Medicine In Film: The Sea Inside

Ahoy there, dear readers! Apologies in advance for this post seeming a little rough around the edges or too rambly, but I lost my laptop charger this week and have been out of commission for a few days so I'm a little behind on things. Now where did we leave off? Ah yes; last time we had a demented old lady being cared for by her devoted husband and today we're looking at a quadriplegic Spaniard who has been trying to die for 30 years. Well shit, this is just getting perkier and perkier in't it. Shall we?

Today's film is The Sea Inside (or Mar Adentro), starring Javier Bardem; a true story of the 3-decade-long struggle of the author Ramon Sampedro, who suffered a paralyzing neck injury in his 20s, to be given the right to take his own life by Spanish courts. Another author? I think the real moral here is not to write books unless you want to have some seriously nasty shit happen to you.

Like male-pattern balding.

After breaking his neck in an accident while diving on a beach, Sampedro had been left completely paralysed from the neck down, dependant on his Sister-in-Law and other members of his family to help him from day to day. He believes that he has lost all dignity in his life and would like to be able to bow out gracefully before he becomes even more of a drain on his family. The film is all about that battle with Spanish courts for Sampedro's right to die and attempts to shine a light on the myriad factors that influence the views of people on both sides of the debate. Actually, for a film charting the life and opinions of a man very much parked in the pro-euthanasia camp (well he can't exactly move over to the other one) the director, Alejandro Amenabar, has managed to create a rather well balanced exploration of both the factors that influence our decisions regarding end of life care and how those decisions resonate through those closest to us, affecting the lives of everyone involved. This paragraph is a little dry, so here's a photograph of Lola Duenas pulling a funny face:

Marvel as she pushes her chin out the back of her neck.

The Sea Inside is beautiful, in style and substance. The cinematography is marvellous, with every shot framed almost to look like a landscape painting and characters positioned in the set to create images that perfectly encapsulate the situation and tone of the scene. It's bloody impressive that a film that's 80% medium head shots of people can look so lovely all the way through.

Look at the positioning of that potted plant. Genius.

As I said, it doesn't just look nice either. This is a genuinely touching account of the physical and emotional suffering of a man trapped in his own body, dying to get out (I apologise profusely for the pun), and the profound effect his actions have on himself, his friends and his family. From a medical viewpoint, that interaction between the family members and Sampedro's illness is infinitely fascinating, as it gives an insight into the importance of wider family support both when dealing with chronic debilitating illness and end of life care. It also serves to throw up countless other questions regarding euthanasia:

- Who has the right to decide who should live and who should die?

- Is taking your own life a selfish act, neglecting the efforts of the family who have cared for you?

- Is it reasonable (or just fucking retarded) to assume that the thoughts of one person with an illness are meant to reflect the thoughts of all other people with the same illness?

- How many women can a quadriplegic attract like a weird, muscle-wasted strip of fly paper?

- How much of a dick can a priest be, even when he can't move his limbs?

Answer: a really big, floppy, wrinkly one.

Here comes the obligatory paragraph on acting: Javier Bardem is a charm. He's wonderful. I, just, guh. I can't congratulate him enough on managing to perfectly capture the essence of a man forced to face his own mortality every day and to have to actively fight to end his own life; who is dangling helplessly between life and death but manages to face the world with a smile. Ack. His face is enough to bung you up at times. Sadly, that does mean that the rest of the cast has the unenviable task of trying to top his performance, but they all manage in their own way. Belén Rueda (of The Orphanage fame) did a particularly good job as Julia, a lawyer suffering from a nasty condition that causes multiple recurrent strokes, but being a talking potato still trumps gammy legs and uncontrollable drooling.

At least he never has to ask for a straw with his drink.

I watched The Sea Inside with a few of the other medics doing the same project as myself and they actually came up with some interesting observations themselves. Most of them aren't quite as familiar with subtitled films as I am and they found it very difficult to connect with what was going on due to the language barrier between themselves and the characters; this brought up a discussion on the way in which difficulty in communication between two people (be that as a result of language, disability or good old stupidity) reduces the ability of either party to gain a full understanding of the feelings of the other. Language is so full of nuances and subtleties that a barrier in conveying those things dulls the desired impact or completely changes the person's understanding of the situation. In a medical context, that can mean the difference between empathising with a patient while you help them through a difficult diagnosis and delivering bad news to them with the verbal equivalent of beating them over the head with a haddock tied to the end of a mallet. 

Googling the result may be done by the reader as extra credit.

Hey, would you look at the time? I should really round things up. Is The Sea Inside a good movie? Yes. It's pretty, well made, thought provoking and well paced; it's all round a damn good piece of cinema. In comparison to Iris last week, which had pacing issues and trouble with creating a well rounded account of dementia, it's leagues ahead. If you're at all interested in the euthanasia debate or finished watching The Diving Bell and the Butterfly and want more touching stories about people lying in a bed a lot, then it is most definitely worth taking the time to watch. 

I feel like there should be a "but...", but I can't think of anything. Oh, wait, there it was. Huzzah.

Overall Ben Equivalence Rating

Going on Holiday to Spain and Spending Every Day

Looking Out of the Window Listening to Classical Music - 

"Dad, this is fun and all, but can we please go to the beach?"