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Oncology Times:
doi: 10.1097/01.COT.0000289701.14608.52
Turrisi Takes on the Movies

Turrisi Takes on the Movies

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Abstract

Directed by Fernando Meirelles; Screenplay by Jeffrey Caine, adapted from the novel by John Le Carrè. Starring Ralph Fiennes, Rachel Weisz, Danny Huston, Hubert Koundé, Bill Nighy; Rated R, 129 minutes

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‘THE CONSTANT GARDNER’

Movie titles too commonly offer misdirection. Those of you hoping to learn about perennials or the different varieties of orchids, an avocation of my own, would do well to go elsewhere. The minor occupation of Ralph Fiennes' character, Justin Quayle, in her Majesty's foreign service in Kenya, tips you off only to find that his constancy flags and his subdued passion, which is a Ralph Fiennes specialty, boil over in the overheated, still-dark-despite-scorching sun of Africa.

I confess that I have not read John Le Carrè novels, which I perhaps wrongly linked with the cold war and spies, but the intricate and angry tone of this movie spurs me to do so in the future.

Rather than gardening, this movie has much to do with “pharming,” and that, of course, is why I selected it for review.

The director, Fernando Meirelles, also directed City of God (OT 9/10/03), with its stark realities, including brutalities and atrocities, of Brazilian favellas. I thought he might be a youthful idealist, but his talent has been mostly hidden from English speakers because his work has been in Portuguese—he's close to my age, and that is no longer young.

The translation of global problems, their realities, and the dire realities of their collision, especially when idealism gets in the way of profit, formulate the moving spirit of this gripping film.

Justin Quayle is a subdued understated functionary sent to deliver a lecture for his boss. He is harangued by his wife, Tessa, played marvelously by Rachel Weisz, about the foreign policy that the Blair government wages. As fiery as she is shrill, her passion inflames her but not him, and the singed audience meekly departs as she and Justin have an apologetic rapprochement.

Justin appears the milquetoast to her Bloody Mary with extra Tabasco, as she leads the romance and ultimately makes the proposal that she travel with him to his new posting in Kenya. This unfolds in flashback as does the plot of what makes him soar to the heights of a passionate pursuit of truth about his wife, their relationship, and the betrayal of those close and the friendship of those who would seem to be remote and not in any way connected.

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Unethical Conduct of Clinical Trials

White turns black, and black pales purely as Africa unfolds the plots that allow for unnecessary death, and the unethical conduct of clinical trials on the unknowing with the complicity of powers for the love of money, the root of most modern evil.

The performance of Fiennes is sterling in his metamorphosis from bureaucrat to jihadist for truth. Rachel Weicz's nuanced passion fuels this movie into the stratosphere, and the veracity rings like the tingle of a fork on crystal.

Fiennes endures innuendo about Tessa's relationship with Arnold Bluhm (Hubert Koundé), a black African physician and friend who flies off with Tessa in the opening scenes and disappears with her.

Their equal fates are revealed later, as are their tarnished reputations polished by the luster of truth. Danny Huston plays Sandy Woodrow, who one can tell is harboring a secret, and his friendship will prove to be unreliable.

The quiet villainy of Sir Bernard Pellegrin (the French name suggests that he is a Pilgrim) progressively revealed and couched in club rooms and fine dining atmosphere—all part of colonial noblesse oblige, of course (not).

Bill Nighy portrays him deftly, making him imperious but human. One watches and wonders to what lengths we deceive first ourselves, and then our colleagues, until finally the corruption becomes too much and the consequences too uncivilized to bear, and we see the roots of genocides and pogroms.

Pharma is pilloried but mostly in absentia. One character utters than no drug company does anything for nothing.

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Government Complicity

It is the government complicity that is more skewered, but the allegation is made that companies unwittingly test new drugs as they “gave away” antiretrovirals, because the new threat really is a demon strain of TB. The vista of pandemic flu has captured some attention, but drug-resistant bacteria and super-strength TB drugs have not been as vivid.

Other reviewers of the movie connect this to the Vioxx revelations and the current wrongful death trials presuming that the company was well aware of the “overwhelming hazard” and blind to the liability of foisting a defective product on the market—the idea in the movie is that toxic deaths are hidden so that the company can rush their new anti-tuberculosis drug to market.

I do not pretend to know the issues, but I recall my pharmacology professor announcing on day one that all drugs were poisons. Competitiveness amongst the companies, both for products and for the “opinion leaders” remains remarkable.

I'm stunned to see how quickly Iressa's star has faded in favor of Tarceva—I've seen the data, and I am not as convinced as many of you and the FDA seem to be.

As we endure another foreboding energy crisis in fossil fuels, I recall The China Syndrome, the movie that along with Three Mile Island and Chernobyl ended interest in nuclear power. Are we too quick to see evil in companies and too blind to see the potential for good?

I know Iressa and Vioxx benefited some, and alternate sources of energy are looking awfully good again. The clear clinical trials ethics violations depicted in the movie are perhaps parody, but movies move minds—is this the evil pharmaceutical government or medical complex?

Are clinical trials being outsourced to Africa and unethically conducted, or are the barriers and expectations too high in our own nation?

This is an excellent movie, not without flaws, but as we tend the gardens of our lives, we indeed must constantly weed the toxic elements, and cultivate and grow what is good and beautiful.

Figure. By Andrew T....
Figure. By Andrew T....
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We must be vigilant: Every bloom is not sweet nor surely safe after we recover from its alluring aroma. What appears to be a weed may be an herb, and that discarded might hold true virtue and value.

Ethical principles are constant, and greed, betrayal, and lust tempt daily. I am not ever sure the government is here to help us. Deliver us from evil; give us wisdom.

© 2005 Lippincott Williams & Wilkins, Inc.

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