The Whale

I finally saw this movie as it hit my subscription networks. It is an interesting story from many perspectives that is expertly told and acted. It raises several perspectives relevant to psychiatry but thankfully that explicit connection was left out of the production.  As the final credits rolled – I noticed that it was adapted from a play.  This is the closest I would come to seeing a play.  I do not think that I am constitutionally able to watch plays. They all seem contrived, overacted, and at times require a level of immediate and shared imagination that I do not possess.  I prefer solid ground as a jumping off point – even if things go awry from there.

The stark reality of this film is the home of Charlie (played by Brendan Fraser).  We meet him as he is teaching an online course in creative writing and see a typical Zoom interface. Charlie is the only one without a visual display.  He explains that his camera is broken. The scene cuts to his home. It is a dismal setting.  We see that Charlie is massively obese, barely able to ambulate and then with great effort, and in very poor health. At one point his nurse and friend Liz (played by Hong Chau) enters and tells him that he has hypertension and congestive heart failure to the point he needs to be seen emergently or he will be dead in a few days.  His poor health is displayed many times as he starts laughing but that rapidly turns into a cough and then chest pain. Over the course of the story, we learn that Charlie was not always like this but after losing his lover Alan to suicide he began overeating and gained a massive amount of weight. We see him binge eating at several points in the film – in one case biting off a fourth of a large meatball and cheese sub sandwich and obstructing his own airway to the point that Liz had to jump on his back to dislodge the food. After chastising him she picks the remaining sandwich off the floor and hands it to him.

The food theme is prominent over the several days duration of the film. Charlie gets a pizza delivered every day and he leaves the money in the mailbox.  The delivery driver talks with him through the door and eventually they address each other by their first names. At the last delivery the driver asks Charlies repeatedly if he is OK and appears to walk away.  As Charlie opens the door, he notices the driver is off to his left looking at him and appearing mildly shocked. Neither of them speaks but Charlie goes back in the house obviously upset and binge eats the pizza along with several additional items he adds from his refrigerator.

Charlie’s self-destructive eating and the associated self-loathing is a prominent theme throughout along with the expression of disgust.  He actively seeks confirmation that he is disgusting on a physical basis but only gets it spontaneously from his daughter Ellie (played by Sadie Sink).  Ellie is an angry teenager, performing suboptimally in school and she directs much anger at Charlie for abandoning her at 8 years of age when he left for the relationship with Alan.   Charlie actively seeks a relationship with her and at one point promises her a large sum of money just to spend more time with him, even though the time he has left is measured in days. He repeatedly apologized for his “bad decisions” in the past and emphasizes that he wants to try to make things right.  He would go as far as helping her write essays that might allow her to pass to the next grade in high school.

Two other characters are introduced over the course of the film.  Thomas (played by Ty Simpkins) shows up at Charlie’s door one day as a Christian missionary. He presents himself as a person intent on saving Charlie through God and Christianity.  He comes into dialogues with both Liz and Ellie.  Liz pointedly tells him to stay away from Charlie - that there are people who do not need to be saved.  She also points out the significant flaws in the local church that Thomas is affiliated with. Her father is the pastor of that church and Alan was her brother. Her father tried to arrange a marriage for Alan and described his suicide as a tragic accident. In his conversation with Ellie, Thomas discloses enough details of his life and why he might be estranged from his parents that Ellie is able to track them down. That eventually leads to reconciliation.

Charlie’s ex-wife Mary (played by Samantha Morton) appears toward the end of the film. There is a detailed discussion of the mistakes that were made and Mary’s chance meeting of Alan in a WalMart parking lot.  Even though there is a lot of tension, there is still an obvious level of caring between Charlie and Mary. Mary discusses Charlie’s unflagging optimism as one of his attributes that she misses. At some point it becomes obvious that the large sum of money that Charlie intends to give to Ellie may have come at a cost to his own health.  He has no health insurance and Liz points out what additional services he could have received.  Charlie refuses medical care and emergency services based on the cost, although that refusal is also consistent with his self-destructive path. He hears Liz describe the stress that he is putting her through but is unfazed.

Throughout the film, an essay about Moby Dick is referred to. The basic message of the essay is that the author can deny aspects of his own life and introspection about it – by focusing on killing whales. We eventually learn that this essay was written by Ellie when she was in the 5^th grade.  Charlie asks people to read him the essay when he is in a medical crisis with chest pain, shortness of breath, and diaphoresis.  He finds it comforting.  He also retypes the essay and gives it to her for school and she becomes enraged when she finds out. Charlie emphasizes that he only meant to show her that he appreciated her intelligence and creativity.

At a psychological level, Charlie is dependent and self-effacing. His motivation appears to be trying to correct past mistakes, especially abandoning Ellie, even though that was a complicated process that he was only partially responsible for. His reaction in these problematic scenarios is to accept the blame and go far beyond that to see himself as a disgusting person and ultimately a physically disgusting person (his characterization) that he produced by excessive eating.   

Several reviewers commented on the empathy in the film, but I really did not see any. Nobody seems interested in what happened to Charlie and how he got into this predicament – only that he is in it. They are attached to Charlie for various reasons but also out of their own self-interest.  As in real life, a lot of emotion happens in those settings as people are frustrated with Charlie when he does not accept their advice.

A relevant psychiatric dimension is the issue of involuntary treatment. In these last days of his life we see that Charlie has very high blood pressure, congestive heart failure, and possible angina that necessitate emergency care. Liz confirms that she has discussed his situation with an emergency medicine physician who concurs with her opinion.  Charlie even Googles his numerical blood pressure to confirm that it is an emergency. And through the film, he says he will not be treated and Liz agrees that she will not force the issue. But suppose that she wanted to.  What might happen in this situation?  Charlie could be transported to the ED, treated, and agree with admission for stabilization. He has no apparent psychiatric diagnosis, but it does not take too much imagination to see how any extended dialogue would get into the area of self-care and self-destruction to the point that the attending physician would consider an emergency hold. It is not uncommon to see people who have secluded themselves and not taken care of themselves admitted to inpatient psychiatric units with as many medical problems as Charlie. Suicide by food or lack of self-care is less dramatic than other methods but it can produce the same result.

Would Charlie be seen as depressed?  Probably – but is that the real problem? Moral injury seems to be a more proximate cause superimposed on a man who accepts all of the bad things happening in his life as his fault and reacts according. It allows him a veneer of optimism, while never having to confront the realty that human relationships are more complicated than that.  

Psychiatric speculation aside, this is a complex film that you must see.  The writing and acting is excellent.  The interpersonal drama has unique dynamics and is first rate.  I hope to see all these actors in other projects. It is a well thought out story line – right down to Charlie’s Zoom exit from his creative writing class. And importantly there is a clear message that there are all kinds of people out there struggling through life as best as they can every day. Those struggles may prove resistant to the insights and best advice from others.   

 

George Dawson, MD, DFAPA

A Great Independent Film and Its Lessons

When I first saw the trailer for The Last Black Man in San Francisco I knew it was a movie I had to see. The trailer itself suggested great cinematography and a unique story. By the time I looked for it again at my local cinema it was gone. I subsequently learned it was critically acclaimed but did not make much at the box office. I was very pleased when I was working out two nights ago and it popped up as a streaming choice on Amazon. It turns out that this is an outstanding independent film and I will probably come back to it.

I have not reviewed a film on this blog for some time but will include the customary spoiler alert. Some people just prefer a global recommendation rather than details. At this point I am going to proceed with some details.  This film is primarily about the relationship between two young black men - Jimmie Fails and Montgomery “Mont” Allen. Over the course of the film we learn that they are best friends.  We also learn that they are both staying with Mont’s blind grandfather. The conditions are less than optimal. We see Jimmie sleeping on the floor of Mont’s room. We see all three men watching television and Mont providing a running commentary for his grandfather sometimes to Jimmie’s exasperation. We learn that Mont is an aspiring playwright and artist. We catch glimpses of his work and his grandfather is very encouraging.

In the opening scene Jimmie and Mont skateboard to a very large Victorian house in another part of San Francisco. We learn that Jimmie used to live in this house and that he said his grandfather built it in 1946. The opening scene at the house he is painting some windows but there is a couple in the house and the woman of that couple is very angry with him for not staying away from the house. Jimmy and Mont talk about maintaining various aspects of the house. At one point the couple moves out and they move in. They go so far as to get furniture from Jimmie’s aunt’s home and move that into the place. There is not a very clear plan for possession of the house. They eventually have some interactions with a realtor, a banker, and a county official. None of those interactions are productive in terms of helping them purchase or acquire rights to stay in the home. Jimmie eventually tells Mont that his plan is to stay there no matter what. We eventually learn that Jimmie’s grandfather really did not build the house and that it was constructed in the late 19^th century.

As Jimmie and Mont travel between Grandpa Allen’s home in the mansion they regularly encounter a group of young black men out of the street.  One of them was a tall young man named Kofi who Jimmie knew from the year he spent in a group home. They were both skateboarders.  Jimmie thought that Kofi was quite good and asked him if he was still skateboarding. Kofi said that he was not. The skateboarding theme was important because Jimmie appeared older than most skateboarders and as his father put it “dressed like a white boy” in a red flannel shirt and khaki pants. There was a lyrical scene when Jimmie was skating down the San Francisco hill to Jefferson Airplane - until he wiped out three quarters of the way down the hill. I took the skateboarding as a symbol of Jimmie being stuck in an earlier time and what he has to do with the skateboard in order to move on - confirms this later in the film.

Kofi was the only young man invited to the Victorian house by Jimmie and Mont. When he was there, they all seemed to enjoy themselves. That was in contrast to the confrontations that Jimmie and Mont had with the young group of men in general.  They had very different styles of interacting with these young men. Mont was nonconfrontational and seemed to take a didactic role with them in that in one scene was described as “directing”. Jimmie was more confrontational and at one point asked Mont about his style of interacting. Mont told him that by avoiding confrontation he was able to appreciate these other men for who they really were.

The dynamics between Mont, Jimmie, and this young group of men was one of the most interesting aspects of this film. Jimmie characterized this group as “talking shit”.  This is a colloquial expression for young men engaging in interactions that could be considered sarcastic or overtly mocking. In some cases physical threats are feigned and there is always some risk of bullying or actual physical confrontation. This type of behavior in young men is common and as far as I know occurs in all cultures. A common way of dealing with it is to just avoid it. Mont and Jimmie do not avoid it.  Mont continues with what I saw as an empathic but at times eccentric approach to the mocking. Jimmie tends to deal with it in a more straightforward way by making similar statements or feigning physical aggression. The risk of “talking shit” is highlighted when Jimmie and Mont learned that their friend Kofi was shot and killed by a gang in one of these confrontations.

Jimmie and Mont learned about Kofi’s death from the group of young men they encounter. Jimmie becomes very confrontational trying to learn about what actually happened and it appears that he is at risk for a physical confrontation with one of the men. Instead that man becomes very tearful, start sobbing, and embraces Jimmie in one of the more emotional scenes of the film.

Kofi’s death was the subject of a one-man play put on by Mont in the Victorian house. In the play he confronted the small audience of local people and what they really knew about Kofi. During the exercise he  elicits a number of superficial observations from the audience. He asked Jimmie for comments and he described the positive and negative aspects of his relationship with Kofi concluding “people aren’t one thing”. From there and in the same setting Mont confronts Jimmie about the fact that his grandfather did not build the house. Jimmie gets angry and leaves and all of the theatergoers file out after that.

Jimmie eventually accepts the reality that he will never be able to stay at the Victorian house that his family used to live in. He grows more uneasy staying with Mont and his grandfather.  He leaves one night, with a note behind to Mont thanking him for being his best friend.

That basic story line is set in what I would describe as a separate visual story. That story has elements of how people have been misplaced in San Francisco by the current housing crisis, how that toll has fallen unevenly and unfairly on people who are not making high incomes, and how people who show up for a job in that area might not have the same appreciation for the area as long-term residents do. There is the clear message that the plight of low income people is being ignored by responsible officials to the point that their health is endangered. At one point Jimmie asks the rhetorical question about why a millionaire is more entitled to stay in his old family home than he is.  From the visual standpoint the story is brilliantly told.

On an interpersonal level, this is a story about relationships between men. The main characters Mont and Jimmie are interesting and likable. I found myself rooting for them and hoping that nothing bad would happen to them. In the final scene Jimmie is rowing a small boat in Pacific swells by the Golden Gate Bridge.  He is not in any danger but you wonder where he is headed.

And you wish him well.

George Dawson, MD, DFAPA



Graphics Credit:

Shutterstock per their standard agreement. "Painted ladies from Alamo square park over San Francisco skyline during the day."   By Sergey Novikov.