to seduction and waiting for the surprise. He uses the movement in and out of shadows in Fred’s own house, in and out of time in Fred’s elliptical narrative, and in and out of Fred’s identity to intensify the uncanny feeling of unreality that ensues when panic creeps up from within. While Fred talks to the police about some video tapes that have been left on their doorstep, it gradually dawns on us that the tapes could only have been shot from his own mind’s eye. Fred and Renee are frightened, in other words, by the implications of paranoia; it is as if the video has been taken from the viewpoint of Fred’s sexual jealousy, outside ordinary reality and not able to be discussed by the couple in any rational fashion. Fred disavows any responsibility for this emotional complex, telling the police only that he does not own or like video cameras because he wants “to remember things my own way, not necessarily the way they happened.” In this instant, we become aware that Fred has chosen the point of view of madness, now verified as a separate reality on video. Lynch and his main character have begun to actively intermingle two viable realities. Fred’s inner reality now exists as “actual” memory, captured on camera. Swimming around in this particular ocean of confusion mixed with fear, memory is like a dream. The linearity of events becomes uncertain. Emotions are sucked up as if they were images, mixed up with facts and spit back as perceptions that openly distort what is being seen. Waking reality, sleeping reality, remembered reality, imagined reality and not-yet-imagined reality all collapse into each other. Just an instance of doubt gives rise to a whole story; the dream insists that it be taken seriously.

Mythically, Lost Highway is the dark night of the soul with an unconscious Eros bidding a man deep into his psyche, his love drawing him into the underworld close to death in life. Loving the woman who captivates him instead of a woman captivated by him, Fred becomes a prisoner of his fear of inadequacy. The anima pulls the hero into the unconscious with an amazing force, just as intense sexual passion can culminate for a man in an experience of fragility that is anything but manly, in an orgasm more like losing than winning. He feels his mortality, his vulnerability, his insufficiency, and — perhaps most of all — he is touched by life’s uncertainty. The fluidity of his feelings terrifies him and destablizes his coherence. He loses his ability to remain in control not only of Renee but of his own self. The non-linear nature of Lynch’s film thus becomes a reflection of the inner state and process of his main character, Fred.

It is true that as an audience, we keep feeling (like some of the critics who have disliked the film) that this is all wrong: a director, like a man, is supposed to be in control. But Lynch, like Fred, attacks dreamlike images as if they were real and relates to real events as if they were dreams. Seemingly, the love of film opens Lynch up, again like Fred, to a wild insecurity that drives him into irrational sensation, unintelligible shifts in reality and palpable changes in the identity of his central characters. There is be no other way to tell this story. Fred is in the grips of an even more insidious cinematic shapeshifter, on the road to meeting his own, internal demon. Personified effectively by a white-faced, trickster figure (a two headed snake, reminiscent of both Klaus Kinski’s nosferatu vampire as well as the Joker in Batman comics and played to the hilt by Robert Blake), the “demon” of repressed male rage introduces himself to Fred at a party. Renee is having a drink nearby with a guy from her past. The demon, in a memorable “twice” doubled-identity cell phone scene, tells Fred that he, Fred himself, has already invited him into his house. And that, in fact, as they speak face-to-face at the party, he, the demon, is simultaneously at home in Fred’s house. The implication is clear. Fred’s inner hostility is bubbling to the surface and beginning to wreak havoc. Tormented by the shapeshifter he himself has now become, Fred’s psyche caves into the inescapable connection between polarized opposites (love and hate, arousal and impotence, Eros and Thanatos) and his own violent nature. Psychologically, what is revealed is the paradox inherent in the male fantasy of arousal within this heterosexist anima set-up: the dueling desire to control, and finally kill, the very one who enlivens feeling. For this reason, any woman entering into a man’s emotional life is both terrifying and fascinating. She never comes without also bringing the fear of his not being ruthless enough to conquer and thereby destroy her. This anima fantasy takes root in an inescapable truth; women are powerful. Women do hold a mysterious power over men because they cannot be controlled — more precisely, because they offer an option for an alternative male identity that drives a man onto a lost highway of possibility.

Nowhere else in the film does Lynch depart from logic to convey a sense of inner reality as much as when he changes Fred’s identity to Pete, the twenty-ish garage mechanic (played with just the right degree of post-adolescent erotic acuity by the brooding Balthzar Getty). When Fred finds himself imprisoned in the psychic reality of having killed his wife, he is wracked by a headache and starts to regress; perhaps because his obsession seems more like a younger man’s preoccupation with the unreachable beauty of a big screen goddess than genuine grief over Arquette’s loss, he morphs into the morally less complex Pete. Here Lynch seems both to pose his audience with the question “Why Pete?” and to make us feel that in becoming Fred’s avatar that something terrible has happened to Pete, too. The scar on the side of his head suggests some horrible lobotomizing experience that Pete’s parents won’t talk about. Could Pete have been snatched by aliens, or perhaps by Fred’s demon? Sexual obsession, beyond its effect on the spirit can feel like some other being has come to inhabit the body. When Alice (Arquette again, now a sultry blonde) stands in the street just outside the garage in a tight white dress, wobbling in platform heels, looking for Pete and asks in a little girl voice if he would like to take her to dinner, the scene is a retro-fifties young American male’s dream. And when Lynch turns Pete and Alice into two beings of luminous light making love in the desert, we are held spellbound as if viewing unearthly beings from another planet. But more importantly, the passionate encounter is a direct comparison to the dead-end, dead-body, lovemaking we witnessed early on between Fred and Renee. We already know what’s coming. “I want you,” Pete cries out from the depths of his soul. “Well, you can never have me,” Alice hisses predictably, and in a nakedness no longer vulnerable to any manipulation, lifts herself up out of Pete’s reach and walks away in those dreadful shoes across the sand of a now arid fantasy — straight out of the picture.

Contrary to the assertions of some critics that the film is all style and no substance, David Lynch and his team of filmmakers have used their extraordinary command of the movie medium almost as a direct argument to articulate why there is such a widespread resistance to narrative in so much good contemporary art. To those who would honestly envision it, the sexual state of things no longer grants the luxury of an unearned coherence. By borrowing the discontinuous discourse of dreams, Lynch has succeeded in conveying what we too often try to conceal from ourselves, the torture of insecurity in the American male psyche, from which there is no present vision of reprieve. The only hope is to go where Lynch takes us in the final moment of his own wild at heart, emerging vision, on a desperate drive into a black night, kept to center by nothing but yellow broken lines.

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