Sunday, May 26, 2013

Side Effects -- big pharma ethics and quick fix mentality

Director: Steven Soderbergh, 2013 (R)

In what he has said is his last film, director Steven Soderbergh brings his cold and crafted camerawork (he does his own cinematography) to a contemporary big-Pharma story that could be pulled from tomorrow’s headlines. But the film is not really about medical ethics. It turns out that it is a sharp psychological mystery.

As the movie opens, Emily Taylor (Rooney Mara, The Girl with the Dragon Tattoo) is waiting for her husband Martin (Channing Tatum, The Vow) to be released from jail. He is serving four years for insider trading, a white collar crime that carries with it a social stigma. Suffering from depression and anxiety, it comes to the fore when she drives her car into a wall in a suicide attempt after Martin’s release does not bring back her earlier normality. In the hospital she encounters Doctor Banks (Jude Law, Sherlock Holmes), a psychiatrist. Sensing something deeper, he stipulates that she come see him after she is released.

Her initial visit results in a prescription for a cocktail of drugs. But these don’t seem  to work, as they leave her struggling to cope. When Banks runs into her previous psychiatrist Dr. Siebert (Catherine Zeta-Jones, No Reservations), she offers a suggestion: put her on an experimental drug called Ablixa. Although it carries a long list of side-effects, it seems to help Emily cope with her blues.

In the first half of the film, as we expect the movie to be about the ethics of medical doctors’ incestuous relationship with the pharmaceutical companies, Soderbergh paints a dark picture of this association. Banks is offered a chance to participate in an experimental trial, being paid big bucks to be a mouthpiece for the drug company. Although he explains the trial to the patients he coopts into joining the trial, he never reveals how lucrative it is for him, with so little work.

Ethically, such connection with the drug manufacturer without giving full disclosure is questionable at best and criminal at worst. The doctor is viewed as an objective professional, providing prescriptions that are in the best interest of the patient. We don’t expect such prescriptions to be filing his pocketbook. But that is what is happening, at least in this part of the film.

Yet Soderbergh does not camp on this. Indeed, the side effects of Ablixa become the focus at the center of the film. They cause a tragic incident that puts Emily in dire trouble. And as Banks was the prescribing doctor, it puts Banks in the cross-hairs too. And the second half of the film leaves the ethical questions behind, and instead take the viewer on an intriguing mystery. Although it may seem to some to be typical of many psychological thrillers, Soderbergh keeps the viewer engaged with a keen sense of pacing.

Despite the lack of likeable characters here, given that all are ethically or criminally twisted in one way or another, the quality of the acting makes them compelling. Mara brings an air of believability to Emily, as a fragile soul struggling to cope with normal living. Law is back in top form as a man caught in the middle of circumstances beyond his control. Zeta-Jones is delicious as a shady psychiatrist. And even Tatum shows his acting chops, making clear that he is not just a pretty face.

The second half of the film plays out without any obvious ethical dilemmas, and without answering any of the questions raised in the first half. But that first half offers some additional societal commentary. The tag-line says it all: “One pill can change your life.” And the film shows this, with Dr. Banks giving his wife a pill to help her before a job interview, telling her that everyone does it to get an edge.

This is symptomatic of America’s quick fix mentality. We seem to want our problems and our issues resolved right now, with minimal effort. And a pill swallowed with a glass of water is a very easy way to deal with life. Whether it’s an upper or a downer, a legal or illegal drug, we want to pop it and move on. We have no patience. We are in too much of a rush. We need to slow down. We need to allow our bodies to deal with life without overmedication. We must disregard the bombardment of messages from the drug companies that show up in the middle of our prime time shows. Even though they give us a list of side effects, these are usually voiced in rapid fire at the end of the commercial. If we took the time to listen to these and evaluated the risk, perhaps we would refrain more. Side effects can be more dangerous than the benefits of the drugs themselves.

 Copyright ©2013, Martin Baggs

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