Brain disorders in the real world and at the movies.

Cinema Paradiso

Brain injury and dementia can result in dramatic changes in cognition and personality. Add the emotional factors that are obviously at play when a loved one has a brain injury or dementia and you have the perfect ingredient for a night at the movies.

The British neuropsychologist Sallie Baxendale has pointed out that although amnesia is a relatively rare clinical disorder it has been a popular topic ever since the silent movies. Recent movies featuring amnesia, although not always realistically, are The Eternal Sunshine of the Spotless Mind (2004), 50 First Dates (2004), The Bourne Identity (2002) and Finding Nemo (2003). Quite a few movies have been made about dementia, a very common disorder among the elderly; Iris (2001), A Song for Martin (2001), Notebook (2004) and Away from Her (2006).

Brain disorders in the movies

Mrs. Turner, your husband is incredibly lucky. The bullet wound to the head caused minimal damage. See, it hit the right frontal lobe. That’s the only part of the brain that has redundant systems. I mean, if you’re going to get shot in the head … that’s the way to do it.”

This quote is from the movie Regarding Henry (1991) that tells the story of Henry, a ruthless lawyer, who gets shot in the head and becomes a better man! According to his doctor Henry was lucky that the bullet hit the frontal lobes. Although the frontal lobes used to be somewhat of a mystery and were thought to have no particular role this was not the case any more when Regarding Henry was made. We are now all too aware of the devastating effects of frontal lobe injuries or disease.

One sees many similar myths and misconceptions in movies and TV shows. At the same time films and TV show fuel and maintain these misconceptions. In a a recent study on public beliefs about brain injury in Britan close to 40% of the participants reported that their knowledge about brain injury was derived from TV, films and other media. Almost 30% of the participants also believed that memory loss could be cured by a second blow to the head. This mistaken notion is also seen in many movies (e.g., Tarzan the Tiger from 1922). Research has also shown that many people, including screenwriters, believe that upon waking from coma patients are lucid, able to get out of bed immediately and remember and speak normally (e.g., Blind Horizon, 2003). Just like brain injury and amnesia, dementia is in general not convincingly described in films. For example, in the movie A Song for Martin (2001) a neurologist diagnoses Alzheimer´s dementia merely by looking at a brain scan. This is not possible. In this context it is interesting to note that studies on lay knowledge of Alzheimer´s disease show that many people to think that a brain scan is critical in the diagnosis of dementia. It certainly is important in excluding other causes of cognitive decline but one does not “see” Alzheimer´s disease on a brain scan.

In conclusion

Obviously the scientific community cannot dictate the movie industry. Movies are made to be dramatic and fun. Their goal is not to be educational or to realistically depict brain injury, dementia, psychiatric disease and medical procedures. At the same time movies can sustain myths and misconceptions as well as prejudices about various medical conditions.

I generally manage to leave the neuropsychologist in me at home and enjoy the movies even though they may be unrealistic. One cannot always be at work! However, I also have to confess that I would prefer clinical syndromes to be depicted realistically. I am certain that accuracy would not diminish the dramatic impact of movies dealing with serious illnesses affecting the brain. Reality is dramatic enough. So, next time you see a movie do not forget that artistic license is generally considered more important than accuracy and most screenwriters appear to do little research when writing about neurological conditions.

Based on:

Baxendale, S. (2003). Epilepsy at the movies: possession to presidential assassination. The Lancet, 2(12), 764-770.

Baxendale, S. (2004). Memories aren’t made of this: amnesia at the movies. British Medical Journal, 329 (7480), 1480-1483.

Chapman, R. C. G. and Hudson, J. M. (2010). Beliefs about brain injury in Britain. Brain Injury, 24(6), 797-801.

Seger, K. (2007). Degenerative dementia and their medical care in the movies. Alzheimer´s Disease and Associated Disorders, 21(1), 55-59.

Wijdicks, E. F. M. and Wijdicks, C. A. (2006). The portrayal of coma in contemporary motion pictures. Neurology 66(9), 1300-1303.

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