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Turrisi, Andrew T. III MD

doi: 10.1097/01.COT.0000302914.38162.a9
Turrisi Takes on the Movies

Chairman and Chief Department of Radiation Oncology Wayne State University School of Medicine Barbara Ann Karmanos Cancer Institute Detroit Medical Center

Starring Hillary Swank, Clint Eastwood, Morgan Freeman, Brian F. O'Byrne. Directed by Clint Eastwood; written by Paul Haggis, based on stories from “Rope Burns” by F.X. Toole; cinematography by Tom Stern; original score by Clint Eastwood, Rated PG-13, 132 minutes.

Now that much of the dust has settled about this movie, many of you may not have seen it, so I want to warn that I will get to the heart of it in the last section of this review.

Many have read or heard that this is a “fight movie,” or a female Rocky story with virtuosic performances laurelled at the Academy Awards this year, and indeed it is all of those things. But at the heart is a subject skirted by many reviews and an issue very pertinent to what we deal with as oncologists.

Let me just tantalize you with the fact that as with much of life, this movie deals a lot more about hard realities than with the simple surface issues that seem obvious.

The Hemingwayesque dialogue created by Paul Haggis' adaptation of F.X. Toole's saga overflows with Irish overtones and Roman Catholic themes and undercurrents. It is not just Rocky with a female protagonist.

Many are Clint Eastwood fawning fans, but along with Mystic River, this chalks up two masterpiece films in a row and begins to sway me into glowing praise. This extraordinary film deals with many core issues and no simple preachy resolutions to tough problems. Family values rush forward from many angles.

The characters are well defined in the main, with Frankie (Clint Eastwood) and Scrap-Iron Dupris (Morgan Freeman) portraying a lifelong ring-and-gym career history.

Scrap-Iron drones with the narrator's steady beat, pacing the action of dialogue and character to inexorable ends. Frankie reads metaphysical poetry, attends Mass daily, and encounters a burned-out, hardened priest, Father Byrne, who barely tolerates Frankie's goading questions of doctrine and faith.

Frankie has had an unspoken tragic parting with his daughter, and like Starbuck in Moby Dick, pursues his lost progeny and seeks to repair the gulf of separation, but his letters are regularly returned unopened.

While one doesn't know the cause of the rift, the cruelty of realizing that a living breathing person receives the epistles and rejects them, time after time, must be harder wounds to bear than any pummeling that a beating would deliver.

The good Father Byrne rubs salt into the wound by declaiming that daily communicants must suffer unspeakable burdens to atone with daily Mass. Abuse from the altar comes even worse when the spirit is whipped than when the body is defiled.

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Guilt of Allowing a Fight to Go Too Long

Frankie is also stalked by the guilt of allowing a fight to go on too long for Scrap-Iron, who has lost an eye in the fight game, but keeps his remaining eye on his forgiven and redeemed friend.

Maggie has her own family from hell. As we as a nation “focus on the family” and listen to other views of “family values,” this gives another glimpse into a family that provides a model for what every decent family should avoid being.

While Dante's Inferno catalogues the plagues and punishments of the varied circles or levels of hell, an unsustaining, ungrateful, disapproving family was missed by the great Italian poet, but families of this ilk create hell on earth.

The mother, Earline Fitzgerald (Margo Martindale), resides in a trailer in Missouri. Her great expectations of what her children owe her, what the world owes her, and how there is nothing that she has ever done wrong, ever will do wrong, or has anything to apologize about, show us a great example of what not to be as a parent.

Martindale coolly plays this part, delivering a superb and villainous role that few have singled out or lauded. The puzzle is why Maggie risks everything to win her affection and approval, and you want to nudge her and tell her not to bother.

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Read No Further If You Do Not Want Key Plot Points Revealed

Read no further if you do not want the unexpressed and glossed over in the reviews aspect of this movie spoiled.

Maggie under Frankie Dunn's skillful tutelage has become an expert female boxer, and whips every opponent she meets in the ring. I was drawn to Maggie and Frankie's struggle with their families and her displaced anger as she landed punches on these mannish women.

In the championship fight against Billie “the Blue Bear” (Lucia Rijker)—a known below-the-belt fighter—Maggie is struck an illegal blow, falls perilously and uncontrollably on her corner stool, and subluxates the C-1,2 vertebral junction.

The resultant paralysis brings on a passion play with deeply conflicted moral overtones. Maggie's plight leaves her fully aware and cognizant, and convinced that she does not want to live this existence.

Also dealing with this subject is Alejandro Amenabar's The Sea Inside, starring Javier Bardem, who plays a quadriplegic unable to end what he views to be a “useless existence.”

Each movie comes to answers that I presume would be called part of the “Tyranny of Relativism,” by those extolling the culture of life and seeking absolutes in order to tell others what choices they need to make.

As we are in a war where one person's religious views are increasingly being pushed on to those of differing points of view, and embryonic stem cell research may be filibustered by a “culture of life” senator, creationism and intelligent design theological perspectives are parrying with evolution on the 80th anniversary of the Scopes trial.

As oncologists, we deal with those close to death regularly. Our sacred mission continues to be to serve our patients and by Hippocratic Oath to never intend to end life, but our goal clearly is to provide humane relief from pain and suffering.

Individuals' end of life with dignity and rights to choose for themselves are very close to the core issues in these movies and the national angst about what defines human life and when is it over, as typified by the Schiavo fiasco.



The steps taken in Million Dollar Baby are kept in limbo and morally foggy, but the request and choices made are closely paralleled in the desires of many of our patients who may choose to end suffering and the protraction of their death.

These are deep and fundamental issues, close to us, but surprisingly generally avoided in all of the justified praise of this fine movie.

I respect my patients too much to provide my categorical solutions here, but I worry about how easy it is for others to decide morality when they have not walked the path of those in these situations.

What can be more chilling than knowing that someone else would be there to decide moral decisions for each and every one of us? Loving one's neighbor crosses boundaries when it involves telling the person what to do. Privacy and freedom of the most fundamental kind are at stake while self-appointed moralists decide what's right for you, your children, and your patients.

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