Dressed up or messed up, disease gets top billing at the movies this year DOCTOR OSCAR

March 21, 1994|By Jean Marbella | Jean Marbella,Sun Staff Writer

Artistic license allows you to fudge the facts for the sake of your art. A medical license allows you to practice medicine. What happens when they meet?

You get movies in which medicine plays a starring role or serves as a plot device, sometimes with great accuracy, other times with only accidental resemblance to what really goes on in the hospital.

Medicine is understandably an intriguing subject for filmmakers.

A good medical mystery can rival any criminal whodunit for excitement and surprise twists. A terminal illness is the ultimate tragedy; a cure is among the most uplifting of happy endings.

The Academy Awards over the years have rewarded medical themes: Movies such as "Rain Man" (autism) and "One Flew Over the Cuckoo's Nest" (inside a mental hospital) have won best picture Oscars.

Daniel Day-Lewis won in 1989 for playing a cerebral palsy victim in "My Left Foot"; and Marlee Matlin won in 1986 for her portrayal of a deaf woman in "Children of a Lesser God."

Several recent movies similarly have ventured into the medical world, and so, on the day of the real Academy Awards, we decided to issue our own Oscars to those brave enough to take on this precise and necessarily fastidious field.

We asked real doctors to give us scalpels up or scalpels down on how Hollywood has portrayed their particular specialties. The envelopes, please:

* Most overdue portrayal of a disease: "Philadelphia"

More than a dozen years into the Age of AIDS, "Philadelphia" is the first mainstream Hollywood movie to focus on the disease. And that alone is enough to win it plaudits from those who have dealt with its ravages.

"I thought overall it was a very moving film that will open a lot of people's eyes," says Dr. Joel Gallant, director of the HIV clinic at Johns Hopkins Hospital. "It puts a human face on AIDS."

If pressed, he will quibble with some of the medical details, such as how the film handles the tell-tale Kaposi's sarcoma lesions, a skin cancer common to people with AIDS. Early in the film, Mr. Hanks' character develops lesions on his face -- which he claims alerts his law partners to his disease and leads to his firing -- but then, apparently through chemotherapy, "they miraculously disappear," Dr. Gallant says. "They might improve, but they would not disappear."

Later, an ashen Mr. Hanks is on the witness stand testifying against his former partners. They allege his facial lesions were barely visible; thus they had no idea that he was suffering from AIDS when they fired him. His lawyer requests that he show lesions elsewhere on his body that resemble those previously on his face, and, weakened by the disease, Mr. Hanks slowly, painfully pulls aside his tie, unbuttons his shirt and reveals a chest riddled with lesions, raised and brown, as horrifying as a swarm of leeches.

"That was very realistic," Dr. Gallant says, "but they wouldn't have disappeared from his face at the same time."

Also, the movie is a bit unclear on what actually causes Mr. Hanks' death, Dr. Gallant says. It's probably enough for a mass audience to attribute the death to general "AIDS," which is a bit inaccurate because AIDS is a syndrome, rather than an actual cause of death. Dr. Gallant says what appears to cause the death in the movie is the cytomegalovirus, or CMV, which, among other things, causes vision problems such as those Mr. Hanks' character suffers toward the end of the film. CMV, he says, would also explain why he is hooked up to an intravenous line at home, a prop that plays into a particularly affecting scene in which Mr. Hanks speaks along with a Maria Callas recording of an aria.

* Most imaginative use of transplant surgery: "Blink"

Madeleine Stowe is a musician who has been blind since childhood, when her abusive mother smashed her into a mirror. She regains sight through successful cornea transplant operations, but with a complication: She "sees" things but doesn't organize them into coherent images until later.

This makes her a less-than-perfect witness when a neighbor is murdered by a serial killer whom she "sees" in the hallway.

"There would be some blurring of the images for a while," says Dr. Terrence O'Brien, a Johns Hopkins ophthalmologist who performs corneal transplants. "But there's no delay in the brain processing the image. The optical properties of the eye are very straightforward. A cornea transplant would have nothing to do with images which are processed at the level of the brain."

"You do not get delayed images," agrees Dr. Ronald Smith, president of the American Academy of Ophthalmology. "A cornea is simply a window -- it doesn't capture images and store them."

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