He Finds a Place Where Cinema and Neurology Intersect

Dr. Wijdicks spoke with Neurology Today about how his passion for film has shaped his work inside and outside the clinic. The interview has been edited for clarity and space.

There was no single “magic moment” when I became interested in film. It's just always gradually grown and become more and more of a fascination for me. I grew up in the Netherlands, so I didn't come up with American movies too much, and I have mostly been interested in European directors and European films. My kids at one point told me that I had to see the “Star Wars” movies or I wouldn't understand cultural references, and I couldn't figure out what order I should see them in. I ended up starting from beginning to end because “Episode I” was playing in a theater near me. So, I went from higher technology to lower technology in seeing the earlier films, which is not a recommended experience, but I now understand the jokes better. Film for me is my major form of relaxation, although I don't see it exactly as entertainment but probably more as a major art form, like opera. Movies do something to you, and when a movie does something to you, that's something enduring. How the brain responds to certain genres of film is in itself an interesting topic.

I watch nearly 75 to 100 movies a year. About 15 years ago, my wife and I had a window of opportunity in our budget to build a home theater, along with a prolonged healthcare scare with treatment which required a breather, and now we have a large collection of Blu-Rays, many hundreds of movies, and many nights at home are dinner and a movie. I have a little film club with about seven other friends (one of whom went to film school) that we've been doing now consistently for about four to five years, and we meet about once a month, mostly in the winter months. We tend not to choose too many depressing movies (even though they are often the best), especially in the wonderful Minnesota winters, and we look for a lot of humor. In the summer, we are in a musical and documentary mode. The last one we saw was “Company,” the film about the recording of the Stephen Sondheim musical, which is tremendous. We also recently watched Scorsese's “The Last Waltz” and Whitman's “The Last Days of Disco.” In the winter, we will be exploring French and Italian films from the iconic directors like Robert Bresson, Jacques Tati, Jean-Pierre Melville, Michelangelo Antonioni, Luchino Visconti, and Ettore Scola.

There are many films that have made a deep impression on me, and I will always rewatch them. In terms of American movies, I would say anything by Stanley Kubrick—“The Shining” is probably his most impressive one—and of course Francis Ford Coppola with the incomparable “The Godfather” series. I also greatly admire his daughter Sofia's films. But probably my favorite film from the 21st century is “Caché,” directed by Michael Haneke. It explores the idea of something happening to you in your youth, when you do something to another kid and it comes back to haunt you much, much later—it's psychological thunder. [Starring Daniel Auteuil and Juliette Binoche, “Caché” was filmed in Paris and Vienna and is ranked on BBC's list of 100 Greatest Films of the 21^st Century.]

I started writing film reviews and criticism of neurology in film for Neurology Today, which was a new thing for me, and I had to learn a new style of writing for it. I don't see myself as a classic film critic; I offer a perspective that's a little different. That in turn led to writing reviews for Lancet Neurology, and ultimately one thing led to another, and I wrote my first book. Then a hobby becomes work!

Filmmakers are interested in changed cognition and changed mobility as a good trope and plot element for their movies, in a way that they may not be as interested in orthopedics or cardiology. You can kill off a character or put him/her in a coma with revenge after awakening many years later. It's always been of interest to filmmakers to use neurologic injury and coping with it and its rehabilitation as a major plot element, but over time there has been a significant increase in using neurology in films. Indeed, neurology was part of the very beginning of film; Eadweard Muybridge, the English photographer, made sequential photographs that eventually became film, using human gait as an example. He worked with the neurologist Francis Dercum, and his book, The Human Figure in Motion, published in 1901, contained photographs of neurologic movements diagnosed as locomotor ataxia. There is quite a bit of neurology in silent films, too.

Another movie on my top 10 list is “The Father” with Anthony Hopkins, who received a well-deserved Oscar. It's an incredible portrayal of dementia. We don't know what it feels like to have dementia from the inside, of course, but it gives you the sense of what it might be like, how disoriented someone can feel being in their own flat and seeing things change, not recognizing people, mistaking one person for another. It's unbelievably well done and well researched.

I've also done the same thing with psychiatry residents, with films such as “Titicutt Follies,” a 1967 movie about institutionalization at an asylum in Massachusetts. [The movie, which showed the inhumane treatment of patients with schizophrenia at the State Hospital for the Criminally Insane, was recalled from distribution by a state court judge citing concerns about the violation of patients' privacy and was only permitted to be released to the public in 1991.] We've also watched John Huston's 1946 film “Let There Be Light,” about post-traumatic stress disorder, depression, and suicidal ideation. It was the last in a series of four films he directed while serving in the US Army Signal Corps during World War II, and it was very advanced for its time, one of the first movies where functional neurology becomes a major topic. It, too, was banned for a while, because the military felt that it was too much to show, depicting soldiers who are weak and unable to fight. They didn't want to see that, and it wasn't released until the 1980s.

In my own field of neurointensive care, I typically see comatose patients and those with severe neurologic injury, and many of the films use the kinds of patients that I see as their topics. While there have been a few films involving Parkinson's disease or multiple sclerosis, there are so many more on traumatic head injury, coma, or other sudden, unexpected neurologic conditions. There has also been a bit of a shift over the course of the history of neurology and film; initially, a lot of it was about amnesia and memory difficulties, actors with microcephaly (Schlitzie in “Freaks”) or actors with disorders such as acromegaly in “The Creeper.” Recently, there has been an increased focus on dementia in film, and of course that is one of the biggest problems we are facing in neurology. I hope that filmmakers will continue to try to show what these conditions are really like, how people are coping with them, and how they affect lives. Many are serious about the disorders they portray.