JUMP CUT
A REVIEW OF CONTEMPORARY MEDIA

Friedrich works on her vine embroidery. The room's colors and furnishings and quality of light are in strong contrast to those of the hospital.

Shopping for the ingredients for Chinese herbal tea. The mise en scène connotes “natural” medicine as opposed to “scientific” modern medicine.

Embroidering the uterus.

Embroiders a flower for the vine.

Embroidering the breast and its ducts for the vine.

The film begins with a shot of a corner of a hospital’s reception area. It’s uncluttered and uninhabited space and its precise geometry of horizontals and verticals offer intimations of the hospital’s alienating environment.

The film’s title follows the opening shots of the hospital’s reception area, which, like all the hospital material, was shot more-or-less clandestinely with a high-8 video camera.

Friedrich submits impassively to an examination by a doctor reduced to arms and hands while the ubiquitous and (to the layperson) enigmatic medical instruments hang (innocently or ominously) on the wall behind her.

Friedrich waiting for breast surgery accompanied by the ever-present machinery of modern medicine.

Friedrich declaring to the camera she is carrying down a hospital hall, “I hate hospitals.”

Examples of the “weird framing” resulting from Friedrich’s having to set up the camera before her sessions with doctors and nurses.

 

Scars

The film’s theme-and-variation structure involves comparable uses of sound, images and intertitles. Each account of an operation begins with a voice-over providing a textbook description of the part of the body requiring surgery. In chronological order of the operations, they are the spleen (a large cyst), the ovaries (an abscess), a ligament in one knee (damaged while skiing), cartilage in the other knee (general wear-and-tear: “Was it,” Friedrich asks in an intertitle, “the tennis or the African dance class?”), the uterus (polyps), and one breast (“something in my ducts,” Friedrich explains in an intertitle). The last operation receives considerably more attention that any of the previous ones, but thanks to photographs, medical records, and narrative details in intertitles, each operation is vividly and cinematically realized. In each case, as well, we see Friedrich working on her embroidered version of the spleen, ovaries, knee ligaments, and so on. Accompanied by a leaf indicating the year of the operation, each object of an operation appears in chronological order among the vine’s more conventional flowers and leaves.

In contrast to the embroidered vine’s floral chronology of the operations, purely factual, impersonal intertitles identify each operation as if they were labels on Friedrich’s medical files: “Operation number one: November 20, 1977, age 22,” “Operation number two: July 23, 1985, age 31,” etc., concluding with “Operation number six: October 15, 1999, age 44.” While we do not see the actual operations, we do see photographs or filmed images of the resulting scars. [10] [open endnotes in new window] “You’re a great healer, that scar really faded,” a doctor tells Friedrich. The same, however, cannot be said of the psychological scars. As Friedrich says in an intertitle following her third operation,

“A year passed. The scars healed. But I was a wreck.”

Friedrich embroiders the spleen for her “vine of operations.” A photograph of the scar left from the operation on Friedrich’s spleen.
A photograph of the scar left from the operation on Friedrich’s ovaries. Embroidering the pituitary gland.

Along with images of the scars, Friedrich supplies closure for each operation’s mini-narrative by reading (in voice-over) from the official medical report on the surgery. After some detailed, technical information about specific surgical procedures, all the reports conclude with formulaic phrases that serve as increasingly ironic refrains:

  • “The patient tolerated the procedure well. Estimated blood loss was about 500 ccs. The patient was sent to the recovery room in a satisfactory condition.”
  • “The patient is taken to the recovery room in satisfactory condition.”
  • “The patient was then placed in a knee extension brace and brought to the recovery room in good condition.”
  • “The patient was brought to the recovery room in good condition.”
  • “The patient was transferred to the recovery room in satisfactory condition having tolerated the procedure well.”
  • “The wound is sterilely dressed and the patient, having tolerated the procedure well, is brought to the recovery room in good condition.”

Thus the medical establishment regularly welcomes “the patient” back to the kingdom of the well. Friedrich leaves us to reflect upon the gap between the pain and anxiety she undergoes with each operation and the dispassionate, impersonal, and self-assured resolution offered by the medical establishment.

When the trauma of surgery is not involved, Friedrich’s passage from sickness to health is slower but profoundly more satisfying. Following operation number three, a voice-over provides information about the pituitary gland, and a close-up shows Friedrich’s needle and thread creating her embroidered version of that gland. One of the hormones produced by the pituitary gland, we learn from the voice-over, is prolactin, which characteristically increases after women give birth and, consequently, is associated with lactation and a decrease in sexual desire. During an appointment with her doctor Friedrich says that a blood test in 1989 revealed her prolactin level to be 300; an intertitle informs us, “Normal prolactin levels range from 3 to 20.” In a later sequence of intertitles Friedrich declares,

“No wonder I cried for hours on end. No wonder I rarely wanted to have sex. I’d spent ten years in a post-partum condition.”

She takes various measures to bring down her prolactin count: acupuncture, Chinese herbal remedies, t’ai chi, a healthier diet, a prescribed medication. They gradually achieve their purpose. Subsequent intertitles chart her improvement: from 300 to 146, to 119, to 50, to 35, and finally, as she waits for still another meeting with a doctor, Friedrich looks into the camera and tells us that her “prolactin level [is] down to about 25” and adds, “I certainly feel better.” In contrast to the hospital’s formulaic reports on the “satisfactory condition” of “the patient,” Friedrich’s intertitle provides a more humane and fulfilling closure: “What a relief to have my body back.” And alluding to the near breakdown of her relationship with her partner, the next intertitle reads, “And a pleasure for both of us.”

This optimistic declaration comes after her sixth operation, a biopsy which shows that what her doctor idiomatically calls “junk” in the ducts of the breast is “totally benign.” Despite this encouraging outcome, the biopsy appears to have been the most traumatic of Friedrich’s six operations. It leads to her fullest exposure of the effects of an operation on her body and her emotions, and produces her fullest confession of vulnerability. Before the operation she already has misgivings. “I really, really, really, really don’t want to do this,” she says, before filming her reflection in a mirror. With a video camera held up to her eye she films her bare breasts, slowly zooming in on the one to be operated on. After the operation she again films herself in a mirror, removing her bra to reveal a bandage on her left breast as she talks about the operation’s after-effects of swelling and pain. After some intervening shots, including one of Friedrich hearing the doctor’s reassuring report on the negative results of the biopsy, Friedrich is again in front of the mirror, at which point she pulls off the bandage to reveal the partially healed incision on her breast. “Hideous” she exclaims. “I can’t imagine you want to look at this. But it has improved.” “Six days later,” as an intertitle announces, she films the breast again, now bandaged with a narrower strip of tape and showing a large, brownish bruise next to the bandage. In voice-over Friedrich says,

“You know, when I look at it, I alternate between thinking, ‘Poor thing,’ and thinking, ‘Uhh, you are so ugly.’ And it looked so much worse before, but I kinda can’t bear to look at it, and then I think I should look at it. I should think good thoughts about it and wish it to feel better. So, anyway I’m going to take this thing off and, uh, put another one on—maybe. I don’t know. Maybe I should keep this thing covered. It feels very exposed.”

Although she does not force us to watch as she pulls off the bandage this time, we cannot help but empathize with the physical suffering and unhappiness Friedrich’s body has, again, inflicted upon her.

That empathy is burdened, however, with conflicting affective and visceral responses–as Friedrich recognizes: “I can’t imagine you want to look at this.” And she shares our ambivalence: “I kinda can’t bear to look at it, and then I think I should look at it.” If she should look at it for therapeutic reasons, we should look at it as, on the one hand, a signifier of documentary authenticity literally incised on the filmmaker’s body, and on the other hand, as a metonymic summation of the physical and emotional traumas Friedrich has experienced as, again and again in the course of her film/life, she has gone through the rituals of examination, operation and recovery. The culminating image of the wounded breast drives home the point that both the autobiographical credibility and the social-political relevance of the film depend upon the presence of her body on screen.

Friedrich films herself in the bathroom mirror before her breast surgery. In front of the bathroom mirror, Friedrich films herself after the breast surgery.
The filmmaker filming herself filming herself. Friedrich’s swollen and bandaged breast several days after the surgery.
The breast approximately two weeks after the surgery. Friedrich’s reflection in the bathroom mirror during her rant about her ill heath and its consequences for her physical and mental life and her relationships.

This final image of her body’s vulnerability also serves as a visual introduction to a climactic monologue in which Friedrich releases the frustrations and anxieties that have built up over her many years of operations. In a medium close-up of her head and bare shoulders, Friedrich stares balefully into the camera and declares,

“I just don’t want to feel like this anymore. I don’t want to go the hospital anymore. I don’t want to have any more surgery. I don’t want to have any more scars. I don’t want to be black and blue. I don’t want to be in pain. I don’t want to take Tylenol with codeine. I don’t want to have my girlfriend worry about me. I don’t want to have her angry at me. I don’t want to ever have to ask her to take care of me when these things happen. I really don’t want this to ever happen again. And I said that the last time I had surgery, and I was sure it would be the last time, and now I’m saying it again, and I feel like having it happen the last time, now that I’m saying it again doesn’t mean anything either. And a year from now, I’m gonna be standing in this bathroom staring at yet another part of my body that has a scar on it. And I’m fucking sick and tired of it, and I just want to be healthy, and I want to be whole, and I don’t want to have, you know, scar, scar, scar, scar, scar, scar inside. I just don’t want any more of them.”

Although it will take time for the latest scar to heal completely, this outpouring of pent-up emotions marks a turning point in the film’s chronicle of operations. It signals Friedrich’s renunciation of citizenship in the kingdom of the sick—though one suspects the psychological scars will never disappear completely. Nor will concerns about her health simply vanish. She will still have to deal with some unexpected bleeding from the biopsy incision; she will have a mammogram that “raised some questions” but did not lead to further surgery; she will undergo bone density tests and start taking calcium pills to guard against osteoporosis; she will face the fact that menopause looms on the horizon. (“Oh, not menopause...” she superimposes on a shot of herself sitting on an examining table as her doctor broaches the subject.) All of this suggests that the border between health and ill-health is more permeable and ill-defined than Sontag’s dichotomous kingdoms of sickness and health would suggest. Seen from the perspective of disability studies, illness and wellness are relational, not antithetical. Nevertheless, in both the narrative structure and the discourse on health in The Odds of Recovery, Friedrich makes it clear that the appropriate closure to illness is recovery. With the succession of her operations at an end and her prolactin level nearly normal, Friedrich devotes the remainder of her film to a cautiously hopeful renewal of her citizenship in the kingdom of the well.

Hospital

 The Odds of Recovery opens with a dark screen and the clatter and hum of a busy office–announcing, before we realize it, the institutionalized, bureaucratic structure of the health-care system. The noise continues over an extreme close-up of papers on a clipboard.

Soft-focused, nearly abstract images of forms to be filled out at the reception desk suggest, perhaps, Friedrich’s subjective response to the standard procedures of checking in at a hospital.

They move out of the frame, revealing a partial view of the blueish-white interior of the reception area of a hospital. A hand holding some papers crosses the frame. An extreme close-up of a hospital form gives way to softly focused, abstract blue-white shapes that fill the screen as the following exchange takes place between a hospital receptionist and the filmmaker:

“What I’m highlightin’, ma’am, is just to be filled out please, so we can get a chart going on you.”
“I don’t know where the health proxy chart is.”
“Right there. That’s the one in your hand.
“Well, it doesn’t—oh, okay—yeah.”
“Now, the one you have in your hand, that one’s gonna go in your chart.”
“Okay.”
“Then there’s the other copy in the book.”
“Okay. Fine.”
“Okay, Miss Friedrich—uh, married, single, widowed, divorced?”
“Domestic partner.”
"Okay, ma’am, when you’re finished you have to take everything from the top off only, including your bra.”

A cut to a neatly folded hospital gown on the seat of a chair accompanies the final instruction: “And you put that gown on.” A montage sequence of Friedrich dealing with various hospital gowns follows. She puts on a gown while commenting, “I hate these things”; puts on a different gown; unfolds and examines a crackling pink paper rectangle, muttering,

“What the fuck is this? Oh, I thought it was a robe. It’s just a towel. Okay.”

Friedrich in her seeming interminable struggles with hospital gowns and paper jackets.

After a brief interlude with Friedrich sitting in a chair talking with a doctor, the montage sequence continues. Friedrich awkwardly tries to reach the ties of a hospital gown dangling behind her back. She tosses a gown on an examining table and puts on her bra as she irritably says to herself (and us):

“Get dressed. Get undressed. Get dressed. Get undressed. Eat your lunch. Wait. Get undressed again. Get dressed. I’ll talk to her. I’ll talk to you. She’ll talk to you. I’ll talk to her. We’ll talk to each other.”

The sequence ends as she picks up another crackling paper shape remarking, “Now it’s blue. Sometimes it’s pink. Sometimes it’s blue. She called it a jacket. It feels like—” She puts it on and leaning toward the camera says, “You see this? It has tape so you can make it stick together.” She closes the front with the tape, and with light mockery of both herself and the sterile institutional apparel she’s required to wear, she poses for the camera like a fashion model as she adds with feigned delight, “See? Jacket!”

Friedrich in the embrace of the hospital’s formidable, high-tech machinery. Another image of the hospital’s modern technology.

From the opening of the film, Friedrich shows herself to be unhappily familiar with the role she has to play within the power structure of institutionalized health care. The physical manifestation of that power structure is the hospital, and with a High-8 video camera Friedrich surreptitiously captures the hospital’s spaces and sounds, its generic furniture and enigmatic equipment, its rituals of checking in, answering questionnaires, filling out forms, submitting to the indignities of hospital gowns and “jackets” (“just all planned humiliation” she complains after another struggle with a hospital gown), and meeting with doctors who may or may not provide the information and useful advice she needs.

Friedrich’s unorthodox and relatively low-tech method of recording sounds and images in hospitals produces a sense of intimacy and immediacy in her presentation of her many encounters with the structural and human components of the health-care system. It also contributes a distinct visual style to the hospital footage. As the film’s opening images indicate, Friedrich was able to bring her small video camera into the hospital and, holding it in her hand or setting it down on a counter or desk, film, in close-up detail, the charts and paperwork that go along with checking in at the hospital. (If asked, she simply pretended that the camera wasn’t turned on.) At the same time, she could record the ensuing conversations and the accompanying ambient sound. For examinations and consultations, she set up the camera before the doctor arrived. In most cases, the camera seems to have been placed about waist-high, so that the framing allows us to see Friedrich only from chest to knees as she sits on a chair or the edge of an examining table. Frequently the doctor is not visible at all, or appears only as a shoulder and arm or a back at the edge of the frame. This “weird framing,” as Friedrich has called it, contributes to the film’s representation of the hospital as an impersonal, alienating environment.[11] Born of necessity, the framing has the effect of a conscious strategy to reduce the sense of Friedrich as a whole person and to de-personalize the doctors and eliminate face-to-face, human contact in the patient-doctor relationship. The cumulative effect is to make the hospital seem inhospitable, a public-private space designed to maintain the patient’s subservient role in the power structure of the medical establishment.

Nevertheless, thanks to the medical system, Friedrich survived six operations.[12] Significantly, her critique of the system does not seem intended to expose its failures in order to argue for reforms (à la Michael Moore), but rather to make its workings visible through the lens of her own experience, to document one person’s exposure to the system and the toll it takes on her physical and psychological well-being. The entrenched, private health-care system is presented as a given with a set of variables over which the individual has little, if any, control. As filmmaker-patient, Friedrich offers her own point of view on how those variables affect her survival within the policies and practices of the health-care system, but it is impossible to ignore the implications for anyone else who must enter the kingdom of the sick.

If Friedrich is hard on the health-care system, she is also hard on herself. Her presentation of herself is not especially kind or ingratiating. She makes no effort to hide the fact that she can be impatient and even slightly paranoid when, for example, she has to deal with the standard hospital gown. As noted earlier, she blames “planned humiliation” for her difficulty in figuring out how to tie the gown’s strings properly: “They make it in such a way there’s no way to tie it so you’re not hanging out,” she asserts. But when she finally succeeds, she grimly states, “I’ll do it so well they won’t be able to get into it—get to me.” A long sigh follows, signifying her recognition of the futility of her little gesture of rebellion against the system, while at the same time eliciting the viewer’s empathetic recognition of the endless humiliations and frustrations of those who must submit to the prescribed routines of the health-care system.

Equally revealing is a short sequence in which Friedrich, wearing the ubiquitous hospital gown and visible only from waist to knees, paces back and forth in front of the camera as she berates herself for forgetting to set the camera on record when a nurse came in for a pre-screening before her biopsy. Friedrich says,

“What I wanted to do was to record what a bitch I was with her because I’m so angry about how they never keep the charts and never—you know—don’t even read them.”

At another point we see Friedrich getting off an examining table and pleading with an off-screen nurse, “Please don’t let this doctor make me wait longer. I just can’t bear it.” And a little later, as Friedrich walks down a hospital hallway, she looks down into the camera and declares, “I hate hospitals.” Does that say more about hospitals or about her? Certainly it is a self-revelatory moment, capsulizing her frustration with her enforced submission to the hospital’s implacable regime. And through the representation of herself within that regime, Friedrich most clearly illustrates the degree to which autobiographical subjectivity derives from the intersection of, as Renov puts it, “the domain of the subject and that of the enveloping world.”

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