HUGO: Bioethics and Technology

I have wanted to write about film as a relatively new technology in the human psyche. Here technology refers to all applied knowledge.  There is so much to say that it's been hard to find a way.  Martin Scorsese's film HUGO eases my task. This is a children's film and is all the better for its target audience. It is adapted from Brian Selznick's novel; a historical fantasy by screenwriter John Logan. Hugo is also the name of the main character. HUGO helps understand how technology in film both reflects and influences the human mind. Technology can push us to the brink of destruction. This is the usual, and anti-transhumanist use of technology in film. Teetering on that edge, between genius and ruin we often find  scientists, doctors, engineers, film directors and others cursed with creativity. HUGO is a film about the symbiosis between man, art and technology. 

This is not a film that fears technology, the main character is driven by it.  Hugo lives between the walls of the Gare Montparnasse in Paris in the 1930s. The setting is not the Gare Montparnasse of today, rebuilt in the 1960s and where the TVG shoots off to Bordeaux.   It is more the site of the 1895 spectacular train derailment, reported in all the world's newspapers and in Hugo's nightmares.  Afterall, the steam engine train was the technological revolution of the 19th century, as the large screen and rocket was of the twentieth and the small screen is of the twenty-first. A reclusive pre-teen orphan, Hugo maintains the train station's clock works.  He studies mechanics, in service of repairing an automaton; the broken mechanical robot left by the boy's now dead father.

Beneficence is the bioethical principle supporting the obligation to do good with knowledge and by corollary the technology it spawns.  Knowledge, like Eve's apple, causes enormous bioethical conflicts between autonomy, justice and a bunch of other principles.  We never quite know what new technology breeds down the timeline. Knowledge keeps us pushing down the path of uncertainty. This uncertainty runs rampant in the case of screen technology, as with other applied technology.   Screen technology includes the large screen (movies, television) and the small screens (computers, cell phones).   In a recent New Yorker cartoon Dr. Frankenstein types on a computer explaining to Igor, "I've given up trying to create life and instead create online persona."   Frankenstein's monster is an enduring bioethical metaphor for the conflict between knowledge and its abuse.

What are the unreasonable risks? We now know that our beloved hand-held screened smart phones can both make and squelch social change. Distributive computing can be used to single out a disease gene.  Distributive computing can also locate a dissident texting news of revolution on a small screen.  Bioethics enhances reasoning about how to use technology.  Any technology created will be used; the bridle is considerate ethical analysis.

December 28, 1895, the Lumiere (Light) brothers projected film the first public audience.  Like a good sculpture inspiring a poet, the Lumiere films generated even more film, art and technology. Since that December, people have struggled to understand how stories told on screen actually work.  We are fascinated by animation. It breathes life into inanimate mythical versions of ourselves.  Like Aristotle's Greek dramas, viewers experience without personal threat.  Resolution of unspeakable conflicts between people and their Gods provide relief that most anything is possible. Our own worries amount to a hill of beans. Hugo explores much territory unbearable to traverse in real life;  death of parents, homelessness, starvation, worthlessness,  loss of meaning,  Use of  3D vision, stop action, computer generation,  magnification, and other film techniques, set just enough difference between us and the characters so that we feel  safe. Things seem "almost real." The power for the viewer is in the "almost. " 

We are limited in knowledge about how the grammar of film changes our perception. In bioethics, limited knowledge is a venue for research.  We know that people perceive first from direct contact, through primary socialization.  However, film works by perception through secondary contact. Children, in northern Maine, may rarely see Black people. Popular children's television makes these kids feel they know black people.  That is secondary socialization. The rub is we are not sure what we learned primarily or secondarily.  This is a pitfall of screen stories, illustrated in Hugo, through early audience reactions to film. The audience capacity to adapt to images altering the psyche is subject to manipulation, as depicted in the film Clock Work Orange (Kubrick, 1971) and the use of video games to train soldiers.  

HUGO's historical fantasy elements show how Freud's subconscious resorts visual images and dialog to create meaning.   Film was born in  the time when the seat of human consciousness was just beginning to  shift from the heart to the brain.  Film influences the psyche by intangible reflections constructed from a few cents worth of conduits for electrical current and light. Projectors and the brain share similar physical parts, lenses, conduits, a framed view. Memories from film are stored neurologically in the same as our memories from reality.

HUGO pays homage to every aspect of early film grammar.  In this movie, we re-meet the silent classic The Perils of Pauline.  Harold Lloyd in Safety at Last (New Meyer and Newman, 1922) and Hugo both dangle from a clock face. There are images reminiscent of Metropolis. (Lang, 1927). The use of a mild mannered secret identity elevates an early filmmaker to heights previously only seen in the super hero genre.  Martin Scorsese spends much of his energy protecting and preserving movies. Through his work the cinema's origins, grammar and impact can be better understood. Knowing how film causes response, helps viewers to choose the way the works affect them. 

There is a strong importance of the traditional written word in Hugo. Screen literacy derives from written literacy. Films are written before they are produced. Screen stories are the literature and technology of our time.  Screen stories can be used as an excuse for ignorance, but not the best of them.  The screen can sedate but also inspire. Film conveys viewers from one place to another faster than a locomotive.  Bioethics is the bridle but also a prod for innovation in technology. Bioethics assumes enhanced ethical analysis influences best moral outcomes. HUGO asks us not to focus on the worst outcomes of film technology, but to promote the best. Film fans should not despair. What screen technology takes away it can give back.


Frankenstein. (35 mm) directed by James Whale. 1931. USA. Universal.
Clock Work Orange (35 mm) directed by Stanly Kubrick. 1971.  USA.Warner. 137 min.
see Inception: transhumanist dreams resolve grief ( 7/17/10 Bioethicsscreenreflections)

Perils of Pauline ( 16mm) directed by Louis J. Gasnier
Donald MacKenzie  1914.  USA. General Film Company & Eclectic Film Company.

Le Voyage dans la lune ( Trip to the moon) ( 16mm) Georges Melies. 1902.  France. Gaston Melies Films.  14 min.

Metropolis. (16mm) directed by Fritz Lang. 1927.   Germany UFA. 153 mins ( at 24 frames/min)

Safety at Last.  Fred C. Newmeyer and  Sam Taylor. 1923.  USA.  Hal Roach Studios.  73 min.

Williams, S.  Justice Autonomy and Transhumanism: YESTERDAY.  in The Picture of Health.:  eds. H. Colt, S. Quadrelli, L. Friedman   Oxford University Press .
New York. 2010

FREEDOM WRITERS, meet TO SIR WITH LOVE: Bioethics, Film and Understanding

FREEDOM WRITERS is another in the genre that started with the movie TO SIR WITH LOVE. It tells the story of a desperate inner city high school English teacher (Hilary Swank) forced to get creative. She discovers that every kid in her class, but one, knows first-hand what a Holocaust is. However, every kid in her class but the same one, does not actually know what "The Holocaust” was. 

This is the story of how a single teacher can change lives.  In films about the transformative power of education, the children are at risks in most ways defined by the Declaration of Human Rights; food, housing, education, safety.  The learning gap between the rich and the poor screams for the principle of justice. However, conflict in the principle of beneficence is more accurate.  Ignorance is the disease to be fixed.  Beneficence is ethical use of knowledge. Beneficence directs what we ought to be doing with the knowledge we have. 

In principle based ethical decision making, we look for tensions between beneficence, autonomy and justice.  Clarifying the tensions supports the "hunch" that there is an ethical conflict.    In the medical context, beneficence is an obligation to transfer medical information. Information communication requires understanding. How do you make a person understand?

In FREEDOM WRITERS, the teacher physically walls her students off from the chaos of the contextual, geopolitical features which bear on justice.  She closes the door to her class room with the kids inside of it. A safe haven is created out of the storm. This is a smart approach when faced with a bioethical dilemma.  You can't control the geopolitical matters that create social injustice so you do what you can. Conflicts are best resolved resulting in suitable action if the order of considerations is weighted; starting with beneficence, then autonomy and finally justice. Our creative teacher takes her students out of the fray. She weights beneficence, or conveying knowledge, as the first priority. 

In FREEDOM WRITERS, the hook is introducing a group of adolescents to the Holocaust memoir, The Diary of Anne Frank.  Anne's story "de-alienates" the contemporary children. It makes them a part of a broader historical context. The students are freed from the narrow confines of a culture of underdevelopment by exposure to Anne Frank's life and death. 

It is not necessary to grasps every single aspect of a complex field but a clear conceptual understanding of the trends resultant from key information is important.  If knowledge is not relevant to groups of people themselves, it may not be absorbed.  How groups define themselves is called culture. Cultural relevance gaps frequently limit appropriate distribution of benefits and burdens (Justice) as regards information exchange.    

The basis of using film to enhance ethical analysis results from the interchangeable energies associated with narrative forms. Narrative forms include the Aristotelian six arts: dance, music, painting, literature, drama and poetry. Film is referred to as a synergy of all of the arts; becoming Andre Bazin's "seventh art".  What all the arts have in common is narrative.  Narrative forms have historically conveyed morality, through myths, jokes, fables, or religious books.  A specific case is outlined or seen.  The telling case has a theme which guides the observer to a planned engagement, a final conclusion and a resolution as the process finishes.  Using stories or cases to convey morality, is called Casuistry. It seems to work because it connects our common morality, leaving us to feel less alone.  This is how the teacher in FREEDOM WRITERS enhances understanding. 

The classic format of teacher "rescuing" the under developed children in films, is not always about white folks going to the black ghetto. The genre was initiated by the legendary Sydney Poitier, a black man, cast in TO SIR WITH LOVE.  This teacher changed the lives of working class white English teens.  Class, in the Euro-American context, has become synonymous with race. The most compelling films deal with those who return or stay in their communities to provide change. Examples of this version of the genre include STAND AND DELIVER (Menendez, 1988) and COACH CARTER (Carter, 2005).

Freedom Writers. dir. (35mm) directed by Richard LaGraveness.  USA. 2007. Paramount. 122 min. 

To Sir with Love (35 mm) directed by James Clavell. UK. 1967. Columbia. 105 min.

Also read:

Frank, Anneles Marie. The Diary of a Young Girl. (The Diary of Anne Frank) 1947. Bergen Belsen Concentration Camp 1947

For more information on bioethics film and understanding: see

this blog site section on  Film/Bioethics Literacy - Lighten Up: Dying on Screen Slides  .030 and  .018 ( Narrative and Casuistry)  and slides 019 and 0.20 (Informed Consent)

 

WAITING FOR SUPERMAN, TO EDUCATE A GIRL: Education and Bioethics

During a recent California governor’s election race, ethical tensions surrounding "the American knowledge gaps" were voiced. Most party candidates endorsed the film WAITING FOR SUPERMAN.  WAITING FOR SUPERMAN is a documentary about young American teachers striving to change the broken public education system. This, like other documentaries, tells the story by following individuals who are, in this case, striving for better education. The story also tracks the careers of a number of graduates, trained in Teach for America, as they struggle to build more equitable models of education for American Children. These teacher's gains are modest overall, but large in the communities where they have served. 

WAITING FOR SUPERMAN argues that communities have not let down the schools so much as schools have let down communities. Accompanying the analysis are truly shocking facts about the ways in which American public school districts are operated. Administrative rigidity appears to be to a detriment to education of the poorest students in the country. In contrast, educators are left to do one of the hardest jobs with limited resources. 

WAITING FOR SUPERMAN falls short in its analysis of the education gap because it never quite explains the value of education. Many of the kids depicted believe education will get them a good job. The film never corrects this misconception. Though better educated people are shown to have better jobs, all better educated people don't.  Getting a job through education is certainly a passé expectation in the current era.  FREEDOM WRITERS(LaGraveness, 2007), on the other hand, suggests that education enhances human consciousness.  Enhanced human consciousness changes the quality of individual lives; a more reliable outcome than guaranteed employment for most under-resourced communities. 

Looking at the educational gap more globally provides a better context than race alone. It also leads to more allied existences. TO EDUCATE A GIRL squarely anchors itself in expanding human consciousness. It, like WAITING FOR SUPERMAN, is a documentary. TO EDUCATE A GIRL best addresses all of the dimensions  of ethical  conflicts in education;  beneficence, autonomy and justice issues.  I screened this film at the Mill Valley Film Festival this past October. It is directed by Frederick Rendina and Oren Rudavsky.  It was made primarily with United Nations funds and was undistributed at the time of my viewing. It is, to my mind, the best of the type. TO EDUCATE A GIRL offers a thoroughly modern handling of how to fix significant aspects of the education gap between subsets of classes and universalizes the context. 

In a paradigm flip, TO EDUCATE A GIRL suggest that the true underclass of concern are the 110 million school aged children, not in school or under-schooled; two thirds of whom are girls. The narrative places the lower status of women squarely in the center of the major conflicts of human development. It weaves the geopolitical contextual features of the two nations of Nepal and Uganda. Both of these nations are fresh out of civil war. 

TO EDUCATE A GIRL gets high points for demonstrating how people can explore their own cultural attitudes, legacies of religion, colonialism and neocolonialism. It illustrates which attitudes cripple and underdevelop a generation's knowledge. It also highlights those practices which support beneficence, autonomy and justice.

Use of modern techniques of radio, television and the public health model of outreach are promoted in TO EDUCATE A GIRL. Equal weight is given to technical and more traditional models of singing and performing stories to guide better understanding. 

The fierce competition to get into "the best school" as in WAITING FOR SUPERMAN does not exist in TO EDUCATE A GIRL.  The goal instead is getting into school at all. Like the barefoot doctors movement, the film demonstrates a barefoot teacher’s movement. Teachers recruit children from villages by convincing their families to send their children to school. These teachers educate families first. The film also documents boys and men supporting themselves through supporting their sisters and wives aspirations.  It is the enlightened mother's, who wish to protect their girls from the perils of underdeveloped womanhood, who ultimately facilitate the most attitudinal change regarding education.  

TO EDUCATE A GIRL provides an honest assessment of real obstacles in girl’s lives. Girls in most cultures, including the developed world, often do domestic work and toil in actual or metaphorical fields. Girls are sent out to work at an early age in under-resourced families. They are reliable as are usually their mothers.  If not working outside of the home, girls are often responsible for raising their siblings and caring for the elderly while the adults are working, dead or incarcerated. In many instances, forced or arranged marriages are required to support a girl’s family. Finally, female child genocide is a feature where agriculture and resources are limited. Girls create more mouths to feed. 

During war and the aftermath there is cultural destruction. Girls and women are often victimized by sexual assault. This occurs to a greater extent when women and girls are also political prisoners. Here victims of rape in the developed world meet their international sister in post-traumatic stress.  We find a similar circumstance in natural disasters and wherever people are refugeed or decimated en masse. Walking to school can mean losing a girl’s life in many contexts.  All of these are shown in TO EDUCATE A GIRL.  All of these frequently preclude the educational aspirations of girls. 

Fancy uncrowded classrooms may be ideal; however, they are not sufficient.  A good teacher, on the other hand, can transform even the worst classroom into a learning environment. The best and most creative teachers are needed in the most difficult circumstances.  A good teacher engages the learner. This is not to say they must be touchy feely. Teachers as shown in these films must have an organized program for engagement applicable to the community they teach.  Without engagement there can be no understanding and beneficence becomes a theoretical construct.  Without understanding there can be no autonomy and all the clinical medical ethical devices like informed consent and advance directives become useless.  Without autonomy there can be no transformation of individuals to form just societies. 

Waiting for Superman (DVD) directed by Davis Guggenheim. USA. 2010. Paramount Vantage. 112 min. 

 

To Educate a Girl. (DVD) directed by Frederick Rendina and Oren Rudavsky. 2010 USA/Uganda/Nepal Talking Drum Pictures. 2010.  70 min.

For more information on understanding, education and bioethics: see

this blog site  section on  Film/Bioethics Literacy - Lighten Up: Dying on Screen Slide 25, ( Spiritual Assessment & Cultural Relevance)

THE KIDS ARE ALL RIGHT meets KRAMER VS KRAMER: Cell, Reproductive Science and Bioethics

I saw THE KIDS ARE ALL RIGHT in July of 2010.  Annette Bening was a highlighted guest at the Mill Valley Film Festival the following October. I suspected it would be an Oscar contender and so might not need the support of this blog to get into the teaching dialog in bioethics.  I couldn’t help noticing that as a bioethicist my take was different from the reviewers I read.

THE KIDS ARE ALL RIGHT is a movie beautifully acted by leads Annette Bening and Julianne Moore. They are two women married to each other who co-parent two children (Mia Wasikowska and Josh Hutcherson). The children seek out their biological father (Mark Ruffalo). The father is a womanizing habitually single man who gets his come uppings from the mothers, the children and his current bed partner and longtime friend (Yaya DaCosta).  THE KIDS ARE ALL RIGHT is about an average, upper middle class, American, nuclear family undergoing changes.  

There is no progressive politic in this film; neither feminist, racial, gender or even sexual, no call to action other than to hold onto your family tight and ride the roller coaster. It is a statement of facts of this family, presented as blithely as the reality that the sun rises in the east.  Writer-director Lisa Cholodenko shows craftsmanship in not cluttering the presentation with exposition. What buys our attention is the bioethical-cultural C change inherent in this narrative. 

Forty years ago, the characters and premise of the KIDS ARE ALL RIGHT would have given worldwide viewers whip lash.  Of the Mom’s in this film, one is a woman gynecologist.  Back in the day gynecology was considered a surgical subspecialty solidly dominated by men.  Informed consent only really hit real world medicine about thirty years ago. In THE KIDS ARE ALL RIGHT even the anonymous sperm donor has the opportunity to give informed consent before being contacted by his genetic daughter. Adopted children only recently have hope of routinely identifying their biological parents, it makes sense that this right should extend to genetic parents as well.  

Sperm banks differ in how they select donors.  One cryo-bank accepts only donors who attend or have graduated from a four year university, are tall, trim, heterosexual and between 19 and 34. Another bank only takes sperm from Nobel Prize winners. Newer sperm banks seek more eclectic gene pools. We like to think this diversity is an effort to avoid any appearance of supporting eugenics.  The genetic Papa in the KIDS ARE ALL RIGHT is a college drop-out and cook with a preference for meaningless sex. He is flawed like most people.  We gather from his comments that he may have fathered more than ten children by sperm donation for money.  Currently there are restrictions for number of children a sperm donor may parent. Fathering less than 10 children by sperm donation seems to statistically limit accidental marriage possibilities between siblings. Payment for sperm donation still occurs. You can’t buy babies but you can buy the stuff they are made of.   

Sperm donors and client parent rights are usually established via written informed consent that is signed by the client and surrogate. The informed consent is verified by the client's doctor. The principle of informed consent is a device of the medical ethical principle of autonomy.  It was the 1974 Belmont Report on the Protection of Human Research Subjects, the federal government's procedural response to the US Public Health Service Syphilis Study at Tuskegee, that established informed consent as a norm in both research and clinical patient interaction. 

Deep in the narrative of THE KIDS ARE ALL RIGHT lays the story of Baby M. In 1988, the New Jersey Superior Court awarded custody of “Baby M” to a couple named Stern under a “best interest of the child analysis”.  This analysis attempts to circumvent the commodification of children whilst recognizing the contractual relationship between clients who employ surrogates and their gene donors. This court’s analysis validated the surrogacy contract between Mary Beth Whitehead, the genetic mother of “Baby M,” and the Sterns, the client parents. However, buried in the best interest of the child decision, there may be a bias against Ms. Whitehead’s potential of being disabled by Multiple Sclerosis and her circumstantial psychological unbalance.  Informed consent is used as evidence of a fiscal contract in surrogacy.  It is a twist in clinical ethics that a device to insure autonomy can inadvertently lead to human commodification.   Commodification of human beings is of particular concern to groups of people, and their offspring, who have historically or currently been bought and sold. 

In THE KIDS ARE ALL RIGHT, two children result from cell science. Cell Science has led to extraordinary technological advances including fertility surrogacy, vaccines, and most prominently the human genome project.   Completed in 2003, the Human Genome Project (HGP) was a 13-year project coordinated by the U.S. Department of Energy and the National Institutes of Health. Its goals were to identify the 20-25,000 genes in the human DNA, determine the sequence of billions of base pairs, store the information in databases, improve data analysis, transfer technologies to the private sector, and address the ethical, legal and social issues that arise from genetic  technologies.

Not the least of ethical concerns related to cell science and its offsprings, reproductive technology and the Human Genome Project,  is the origins of the cells used to develop them.  Much of what we know of cell science derives from cells taken from an African American woman named Henrietta Lacks. In the 1950s, Mrs. Lacks resided in Baltimore. She was born from tobacco sharecropper slave roots in Clover, Virginia.  Her cells were taken from her during a biopsy for cancer. They were used for research purposes without her permission.   Her cells were named HeLa. HeLa became the first human cell line to grow in-vitro. HeLa is the origin of billions of dollars reaped by  private technology companies.  Neither Mrs. Lacks and her family, nor anyone else who has their tissue taken in medical procedures, has the legal right to consent or veto how their tissue is used once extracted.  

Generally there is no legal support for extending personal or family autonomy to the tissue of a person, unless it is to be implanted in a living recipient. Tissue routinely excised in medical procedures provides its source no legal assurance to partake in revenue that is generated by the use of their body part.  If there is no informed consent, there is no contract to be legally upheld. Like Mrs. Lacks, anyone's human body parts can be scattered across the world. This lack of wholeness, particularly at the point of death, is more than fiscally important in many cultures.  

THE KIDS ARE ALL RIGHT signifies an advance in human consciousness as regards same sex relationships and marriages.  KRAMER VS KRAMER premiered in 1979, creating a shock wave in its conclusion.  Mrs. Kramer (Meryl Streep) is a Lesbian.  Mr. Kramer (Dustin Hoffman) is inconsolable. The two enter a bitter divorce and custody battle underpinned by the emergence of their gender preferences.  The battle outed the gay parent on screen for the first time in history. However, Kramer vs. Kramer also highlighted the capacity for parents to show love for their children despite personal issues between themselves. They do the right thing; Mr. Kramer, Mrs. Kramer and her lesbian partner find a way to raise the child.  In THE KIDS ARE ALL RIGHT, the gender preferences of the moms are hardly a question in contrast to KRAMER VS KRAMER.  Ethical conflicts of reproductive technology and challenges of honesty between family members are correctly more important in THE KIDS ARE ALL RIGHT.

The Kids Are All Right.  35 mm. Directed by Lisa Cholodenko. USA. 2010. Focus Films. (106 min)

Kramer vs. Kramer.  35 mm. Directed by Robert Benton. USA. 1979. Columbia Pictures. (105 min) 

For further information:

http://www.kylewood.com/familylaw/babym.htm. In the Matter of Baby M., 109 N.J. 396. 1988.

Skoot, R. The Immortal Life of Henrietta Lacks. Random House Inc.., New York.  2010, 2011

FOREST OF SWORDS: Patient Shows Up as Doctor

Forest of Swords is a documentary in progress by Filmmakers Helen S. Cohen and Mark Lipman.  The film is an intimate portrait of the recovery of Dr. Grace Dammann and family from catastrophic injury. The filmmakers have followed Grace and her family on camera from the day of her first discharge from the hospital. One wouldn't think of this material as rejuvenating or humorous but in the hands of this subject and these filmmakers both are true. Through this handling emerges a picture of what resilience is and how it nurtures healing.

In May of 2008, just before Memorial Day, Grace was in a violent motor vehicle collision on the Golden Gate Bridge.  This resulted in a coma for 6 weeks and the shattering of nearly every bone in her body as well as other injuries. Her 14 year old daughter and family dog were present in the vehicle and were physically remarkably unharmed.  

To date, Grace has endured over two years of surgery, and rehabilitation medicine.  Hers is a story of support through concentric circles of interlocking family and friends. These circles range from myriad individuals (see caringbridge.org) to the global reach of the San Francisco Zen Center, creative luminaries and medical professionals. Grace has lived to tell the story from the edge of life and from both sides of the doctor patient relationship. Both the edges of life and the doctor patient relationship are daily part of the applied bioethics known as clinical medical ethics. 

In the fiction "medical film genre" many works turn on physician's needing to heal themselves (FRANKENSTEIN, Whale 1931), becoming better doctors in the process (THE DOCTOR, Roberts 1992), and communities healing physicians (CITY OF JOY, Jaffe 1992).  FOREST OF SWORDS brings to the party an important conceptual shift.  In Grace's story we see a patient, who happens to be a physician, become her own agent for healing.  This is important because deep inside of every seasoned medical doctor is a recognition that every patient is the key to their own recovery or tolerance of illness. The question that FOREST OF SWORDS begins to answer is how patients, clinician's and families might best tap that vital energy. 

To be honest Grace's life and persona before the accident was remarkable. His Holiness the Dalai Lama presented Grace the “Unsung Heroes of Compassion" award in 2005 for her care of thousands of AIDS patients, during the era when HIV/AIDS was always a death sentence.  How Grace and her family became a part of Isabel Allende's extended family is reflected in the author's 2008 memoir sequel, The Sum of Our Days.  Grace's unique spirit and genius inform the power of FOREST OF SWORDS.  

Be warned, this is not looking like a film for wimps or the faint of heart.  It makes the strong argument that the best hope for resilient recovery from injury is a foundation of a connected and intentional life.  If you can swing it you ought to be working on that foundation both before and after injury.  As Grace would say "showing up” every day is key.  The film, whose working title is Forest of Swords, is about life and recovery.  

FOREST OF SWORDS (DVD) (working title) Directed by Helen S. Cohen and Mark Lipman. Open Studio Productions. USA. In production (2010) To learn more about this film, previews and to support its development see http:www.openstudioproductions.com/independent.html

See Film/Bioethics Literacy section on this blog for more on "doctors as patients" and the Medical Film Genre. (Lighten Up Slides: slides 61 and 62 define the medical film genre, slide 70 medical film genre filmography and slide 71 medical film genre videography)

CHILD OF GIANTS: Lange & Dixon's Legacy

CHILD OF GIANTS is a documentary about being the child of two creative masters of the last century; photographer Dorothea Lange and painter Maynard Dixon. It is an honestly crafted work. It brings depth to the artist, honoring their work, without idolizing them. Tom Ropelewski, a screenwriter known for romantic comedies, recognized in Daniel Dixon's handling of his life with extraordinary parents a really good story. Daniel, an advertising copy writer, had a way of telling stories that translated tragedy into "matter of fact" and sometimes humor. Daniel's is the main narrative voice in the story. His perspectives are augmented by his brother's, other family members' and his parent's art. The oldest child often has more understanding of their parents, in hind sight, than others. It is not easy to be the offspring of people whose destiny is to change the way we see the world. Often the parents don't know what their destiny is; they just do what they do with passion, while walking a tight rope over an ocean of uncharted waters.

Dorothea Lange was some twenty years younger than her husband Dixon. Her early experience with her own parents’ marriage hadn't left her a big fan of convention. She was a feminist before the word was coined. Like her contemporary visual artist women colleagues, Freda Kahlo and Georgia O'Keefe she was a force to be reckoned with. Also, like them, her partners of necessity had to revel in the uniqueness of her creative character and be unintimidated by it. Maynard Dixon was not the hand maiden husband to the great genius of Dorothea Lange. She was his equal. Neither sacrificed much for the other's career; the children suffered for both.

Among the greatest challenges in raising children with an understanding of oppression is insuring they do not become victims of it. There are critical points in children's lives were they need to be secure, that they are the center of the universe. But when your mother is busy advancing a new art form which has the power to document a call for justice in a turbulent time of history, it's pretty clear you are not the center of the universe. When your father disappears for months at a time to paint the vanishing indigenous peoples and lands of the south west, it's rather like telling children there is no Santa Claus at the wrong point in their development.

Dorothea watched the great depression unfold from the window of her studio in San Francisco. When given the opportunity to use her skill to express something of meaning about the depression she did so with singular elegance, creating icons which changed policy and arguably ushered in the error of the concerned photographer. During the internment of Japanese Americans she used the camera again as an organ of human consciousness, creating enduring images of strength and shame.

In medicine we know how you describe a problem affects how you handle the problem. As in the HIV/AIDS epidemic, what you call a thing determines how you respond to it. If it is seen as a narrow outbreak or an isolated economic depression in rural areas -- government has little need to intervene. A whiny baby gets Tylenol and is sent home; an inconsolable febrile child gets a lumbar puncture and admitted. When evidence of wide scale suffering and despair is undeniably documented as in Dorothea's photographs of the depression, the narrative cannot be ignored.

Modern medical ethics is usually taught by the principle based method. In this method one learns to analyze the tension between major ethical principles, particularly beneficence, autonomy, and justice. An alternative to principal based moral reasoning is casuistry. Casuistry uses cases or stories to enhance moral reasoning. The density of visual works of Lange and M. Dixon in the film demonstrate how their visual narrative was able to bring otherwise distant stories to the eye line of masses of Americans. This proximity of visual narrative affected moral reasoning around social policy. Dorothea found greater meaning in her work than in her marriage. The marriage broke up at a time when people were rarely divorced. The Dixon boys were destabilized once again.

In general, all children have a problem forgiving parents for destroying the family romance; children of giants or not. Forgiveness begins to happen when you are a parent yourself. Child of Giants is a story of how Daniel and John were both damaged and nourished by the eccentricities and strengths of their parents, and then forgave them their humanity. It is said that the developmental tasks of life's end include communicating to those whom you love some specifics. Daniel Dixon died before seeing the final cut of CHILD OF GIANTS. However, it seems that in the process of making the film, Daniel's final developmental tasks were achieved. It is our good fortune that filmmaker Tom Ropeleski had the good sense and skill to create this documentary. After all, the legacy of a great artist should be that they inspire more great artists.

CHILD OF GIANTS. DVD. Directed by Tom Ropeleski. USA. 2010.

MIRAL: Roots of Peace

MIRAL is a cross cultural, inter-generational film about preparing people for Peace; particularly those who have been oppressed by war. Peace in the world of bioethics is a “good,” which can only be held by humanity as a whole -- not the individual. It is important to understand that Peace is likely to be found in a collective unconscious which transcends our divisions. Peace exist in the territory that connects us, not that which separates us.  

Miral, a seventeen year old girl derives from the characters of three other women in the film. These women are reminiscent of universal stories from the era before God was considered male. Universal stories resonate within the human core and contain archetypes. Archetypes are imprints that exist in our psyches. Those of us who work with dying people encourage personal narratives; how many times we hear King Lear and his daughters! Archetypes are a way in which human beings make sense of complex experiences. Artists tend to express these core experiences in ways that translate across culture. The term archetypes comes from the Greek word archetypos, meaning "first of its kind."  Archetypes derive from icons. Icons are Gods and their doppelganger Monsters.   

When God was a woman, she had three parts: Creation, Love, and Destruction.  Nadia is Miral's mother. Nadia was a victim of sexual violence, which resulted in the creation of Miral. Nadia's indomitable spirit of resistance was manifested by her gnawing off parts of herself to escape the trap in which she was caught; until predictably there was nothing left.  Hind el Husseni  as a young Palestinian woman, turned a corner in the blue dawn light of Jerusalem to find 55  children hungry and displaced by the Deir Yassin massacre. This massacre destroyed an Arab- Palestinian village during the civil war that just preceded the end of British rule of Palestine & Israel in 1948.  Hind's first statement to the children in the school she founded is always, "I love you." Not unlike Maria Montessori Hind sets about the task of educating children for Peace. Fatima, a nurse is fired for freeing patients who would be taken as prisoners of war.  This injustice radicalizes Fatima to extremism. Fatima meets Nadia in prison while serving 3 life sentences for a bomb that did not go off. Fatima's brother, who works at the home for children with Hind, cares for Nadia at his sister’s request. He then marries Nadia, raising her baby, Miral, as his own and educating her at Hind's school.  Nadia, Hind, and Fatima contribute parts of Miral, "a common red flower that grows by the side of the road.”   Hence creation, love and destruction bring the roots of Peace.     

MIRAL is a good film for those interested in bioethical issues because it deals with ethical conflict at global, historical and personal levels.  In Fatima, it has a direct reference to ethical conflict in a health care provider. It demands a review of the Declaration of Human Rights which is an important part of the origin of the field of modern bioethics. Miral's ethical conflict is truly tripartite between, beneficence (what knowledge brings and she has been impeccably educated); autonomy (respect for the right to act in her own self-interest) manifested by her love for Hani who at the time is embracing acts of sabotage which risk life; and justice (equipoise in distribution of risk and burdens) for a people displaced for centuries (Jewish people) and a people being refugeed to accommodate them (Palestinians).   

Julian Schnabel is a Jewish American painter and clearly consummate film director. He is the son of a 1948 Hadassah president and so is hardwired to attempt to do good against the odds. He and Palestinian writer, Rula Jebreal, bring her semi-autobiographical novel to the screen. The film's collaborative process reflects the struggle and goals about which it speaks. In this film steeped in war, Schnabel's apt creative capacity shows no graphic violence. A bulldozer wrecking a Palestinian home rips tears from us as we add our reactions to the shots of the impotent members of the refugee camp. Our emotional temperature is changed with the use of film craft: shifting color, saturation, grain and focus. The films words are spare, visuals are modern, and the music decisive.  An homage to EXODUS (Preminger, 1960) in handling of geography and innovation of storytelling,   Mr. Schnabel and film family have created a film both epic and specifically intimate.  We identify with Miral's adolescent evolution to Peace agency and more importantly, we want to be her.     

MIRAL.  35 mm. Directed by Julian Schnabel. Venice/France/USA.  2010. The Weinstein Company.  (112 min)  

For more Film / Bioethics Literacy on this site see: "Lighten Up" slides, 0.045, 0.046 (How film changes culture), .053 (Read All Tracts), 0.057 (lighting what is it saying). 

also cf. LA MISSION: Prototype for the Peace Genre  on this site May 2010