Share this article on:

An Old Movie, A Newer Book Make Neurology Front and Center


doi: 10.1097/01.NT.0000372258.79070.2e

Dr. Rowland, chief editor emeritus of Neurology Today, is professor of neurology at the Columbia University College of Physicians & Surgeons Neurological Institute.


By Diane Broadbent Friedman. AuthorHouse, Bloomington IN 2008

In 1990, Diane Broadbent Friedman, a nurse practitioner who specializes in epilepsy, saw a British television film — A Matter of Lie and Death — that inspired her greatly. She recognized “detailed neurologic information” in the film and was so impressed by the medical accuracy of the writers Michael Powell and Emeric Pressburger that she decided to research how they did it. She scoured the medical literature to determine which medical journals would have been available to the two producers of the film.

All done before PubMed was created, Friedman managed to gather enough information, with the aid of librarians, to write a paper entitled “A Matter of Fried Onions,” which was published in 1992 in the journal Seizure. In the paper, Friedman analyzed in great detail the neurological aspects of the film. Now, she has expanded that article into a book A Matter of Life and Death: The Brain Revealed by the Mind of Michael Powell.

The film that started Friedman on this journey starred David Niven as Peter Carter, a 21-year-old Royal Air Force bomber pilot during World War II, and Kim Hunter as an American flight control officer. (In real life, Niven was later to make his mark neurologically the hard way when he became one of the celebrities who contracted amyotrophic lateral sclerosis and became a spokesperson for that disease.)

The romance between the two characters begins with an in-flight conversation in which he tells her that his crew were all dead, that his plane had caught on fire, and that parachutes had been destroyed. Rather than incinerating himself, he had opted to jump to certain death, but instead, he landed in the water, survived, and made it to shore. In rapid sequence the two characters meet and fall in love.

As improbable as this tale is, it was based on reality. Nicholas Alkemade, age 21, was an RAF tail gunner when his plane was shot down while returning from a raid on Berlin. He jumped without a parachute and fell 18,000 feet, surviving with only minor injuries. His story was recorded by another pilot who met him in a German prison camp.

“The British film was credible for another reason. The writers had created many respected, award-winning movies, including I Know Where I Am Going” starring Wendy Hiller. Their “Red Shoes,” with Moira Shearer is regarded as the best-ever movie about ballet. Powell was especially known as a stickler for accuracy. But “A Matter of Life And Death” mixes fantasy and reality.

As for the reality, Friedman discerned the considerable evidence that the protagonist in the movie had temporal lobe seizures, with olfactory hallucinations, as a result of an earlier head injury with optico-chiasmal arachnoiditis, a clinical diagnosis no longer fashionable but which was at the time, and still occurs after rupture of and anterior communicating aneurysm.

Friedman documents that the contemporary neurology textbooks cited as references for the physicians who took care of Peter Carter in the film were indeed well-known. One text was written by Sir Charles Symonds and another one was by Sir James Purves-Stewart. Both books were also sources of neurological training for Michael Powell. Friedman also concluded that Powell must also have had some personal neurological tutoring. How else could a moviemaker concoct a scene where the neurological consultant would pull a key out of his pocket to elicit a Babinski sign?

Friedman writes that the film's neurosurgeon is modeled after the great Hugh Cairns, who was not only a surgeon but also an early champion for the use of helmets to protect cyclists, a need illustrated by the death of one of his own patients with a head injury, Lawrence of Arabia.



Friedman focuses on the movie's fantasy segments, as well. For instance, Conductor 71 is a foppish figure who had been trained at the time of the French Revolution to conduct the recently deceased to heaven. However, the fog is too thick and the Conductor cannot find the Niven character for 24 hours, thereby introducing uncertainty about the precise day of his death.

In the film, a formal inquiry is set up and the anti-British biased “prosecutor” is played by the great Raymond Massey who died in the American revolution at the hands of redcoats. The defense is handled by Roger Livesey, one of Powell's favorite actors, playing the part of a physician who had tracked down Carter's epilepsy to the arachnoiditis and recommended neurosurgical therapy.

The American version of “A Matter of Life and Death” is entitled “Stairway to Heaven.” When it was first shown in the United States in 1946 on Christmas day, the New York Times critic Bosley Crowther praised its “delicate charm, the adult humor, and visual virtuosity” and a “deliciously sophisticated frolic in imagination's realm.”

In England, almost 50 years later, the British-made film is still popular; garnering second place to “Get Carter,” a Michael Caine film, in a BBC poll of the best films ever made in that country.

In one scene of “A Matter of Life and Death,” Niven's character is seen riding a broad and seemingly endless but magnificent marble escalator. At either side of each step is a super-sized statue of some notable historical figure. Friedman cleverly points out that instead of the statues being excessively large, the human figure might be feeling minute, just as Alice in Wonderland, had to deal with Lilliputians.

All of this makes “A Matter of Life and Death” one of the few important films and books about epilepsy or any neurological disorder. Kudos goes to Diane Broadbent Friedman for documenting the great efforts of Michael Powell and Emeric Pressburger. •

©2010 American Academy of Neurology