Doctoring in Cinema
Excerpts from Cinema MD: The History of Medicine on Screen
By Eelco F. M. Wijdicks
Medicine of Cinema has had a number of defining eras, and we cannot expect to find a chronologic history. The motivation of filmmakers to use medical topics can be linked to several developments in medicine, which may explain the certain preferences in the filming of medicine. Examples are Contagion, when the recent SARS virus (and now COVID -19) was creating havoc and Let There Be Light, when the troops came home and needed psychiatric care.
From the silent era through the early 1930s, a large body of films has been lost. However, from the available offerings from the period, we do know that silent cinema was largely devoid of well-developed medical themes. Many films were based on old vaudeville routines. Neurologic and psychiatric themes were exploited, likely to strike fear and titillate the audience, such as the criminally disposed psychiatrist Dr. Caligari in The Cabinet of Dr. Caligari, psychologist Dr Mabuse in Dr. Mabuse the Gambler and The Testament of Dr. Mabuse, or the weirdly incomprehensible Dr Dippy in Dr Dippy’s Sanitarium. The silent era had no good identifiable medical theme and a hodge podge of images and mockery.
The early “talkies” of the 1930s were comedies, love stories, or westerns. Physicians were secondary characters in the script, and often a country doctor in a dark suit and top hat would listen to the chest, feel the pulse, or extricate a bullet. The 1930s also launched a medical freak show with M, Frankenstein, Dr Jekyll and Mr. Hyde, and Freaks― all debuting between 1931 and 1932. These films portraying lost souls, disabled freaks of nature, and monsters as major burdens to society suggested eugenic anxieties and assumptions, but this connection is conjectural. Filmmakers generally had no role in these campaigns; their principal goal was only to shock and frighten the audience. Attempts with hindsight to link the films to concurrent events are potentially specious, and box office receipts at the time (and now) provided a much stronger motivation to stick to a genre. The 200th anniversary of the publication of Mary Shelley’s Frankenstein novel has resulted in a slew of articles on efforts to improve conditions and opportunities for the disadvantaged. Modern monsters are now cyborgs (RoboCop, The Terminator), but in reality, medical technology is far more benign, therapeutic, and shapeshifting ― patients “cyborgized” with brain-computer interfaces to control epilepsy, cochlear implants, and (perhaps soon) retinal implants.
In the 1940s and 1950s, many films depicted self-sacrificing physicians and angelic nurses. The Film Noir style, although primarily concerned with crime, was also suited to show the effects of alcoholism (The Lost Weekend, Drunken Angel) and extreme craziness (The Snake Pit). The early days of the Horror genre also surprisingly produced movies of interest to physicians (Corridors of Blood on anesthesia and addiction and Eyes without a Face on facial transplantation); however, there was little else to salvage from the rubble of horror and slasher films in the mid-20th century. Moreover, films in postwar Italy and Japan depicted the sadness of being old, ill, and forgotten; they may perhaps have served as metaphors for losing the Second World War. Notable in this genre was Drunken Angel, a Kurosawa film depicting wartime defeat with the physician treating tuberculosis in the swamplands of Japan.
While great medical breakthroughs, such as the development of antibiotic isoniazid to treat tuberculosis infections and, of course, the polio vaccine, occurred in the 1940s and 1950s, cinematic depictions of these discoveries were not rapidly forthcoming. The sole exceptions were Bigger than Life, which depicted misuse of the wonder drug cortisone, and Carol Reed’s 1949 The Third Man on the discovery of penicillin, which was injected into the first human in 1942 and made available for mass distribution just in time for World War II. The Third Man makes penicillin the object of a crime, when antihero Harry Lyme (Orson Welles) steals penicillin from a British military hospital in post-war, Allied-occupied Vienna and sells it in a diluted form on the black market.
The social revolution of the 1960s quickly ended any filmmaking tendency to glorify medicine, and perceptions quickly evolved from awe to suspicion to disdain. Directors of the cinematic new wave produced a slew of defiantly gritty, misanthropic films and found much to criticize in the 1970s. Incontrovertibly, the most noteworthy film of the period was M.A.S.H., which made a mockery of brave battle surgeons and surgical nurses. In later films, the social status of physicians was high, and their offices were spacious with large desks cluttered with books suggesting wisdom. Quite a few movie surgeons enjoy a hedonistic lifestyle with sports cars and lush country homes. Exploitive relationships are also common in these movies; the physician’s failure to maintain boundaries was used as a plot device. We can only speculate if this depiction has negatively influenced the lay public opinion.
Successful organ transplantation in the late 1960s, inarguably one of the most important developments in the history of medicine, figures lightly in Cinema except in the horror genre. Early on, filmmakers seized on the concept of face transplantation (something only now becoming a reality) and the always-interesting brain transplantation (e.g., Change of Mind and the racially tinted recent horror Get Out).
Filmmakers were quick to capitalize on the ethics of organ donation to create thrillers about deplorable physician behavior, donor-recipient contact, conspiring to obtain a donor organ for a loved one, and the practice of organ trafficking. It has also entered the genre of science fiction, where clones are bred as replacement parts for the elite. [...] Medicine of Cinema ―a retrospective category rather than a redeemed genre―may glamorize, exaggerate, misrepresent, or even falsify the practice of medicine distorting its complexity, but we anticipated that. […] Viewing it as a whole, we see our humanity, our society, our medical practice and our ethics. Its implicit relevance is that it enhances our personal values and our duty to take care of the sick.