Considering how many long-term sick and disabled people there are in real life, we don't see them in the movies very often. Even less well represented are those who spend their time providing basic care for such people, despite the fact that the patient-carer relationship has the potential for a fascinating narrative dynamic. However, a number of films have attempted to address aspects of the patient-carer dyad.
Communication has been the focus of several film-makers' attempts to portray the patient-carer relationship. In The Bone Collector and both versions of Rear Window, disabled heroes must convince others to act on their behalf in order to try and solve the mysteries they're faced with. These films employ a familiar Hollywood action format, yet their accomplished stars - Denzel Washington, James Stewart and Christopher Reeve (who was, of course, severely disabled himself) go further in order to express the frustrations of their limited independence and the emotional complications which develop between them and the people they depend on.
Each of these films shows the patient-carer relationship in a positive way, showing how dependent individuals can still enrich the lives of those close to them. By contrast, Whatever Happened to Baby Jane- presents a situation in which that relationship has gone sour. Drawing on the famous animosity between its two aging stars, Bette Davis and Joan Crawford, it tells the story of a former actress disabled by a car crash and living in the care of her tyrannical sister who is, in turn, slowly losing her mind. There's attendant melodrama regarding who caused the crash, but most of the guilt and frustration which the actresses display relates directly to their immediate situation. Dramatic set pieces ably illustrate the disabled woman's vulnerability, yet she is never reduced to a two dimensional character - the unpleasantness between the two is mutual. Feeling trapped by her situation, the carer, Jane, retreats into dreams of her childhood fame. Through the lens of melodrama this Hollywood classic reveals many of the struggles which real people in situations of this sort have to deal with.
The notion of sacrifice on the part of the carer, and the strain which this, in turn, places on the patient, has proven difficult for film-makers, with only a few successful examples in American cinema. Darren Aronofsky's The Fountain tells the story of a man trying desperately to help his wife, who is dying of cancer, and alienating her in the process, though the couple gradually recover the understanding which was once central to their relationship. In David Lynch's The Elephant Man, the deformed John Merrick (also suffering from neurofibromatosis and what was later confirmed as proteus syndrome) attracts the attention of a physician who gradually comes to undertake much of his personal care, forming a strong personal relationship with him in the process. Lynch had previously directed Eraserhead, which tells the story of a man struggling to cope with his responsibility to his premature and grotesquely deformed baby. The imagery may be monstrous, but the power of the film is in its subtle understanding of how much the hero loves his child despite feeling oppressed by its demands. Aronofsky's use of fantasy tropes and Lynch's use of horror permit them to explore the strength of feeling aroused by such circumstances without resorting to melodrama.
Simpler explorations of this relationship have taken place in European cinema. Like The Elephant Man, My Nikifor is set in the 1800s. Its central character, a (real life) famous painter, suffers from tuberculosis, and as at the time there was no vaccine for this disease just being around him is dangerous. Nevertheless, a fellow artist, Marian, is so impressed by his talent and so horrified by his condition that he takes it upon himself to care for him, although this means he must part with his family. This award-winning Polish film is interesting in the way it balances the concerns of both patient and carer, showing them both as complex individuals who, despite the stress of it all, benefit greatly from their close relationship. Though he enters it voluntarily, Marian finds himself morally incapable of leaving, and his journey is not an easy one, yet the film's overall tone is positive.
Tsai Ming-Liang's I Don't Want to Sleep Alone, set in the slums of Malaysia, explores both voluntary and 'involuntary' caring relationships. At its heart is a young man in a coma, from which he may never awake; he is tended by his mother, who feels it is her duty, and by a young waitress who works in her cafe. Their devotion to the sleeping patient gradually inspires jealousy between the two women. Meanwhile, their neighbor discovers a stranger unconscious in the street after an attack and takes him into his own home to care for him. As the stranger recovers, the film asks questions about how he should relate to his savior, what he might (emotionally) owe and to what extent this still leaves him free to be himself.
The notion of an unrelated individual, not a member of the medical profession, stepping in to 'rescue' a sick or disabled person, can present a sentimental temptation which Hollywood finds hard to resist. Samuel L Jackson's aggressive attempts to help Christina Ricci's self-destructive victim of post traumatic stress disorder in Black Snake Moan create a story which is deeply misogynistic and always opts for sensationalism over sense, but the ostensibly similar relationship between Don Cheadle and Adam Sandler in Reign Over Me is much more delicately judged. Starting out as a friendship (renewed after several years' separation), it gradually morphs into something else; if Cheadle is a rescuer, he's an accidental one, so his concern comes across as genuine rather than as a play for hero status. Meanwhile, the eponymous Vera Drake spends her days caring for ill and elderly neighbors simply because she perceives it as her duty, part of the role of a good woman in 1950s England.
Vera Drake, centering as it does on the issue of abortion, is able to treat its patient-carer relationships with delicacy because they are not at the heart of the plot - they are not obliged to carry the full emotional weight of the film. Incidental characters in films often have more space to develop in realistic ways, and their presence has an important impact on viewers - it shows that people experience illness and disability, and being carers, without it being the only important thing in their lives. In this way, it reminds us that they are people and it often makes them easier for general audiences to relate to. A good example of this is Michael Caine's situation in Children of Men. Himself merely a supporting character, whom we meet because he is important to the hero's progress, he is also a carer for his severely disabled wife, a former journalist and victim of torture. Although we see them interact in only three brief scenes, and she is mute, Caine skillfully conveys the intensity of feeling between them so that we can believe in the importance of this relationship which has lasted for years after the wife ceased to be an active participant in it. It communicates very effectively the reason why people might remain carers in the face of isolation and financial loss by illustrating something which is often lost in Hollywood's dialogue about the patient-carer relationship: that, very often, these are people who love each other.
Due to the temptations of sensationalism and the difficulty in dealing with such complex issues within two-hour time frames, the mainstream movie industry will probably always struggle to paint convincing portraits of patient-carer relationships. Often it does better when adapting real life stories, such as the relationship between Christy Brown (Daniel Day Lewis) and his mother (played by Brenda Fricker) in My Left Foot. There we see a woman who devotes her life to enabling her son to be a success despite his cerebral palsy. While his father takes pride in his son's achievements, her sense of satisfaction seems to stem from her own hard work in supporting him. The film did wonders for public awareness of cerebral palsy and helped raise a considerable amount of money for related charities; yet, just as is so often the case in real life, the experiences of the carer attracted little attention.
If the variety of these movie representations tells us anything, it is that the patient-carer relationship is at once sensational and invisible. Sensational because the public are always fascinated by illness and disability and by power exchanges; invisible because it is so rare for it to be portrayed honestly. Caring - and being cared for - are (emotionally as well as physically) hard work, which is not what people generally want to see when they go to the cinema. Only a handful of films manage to get beyond that aspect and remind us that there is beauty to be found in these relationships too.