A Matter of Life and Death was made in 1946. It’s a film by Powell and Pressburger. They tell the story of a pilot, Peter Carter, shot down during the Second World War. But as he falls to Earth, the angel sent to bring his soul to heaven loses him in the fog, and by the time they find him he has fallen in love so he pleads to be allowed to stay alive a while longer. A court case to decide the issue is set up in Heaven. OK, so far, you’re thinking “this is just crazy, isn’t it?” Well, it’s a much more interesting movie than just a fantasy. And here’s what makes it interesting for me – Peter’s new love, June, asks a doctor friend to see him. This doctor, Dr Frank Reeves, is a neurologist and diagnoses that the pilot is suffering from a brain lesion which is affecting his visual pathways and so causing these vivid hallucinations of angels, heaven and a court case. What Dr Reeves very cleverly realises is that Peter’s story of the court case in heaven is so coherent and convincing to him (Peter) that if the case goes against him he will die and if it goes in his favour he will live. He deliberately encourages Peter to develop a positive narrative of how the case may go while persuading a neurosurgical colleague to operate on Peter.
The operation is successful and so, of course, is the court case.
Although this movie was made way back in 1946 it is remarkably perceptive and knowing with regard to the human psyche. It shows the importance of narrative in making sense of our experiences and it shows neatly how two different narratives (the medical/neurosurgical one and the patient’s one) can intertwine, indeed, MUST intertwine to produce a successful result of a treatment. The key scene is just over an hour into the movie where Dr Reeves is explaining his diagnosis and the importance of Peter’s narrative. I especially smiled at this comment by Frank Reeves –
A weak mind isn’t strong enough to hurt itself. Stupidity has saved many a man from going mad.
This is part of his argument that this “delusion” of Peter’s is not madness but is a physical problem of the brain. He argues that the delusion has its own internal logic and that Peter has an exceptionally good imagination. This is an interesting early exploration of the relationship between psychiatric illnesses and organic brain disease. But mostly it is an interesting exploration of the importance of the patient’s narrative, not only as a key method of diagnosis (a skill I fear is being lost in Medicine today) but also as a determining factor in healing, even in tipping the balance between life and death. More than this, it makes me think about the age belief – that there is a fine line between genius and madness. However, there is no known link between IQ (one measure of “strength” of mind) and the chances of having a mental illness. But is this what Frank means by “strong” or “weak”? What IS a “strong” mind? Frank says nothing about Peter’s intelligence, what he emphasises are Peter’s imagination and his ability to be logical. Here is what he really means – a “strong” mind has at least two strong capabilities – imagination and logic. Aren’t these key tools in the creation of narratives? Aren’t the most compelling narratives the ones which have been well imagined and seem to the reader to make sense (within their own terms)?
So, what of this apparent danger in a “strong” mind? If we think of this the same way as Frank we can see that if the narrative we tell ourselves becomes dislocated from external reality but is a STRONG narrative then it becomes harmful. This is the way I understand psychosis – a psychotic state is one where the person’s beliefs, their narrative of self, is not well connected to external reality and so becomes a hindrance rather than a help in living.
What’s the lesson here? It’s good to develop a strong narrative ability (it is this, at least partially, which saves Peter’s life – OK, I know, some will argue it’s the surgeon’s skill which does it, but time and time again recovery depends on individual patient’s mental state even when the same pathology is excised by the same surgeon). The danger lies in creating stories which don’t make sense of external reality when the storyteller fails to realise that. We can protect ourselves from that by sharing our narratives to co-create with others the narratives that make sense of all our lives.
What a great movie! I haven’t even touched on the technique of this film, the use of colour and black and white, the special effects, the framing, lighting, scene setting. I should also warn you that if you are of a sensitive disposition (like me) you’ll be in tears in the first ten minutes of this movie (I was!!)
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