Cinema of splendour: Reporting from Dubai international Film Festival (DIFF) 2015
Dr Khalid Ali, Screening Room Editor
When I visited Dubai International Film Festival (DIFF https://www.dubaifilmfest.com/) for the first time in December 2015, I was not expecting to find so many films exploring health and well-being from all over the world. The variety of films on offer explored contemporary issues such as euthanasia and the right to die (Last cab to Darwin, directed by Jeremy Sims, Australia 2015), terminal illness (Dry, hot summers, directed by Sherif El Bendary, Egypt,2015, https://stg-blogs.bmj.com/medical-humanities/2016/01/04/khalid-ali-taxi-ride-to-eternity-review-of-dry-hot-summers/), doctor-patient relationships (Waiting, directed by Anu Menon, India 2015), sports medicine and its ethically challenging medico-legal implications (Concussion, directed by Peter Landesman, USA 2015), and the aftermath of an epidemic of sleeping sickness (Cemetery of splendour, directed by Apichatpong Weerasethakul, Thailand 2015).
Old age and its colourful diversity of frailty alongside resilience, health and disease, creativity and cognitive decline were also present in ‘The lady in the van, directed by Nicholas Hytner, UK 2015’ and ‘Youth, directed by Paolo Sorrentino, Italy 2015’. I was once again reminded that arts and films in particular have a lot more to offer. By portraying artistically the lived experience of human suffering, healthcare professionals can begin to understand the determinants of physical and mental well-being and subsequently deliver dignified compassionate care. Films are no longer entertainment vehicles only; they do have a ‘healing power’. An elegant example of such ground-breaking ability of ‘healing through understanding’ came from the film ’23 Kilometres’ that will be reviewed here.
Review: 23 Kilometres, Canada, UAE, directed by Noura Kevorkian
Review by Jane Peek, Research Fellow, Brighton and Sussex Medical School
In this mesmerising film tracing the experience of living with late-stage Parkinson’s, the Canadian film director, Noura Kevorkian, weaves a powerful narrative that draws us into the life, mind and body of her father. Through a masterful use of imagery and sound, the audience joins Barkev Kevorkian as he drives a ‘23 Kilometres’ along the Damascus road through the Bekaa Valley in Lebanon to get to the local cinema with his 4 daughters. In an unflinching portrayal of the cruel effects riven by Parkinson’s on Barkev’s mind and body, this intimate story explores loss, isolation and entrapment. The storyline gradually shapes and expands our understanding of how it might feel to have this progressive, degenerative, incurable disease. It is a portrayal that far transcends a still commonly held view that Parkinson’s is little more than ‘the cause of a bit of tremor in elderly folks.’[i]
Whilst Barkev does have a tremorous form of Parkinson’s,[ii] we soon learn that the condition is about so much more than this. Beginning with a clip recorded before Parkinson’s robs him of the ability to speak, or hypomimia (‘masked’ face) reduces his ability to convey emotions through facial expressions, we are able to hear Barkev’s last words. We hear his voice doing what the voice does best – expressing thoughts, feelings and emotions, telling us of his love for cosmology. Thereafter, he must rely on recording any thoughts, feelings and emotions in a journal, even though this, too, becomes a painstaking task as micrographia (small, cramped handwriting) takes a grip.
Alongside bold imagery and music, it is snippets from his journal entries superimposed on the screen that take us into his internal world- a world full of wonderful surprises to discover when one watches this film. Through one of the journal entries we learn, heartbreakingly, of Barkev’s strong desire to be able to speak again. And yet, paradoxically, it is the inability to use his physical voice that allows us to imagine our way into his world and become more than mere observers. Although his life story, like his disease, is individual and personal, as viewers we not only accompany him on his physical and metaphorical journey, but also feel as though we have become a part of it.
The film’s narrative thread moves unremittingly between past, present and future and guides us to interpret his story that is peopled by vivid hallucinations brought on by the disease and side effects of medication. At times, the experiential aspect of the film can feel unnerving, confusing, even frustrating, as Kevorkian’s use of ‘real’ time forces us to slow down and endure, like him, some of the bewildering consequences of his illness. But herein lies the bewitching power of this film. It enables us to empathise with the very real physical, social and emotional implications of living with a chronic illness such as Parkinson’s, whilst reminding us that, regardless of our health, nobody is exempt from the existential challenge that ‘we are all living a life on our way to dying.’ An uncomfortable difference is the fact that Barkev’s diagnosis exposes him early on to unwanted knowledge of his imminent future.
Parkinson’s disease specialists are still trying to shift the medical perception of Parkinson’s as a ‘benign’ movement disorder, to one in which Parkinson’s is viewed as a neuropsychiatric disorder involving multicentric neurodegeneration and many more non-motor than motor symptoms. Parkinson’s patients are often ‘desperate’ for others to understand what life is like for them[iii]. This film speaks to both these needs, offering a means of shifting perception as well as the opportunity to witness and empathise with one man’s experience of living with Parkinson’s. It is a film that confronts the harsh realities of this disease, whilst retaining the dignity of its subject. Both profoundly moving and uplifting, the film underscores the universal predicament of what it means to be human, speaking in ways that the spoken word cannot.
Address for correspondence: j.peek@bsms.ac.uk
i Calne, D.B. (2002). “What triggers the ‘Shaking Palsy’?” Cerebrum 4 (2).
iiThere is also an akinetic (rigid) form, which is the chief reason the 19th century neurologist, Charcot, chose to refer to the condition as ‘La Maladie Parkinson’ instead of the Shaking Palsy.
iiihttp://www.healthtalk.org/ (previously known as healthtalkonline)