Tuesday, October 27, 2009

"Nothing Sacred"- run, don't walk, to see it.

I watched the movie “Nothing Sacred” in my continuing quest to understand what it must have been like in an earlier America. This movie, starring Carole Lombard and Frederic March was made in 1937. Here is a plot synopsis from Wikipedia:

“New York newspaper reporter Wally Cook (Fredric March) tries to pass off an ordinary African-American (Troy Brown) as an African nobleman hosting a charity event. Wally Cook is demoted to writing obituaries. He begs his boss Oliver Stone (Walter Connolly) for another chance. Wally is sent to Warsaw, a fictional town in Vermont, to interview Hazel Flagg (Carole Lombard), a woman supposedly dying of radium poisoning. When Cook finally locates Hazel, she is crying because her doctor has told her that she is not dying. Unaware of this, he invites her to New York as the guest of the Morning Star newspaper. The newspaper uses her story to increase its circulation. She receives a ticker tape parade and the key to the city, and becomes an inspiration to many. In addition, she and Wally fall in love. When it is finally discovered that Hazel is not really dying, city officials decide that it would be better to avoid embarrassment by having it seem that she committed suicide. Hazel and Wally get married and quietly set sail for the tropics.”

It doesn’t seem like a great plot but then many movies do not have a great plot (think “Transformers,” anything with Ryan Reynolds or Jennifer Anniston). Nevertheless, this movie was thoroughly enjoyable and maybe verged on greatness, mostly because of Lombard.

Again from Wikipedia:

“Carole Lombard (October 6, 1908 – January 16, 1942) was an American actress. She was particularly noted for her comedic roles in several classic films of the 1930s, most notably in the 1936 film My Man Godfrey. She is listed as one of the American Film Institute's greatest stars of all time and was the highest-paid star in Hollywood in the late 1930s, earning around $500,000 per year (more than five times the salary of the US President). Lombard's career was cut short when she died at the age of 33 in the crash of TWA Flight 3.”

This is the first time I saw Lombard in a movie. She was an incredible comedic actress. She was delicately beautiful with a beautiful pale complexion. She was great in the role of Hazel because she did not have to act funny. She simply was. She read funny lines with an earnestness that she probably would also have used for Shakespeare. I think she was a comedic genius. She was such a contrast to the strident, mugging, and dim-witted Lucille Ball. She also was a great contrast to Rosalind Russell who morphed from a fashion model, to “tough broad”, to someone who calls everyone “dahling” to Auntie Mame , a model for every drag queen. Lombard was light, not prone to pratfalls or overacting. She always kept control of her character so that it did not stoop to become a cartoon or a parody. This makes her early death all the sadder. Her personal life was interesting. Her first marriage, which ended in divorce, was to William Powell. Gun She then has a relationship with Russ Columbo, who died in a gun accident. She later said that Columbo was the love of her life. Her last husband was Clark Gable, who called her the love of his life. My fantasy is that she would be a person with whom I would enjoy spending time. Her easy going style must have captivated those around her.

Frederic March was a very competent actor and played a good straight man to Lombard’s Hazel.

There are several other things about the movie that were noteworthy:

1. This was the only Technicolor film that Lombard made. In the print that I saw, the colors were muted and not highly saturated. I liked the effect.

2. Shots of New York were all rear projections, which were not always successful. There is an interesting flyover of Manhattan when Hazel and Wally fly to New York. The city view out of the airplane window was obviously a special effect but lower Manhattan, with its mostly pre-modernism buildings, was impressive. The city had many neo-classic skyscrapers that today probably look dated but in 1937 they looked grand.

3. Most of the interiors were in the Art Moderne or Streamline Moderne style that was a late branch of the Art Deco design style. Its architectural style emphasized curving forms, long horizontal lines, and sometimes nautical elements (such as railings and porthole windows). It reached its height in 1937. Art Moderne seemed to be lost in comparison to the more widely known Deco and Bauhaus styles. There is a night club in “Nothing Sacred”, called Club Moderne, which is a perfect example of this style. There were round lights, sitting on round columns with Deco-inspired lighting. Banisters along the various levels of the club were long metal railings that gently curved toward the ground when they ended. These movie night clubs were always large and elegant. People sat at tables and the dance floor, at least in Club Moderne, was on a stage. People dressed formally and no one seemed to break a sweat. The movie nightclubs of this period were always elegant. My guess is that the clubs of Hollywood legend, e.g., Ciro’s and Mocambo (both opened shortly after the making of “Nothing Sacred”), may have been something like Club Moderne, although in a different architectural style.

4. No one smoked in “Nothing Sacred.”

5. There were fresh flowers in every scene, which added even more glamour to the Moderne style.

6. The movie was a critique of newspapers that made-up news to increase circulation. Sound familiar? (Look up Fox news, CNN, or CNBC if you aren’t familiar with this concept.) You may remember newspapers-they were awkwardly sized pieces of paper with news stories printed on them. In the past nearly every major city had at least two. Today, the internet-based “Huffington Post” fulfills that function for some cities, such as Denver. Many papers are dying today because their leadership did not learn the lesson of the music industry’s demise in the digital age. Too bad- so sad.

If you ever have the chance, spend the 90 minutes it takes to watch “Nothing Sacred.” It is a classy and funny movie, with a magical leading lady, that provides a friendly glimpse into the late 1930s.

Sunday, October 25, 2009

"High Anxiety"- better remembered

I watched the Mel Brooks’ movie “High Anxiety” the other day. I remember enjoying Brooks’ films over the year and thought it would be a good laugh to watch this Hitchcock parody again. I learned that parody is best enjoyed the closer it is to the event being parodied. When too much time has elapsed the target of the parody becomes something of a dim memory. What was cutting edge becomes dull and blunted. Of course Hitchcock was a great director and many of his movies were inspired. His directorial bag of tricks was large and his stories seemed so fresh when they were, well, fresh. The best parts of “High Anxiety” are those that poke fun at that bag of tricks. There is a scene with the wonderful Cloris Leachman as Nurse Diesel and Harvey Korman as her B&D psychiatrist playmate. They are sitting at a glass topped table and Brooks, taking a page from Hitchcock, has the camera photographing the actors through the glass top. It is wonderful to watch the camera contend with coffee cups and plates being moved around by Leachman and Korman without regard to where the camera is. Leachman has a hilarious thin mustache and she talks with her mouth continually clenched. She embodies all the bad psychiatric nurses found in so many movies.  Korman acts with just a bit of the effete, making the two a great comedic couple. Madelaine Kahn is also a treat to watch. She has a way of using her mouth and hair to demonstrate movie-fake sensuality. A Kahn scene that works very well is when Brooks calls her from a phone booth while he is being strangled. She interprets it as a heavy breathing pervert call. She initially feigns disgust but gradually begins to ask questions, “ How did you, ummmm... get my room number? I am not going to listen to any more of this, I mean, I've had just about enough! What are you wearing? Jeans? you're wearing jeans? I bet they're tight.” She does this while throwing back her long blonde hair like some glamorous Hollywood leading lady of days past. There is also one funny scene where Brooks parodies the famous “Psycho” shower scene. However, Brooks does not have the comedic timing and rubber face that Gene Wilder had in the much funnier “Young Frankenstein.” Brooks’ Jewish schtick also seems tired today. But most of the movie is like silly filler that was probably quite funny in 1977 but not so much now.

“High Anxiety” makes reference also to Hitchcocks’s“The Birds,” “Vertigo,”, “Marnie”, “Suspicion” and others. It also sends up films of other directors including “Blow Up, “the Pink Panther,” and “The Wizard of Oz.”

I suppose that when I watch the “Scary Movie” films 30-years from now, I will probably forget the movies they were parodying and wonder why I liked “Scary Movie 3” so much. So too is the fate of “High Anxiety” 30 years later.

The sense of "I"

The other night on Irish TV I saw a fascinating show about how the sense of “I” or “me” arises out of the brain. In other words, what happens at the neuronal level that causes us to organize the world as “me” and “not me.” The narrator was a mathematician atheist. He began the discussion with a review of Descartes’ notions of mind-body dualism which attempted, but ultimately failed to answer the question of how a nonmaterial mind could influence a material body, without invoking supernatural explanations. This program was attempting to summarize our current understanding of the mind-body issue by reviewing some current research.

The assumption of most of the research reviewed arises out of the assumption that the sense of “I” arises from the brain. As a result, some of the studies focused on neurological investigations. The first involved cortical stimulation of the brain. MRI scans were done at the same time to describe how electrical impulses flow within the brain. This study showed that, when awake, the area stimulated immediately shows a response, but that other areas of the brain then show electrical activity. This appears to show that in the awake brain, various areas communicate with each other after stimulation and that activity is not limited to just one area. In contrast, when an area is stimulated in the sleeping brain, electrical activity is limited to just the area stimulated. When a person is asleep, and presumably without the sense of “I”, his or her brain functions differently than when awake, when presumably the individual has the sense of “I.”

Another study showed that in one individual, there are neurons that appear to store information of a certain type. The researchers found that a certain bundle of neurons stored material related to Jennifer Anniston. When the individual was shown a picture of Anniston, the neurons fired. When shown a picture of Anniston and Brad Pitt, the neurons did not fire. However, when the subject was shown the letters “Jennifer Anniston”, the neurons again fired. The researcher concluded that neurons were storing the concept “Jennifer Anniston” rather than just her visual image. This seems to indicate that single or bundled neurons act as file folders for concepts. Thus, the neurons could, by extension, contain a concept of “I”.

The final study focused on how visual cues can support the sense of “I.” The experiment involved having a subject wear a visor that contained a video screen, much like those that are used to view movies with a portable video player. The visor blocks out visual input except that which is on the screen. Attached to the visor are two video cameras mounted behind the subject. As a result of this setup, the subject is viewing himself as seen by another person. The subject reported disorientation as a result of the confusion between his predetermined sense of location and the visual cues of being in a different location based on the feeds from the cameras. To compound the confusion, the experimenter placed the video cameras on his head and then walked around. This was even more confusing for the subject, given that he was seated. From the subject’s point of view, his sense of “I” was being disturbed by the incongruous video feed. This study was certainly interesting, but struck me as a bit gimmicky. It did not demonstrate whether the subject would become habituated to the incongruous video cues and thus recover to some degree the sense of “I.”

Like many TV-based summaries of research, this British-made show did not have time to explore all of the limitations of the studies nor the antecedent and subsequent studies that may have shed more light on the phenomenon investigated. The show did show how science can approach the study of how the sense of “I” is created. From the results presented, the mind-body interaction arises out of neuronal activity and sensory input. This seems obvious, but the obvious is not always correct.

One of the problems with this, and other neurological research, is that the studies must use such large and complicated machinery that the process of measuring the phenomenon being studied introduces a certain artificiality that likely influences the results. As technology continues to evolve, more sophisticated and miniaturized equipment may help reduce the influence of the process of measurement on the findings.

Tuesday, October 20, 2009

"Fellini: I am a Born Liar"

“Fellini: I am a Born Liar” was recently shown on Irish TV. It was made in 1993 and provides the last interview the Federico Fellini had before his death. Fellini was considered one of the most influential movie directors of the mid-twentieth century. His films include “8 1/2”, “Satyricon”, “Fellini’s Roma”, and “Juliet of the Spirits.” The interview with Fellini was interesting and led me to modify my view of his work. The interview contains clips of his movies, but does not identify which movies they were in. They are used to illustrate his ideas rather than to be a “greatest hits” compendium. I frequently find that interviews with artists are tedious because artists frequently talk in a language that has meaning for them but is so idiosyncratic that it leaves the rest of us behind. This is particularly a problem for someone like me who tends to be a concrete thinker and a reductionist. This interview was no different and it was made worse because it was in Italian with English subtitles. When I have seen English language films with English subtitles, I can see how meaning can be slightly changed through the subtitling process. I can only imagine what was done here.

The interview with Fellini was augmented by interviews with Donald Sutherland and Terrance Stamp, two of the most interesting and talented actors in the last 60 years. Neither actor seemed to like working with Fellini very much. They both found him to be overbearing in some instances and too uninvolved in others. Fellini, in contrast, thought that he was very tuned into actors and that he liked them very much. The one actor with whom he had a long-term professional relationship was not interviewed, i.e., Marcello Mastroianni. From others interviewed it seems that Mastroianni was able to not personalize Fellini’s direction and he often simply walked away. Nevertheless his acting style was probably more to Fellini’s natural rhythm that Sutherland’s and Stamp’s.

After Fellini sought treatment for depression from a psychoanalyst, his movies became more informed by Freudian theory. His movies were never just about storytelling. They were not simply a presentation of his perception of a story. Rather they were about his interpretation of the story through the lens of his understanding of his psychological makeup. In that way, Fellini’s movies were self-indulgent and sometimes full of images that were strange and unapproachable. Fellini used actors who were often grotesquely overweight with big hair and who were scantily clad. He used little people, old people, and disabled people to populate his cities and towns. He used these characters not because he was particularly interested in them, but because they reflected his psyche. They were representative of his fears, conflicts, and neuroses. Through his approach, Fellini invited us into his psychoanalysis but we often did not know what he was showing us.

There were two scenes from his films that were part of this interview that illustrated this. The first involved three children on a beach who were peeking in a cabana to see a woman change into her beach clothes. Because it was his recollection of the beach, he insisted that the real ocean would not reflect the quality of memory. He then had his designers build a faux ocean using large sheets of plastic that made artificial waves when moved. In this scene, the woman in the cabana exited and started to walk toward the ocean. She was dressed in a red bikini. She was voluptuous but her derriere was large. This scene incorporated techniques that were designed to make concrete Fellini’s memory using artifice and grotesquerie. One other point- Fellini never stooped to making the scene gratuitously sexy. There was never a close up on the woman’s posterior to highlight its ampleness. What a contrast to modern movie making.

The other scene that I thought illustrated Fellini’s art. It was a scene in a large hotel lobby. I was not certain if this was a real hotel or a set. The lobby was a baroque concoction in red, white and gold leaf. Mastrioanni walked across the lobby. At first the scene was presented in full color. It was then replayed in Fellini’s black and white. It was amazing for me to see how the latter transformed the scene into an abstract work of art. I interpreted this brief scene differently when the color was stripped out. It became cooler and the actor became less engaged with the surrounding but more engaged with me. It was fascinating.

“Fellini: I am a Born Liar” informed me about Fellini’s art. I am less convinced that his work is as great as I once thought, but hearing (or reading) him discuss his films was interesting and provided insights into Fellini’s filmmaking approach. There are scores of movies by others that are indebted to Fellini’s technique of using the director's psychological constructs to tell a story.

"Echo der Stars"

Kuwaiti cable TV is an international mix of television shows that show the best and worst of many cultures. Last night it showed the best of Germany. “Echo der Stars” is the annual German awards show for classical music. To an American classical music fan, this was a pleasant surprise since classical music is no longer a focus of American culture. I do not understand the German language, except a few words, like danke, schnitzel, Leipzig, and orchester, but I don’t think and any of the award recipients thanked god for their award. In addition, there was no crotch grabbing, swearing, interrupting, or interjecting that someone else should have won the award. I am not passing judgment on those behaviors, just drawing a contrast.

I tuned after the show had begun but the first piece of music I heard was a Monteverde piece played on period instruments and sung by a soprano and a countertenor. It was beautiful. We do not hear many countertenors in the US so it was a treat to hear. Awards were presented to Placido Domingo and David Fray. Domingo is so skilled a vocalist that I marvel at the control he has in his lungs, diaphragm, and vocal chords. Fray is a young French pianist who is quirky. He sits in an arm chair, rather than on a piano bench. He apparently sings along with the music and also conducts the orchestra from time to time, although when he played his solo, he kept his flamboyance under control. His played “La Vida Breve” by deFalla. He obviously is talented and, apropos of nothing, he is tall, thin and handsome. He has nicely styled long hair.

One nominee was Sir Simon Rattle with the Berlin Philharmonic for their China trip. There was a clip of Rattle coming out of a building with a crowd of at least 5,000 Chinese cheering for him. What a wonderful reception!

The show was live from the Dresden Concert Hall, which is a beautiful baroque facility with gold leaf everywhere. The ceiling of the stage has a series of moveable squares that are adjustable to improve the acoustics. One side is mirrored and when visible creates fascinating reflections of the orchestra and audience. There was a brief glimpse of the hallway outside of the concert hall. It looked as if it was straight from “Le Belle Epoque.” The Staatskapple Orchestra is the resident orchestra and its conductor, Fabio Luisi, won an award for conductor of the year. There was once quirky transcription of Bizet’s “Carmen” played by a saxophone trio and a clarino trumpet. I appreciated how unmusical saxophones can be, but piece was different and it challenged the ear.

The presenters, award winners, and audience were all formally dressed. There were even twenty-something people in the audience, which is not something we usually see in American concert halls.

I do have some frivolous observations. The first is that one of the masters of ceremony had a pompadour that must have been at least 6 inches tall. His hair swirled around his head until it looked something like a miniature Devils Tower. The second is that the concert master was bald on the top of his head with long red hair at the sides. He looked like Krusty the Clown. Finally, the award given to the winners looked to me like a cross between a meat cleaver and a mitre saw.

After the show was finished, I turned to the Kuwaiti Showtime cable network. There, in all of its glory, was a showing of one of the pinnacles of American culture, “The Texas Chainsaw Massacre.”

Friday, October 16, 2009

Irish TV and "Design for Life"

Irish television is rather limited. There are about 15 channels. Two are in Arabic, two are soccer dominated, two are news channels and the rest are made up of period dramas, antique shows, game shows (in great supply), Springer clones, Ellen, Oprah, Dr. Phil, and Judge Judy. They seem to like our old TV westerns and “Murder She Wrote.” The best programming seems to be very late at night. Some of these shows are signed, which is not the norm during the day. Apparently the hearing- impaired only watch TV at 3:30 in the morning.

I saw a very interesting show last night at about 2:00AM. It’s called “Design for Life” and it is similar to our reality shows like “Top Model,” “Project Runway,” and the various cooking shows. I liked it because it involves several students designing a product that, if deemed the winner of the competition, will result in one of the students being placed in the studio of Phillippe Starck, who is a French product designer and probably the best known designer in the New Design style. His designs range from spectacular interior designs to mass produced consumer goods such as toothbrushes, chairs, and even houses.

The students must design a product that will help people. One designed a cane-like stand to assist the elderly to stand up from a chair. Another designed a glove-like device for women to wear that can be used to shine a bright light into the eye of an attacker. The third student designed a wobbly chair for children to improve their coordination. The final student designed a tray with utensils for the blind. They must not only design the project, have a model made of it, but also create a logo and marketing material for it. The students were bright, serious, and articulate. This show would never make it on American television. It is too cerebral and design as a profession has never penetrated the popular culture in the way that clothing- and people-designing has.

I enjoyed watching Starck give feedback to the students. They are from the UK and he is from France, of which there is no doubt because of his thick accent. While they are attempting to design a useful product for persons in special circumstances, Starck’s comments are very conceptual. The challenge for the students is, of course, to makes sense of what the master is saying and apply it concretely. I remember working in a consulting firm where the owner gave such conceptual comments that I was somehow to apply to writing a proposal for government funding. I think he thought he was brilliant. I usually walked away wondering what he, in fact he had said. I was miserable at implementing his lofty feedback. Fortunately, I think he did not know what he was saying or did not remember it because he was fairly bad at following up. In contrast, Starck has two assistants who do follow up and appear to understand his feedback, although they add a lot of their own ideas, much like Tim Gunn on “Runway.”

It was a privilege watching Starck at work. He has a vision for the student’s design projects and it seems to justify his lofty reputation. He also has a sense of humor and seems approachable. There are two finalists and I hope to see who the winner is, but given the lack of predictability in my travel and my sleep, it’s unlikely.

I liked seeing genius at work. Mostly I do not see it at work on American TV. I never get the sense of genius in Heidi Klum, Tom Ford, or Tyra Banks. Not even Bill O’Reilly, in spite of what he thinks of himself.

Thursday, October 15, 2009

"Pandorum"- a mediocre movie

“Pandorum” is a sci-fi picture filmed and financed in Germany. Like “District 9” (reviewed elsewhere) this movie is derivative and fairly predictable. The only surprise comes at the end and makes the movie less that a total loss. The movie stars Dennis Quaid (the Quaid brother not arrested recently for failing to pay a hotel bill) and Ben Foster. I liked Foster. He has earnestness about him and he acts with a certain dignity that doesn’t deteriorate into hysteria, even when faced with a bad script. Quaid adds nothing substantial to his role. A synopsis of the movie can be found in Wikipedia. It includes a laundry list of sci-fi staples: a large dark space ship; a forgotten mission; mutants; an action hero (Foster); a villain (Quaid); long dark ship walkways; a nuclear reactor; a female action hero; special effects (not very good). The only mildly frightening scene in the movie for me was when Foster was in a pipe chase hunting for the flight deck. It was claustrophobic and anxiety provoking. “Pandorum” uses extreme close-ups in the human-mutant battles. There is so much action and no perspective for the viewer that it is mostly impossible to tell what is happening. I assume that it is filmed this way so that we do not get a good view of the mutants. Maybe it is also used to cover up poor execution of CGI effects. There is a similar problem in the “Transformers” movies, although they are a disaster on many other levels (think Meghan Fox and her perpetually open mouth). The music attempts to add to the suspense but it just seemed loud to me. The CGI-effects in the last scene of “Pandorum” are very poorly done. For example, the sprays of water are so obviously a digital effect that they are unconvincing. All in all, this is a mediocre movie probably best avoided except on the SyFy channel.

Saturday, October 10, 2009

The Sacred "Doctor/Patient Relationship"

In the health care reform debate, one of the frequent messages is that "you will be able to keep the same doctor."  Apparently some people are concerned that they will lose the greatest physician ever.- theirs.  What everyone forgets is that employers usually only have three-year contracts with insurance carriers.  When I worked in the commercial insurance world, the turnover of employers was about 20% a year.  That is, every year, 1 in 5 of employers opted to go with a different insurer or health plan. In this situation, employees are frequently forced to select another physician.  The government did not cause this to happen.  The employer did.  In addition, providers drop out of networks, forcing the covered individual to find a new one.  The government does not cause this to happen, the provider does.   I am still wondering why people think insurance companies and providers are their friends?  Its a business relationship! Its not all warm and fuzzy!

Wednesday, October 7, 2009

H1N1 vaccine

I hope that those who opposed a public option to health care reform stand up for what they believe.  Parents who oppose a public option should not allow their children to receive free innoculations through local health departments, schools, etc.  They should realize that this is socialized medicine and therefore they should take their child to their physician and pay for the office visit, and the injection.  That's free enterprise for you. 

Monday, October 5, 2009

Health Care Reform

I have been very disappointed by the health care reform debate that has now become insurance reform, and not good reform at that. Having worked in both and insurance company and in government I think I am capable of seeing the strengths and weaknesses of each as they relate to the purchase of health care services. One feature of government that always impressed me was the emphasis placed on programmatic planning. In general a program plan had to be in place before funds could be spent. The plan had to specify where funds were to be spent and why. The planning emphasis was related to the fact that limited resources had to be allocated in a way that was transparent, and it more often than not included those who would be affected by decisions made. This was not a perfect system, but the practice of actually thinking about resource allocation may have made the process more accountable. Insurance companies, in contrast, operate on business plans. Their role is directly related to system design, although it system design was affected by their decisions. For example, if a commercial insurer chose not to fund a particular procedure, then that procedure was likely to be used by a provider. Given that my interest is in mental health and substance abuse, I found that the limited coverage by commercial insurers shaped how providers practice. The worst example was in substance abuse where a 30-day benefit resulted in 30 lengths of stay. Issues related to system shaping were rarely if never considered by the commercial insurers. Rather, they were concerned about being sure that their expenditures for healthcare were less than what they brought in with premiums. An allowance had to be made for profit and overhead also. This balance is what their business plans are all about. Commercial insurers also develop marketing plans to determine how they will increase revenues and their book of business- all with the goal of increasing premium revenue while maintaining control over expenditures. Neither the governmental nor commercial approach is inherently better than the other; each arises out of the requirements of each system.

I think that those who attended the August community forums did not understand how much government is involved in health care. Here are some of the health care services the government funds: mental health, substance abuse, maternal and child health, public health services,(sanitation, inoculations, prevention and education, restaurant inspection, dentistry, animal control, air quality monitoring, etc) public hospitals, Medicare, Medicaid, the VA health system, developmental disability services (in addition to that provided by Medicaid), community health centers, portions of the Temporary Assistance to Needy Families program, etc. There are also health-related services that the government provides, for example, most medical research, epidemiology, provider licensing, quality assurance, provider contracting, and provider training. One of the reasons they are with the government is that no one else will provide them, including the insurance companies.

Both the government and commercial insurers have attempted to control health care costs. One of the easiest ways for the federal government to contain its costs is to make a program the states' responsibility. It has done it in the Medicaid program by requiring the states to match federal money. This is not a perfect control mechanism since Medicaid is an entitlement and is an open bank vault for those who qualify for the services and who also need them. Another, more aggressive way to contain costs is to provide the states with block grants to fund services. This absolutely limits federal liabilities since grant funded programs are not entitlements. In this kind of system, if more services are to be provided this must be done by lowering unit costs or by providing more state funds. This system has worked well, depending on your point of view, in substance abuse. Most providers will attest to the fact that raises are minimal to non-existent. Government programs have also adopted managed care strategies that first were used by commercial insurers. But I will discuss this more later. It is no great leap of faith to say that government-funded services have been rationed for years. They are rationed through the funding mechanisms already discussed but also by enabling legislation that limits eligibility to certain populations that are usually defined either by need or by income. About 25 years ago the federal government attempted to control costs by funding agencies whose mission it was to curtail the growth of health care costs by reducing unnecessary duplication of health services and facilities. The remnants of this system still function in some states, but decisions were challenged in court by providers who had great resources at their disposal.

Commercial insurers adopted managed care strategies to try to rein in costs. These techniques were roundly criticized by providers, who labeled them as intrusions into their practice and the "doctor patient relationship." Managed care worked to some degree on the margin of cost increases. It used techniques such as utilization management and concurrent review to ensure that only medically necessary services, as defined in the insurance contract, were provided. Again, many people do not understand that insurance is a contractual relationship between a policyholder and the insurance company. The contract defines what will and will not be covered. In general coverage should be to treat illness and injury and should be medically necessary. Thus, cosmetic surgery is not covered, except in the case of an injury or birth defect. Managed care strategies, then, rather than practicing medicine, were practicing contract interpretation. The question for managed care systems is "Is the care that this person receiving consistent with the insurance contract?" This too is rationing care. No one is entitled to services that are not on the covered list of benefits in the insurance contract. Those benefit limits ration care. In addition, deductibles also ration care. The current insurance fad is to provide high-dollar deductibles. For example, a contract might include a $1000 deductible, so that the covered person has fairly high out-of-pocket expenses. This is another example of health care rationing. It also has the perverse incentive of having covered individuals getting as many services as possible in a given year, the goal being to exceed the deductible amount in order to have the health insurance begin coverage while avoiding expenditures in subsequent years. Insurance carriers also used capitation as a means to control costs.  In this system, a provider is paid so much per person enrolled in his/her practice per month.  This provides an incentive to providers to reduce the amount of service they provide per patient.  Theroetically it should also provide an incentive to the provider to do preventive care in order to avoid more expensive care in the future.  There are many ways to structure a capitation system and if a provider is a good buiness person, they still can earn a good income by focusing on prevention, and reducing the services per patient.  As noted above, governmental systems adopted these strategies to try to control costs also.

There are other parties that also assist in the rationing of care. Since most insurance is employer-based, the employer attempts to reduce its costs. It decides how much it wants to pay and the insurance companies design a benefit to fit within those costs. Many employers do not want to pay for certain services (e.g., birth control pills, treatments related to the effects of suicide attempts, mental health, substance abuse) so as to limit their costs. This is rationing. Another layer of expense in the commercial insurance market are the benefit consultants whose job it is to match up an employer with an insurance company that provides what the employer wants to provide at the employers target cost. These middle-men are not free and they usually have very nice offices.

All of these systems of rationing are necessary because providers cannot have an open check book to provide whatever they want. In spite of the supposed sacredness of the provider-patient relationship patients should be aware that their physician, dentist, psychologist, psychiatrist, osteopath, radiologist, etc. make money off of the patient’s sickness. No matter how many oaths, high ethical standards, etc. a profession might have, the truth is that the more services provided the more the providers income. Greed is part of the human condition. The guilds for each of these professions (e.g., the American Medical Association, the American Dental Association, the American Psychological Association) advocate for legislation that usually increases their membership's income. Rarely do they advocate for measures that will negatively affect their membership's pocketbooks. They usually do this under the guise of improving quality. There is the implicit assumption that the more expensive the service the better it is when in reality it usually means the wealthier the provider is. This is also true of hospitals. Their bottom line is enhanced with higher rates of reimbursement and increased hospitalizations.

The elephant in the room of health care reform is indeed provider incomes. Why do physicians usually live in the highest hill in town? No one wants to tackle directly the issue of provider salaries. Public and commercial systems hope that this will be taken care of through controlling reimbursement rates, but since most outpatient services are not scrutinized (at least by commercial insurers) physicians and other providers still can provide more (unneeded) services to boost their incomes.

So what should health care reform include? I actually do not think that a public option by itself will drive down costs, although it may help. I have some other thoughts:

1. Real health care reform can control costs by having physicians and other providers be employees of clinics rather than as independent providers who can bill as they wish. By being employees, a cap can be placed on their salaries. This was the original model for the Health Maintenance Organization but it rarely happens. The alternative to this is to have all providers capitated for all of their business, except for private pay patients.  The only other option for providers would be to accept only private pay

2.  Salaries of commercial insurers executives should be capped. This is about as likely to happen as capping the bonuses on Wall Street, but it would help control costs. Holding their salaries to the same level as government bureaucrats with similar duties is one approach.

3. Providers should receive an incentive to provide preventive services. Everyone should be screened, for example, for colon cancer in order to avoid the costs of having it reach an advance state before treatment is started.

4. There should be a standardized benefit across all funding sources. This would make it easier for employers to judge who should provide coverage for their employees based solely on cost. If an employer cannot afford the standard coverage, tax offsets should be offered.

5. All citizens should be required to have the standard benefit. The unemployed should be able to enroll in a New Medicare program that would offer the standard benefit and continued enrollment would be means tested. That is, a person could stay in the New Medicare only if they do not have sufficient income or are not employed. As soon as they are employed this coverage would stop since all employers would be required to provide the standard benefit package. If this were done, Medicaid would no longer be required to fund health care services, but it would continue to fund social services.

6. All specialty health services (mental health, substance abuse, maternal and child health, etc.) would be part of the standard benefit and they would no longer be funded separately by government.

7. Government's role in health care would be to provide quality assurance and financial audits for he New Medicare program. Government would also continue to support research, training, and quality assurance.

8. With a standard benefit, insurance companies would truly compete on cost.

What are the odds that this will happen? Not much, and it is unfortunate that even the milquetoast proposals before Congress are having their difficulties too. Big commercial insurance and pharmaceutical companies and the guilds have too much money, and hence influence, to make real reform happen. In addition we have an administration that just does not seem up to the fight.

Fortunately for me, I go on the current public option next July, i.e., Medicare.


I am always surprised to see a photo like this.  First, 1980 is nearly 30 years ago.  My daughter and I look very happy (actually no surprise on that one).  My surprise comes from me seeing how good I looked back then.  Jobs, disappointments, stress, and strain (not to mention age) make me look like I do now.  It could be worse- I could look like Danny DeVito.

Social Networking sites

I have regularly used one of the social networking sites.  Lately, however, my interest has fallen off mostly because people I know use it to post stuff about their heartbreak and their alcohol consumption.  Not a good time for me.  Of course, it likely is a function of who are on my friends list, but I had hoped it would give me more- although I am not sure what I expected.  I do have one friend who writes clever and witty notes.  I enjoy her stuff immensely.  When we worked together once, we had people convinced that she had worked for Cirque du Soleil as the hula hoop woman.  We claimed that she could keep 20 hoops spinning at once.  We were very convincing. 

One thing that social networking sites is to focus attention on yourself.  So good for the "me" generation. 

The good news is that on one site I found a high school buddy that I have not seen in several decades!  That's exciting.

"Three Rivers"

As you may know, I am a big fan of Pittsburgh.  Partly it is due to growing up there but part of it is due to my habit of rooting for the underdog.  But aside from those emotional issues I think it is a beautiful city.  I also admire the Pittsburgh Symphony as one of the great in the world. 

Last night, CBS premiered "Three Rivers" a medical drama based in a hospital specializing in transplants.  This makes sense given that the University of Pittsburgh Medical Center is one of the major transplant centers in the country.  3R is one of those medical dramas where we learn about the personal lives of the patients and maybe eventually we will learn that all of the staff are sleeping with each other.  The only actor I knew of in the show was Alfre Woodard as the hospital administrator.  Apprently she is a physician also (like Cutty on "House").  I always think that this a tremendous waste of medical knowledge and realize that others trained to be hospital administrators are better at it.  I am biased because I once replaced a physician as a hospital administrator and thought I did a better job than him. Go figure.

I did not see anyone in the cast who was over 30.  Amazing- maybe that accounts for how wooden their perfromances were.  There was also a husband whose wife and child were in danger because she needed a heart transplant.  He was so unconvincing and I never felt that he was really upset since he seemed to have a Geroge W. Bush smirk.  The hospital facilities were beautiful and they had a computer system like in "CSI Miami" where everything appeared on a wall and all control was achieved by hand movement.  I understand that such technology is several years away, but it is an easy way to show patient records to the audience. 

The shots of Pittsburgh were wonderful and showed what a beautiful city it is.  The flyovers were particularly good. 

The show was sort of a nodder.  I couldn't muster enthusiam for any of the characters or situations.  As much as House is one of the most dysfunctinal characters in prime time, the show's humor and edge are appealing.  "Three Rivers"- not so much.

Sunday, October 4, 2009

"His Girl Friday"- a bad movie

This movie was released in 1940.  It starts Cary Grant and Rosalind Russell, before she bacame a drag queen.  She plays Hildy Johnson, a star newspaper reporter still working for her ex-husband Walter (Grant) at a major chicago newspaper.  Hildy has told Walter that she is going to marry her insurance saleman finance Bruce (Ralph Bellamy).  Unfortunately, Walter doesn't want to lose Hildy to Bruce or to lose Hildy as a reporter.  Walter wants Hildy to cover a major story about a convicted murdered Earl Williams (John Qualen).  things get complicated when William escapes and Hildy and Walter are hiding him in the prison pressroom. 

1.  Grant delivers lines like a maching gun fires bullets.  It can be quite funny and he refers to his real name, Archie Leech.
2.  Russel is ok but she is was not particulry good in this.
3.  The mayor in the movie refers to the "colored vote" and how important it is.
4.  Term "picaninny" is used.  Need I say more?

Bad-o-meter- ++terrible

"The Snows of Kilamanjaro"- a rusty movie

I partially watched “The Snows of Kilimanjaro” on TBS the other night. The movie stars Gregory Peck, Ava Gardner, and Susan Hayward. Seeing Peck and Gardner together reminds me of the eye candy in “Match Point” (Scarlett Johannson and Jonathan Rhys Meyers). But I digress- this movie is loosely based on a work by Hemmingway. I thought the movie was a crashing bore even though it was highly regarded when released. Sometimes I find the acting in movies from the early 1950’s to be so wooden and unrealistic. There is one scene where Susan Hayward walks around a tent where Peck’s character is laid up because of a leg infection. Hayward, who I admire, poses rather than acts. She moves from one position to another as if she was a sculpture come to life. At one point she outstretched her hands in a way that no ordinary person would do, and it looked silly. She is clad in the tightest safari outfit I can remember seeing. She does it justice, but in the hot African weather it would be unbearably hot. The movie garnered kudos for its photography. I admit that I have become spoiled by the CGI effects in modern movies so what once passed as excellent, now seems poorly done. There are scenes where Peck is hunting African game (for sport, I might add!) and it is very apparent he is not actually in the same scene as the animals. The visual focus on him is different than the focus on the animals, so it is obviously a special effect. In another scene he and his party are on a river following a herd of hippos. We never see where the boat meets the water because again he is in a studio, and the hippos are on film. These points don’t deal with the plot, but they were so distracting that I lost the plot. Sometimes I notice that special effects are more apparent on the small screen than in the movies, but the problems in focus must have been apparent in the ‘50s. There is another scene where Peck first meets Gardner is a Parisian jazz café. The music is good, but the scene itself is hilarious. There is a shot of a woman standing against a modern painting (I guess to show that these are denizens of the avant garde). She is absorbed in the music, but she has a look on her face like she should be stoned. Maybe that was the intent, but she looked comical. There is another male extra who is smoking a cigarette. He has a Ceasar haircut and round black glasses. He too looked silly in his effete way. Throughout the parts of the movie that I attended too, Peck was a wastrel who wasted his talent and fortune, and the women in his life (Hayward and Gardner) fretted over everything. Not exactly pictures of strong women. Finally, a word about Gardner. I have said this before in my review of “The Barefoot Contessa”. She was extraordinarily beautiful. Her raven-colored hair, her red lipstick, and pale skin were amazing to look at. She also had the small cleft in her chin that added a bit of the unusual to her face. She had a tiny waist the accentuated the firmness of the rest of her body. She was an average actor, but she steals every scene she is in. I also admire Gregory Peck. He was tall with thick wavy hair. He had yet to reach the pinnacle of his career (in "To Kill a Mockingbird") but his apparent sophistication and elegance were a bit at odds with the dissolute character he played in Kilimanjaro. I guess the point the screenwriter was making is that even the most genetically endowed among us can be losers. For me, this movie is best viewed as a study of the early’ 50’s and its cultural context. The movie as movie was not great.

"Love Laughs at Andy Hardy"- a troubling movie

The Andy Hardy movies were produced in the 1930s-40s. They are said to be the most successful movie series ever. Very quickly Mickey Rooney became the centerpiece of the movie. He and his family lived in a small Midwestern town called Carvel. He lived with his father, Judge Hardy , his mother, and his maiden aunt. He had several love interests, one of whom was Judy Garland. Rooney certainly had high energy on the screen and a certain naïve charm.

I recently watched the last of the series made in 1948. It was titled “Love Laughs at Andy Hardy”. Andy’s love interest was played by Bonita Granville. The plot was simple: Andy returned from the war after having met Granville’s character. He was obviously smitten with her, for example when he walked by a children’s shop, he stopped to pause at a cradle. His mother picked up on the cues quickly. Eventually we find that Granville’s character had fallen in love with her guardian (!!!!) and let Andy know just at the time he was going to propose to her. This was so devastating to Hardy that he was going to drop out of college and join the merchant marine. Of course, Judge Hardy intervened and made sure that Andy was back on track. There was a subplot involving a co-ed (as they called them then) who was played by an actress named Dorothy Ford. Her character, Coffee, was an attractive young woman who happened to be quite tall. Through a joke played by a friend, Rooney and Ford were partnered to go to the homecoming dance. There is a mildly amusing scene where the two dance a jive routine. Coffee called everyone uncle, which may have been cool then but which seems strained and annoying today.

I thought I would enjoy the movie as a guilty pleasure, but alas, I did not. I was troubled by the Hardy family being portrayed as so prim, proper, and, well, healthy. It was a family where there was never anxiety, depression, mania, substance abuse, addiction, anger, insomnia, restless leg syndrome, or any of the other physiological and psychological disorders with which most real families must contend. There were no immigrants (particularly of the illegal kind), no people of color, no outwardly gay people, and the head of the household was always a man. In these movies, the wives stayed at home keeping the household running. There was no reliance on Betty Crocker or McDonald’s to keep the family fed, although the use of a person of color to keep thing in order was permissible. The mother’s role apparently was to fret about family matters; they even seem to have been allowed to define problems, but certainly not to solve them. No, that was the province of the father, who in this case was Judge Hardy. It was the Judge who saved Andy from wasting his life because of him being jilted. The Hardy movies were the precursors to the 1950s television shows such as “Father Knows Best”, “Leave it to Beaver”, etc.

So rather than enjoying this Andy Hardy movie, I began to think how this view of the American family has become permanently seared into the minds of many Americans. In fact, it seems to me that those who advocate a social agenda based on “Family Values” have had this model too ingrained into them. To them, society will only be saved through the traditional Hardy family and its accoutrements (father, mother, children, a house, a car, a pet, a church, a college, a small town, etc.).

I must admit that I too, from time to time, have fallen into the trap of believing that these characteristics are the sine qua non of a successful family. But real families must contend with, for example, mental disorders, single parenthood, poverty, disability, bankruptcy, joblessness, addictions, job stress, religiosity, violence, guns (and their aftermath) , poor health, and the lack of health insurance. So, is the Hardy family a model of anything other than a screenwriter’s imaginings? Probably not. It’s a fantasy and fantasies are fine as long as they are not used to define social policy or be used as a gold standard against which today’s families might be judged. I think its time to let go of the Andy Hardy (and Anderson, and Cleaver) model of the family in order to continue to try to find solutions for all of the issues that real families face. Some (incorrectly) say that this is a kind of socialism. I say it’s our responsibility as a society to care for each other and to recognize that we are all in this together. “Family values” is about as an real approach to life as are the Andy Hardy movies.

"Seance on a Wet Afternoon"- a very good movie

While between naps on Ireland, I came across a movie on TV that I had nearly forgotten about. It’s titled “Séance on a Wet Afternoon.” It stars Kim Hunter and Richard Attenborough. The movie is a study of the psychological deterioration of a woman claiming to be a medium who connects with the spiritual world through her stillborn son Arthur. She convinces her unemployed husband to “borrow” a child so that she can use her pretend psychic talents to lead the police to the child’s whereabouts, thereby demonstrating her skills. The movie was made in the early 1960s and was part of the “British Invasion”, a period where America became fascinated with all things British, in part because of the Beatles. Séance is filmed in brutal black and white.

Attenborough plays a weak husband who agrees to his wife’s sad plan, partially because he loves her and partially because he is frightened of her. Hunter is mesmerizing in her role. She has an almost ethereal look on her face as she plots the horror to unfold. She will at times listen to her huge Victrola that had a gigantic morning glory horn. She visits the parents of the kidnapped child and is so earnest that it is difficult for them to be skeptical of her self-proclaimed talent.

Hunter’s character is careful never to let the child see her face- she always wears a mask while pretending to be a nurse. A key turning point in the movie is when Attenborough inadvertently lets the child see his face. This sealed the child’s fate. The movie ends with a séance conducted for the police inspector investigating the child’s disappearance. The medium’s psychological state had deteriorated to the point that she confessed the plot and the child’s death. This scene is a tour de force for Hunter, who vacillates between victim and victimizer.

There are several noteworthy features of this movie. The first is Hunter’s performance. She inhabits her character and is stunningly convincing as she spirals into psychosis. The second is Attenborough who is outstanding in creating a character that is weak, morally torn, fragile, and frightened. The third is the cinematography that highlights the depressing countryside. The final absolutely stunning feature about this movie is that the child is indeed murdered. In general, American films tend to shy away from showing children being hurt, let alone being killed. This act of violence is so chilling that it elevates the movie from being just a psychological study to being a horror film of the first order.

As an interesting aside, I found out that this movie had been made into an opera which was recently premiered in Santa Barbara. The music was written by Stephen Schwartz of Broadway musical fame. The reviews I read said that Séance on stage is either Broadway-heavy or Opera-light. I’ll stick with the movie

"Never Wave at a WAC"- a bad movie

I purchased a set of 250 "family movies."  Most were made in the 1930s to 1970s.  I will review them from time, espeically focusing on what they teach me about the period in which they were produced.  I have faced my weakness for the guilty pleasure of watching a really bad movie.

“Never Wave at a WAC” was made in 1954. It stars Rosalind Russell and Paul Douglas. Russell was very popular at the time and went on to greater fame in “Aunty Mame” and “Gypsy”. The movie is about a Washington, DC socialite, who, through the manipulation of her Senator father, becomes an enlistee of the Woman’s Army Corp. Hilarity should ensue but it doesn’t. Russell plays the socialite as one who butterflies from one group at a cocktail party to another, spouting witticisms. She does this while keeping her chin in the air as if she is above all others. I think she is the model for every drag queen. When she enlists, she is taken advantage of by her ex-husband who is studying the effects of fabrics to differing environmental conditions. Hilarity should ensue but doesn’t. Russell does the same kind of physical and loud comedy that was Lucille Ball’s trademark. Marie McDonald plays a “blond bombshell” (as they used to say. She was dumb and naively sexual. She is pursued by a sergeant who is always singing. Hilarity should ensue, but it doesn’t. In the finale, Russell reconnects with Douglas, gets drummed out of the corps, has a change of heart and tries to reenlist.

Key points:

1. The only people of color work in the kitchen, except for one enlistee who fires a cannon.

2. Men still whistled at women.

3. Russell managed to drive around the army based in a finned Cadillac, while everyone else was in an army vehicle.

4. I just don’t get Paul Douglas as a romantic lead. He looks like a bull dog.

5. All of the WACs had short hair under their army hats. The curls made a fringe around the hat. They looked very asexual.

6. There were some flyovers of the Pentagon. Having lived in Crystal City, I though these shots were interesting. Even in the 50s there was a network of four lane roads around the building. The area hadn’t yet been destroyed by the high-rises that characterize modern day Pentagon City and Crystal City. Today, the latter is a modernist’s nightmare.

7. Everybody smoked, which may have accounted for Russell’s gravelly voice.

8. The music, by the esteemed Elmer Bernstein, was rearranged military songs, with the occasional “wah, wah ,wah.”

9. General Omar Bradley appears as himself in the movie. Hilarity does finally ensure. In the movie, Bradley sits at a desk and talks on the phone. He had a fairly high pitched voice and he read his lines word-by-word, as an amateur actor does. This was the highlight of the movie.

The Bad-o-Meter rating: +++ Bad.

America the beautiful

Last night, while fighting torpor in Ireland, I watch” Jamie’s American Tour” on TV. Jaime Oliver is a well-known British T.V. personality who does all things related to cooking. Last night’s show had him touring the southern United States in search of authentic southern cuisine. I am not much of a foodie but the show was eye-opening. He went to Savannah and met some southern “socialites.” When he asked them if the recession has affected them, they responded that they simply don’t talk about it. Then he asked them if they voted for President Obama. They said they don’t talk about that also. Wow, talk about heads in the sand. In another segment, he met several people at a local restaurant. He asked what they thought of the President. One woman said that a lot of people do not like him because he is a n*****. Oliver blanched (a food reference) and later talked to the camera and expressed incredulity that the word would actually be used, especially when referring to the President. Finally, he met a restaurant owner who was going to have to give up her restaurant because of her husband’s medical bills. He has no health insurance, had cancer, and now the couple is going to file for bankruptcy. The restaurant owner said that her family could not pay $1000 a month in insurance premiums. Oliver said to the woman that in the UK, health care is free and that she would not be in her situation in such a system. He later addressed the camera and said that he is so happy to be living in a country where healthcare is a right of citizenship. He expressed his dismay that in the richest country in the world, healthcare is not provided to all.

By the way, the Senate Health committee voted down the public option amendments to the insurance reform bill. Since when did the insurance companies become our friends?

"The Final Destination"

“The Final Destination” is the latest in the Destination series. It is remarkable because it was filmed in 3-D. I like these movies because Death is so inventive when it comes to offing people. I particularly liked the first one. Ali Larter is a talented actress who fortuantely does not degenerate into a scream queen. Anyway, the latest installment is based on the same notion that a group of young attractive people cheat death because one of them has a vision of an upcoming tragedy and, as a result, they escape the scene and avoid dying. However, Death proceeds to design all kinds of creative ways to kill the survivors. I don’t think this movie has as many creative deaths as the earlier ones did. Who can forge the guy being sliced horizontally by a flying fence?

3-D technology has improved tremendously. No longer are the images dark and my eyes did not feel they were being made to slightly cross in order to appreciate the depth effects. This Destination movie did have one impaling that made use of the 3-D effect to poke us in the eye, but generally this was held to a minimum. There is one gratuitous explicit sex scene. Since there were children in the audience, I must admit I winced. One of the final scenes has the survivors sitting around a table having a cup of coffee. At one point, I realized that I felt like I was sitting around the table with them. Here, I thought the 3-D technology added immensely to the intimacy of the conversation. It may well be that if this technology is used sparingly and wisely, it can help break down the barrier between the audience and the actors. 3-D did not make this a great movie, but I think it was better than not having it at all.

By the way, the actors were totally forgettable.

"Kitty Foyle: The Natural History of a Woman"

After a trip, I find that I sit and vegetate. I breathe deeply, trying to get the smell of the airplane out of my nose. I stare at the TV hoping that I can reach some kind of mother lode of relaxation. Yesterday, I hit the jackpot. I happened upon “Kitty Foyle: the Natural History of a Woman” on Turner Classic Movies. The movie was released in 1940 and starred Ginger Rogers and the title character. She won the Academy Award for her portrayal. The long title gives us a sense that there is something different about this movie. It’s not just about a woman, but about how that woman evolves. In the early ‘40s the audience may well have had to be prepared for what they were about to see, since the movie does present a strong unmarried woman, looking for a man, who becomes pregnant “out of wedlock” as they used to say. The movie has a prologue that attempts to present a short history of the “white-collared woman” through a series of vignettes that depict a young attractive working woman. This includes her being offered a seat on the trolley- once all of the men get a look at her. The next vignette deals with her being proposed to by a nerdy guy and the young woman becoming all atwitter about it. I was confused by these vignettes- I wasn’t sure what their purpose was and why they were necessary. As the movie unfolded, I better understood their preparatory role for the 1940s audience.

The story is simple. Kitty was the spunky daughter of an Irish immigrant family in center city Philadelphia. She meets, works for, and falls in love with Wyn (Dennis Morgan) of a rich and influential family from Philadelphia’s mainline. Morgan was a handsome guy with a crooked smile, straight teeth and the waviest hair that I have ever seen. His hair is held in place by some oily looking substance but every wave remains perfectly ordered. Anyway, his magazine about Philadelphia runs into financial trouble and he must lay off his employees, including Kitty. Wyn invites Kitty to New York for a weekend and they have a drink in a neighborhood Italian restaurant on the eve of Roosevelts first presidential win. Kitty wants to stay in New York, but Wyn is so tied to his family that he returns to Philadelphia. As a career woman, Kitty works in a cosmetics house. Because she inadvertently pressed a fire alarm button, the store must be evacuated. To escape being blamed, Kitty fakes that she fainted. As luck would have it, the physician who comes to treat her is Mark (James Craig). Mark is immediately smitten with Kitty. Wyn again shows up. Kitty marries Wyn, and then divorces him after a confrontation with his family and soon after, Kitty is pregnant. This must have been shocking to the sensibilities of the 1940 audience. I think this is the reason that the prologue was added in order to forewarn audience. Kitty looses the baby, which I supposed is the way she is punished for being an independent career woman. Later, Wyn again shows up asking Kitty to go to Buenos Aires with him. He wants her to be his mistress because he will not divorce the woman he had subsequently married. Kitty is faced with a dilemma- should she get married to Mark or flee with Wyn?

The plot sounds very sudsy and formulaic, but Rogers’ classy performance keeps everything from sinking under ponderous histrionics. She was a phenomenal actress. She did not open her mouth widely when she talked so that she kept her voice and her face under control. This gave her an understated quality that makes the audience feel that it is overhearing her intimate conversations. Only once in the movie did she become shrill. This was after meeting Wyn’s family who wanted to turn her into a Philadelphia Mainline finishing school graduate. When leaving the families sitting room she shouts that she will never be made over. This was the only part of Roger’s performance that didn’t take advantage of her emotional control. I fault the director for this misstep. The other performances in the movie were forgettable. Morgan’s Wyn is charming, but too good-natured to be convincing as a mainline born and bred patrician. Craig must have been an acting lightweight. He was handsome, poised and well-dressed, but he didn’t provide enough substance or weight to the character to make him a strong counter to Morgan’s Wyn.

The production values of the movie were good. Views of the Philadelphia skyline only included the city hall, so it didn’t look particularly impressive. New York looked far more interesting, which was, of course, what the director was trying to show. The film begins with Rogers engaging herself in a conversation in the mirror. This worked as the device to show the history leading up to where Kitty found herself- should she marry Mark or go with Wyn? Major time shifts are handling by focusing on a snow globe. It was a simple and effective device for indicating a new time period.

“Kitty Foyle” is quite a fine movie. I was really pleasantly surprised to see Rogers’ work. She was a subtle yet forceful actress. I am trying to compare her with someone today, but, alas, subtlety is not part of modern sensibilities. For example, when I see Meryl Streep act, I always think she is secretly saying “Wow, another Oscar for me.” She couldn’t pull off Kitty Foyle in the ways Rogers did. Streep’s Foyle would always be pushing her hair out of her face with the palm of her hand and she would have a foreign accent!

"The Page Turner"

I ran across a movie the other night in Ireland called “The Page Turner.” TPT is a French film and subtitled. I didn’t get to see all of it, and the subtitles required more concentration than I could muster, but the movie grabbed my attention. It is a story of revenge, the details of which I won’t get into since the plot can be found on the web. What really struck me was the style of the film. It provided such a sharp contrast to Hollywood films and reminded me why I admire French filmmaking (see Bunuel’s “Discreet Charm of the Bourgeoisie” for a quick lesson on great French filmmaking). These films tell a story, yes, but the plot develops not only by the narrative and circumstance, but also through the silences. The actors’ glances and pauses, the camera angles, reflections, and music propel the story forward without computer graphics or surround sound. Tension develops not because of what is said, but because of the quiet when two characters are together.

“The Page Turner” would probably be a crashing bore to those who have grown up on Hollywood mayhem. For example, it takes place in the world of classical music. When was the last time Hollywood paid attention to classical music, and no, “August Rush” and the “Soloist” don’t count. In the TPT, the actors are required to play instruments convincingly and they pull it off. I believed that they were playing and if I didn’t, as is the case with so many Hollywood productions, I would have lost interest. Sawing at a violin is not the same thing as bowing.

The two lead actors of the TPT are Catherine Frot as the older Ariane and Deborah Francois as the title character. Frot is a glorious compendium of DNA. She appears to be tall and sturdy- not like a bodybuilder, but there is no doubt that she has a hard body. Francois is softer but equally beautiful, with luminescent skin. Both can say so much with their faces. American actors seem not to have this quality. Take Meghan Fox- her idea of saying something with her face involves keeping her mouth permanently open, sort of like a fish. I think to young actresses, this means sexy. Meryl Streep (see my “Kitty Foyle” review) can’t do anything without facial histrionics (e.g., see “Doubt” where she seems always to be saying to herself “That was so Oscar worthy”). Ryan Reynolds, on the other hand, has a face so blank that I thought he fell into a vat of Botox. He is totally incapable of expressing anything except self-love with his face. Speaking of Botox, I can think of one scene in a movie with a Hollywood actor uses her face to express many emotions during a facial close-up. Nicole Kidman (yes, I know she is Australian) in “Birth” is sitting in a theater after having experience what seems to be a paranormal event. The camera focuses on her face and in a few moments we can see her excitement, horror, happiness, and pain. She is usually not my favorite, but she did pull it off effectively in this scene.

In PT, both Frot and Francois wear elegant and stylish clothes. They always look like they are going to cocktail parties. Between them there are no jeans, no tee-shirts, no bra straps, and no flab. Frot wears a form fitting black dress that exposes one of her shoulders. She looks like a Greek marble statue come to life. While maybe this is not how most women look or dress, it does add elegance to the movie that provides important contrast to its primeval revenge theme. The classical music throughout the film is magnificent and wisely chosen to underscore the drama. In Hollywood, music is manufactured to underscore the drama. To me, the former is so much more effective.

TPT, another in a long line of French psychological dramas, tells its story with subtlety. There may be plot holes, and there are, but the horror, without decapitations and blood spraying everywhere, is very effectively communicated. “The Page Turner” is a great horror movie without the externalities we have come to expect from Hollywood-born and bred horror.

Leonard Cohen: Live in London

“Leonard Cohen: Live in London” was on the local PBS outlet last evening. I am a huge Cohen fan and have been since 1971 when his music was use in the Robert Altman film “McCabe and Mrs. Miller.” (This is a great movie and worthy of immediate ordering from Netflix).

From Wikipedia:

Leonard Norman Cohen, (born September 21, 1934) is a Canadian singer-songwriter, God Among Men, musician, poet and novelist. Cohen published his first book of poetry in Montreal in 1956 and his first novel in 1963. His work often deals with the exploration of religion, isolation, sexuality and complex interpersonal relationships. Famously reclusive, spending years in a Zen Buddhist monastery, and possessing a persona frequently associated with mystique, he is extremely well-regarded by critics for his literary accomplishments and for producing an output of work of high artistic quality over a five-decade career. Musically, Cohen's earliest songs (many of which appeared on the 1967 album, Songs of Leonard Cohen) were rooted in European folk music. In the 1970s, his material encompassed pop, cabaret and world music. Since the 1980s his high baritone voice has evolved into lower registers (bass baritone and bass), with accompaniment from a wide variety of instruments and female backing singers.

Over 2,000 renditions of Cohen's songs have been recorded. Cohen has been inducted into both the Canadian Music Hall of Fame and the Canadian Songwriters Hall of Fame and is also a Companion of the Order of Canada, the nation's highest civilian honour. While giving the speech at his induction into the American Rock and Roll Hall of Fame on March 10, 2008, Lou Reed described Cohen as belonging to the "highest and most influential echelon of songwriters".

The London concert is Cohen’s first in 15 years. He will be in Atlanta on October 20 this year. Cohen returned to touring after he found that his manager had swindled him out of millions of dollars of retirement funds. Cohen successfully sued the manager but has yet to collect.


Suzanne takes you down to her place near the river

You can hear the boats go by

You can spend the night beside her

And you know that shes half crazy

But thats why you want to be there

And she feeds you tea and oranges

That come all the way from china

And just when you mean to tell her

That you have no love to give her

Then she gets you on her wavelength

And she lets the river answer

That youve always been her lover

And you want to travel with her

And you want to travel blind

And you know that she will trust you

For youve touched her perfect body with your mind.

And jesus was a sailor

When he walked upon the water

And he spent a long time watching

From his lonely wooden tower

And when he knew for certain

Only drowning men could see him

He said all men will be sailors then

Until the sea shall free them

But he himself was broken

Long before the sky would open

Forsaken, almost human

He sank beneath your wisdom like a stone

And you want to travel with him

And you want to travel blind

And you think maybe youll trust him

For hes touched your perfect body with his mind.

Now suzanne takes you hand

And she leads you to the river

She is wearing rags and feathers

From salvation army counters

And the sun pours down like honey

On our lady of the harbour

And she shows you where to look

Among the garbage and the flowers

There are heroes in the seaweed

There are children in the morning

They are leaning out for love

And they will lean that way forever

While suzanne holds the mirror

And you want to travel with her

And you want to travel blind

And you know that she will trust you

For shes touched your perfect body with her mind.

Cohen is 74 years old and recently collapse in Spain during a performance. This was apparently due to food poisoning. His voice is a deep baritone and he mostly speaks rather than sings, similar to the “sprechstimme” of Alban Berg. Cohen’s lyrics are deeply personal and not immediately accessible in casual listening. But exploring them carefully is worth the effort. “Hallelujah” is one such song. It has been covered by more than 200 artists worldwide, with one of the more famous versions being that of Tim Buckley. I also recommend the versions of k d lang and Rufus Wainwright.


Now I've heard there was a secret chord

That David played, and it pleased the Lord

But you don't really care for music, do you?

It goes like this

The fourth, the fifth

The minor fall, the major lift

The baffled king composing Hallelujah





Your faith was strong but you needed proof

You saw her bathing on the roof

Her beauty and the moonlight overthrew you

She tied you

To a kitchen chair

She broke your throne, and she cut your hair

And from your lips she drew the Hallelujah

Baby I have been here before

I know this room, I've walked this floor

I used to live alone before I knew you.

I've seen your flag on the marble arch

Love is not a victory march

It's a cold and it's a broken Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah

There was a time you let me know

What's really going on below

But now you never show it to me, do you?

And remember when I moved in you

The holy dove was moving too

And every breath we drew was Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah

You say I took the name in vain

I don't even know the name

But if I did, well really, what's it to you?

There's a blaze of light

In every word

It doesn't matter which you heard

The holy or the broken Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah

I did my best, it wasn't much

I couldn't feel, so I tried to touch

I've told the truth, I didn't come to fool you

And even though

It all went wrong

I'll stand before the Lord of Song

With nothing on my tongue but Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah

Hallelujah, Hallelujah


In the concert, Cohen looks thin and a bit frail. His hands are sinewy and show his veins and tendons. His skin is covered with age spots. He wears a fedora that he takes off from time to time and he has short salt and pepper hair. I anger myself because of my ageism-. I keep expecting him to forget the lyrics. He has a disarmingly sly smile that he flashes every so often. He sings with one fist clenched as if he is shouting at a crowd. I guess in a way he is.

The Sisters of Mercy

O the sisters of mercy they are not

Departed or gone,

They were waiting for me when I thought

That I just cant go on,

And they brought me their comfort

And later they brought me this song.

O I hope you run into them

You whove been traveling so long.

Yes, you who must leave everything

That you cannot control;

It begins with your family,

But soon it comes round to your soul.

Well, Ive been where youre hanging

I think I can see how youre pinned.

When youre not feeling holy,

Your loneliness says that youve sinned.

Well they lay down beside me

I made my confession to them.

They touched both my eyes

And I touched the dew on their hem.

If your life is a leaf

That the seasons tear off and condemn

They will bind you with love

That is graceful and green as a stem.

When I left they were sleeping,

I hope you run into them soon.

Dont turn on the light

You can read their address by the moon;

And you wont make me jealous

If I hear that they sweeten your night

We werent lovers like that

And besides it would still be all right

We werent lovers like that

And besides it would still be all right.

Cohen’s music is so personal, but personal not just for him but for each of us. We all can understand the heartbreak of broken promises and lost dreams. Only he says it better.

So Long, Marianne

Come over to the window, my little darling,

I'd like to try to read your palm.

I used to think I was some kind of Gypsy boy

before I let you take me home.

Now so long, Marianne, it's time that we began

to laugh and cry and cry and laugh about it all again.

Well you know that I love to live with you,

but you make me forget so very much.

I forget to pray for the angels

and then the angels forget to pray for us.

Now so long, Marianne, it's time that we began ...

We met when we were almost young

deep in the green lilac park.

You held on to me like I was a crucifix,

as we went kneeling through the dark.

Oh so long, Marianne, it's time that we began ...

Your letters they all say that you're beside me now.

Then why do I feel alone?

I'm standing on a ledge and your fine spider web

is fastening my ankle to a stone.

Now so long, Marianne, it's time that we began ...

For now I need your hidden love.

I'm cold as a new razor blade.

You left when I told you I was curious,

I never said that I was brave.

Oh so long, Marianne, it's time that we began ...

Oh, you are really such a pretty one.

I see you've gone and changed your name again.

And just when I climbed this whole mountainside,

to wash my eyelids in the rain!

Oh so long, Marianne, it's time that we began ...

A final note- if you see the concert, pay particular attention to the saxophonist- Dino Soldo. He is so skills with all of the instruments he plays. His fingers fly and his improvisations are amazing. He also looks like the definition of cool.

My Publications

Ford, W.E., A client-coding system to maintain confidentiality in a computerized data system. (1976). Hospital and Community Psychiatry. Sep; 27(9): 624-625.

Rodgerson, M.J., Weisman, B., Ford, W.E. (1979) Rate of alcoholism diagnosis in community mental health centers: the effect of the presence of an alcoholism treatment program. Currents in Alcoholism. 7: 149-159.

Beeson, P.G., Ford, W.E., Systems planning for the 80s: The Nebraska Mental Health Desired Services System Model (1983). Community Mental Health Journal. 19(4): 253-264.

Ford, W.E., Planning alcoholism services: a technique for projecting specific service needs (1983). International Journal of the Addictions. Apr; 18(3): 319-331.

Ford, W.E. et al., Predicting alcoholism manpower needs (1983). International Journal of the Addictions. Dec; 18(8): 1049-1062.

Ford, W.E. et al., Predicting alcohol service needs for a National Treatment Utilization Survey (1983). International Journal of the Addictions. Dec; 18(8): 1073-1084.

Ford, W.E., Alcoholism and drug abuse service-forecasting models: a comparative discussion (1985). International Journal of the Addictions. Feb; 20(2):233-252.

Ford, W.E., Alcoholism and drug abuse forecasting techniques: some planning concepts (1986), in Einstein, S (ed), Treating Drug Use. Danbury, CT: D.I.A., 139-154.

Ford, W.E., From theory to practice: the planned treatment of drug users (1989). International Journal of the Addictions. Jan; 24(1): 39-70.

Ford, W.E., Emerging issues in managing substance abuse services (1993). Managing Employee Health Benefits; 2(1); 39-44.

Ford, W.E., AOD benefits under insurance-based plans (1994). TIE Communique: 40-41.

Ford, W.E., Provider profiling: measuring mental health care effectiveness (1994). Managing Employee Health Benefits; 3(1), 43-47.

Ford, W.E., Critical issues facing substance use/misuse and its intervention: a 90s retrospective (1995). International Journal of the Addictions, 30(2): 203-205.

Ford, W.E., Wrong Necessity (1995). Hastings Center Reports. Mar; 25(2):2.

Ford, W.E., The detection of under-treatment in substance abuse managed care (1996). Treatment Today; Spring: 26-27.

Ford, W.E., Perspective on the integration of substance user needs assessment and treatment planning (1997). Substance Use and Misuse. Feb; 32(3): 343-349.

Ford, W.E., Medical necessity: its impact in managed mental health care (1998). Psychiatric Services, 49(2): 183-184.]

Ford, W.E., Understanding the Purchase of Outcome in Substance Abuse Treatment (1999), prepared for the National Council on Alcoholism and Drug Dependence Committee on Benefits).

Ford, W.E., Medical necessity and psychiatric managed care (2000). Psychiatric Clinics of North America., W.B. Saunders, 2000, 23(2), 309- 317.

Ford, W.E. and Smith, M. Substance Abuse and Crime Prevention Act of 2000: Analysis of Plan from the 58 Counties, developed for the California Department of Alcohol and Drug Programs, published at www.adp.cahnet.gov/SACPA Three analytic documents have been produced in this series.

Pringle.JL.; Edmondston L.A.; Holland C.L.; Kirisci L.; Emptage N.P.; Balavage V.K.; Ford W.E.; Etheridge, R.M.; Hubbard, R.L.; Jungblut, E.; Herrell, J.M.(2002). The role of wrap around services in retention and outcome in substance abuse treatment: findings from the wrap around services impact study. Addictive Disorders Treatment, 1(4):109-118.

McDuff, J., and Ford, W.E .(2005), A Report on the Post-September 11 State Disaster Relief Grant Program of SAMHSA’s Center for Substance Abuse Treatment, DHHS Pub. No (SMA) 05-3993, Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration.

Atlanta Symphony Orchestra: the Transcription of Brahms

I attended the Atlanta Symphony Orchestra concert last evening.  Elsewhere I have been critical of the ASO.  It sometimes lack precision, it has pitch problems, and the upper strings can be strident.  Some of this may be due to Symphony, which is a harsh environment accoutically and vistally.  Last evening concert had some of these problems, but the hits were far fewer than the hits.  The program began with contemporary composer Adam Schoenberg's "Finding Rothko."  The piece took full advantage of the full orchestra.  As Schoenberg noted in a short video, the music is not a literal interpretation of Rothko's art, but rather an impression of the artist's work.  The composer also noted that contemporary classical composers have the freedom to compose as they feel the need.  They are not bound by a school (e.g., romatic or classical) or technique (e.g., atonal).  I liked the piece- it kept my attention and I liked the colorful use of the orchestra.  There were some mightly low bass in sections that shoock the house.  This was followed by the Brahms "Concerto for Violin and Orchestra in D Major."  The soloist was Croatian pianist Dejan Lazic.  So what was a pianist doing playing a violin concerto? - you ask.  Lazic transcribed the concerto for piano.  I admire the violin concerto as it is.  It has beautiful melodies, and intricate theme development, and it is well integrated, unlike the music of Tchaikovsky, which seems episodic to me.  Brahms, while being a romatic, never deteriorates into hystrionics.  This transcription generally worked, since Brahms was, in fact, piano-oriented.  At times, however, the orchestra and soloist seemed inbalanced, which I assume is due to a solo violin not being as prominent as as a solo piano.  Lazic is very talented and a treat to watch at the piano.  However, there were some pitch problems in the horn section at the end of the first movement.  The final piece on the program was Mussorgsky's warhorse "Pictures at an Exhibition. " This is exciting and colorful music and Ravel's orchestration makes full use of the orchestra.  The last section, "The Great Gate at Kiev" is one of the best climaxes in the romantic literature.  The ASO played well, except at the end of the first Promenade, the cellos and bass were not together.  This is a difficult section, but I have heard it played by others with much greater precision. 

I sat in row C or the orchestra section.  I like sitting close to the orchestra where the effects of the hall are somewhat muted.  It also provides great views of  conductor Spano and soloist Lazic.  Overall, I enjoyed the concert and look forward to my next with the ASO.

The Creation

After much deliberation (not really) I have decided to create my own blog. It will provide an opportunity to share my art as well as my thoughts. I used Facebook for this but realized how limited the audience is. So, here goes........