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He Finds a Place Where Cinema and Neurology Intersect

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Mayo Clinic professor Eelco Wijdicks, MD, PhD, FAAN, mixed his love of cinema with his respected work in neurocritical care for a series of three books that look at the intersection of film and neurology.

Eelco Wijdicks, MD, PhD, FAAN, professor of neurology and professor of the history of medicine at the Mayo Clinic in Rochester, MN, is reknowned as an expert in neurocritical care. The founding editor of the journal Neurocritical Care, he established Mayo Clinic's neurocritical care in 1991 and originated the FOUR Score Coma Scale. Virtually every neurointensivist has read at least one, if not many, of his more than 25 books in the field with multiple later editions, including The Practice of Emergency and Critical Care Neurology (Oxford University Press), Neurologic Complications of Critical Illness (Oxford University Press), and Examining Neurocritical Patients (Springer).

But not all of Dr. Wijdicks' many books are aimed solely at the clinician in practice. A passionate cinephile, he also authored three books on the intersection of medicine and film, including Neurocinema: When Film Meets Neurology (CRC Press); Cinema, MD: A History of Medicine Onscreen (CRC Press); and his most recent work in the field, Neurocinema—The Sequel (CRC Press), published in April of this year.

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.

How did you develop your fascination with movies?

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.

How many movies do you see over time?

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.

What are some of your favorite films?

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 21st Century.]

What inspired you to write the books about medicine and cinema?

It all started when I was writing a book on coma, and I wanted to write about the public perception of coma. I went into exploring how art represents coma, and eventually ended up in the movies. I then did a study on the portrayal of coma in contemporary motion pictures that was published in Neurology in May of 2006.

We had a panel of neurointensivists and neuroscience nurses rate 22 key scenes from 17 movies for accuracy and then showed the clips to 72 lay people, such as allied health and secretarial staff. Our panel found that only two movies had a reasonably accurate representation (“Dream Life of Angels” and “Reversal of Fortune”), but we found, much to our surprise, that our viewers were unable to identify the inaccuracy of representation of coma, awakenings, and conversations on the experience of being in a coma in eight of the 22 scenes (36 percent). And many of them—28 of the 72 viewers, or 39 percent—said they could potentially allow these scenes to influence their decisions in real life. All of that was a start for me to say, “That's interesting, and could there be more?” and led me to pursue a focus on neurology in cinema.

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!

What is the common thread in your books about medicine and film?

All the books are more like social histories of medicine or neurology as seen through the lens of the filmmaker. I did not want to make the common mistake of sneering at filmmakers or shrug my shoulder in disbelief—“Look at what they have done here and the mistakes they made and how weird it is.” I was far more interested in why they are doing what they are doing. It's surprising that there are a lot of good films out there that can be used for teaching purposes. I often tell residents to watch specific films, such as “The Crash Reel,” about snowboarder Kevin Pearce and his slow recovery from a traumatic brain injury he sustained training for the 2010 Winter Olympics half-pipe competition. He was comatose for a month and in the ICU for a long period of time, tried to get back onto the snowboard and was unable to do so, and faced seizures, memory difficulties, and addiction. It is unique and important, and my hat is off to the director, Lucy Walker, and her team.


“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.”—DR. EELCO WIJDICKS

Why do you think neurology and neurologic conditions are such a common feature in the movies?

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.

What films have some of the most accurate and insightful portrayals of neurologic conditions?

I have my own top 10 list, which is obviously arbitrary [see “Dr. Wijdicks' Top 10 Picks on Neurocinema”], and I have always felt that the film “The Death of Mr. Lazarescu” is extraordinarily important. It's about the lack of resources and the inability to take care of patients—compassion fatigue. It's based on a true story from Romania, about a guy [with alcoholism] and takes a fall and presents to the hospital with a headache. No one is interested in him, and he goes from hospital to hospital and ultimately dies form a subdural hematoma. The story is told as a dark comedy, but it's one of those comedies where you think, “No, I should not be laughing, this is a world I could be in.” The conversations with actors playing neurologists, neurosurgeons, and ED physicians are outrageous, but you can imagine that in a busy, overloaded emergency department, something like this could happen, not necessarily just in Romania.

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.

How do you use film in your teaching of residents?

I've had a residents' book and film club off and on over the past several years, beginning in 2010, and we've watched many of the top 10 list movies as well as “Iris” with Judi Dench, another brilliant film about dementia, and “Declaration of War,” a film on a childhood brain tumor and the hardship of the family. We wrote about our experience with these film discussions in 2014 in Practical Neurology.

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.

How does your interest in film interact with your clinical practice?

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.

Dr. Wijdicks' Top 10 Picks on Neurocinema

  1. “The Death of Mr. Lazarescu,” 2005
  2. “Amour,” 2012
  3. “The Father,” 2020
  4. “The Diving Bell and the Butterfly,” 2007
  5. “My Left Foot,” 1989
  6. “You Don't Know Jack,” 2010
  7. “The Intouchables,” 2011
  8. “Memento,” 2000
  9. “The Crash Reel,” 2013
  10. “Declaration of War,” 2011