Saturday, August 29, 2015

Ode to Medicine: A Passionate Review of the Clinical TV series The Knick

Poster of the TV series The Knick
Medicine has come a long way. Few of us realize this and we rarely think about the struggles it must have taken to get to this current point as we pop a pill for our headache or when we get (or in some cases do not get) our vaccination shots.

When it comes to surgery, the steps and strides have been even greater and filled with more risks and experimentation. We often forget or disregard the downside of experiments. We are often too focused on the end result that we do not acknowledge all the dangers and sacrifices it took to get there. Put differently, how many patients had to – and as awful as this may sound needed to - die under the scalpel to perfect that particular type of surgery.

All these thoughts have been kindled within my skull because of the wonderful turn-of-period series The Knick (2014) directed by Steven Soderbergh. Soderbergh himself is not averse to experimentation. He started off as an indie-wonder with his impressive Sex, Lies, and Videotape (1989) debut; he has made some failures both commercially and critically, Kafka (1991), Full Frontal (2002) come to mind, and some great movies, notably Traffic (2000), the experimental but outstanding The Limey (1999) and the panned but inventive biopic Che (2008), and not to forget the wildly entertaining Ocean trilogy (not to mention Magic Mike (2012)).

In his impressive repertoire, there are also a couple of movies connected to the world of medicine, such as Contagion (2011) about a deadly virus that spreads like wild fire and his what seems to be last (but hopefully he will reconsider) endeavor as a film director, the medically titled movie Side Effects (2013). But it is not only the movies that deal with medicine and experimentation: his style is also considered by many to be cerebral and clinical. So there you have it, no one better to direct a series on the gradual progress of medicine than Steven Soderbergh.

This versatile director might have gotten tired of making movies on the big screen, but looks quite comfortable and at ease with the medium of television. From the familiar cold, unsentimental and beautiful shots often hued with tones of brown and blue to the innovative and anachronistic electronic score of regular composer Cliff Martinez, this is Soderbergh at the top of his game.

The series is about the growing pains of medical science and American society set at the turn of the century in a New York hospital called the Knickerboxer. The series is based on true events and real people, but creative liberties have been taken here and there. Those are, for the most part, for dramatic effect, namely to enhance tensions, and we, for the most part, do not blame the series for this dramatic license since it makes the whole experience all the more exciting.

At the center of the series, at least in the first season, is the brilliant surgeon (and hopeless cocaine addict) Dr. Thackery played proficiently by Clive Owen and the African-American surgeon Dr. Algernon Edwards (André Holland) who is educated in Europe and in many ways an equal to his Caucasian counterpart. The issue of race is a major stumbling block between them, which is to a large degree an evident racist attitude of our protagonist Thackery, but which is also visibly propelled and encouraged by a racist society.

One thing that becomes quite clear in this series is that the United States may have been innovative in science and medicine, but that it was lagging behind Europe in terms of acceptance and tolerance of colored people. Edwards was treated as an equal in Europe, but has to fight tooth and nail for a little bit of acceptance in an openly and unabashedly racist New York (considered one of the more “open-minded” cities of the times).

Ironically, the Knick was meant to help and treat low-income people who are to a large degree immigrants, but there seems to be a clear line demarcating everyone else from the native black population. Although the black people are a part of this New York society and most of whom are suffering from poverty since they have not been given the opportunity to strive, be it in terms of education and income, they are treated as sub-human beings and are not allowed to enter the premises. In other words, the Knick is an institution for the underprivileged and downtrodden minus the black people.

This fact, evidently affects our black surgeon, so he decides to treat them by secretly setting up a practice in the dark cellars of the hospital. He trains his staff and teaches, for example, the janitor enough skills to act as a nurse by night. All of this comes from a compassionate and humanitarian heart, but it is at the same time fueled by personal ambition as he wishes not only to practice medicine, which the white staff does not let him do, but also to undertake his own little experiments to advance and improve upon the medical sciences.

That like any birth and growth, this comes with its own amount of pain and suffering is undeniable. In a proud - but by today's standard notably ironical - speech it is proclaimed that life expectancy has reached the age of 47 from previously the mid-thirties. But it is those baby steps that have given us the high ground today that we can build upon through the use of technology while projecting greater strides and achievements into the future.

The surgeries depicted in the series are messy and bloody and what we would consider barbaric. They lacked suction tubes, so the blood was cleaned and pumped out manually (a strain on the assistant surgeon's arm) and they also lacked knowledge of the best and most effective cutting procedures. At the same time, lack of medical knowledge regarding blood types, for example, had led to a number of deaths whenever blood transfusions had taken place.

All of these deaths and the evident helplessness on the side of the surgeons coupled with the continued seemingly interminable quest to find the missing block or obstacle must have been a strain on their well-being and psychology. In fact, the series starts with the suicide of one of those eminent surgeons who cannot bear the repeated failure of his medical strategy regarding cases of placenta previa that have led to deaths of mothers and their babies. His promising student, Thackery, must now shoulder the burden and he deals with his own demons by injecting cocaine between his toes at work and by smoking opium at night in a Chinese brothel.

Algernon Edwards, who apart from his medical stress has to deal with constant and daily racism, has found another way to release his pain and frustration at work; he gets into random and pointless brawls to vent off all this negative energy, which may be, all things considered, a slightly better but more painful vice than abusing drugs.

I have always considered the job of surgeons to be a stressful choice. In many cases, it may pay well, but the amount of responsibility attached to it outweighs in my mind any potential financial benefits. Even a simple and straightforward surgery can go horribly wrong and become fatal. Nor do we know everything regarding procedures, consequences, and side effects. It is a common fallacy that one assumes that the knowledge one has at any given time is mostly correct, if not infallible, but then new findings arise and turn the previous knowledge on its head.

A minor such example may be the recurring belief that coffee is bad for your health, only to find out its many benefits according to recent research. But more importantly, there are the issues of anesthesia, for instance, where constant revisions and adjustments are necessary due to its effects on the body, especially the brain. In the series, they use cocaine to anesthetize since at the time it was not officially outlawed. Morphine often used as a painkiller is highly addictive and at times can create more problems than good.

The series gives us running gags of dramatic irony where we the modern viewer know more (thanks to the clear focus of hindsight) than the protagonists. For example, when they experiment with an X-ray machine, the characters are amazed that one can see beyond the flesh and take pictures of the bone structure. In one scene, the doctor wants to try it out for a “head-shot.” The operator turns on the X-ray machine and tells him to stand still - for an hour!

There are also parts that may shock and bewilder us, again easy to say in perfect hindsight. That same operator of the X-ray claims that he and his children have been toying around with this machine taking a number of pictures. Oh the horror, by today's standard knowledge of the carcinogenic nature of X-rays.

The very last shot of the series finale for Season 1 is also priceless. As the surgeon is admitted for his cocaine dependency, they are using a new experimental medication certified by the well-known and respectable pharmaceutical company Bayer. We see the patient falling asleep in the background and the close-up gives us the ironical shot (sorry, you need to watch it since I won't spoil this one but perhaps you can already guess what that medication contains).

The series also slightly but aggressively alludes to the field of psychiatry. It is still in its infancy and the series portrays a very negative picture of it or perhaps it was isolating that specific ward from general practice. But since there were still unconfirmed and wildly speculative theories abounding in that field of study (i.e. phrenology), the treatment that the wife of one of the most reprehensible characters in the series gets is shocking and harrowing. The psychologist believes that the germ of madness resides in the teeth and has hence extracted them all!

The Knick takes its time to give us characterizations and a portrait of the era. One can argue that it could have dug deeper into the psyche of its main characters, but without getting confused or bored, we are given the essential and vital information of each character as well as vivid and broad strokes of the city. The Knick's strongest moment must be in Episode 7 provocatively titled “Get the Rope” where a race riot is breathtakingly choreographed and rendered with chilling scenes that it might equal, in terms of film-making and suspense, the impressive edge-on-the-seat raid in True Detective (Season 1 of course)!

Yet there are also a few weaknesses. The surgery scenes were good but they became repetitive after a while, especially with the recurrent graphic images. But more importantly, it portrayed that all those relevant medical inventions can be traced back to Americans. For instance, X-rays are shown as if they had just been invented in the States and that is misleading since Wilhelm Röntgen should get a mention, if not some credit.

The reason for this might be to make up for the barbaric aspects of the American society when it comes to not only class divisions but also cruel and unbridled racism towards its African population (and I have not even touched upon its anti-Catholic aspects). Yet I believe it would have been better to scale down the embellished and exaggerated achievements of the American doctors to a more realistic level since the series could be possibly misconstrued and distorted as an American propaganda piece for medical sciences instead of a historical account of its veritable successes and advances.

Moreover, both main characters are based on real people, but they are at times treated as if they were supermen. They are not invincible and they are flawed in their own ways, but they surely are brave and have given a lot to the medical community. Their unwavering dedication and thirst for knowledge and experimentation have saved lives both in the past and the future.

For instance, it was a surgeon who saved my life decades ago after a burst appendix (which would have definitely killed me in the 1900s and may be life-threatening even today) and an experienced gynecologist who saved my son's life during a complicated and difficult pregnancy. And for all this and more, doctors and all the others who have made contributions, and who, of course, continue to contribute to the medical field I would like to give my heartfelt acknowledgement, appreciation and thanks!

Sunday, August 23, 2015

Happiness is: Book Review of STABLE: The Keys to Heaven on Earth


Headshot of author April Michelle Lewis
There are two things that are on my mind for most of the time: The desire to be (and become) a better person and to be happy. Both of them are often connected to what many designate as the spiritual realm. For instance, my happiness would not be merely about instant gratification nor mere monetary gain; rather I would like to be able to prolong, expand and diversify my happiness so that it includes and envelops first and predominantly my family, but so that its rays may also reflect upon friends and acquaintances.

I believe that once one is in balance with oneself then one finds a certain kind of peace and happiness. Those who lash out or who intend to hurt others or are envious of other people reveal a gap or a want inside; for whatever reason they are not satisfied with who they are or how everything is turning out for them. Most of the unhappy folks may not even accept responsibility, but blame others, their co-workers and bosses, their families, or even their fate and their genes.

As we are constantly looking for happiness, we may be led astray or led to believe that it can be achieved via dubious means. In a material world, where success and personal worth are often measured by wealth, it comes as no surprise that we chase the coveted paper. And while our focus is on making money, we overlook the most important parts and aspects of our lives: the people around us and our own spiritual growth.

In the book Stable: The Keys to Heaven on Earth, April Michelle Lewis tackles some of these issues by presenting her own philosophy based on her personal experiences. She wishes to show us how we can be stable in our lives, that is to be happy and to remain so and not merely on a shallow level. Happiness from a new gadget or new shoes will last only so long; the question is what can fill us with personal and enduring satisfaction, namely of being happy in our skin.

Few of us are. We may accept ourselves and feel balanced once in a while and this tends to be on the odd lucky and bright sunny days, but there is not too much we can do to remain stable. Religions do not generally help much; they may give us (illusory?) moments of security within the confines of a building, but the moment we step out into the real world we either forget or more often we do not apply to the outside what we have learned from those sermons inside the church. Self-help books are temporarily fine, but once we have read them they get shelved and forgotten.

According to Lewis, we can find lasting happiness and constant purpose in our lives by following three specific guidelines, which make up the acronym STABLE. They are Sound Thought (ST), Always Believe (AB), and Life of Excellence (LE). She explains each of her stages in detail and with examples and by occasionally referring to science. She also tells us upfront that it will take time and effort from our part so those who expect quick and magical solutions need not apply. But in the end it is worth its salt, and she equates it with finding heavenly bliss on Earth.

Lewis is also honest with her own background: She is a devout Christian and I doubt she uses those terms as metaphors. Her religious beliefs can be hard to swallow for some or be a turn off for others. I myself who espouse some Christian values and philosophies felt uncomfortable with this fact, but I found that from the get go, we did strike some common ground.

The author believes that organized religion tends to misrepresent and distort the teachings of Christ. Jesus did not want us to judge others and be righteous but showed us to accept each and everyone the way they are. Furthermore, Jesus was not thinking of saving only his kind or his own people.

Also some Christians use their Sunday service as an excuse for actually doing good. It is not enough to sing chants or pray to God and then forget about all those values until next week. As Lewis succinctly puts it, those rituals and deeds matter less in the grand scheme of things since God is hardly worried about whether we eat fish on Fridays or not.

Religion should be about life and living and should be treated as a practical spiritual guide not as a convenient and lazy shortcut to heaven. Along the same vein, no, it is not enough to profess your belief in the Savior Jesus Christ without having lifted a single finger to do any good in the world.

Throughout the book, there are - apart from many religious passages from the Bible - quotes from religious figures, such as Mother Theresa, the occasional hipster, such as John Lennon (his “Imagine” did have the line regarding no religion, just saying), Kelly Clarkson (?), Pocahontas (??), Napoleon Hill, and in terms of science, Lewis refers to some (for the most part positive) psychologists like Martin Seligman and neuroscientists who claim that higher levels of confidence and self-esteem have overall health benefits on the immune system.

Yet the most quoted scientific book is that of Jeffrey Long's Evidence of the Afterlife on Near Death Experiences. Although I have not read that particular book, I have been familiar with its general findings. Dr. Long interviewed many people from different cultures, faiths and nationalities who had been biologically brain-dead, and they reported similar experiences: the flashing of their own lives before their eyes, the importance of interpersonal relationships and feelings of regret regarding them, and also the warm and welcoming presence and embrace of a loving Creator. All of them also claimed that the near death experience profoundly affected them and they realized what was important in their lives and what was not. All in all, all our actions should be fueled and guided by love and forgiveness.

Jeffrey Long's book is the proverbial pot of gold for believers. I certainly feel that it validates to a degree the existence of an afterlife. In the same way, many Christians, including our dear author here, jump upon those findings and claim that they provide scientific proof for God's existence. Yet it is a little rushed and premature to present the information as facts. Furthermore, I believe it to be rather presumptuous to automatically equate a loving creator with the notion of the Christian God or with Jesus Christ.

This is my main issue I have with this book as it claims to accept all faiths, but narrows everything down to its own Christian belief set. Scientific findings are carefully cherry-picked to “prove the one truth (italics in text) that we are all searching for.” The Christian belief goes tightly and rather conveniently hand in hand with the idea of “truth” and I shudder (in some cases even turn away) when I hear or read that somebody claims to know the truth.

In fact, her truth is not as universal as she would like it to be. Christians claim to know the truth, but so do Buddhists, Muslims, and Hindus. If all religions are seen as equal or equally valid, then we cannot raise up a particular one on a pedestal proclaiming that one to be the real one. Incidentally, my favorite line is when she purports that many atheists - at least those she has met herself - can be loving and passionate people!

This book can be summarized as a self-help book with a religious twist. But if we strip away the religious content from the book, there is still a lot of interesting stuff and helpful advice here. Sure, it will be trimmed down and even altered significantly, but it still has its useful aspects.

For instance, there is an element of cognitive, in particular positive, psychology at play. The first phase claims that we should have sound and healthy thoughts about ourselves and about others as a whole. By reinforcing positive aspects, such as personal acceptance and forgiveness, there will be also internal health benefits. We should not let the dark or sad thoughts take over and ought to fight them like military experts and be ready and equipped for assaults and ambushes.

It is the nagging voice in our head that tells us we are wrong, unfit or simply ill-equipped for life or that others are responsible for our misfortunes. Instead, Lewis says replace them with positive thoughts (laced with religious tones). The problem with positive thinking is that there will be more thinking as the bright side wants to think the dark side into submission. Lewis believes that once we have control over our thoughts after fighting them “tooth and nail,” then we can choose the happy ones over the negative trash talk in our heads.

Moreover, Lewis claims that the best strategy is to attack these negative thoughts, the “cruel stranger” in our head firmly and directly and she even blurts out responses in the grocery store or on the street. Apart from this, she talks to God directly and admits that she has many personal conversations with the Almighty (in her car, in her shower, and at her kitchen sink!). So much so that people think she is crazy for talking to herself. She sees and addresses the negative thoughts as bullies and wishes to “brainwash” herself into bliss (but we should be aware of being brainwashed by the world!). After years of this practice (of self-hypnosis?) we will also find bliss too, according to her.

Both the aggressive manner she intends to ward off so-called evil thoughts as well as the fact that part of herself is in constant struggle with another part of her identity makes me think that meditation ought to be a better strategy. In meditation we learn to see thinking as what it is, namely a flow of thoughts both good and bad. Yet we can remain unaffected by both of them and just watch them float by (after years of continuous and strenuous practice, of course).

The second principle of Always Believe is more faith-based. I think that it is also commendable. There are dark moments where we do not see or expect rays of hope, but life can give us the reversal of fortunes all of a sudden and at any given time. It usually comes in cycles where out of great misfortune great fortune may arise. So one should never give up but always fight for a happier day.

In this sense, God or what I would prefer to call the powers that be have a plan for us and everything happens for a reason. Yes, I do believe in both destiny as well as her sister-in-law coincidence. In fact, there is no such thing as coincidence. Nothing happens in isolation and everything is interrelated.

Some years ago, I embarked upon a simple experiment. I made a wish. I asked the universe (God, powers that be) for a specific outcome. In the meantime, I tried my best to reach it of course (you need to work for it too). But guess what? Things that seemed like obstacles before suddenly fell into place, I got the answers and opportunities I needed and in the end, my dream came true and the outcome was indeed what I had wished for (in some cases even better!).

So when Lewis says that she would need a computer and then received one in a contest by the grace of God, I cannot but understandingly smile and confirm this. Such so-called coincidences do happen many times over and I firmly believe that they are coordinated from the other world. So yes, believe in yourself and in your life and in happiness and most importantly do not lose the childhood ability to wish for things. And needless to say, always try and give your best.

The final stage is called Life of Excellence, and by this she means that one must behave in accordance with one's beliefs. That is definitely true. You cannot call yourself a good Christian and hate your neighbor or call yourself spiritual and worship money. As Sartre (not quoted in this book) puts it, we are the summation of acts within our lifetime. The existentialist hits it on the nail and if only more people would replace lip service with actions, the world will be indeed a better place.

We are living in the best of times. We have a relatively solid amount of knowledge about the world, the human body and ourselves; we have access to technology like never before and can reach millions of people at our fingertip, and the sky is indeed our limit. So let us all agree on love and accept ourselves (warts and all), accept our fellow beings (they also have their own warts but who are we to judge) and live in harmony within and without.

This the message I take from this book, and I do recommend it overall. Lewis writes with passion and fervor, and it is quite intoxicating and contagious. Her message is very personal and I am glad she has the courage to share it with us. I also want to thank Drew Tharp for sending me a copy to review. Christians will surely find a lot to admire in this book, but non-Christians can also be inspired by the universal aspects of this book.

Thursday, August 20, 2015

Entering the world of John Cassavetes: A Woman under the Influence

Movie poster of Cassavetes movie
It is a shame that for a number of years I have stayed away from the work of John Cassavetes. I had encountered his name here and there, but refrained from watching any of his movies. My knowledge of him was limited to his role as a so-so actor in Rosemary's Baby (1968). I did not know that he mainly acted in films to gather money for his own cinematic projects.

In my euro-centric view, I had been suspicious of American films because I equated them for the most part with Hollywood. There are, of course, a number of good filmmakers, but I had often felt that they liked the gravitas of the great filmmakers out there. I like Coppola, Spielberg and Woody Allen, but I felt that they came up short in comparison to those whom I deemed masters of cinema: Bergman, Tarkovsky, Fellini, Kurosawa and those illustrious French masters of the New Wave.

This would explain why I was literally shell-shocked about how good Cassavetes' Woman under the Influence really is, my introduction to the work of a cinematic master! This independent anti-Hollywood film was made with financial difficulty in 1974 and is about a woman who is struggling with her daily life, including her roles as a mother and a wife, which seem in direct conflict with her own self-identity. It is quite an existential film that looks at madness in such a poignant and piercing way that it breaks your heart.

Now the 70s is really the golden age of American cinema in my view. Like most of the classic films of those times, such as Dog Day Afternoon, One flew over the Cuckoo's Nest, and The Deer Hunter, these movies strive for authenticity. They look and feel like documentaries and model themselves, consciously or not, after the cinema vérité style.

In other words, there is more focus on ordinary life and situations and with little expository music. The beautifully timed and framed shots of Cassavetes' Woman under the Influence predate the Dogme 95 style of the handheld camera and have a spontaneous feeling to them. The acting also strives to be as natural as possible and is rarely melodramatic, stylized or over the top. As a result, we are given slices of life set in a clearly American context.

And in this American context, we meet a constructor by the name of Nick Longhetti - played against type by “Columbo” Peter Falk - who has to work overtime due to an unexpected burst pipe. He was supposed to be with his wife Mabel as she had charged their children to her mother's care for the night. It was supposed to be their romantic evening together, which considering they have three young children must have come about once in a blue moon.

Nick feels bad about canceling and would rather avoid this sticky situation. Mabel sees this incident as a blunt rejection and ends up getting drunk at a random bar. She then hooks up with a stranger who then takes her home and has sex with her. Cassavetes throws us into the story the same way Michael Cimino in The Deer Hunter (1978) suddenly throws his characters into the madness of war; it takes a bit of time to sort things out and find out how one feels about each of these characters.

In fact, my first impression was that I liked the hard-working husband and was not so thrilled about his wife played brilliantly by Cassavetes' real wife Gena Rowlands. But slowly, our feelings and opinions shift as we get a glimpse of their daily life and, more importantly, their struggles.

This conflict first becomes visible and tangible when after the night shift Nick brings home his co-workers for some early-morning spaghetti. The spaghetti scene seems to drag quite a bit where Mabel asks everyone at the table for their names and then a couple of the construction workers start to sing operatic tunes in Italian. Yet when her husband suddenly and unexpectedly shouts at Mabel to knock it off, the mood shifts and we are left in a similar state of shock as the guests. Our sympathies begin to shift also.

Gradually, the madness of the main character comes into focus. She is struggling hard to find and define her own identity under the circumstances. She is trying hard to be a mother and trying to please her husband by being good and by fulfilling his expectations, but as she overdoes and overplays her roles, all of it turns out to be rather pathetic.

It certainly does not help that her husband is not averse to using violence; he hits her a number of times bullying her into the role he wants her to play for him. Yet despite their problems they seem happy when they are alone together and there are a few glimpses of happiness and love between them. It is when others are involved be it Nick's co-workers or their family members when things get out of hand and beyond control.

The documentary style fits the movie's message quite well. This is not an overdone film like A Beautiful Mind (2001); the madness presented here is more mysterious but also more accessible and strangely personal. We never really know what mental illness she is suffering from except that she is often described as nervous and anxious, and it seems that her husband has his own mental issues as his parenting style is also questionable (who in his right mind shares a six-pack of beer with his under-age children?).

The movie reminded me of Bergman's (movie not the series) Scenes of a Marriage (1973) except that I found Cassavetes' film more moving and more realistic. Woman under the influence captures a number of themes in an effortless way. At the center stage is the couple. We sense that they do love each other, but they find it hard to accept each other and to show and express their love in an appropriate way, whatever that may be. Perhaps both have become victims of how others want and expect them to be.

No scene shows this more than the final one. She is about to return from the mental hospital after a six-month-absence. To welcome her, the awkward husband invites all his friends and colleagues over to throw a party because he thinks that is what she would have wanted.

This multitude of people in a small house does not impress his family members, and his mother played by Cassavetes' very own mother criticizes her son Nick in no unequivocal terms. What was he thinking to invite over all these people? This was supposed to be merely an intimate family event. What were all those strangers doing in the house at such a crucial moment? This would only stress out his wife etc.

He feels embarrassed and paces wildly in the rain asking his mother to send his friends away. And so she does. But we can see that he meant good and wants to surprise his wife. However, it might also be that he wants to show off his “new” wife and show them that she is fine and not crazy (anymore). That he is very sensitive and touchy about the home front and in particular her strange behavior and madness is a running theme throughout the movie.

When Mabel walks in, she is even less herself. She is too calm and seems to almost sleepwalk herself through the scene. Then she asks to see her kids and her husband refuses. He does not want to have a show in front of family members because she would start crying, and they would cry and nobody will have a good time. Whether this is his selfishness speaking or simply a desire to spare her some suffering is not immediately clear.

As her behavior remains restrained, her husband takes her to the side and confronts her. He wants her to be herself again; he wants those nervous and strange mannerisms and tics to return. According to him, this is how she is and he tells her this is her house, that she should not be intimidated by those guests, their family members. Again we could say that he wants her to conform to the impressions he has of her in his own mind. But let's not complicate things.

In a crucial moment, she asks her Dad to please stand up for her. He takes her literally and does so. Then she asks him to sit. He does that too in a bewildered state. Her mother, however, sees through her silent plea for help; their daughter Mabel must have been asking for some kind of protection from her husband. But what can they do? What should they do? All these wild emotions are insinuated via a close-up of the father's face.

This movie has great individual scenes and it is also remarkable that throughout its two-and-a-half hour running time, it rarely drags (minus the spaghetti scene but that had its purpose). The acting is outstanding and we are left in a state of shock. It is one of the best portrayals of madness I have seen.

In fact, it is not only about the suffering and helplessness of being mentally ill, but also about its stigma. At the same time, it shows us that the husband may be mad also, perhaps even more so if we look at the harm his violent behavior causes; notwithstanding, it is the woman that is locked away and treated in a mental hospital.

Finally, the movie shows us that there is often no cure for mental illness. Yet at the same time, this ailing couple still love and need each other in their own way and must fight hard for their sanity and their happiness. A great work by Cassavetes that has made me his fan already; now I am quite thrilled about exploring his other films. And my apologies for underestimating him without giving him a fair trial!