film

Living Between Dreams and Reality

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Imagine suddenly falling asleep mid-conversation. Or collapsing to the floor just because you laughed. For people with narcolepsy, this isn’t dramatic, it’s daily life.

Narcolepsy has been observed since the 18th century, but it was the French neuropsychiatrist Édouard Gélineau who first defined the condition. In 1880, he described patients with an uncontrollable urge to sleep. One of them, a 38-year-old wine merchant, also experienced sudden weakness in his legs whenever he laughed, felt pleasure, or even held a winning hand of cards. Gélineau would later document 14 cases, initially believing narcolepsy to be a new type of neurosis.

For years, the disorder puzzled physicians. In 1957, Yoss and Daly described the classic symptom tetrad: excessive daytime sleepiness, cataplexy (emotion-triggered muscle weakness), sleep paralysis, and hypnagogic hallucinations. Despite overwhelming sleepiness during the day, night-time sleep in narcolepsy is often fragmented and unrefreshing.

Real progress came after the discovery of REM sleep in the 1950s, allowing narcolepsy to be studied using polysomnography. More recently, researchers identified the loss of hypocretin (orexin) neurons in the hypothalamus as a key mechanism behind the disease—a breakthrough that transformed our understanding of its biology.

Narcolepsy usually begins in adolescence or early adulthood and affects about 1 in 2,000 people in the United Kingdom. Diagnosis is often delayed for years, and even with treatment, excessive sleepiness can seriously impair quality of life, increasing accident risk and affecting work, relationships, and mental health. Treatment focuses on stimulants to reduce daytime sleepiness and antidepressants to control cataplexy, sleep paralysis, and hallucinations, alongside psychological and social support.

Narcolepsy has also made its way into popular culture. One of the most striking portrayals appears in My Own Private Idaho (1991), directed by Gus Van Sant, where River Phoenix’s character, Mike Waters, lives with narcolepsy. His sudden sleep attacks—often triggered by emotional stress—are woven into the film’s visual language, blurring dreams, memories, and reality. While not a clinical portrayal, the film captures something deeply truthful about the condition: its unpredictability and the isolation it can impose, long before narcolepsy was widely understood by the public.

Here is a brief excerpt from an interview River Phoenix gave about playing a character with narcolepsy at the time the film was released.

Women and illicit drug use in cinema

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After analysing more than sixty films for a MSc in Medical Humanities entitled “Women and Illicit Substance Use in Cinema”, I am starting a series of posts on filmic representations of female drug users.

Part 1 – Female drug users in Woody Allen’s films

After cocaine resurgence in the 1970s, Woody Allen was probably one of the first filmmakers to depict the expensive substance – used at that time by wealthy bohemian people – in a comic scene in ‘Anne Hall’ (1977). Annie, by the way, smokes weed, dresses in an unconventional style, and is open to drug experimentation:

Another interesting reference of cocaine use in the 1980s appears in ‘Hannah and Her Sisters’ (1986). The movie depicts Holly (Dianne Wiest), a struggling actress with a former cocaine habit. Holly appears snorting cocaine openly in the audience of a punk rock band in a legendary club in New York,  a reference to 1980s cocaine abuse in that scene. Her date Mickey (Allen) says to her that she will develop ‘a third nostril’, takes her to a jazz club, but she continues restlessly snorting coke there:

Holly wears bold outfits, but is insecure. When she stops using cocaine she has difficulties to adjust to an occupation, has a novelty-seeker nature and a competitive relationship with a female friend. Her parents are alcoholic and narcissistic, and her sister attends Alcoholic Anonymous meetings and has a clandestine affair with Hannah’s husband, showing a complicated family dynamic.

Hannah is apparently a successful woman, who has a co-dependent relationship with Holly, supporting financially her new schemes to make money. However, along her self-analysis and determination, Holly grows up, becomes a successful playwright and marries Mickey. Her former cocaine abuse appears as a rite of passage, as she becomes more integrated with herself

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THE MAGIC BULLET

The German Jewish physician and scientist Paul Ehrlich (1854-1915) was the precursor of staining techniques for tissues, worked on the development of a anti-serum to combat diphtheria and his laboratory was responsible for the first treatment available for syphilis, arsphenamine. He was the first to coin the term “chemotherapy”, and received the Nobel Prize in Medicine in 1908 for his contributions to immunology.

Dr Ehrlich searched for a chemical that could not only  stain but also attach itself to  a germ and kill it, without causing harm to the patient’s body. He called them “magic bullets”, these chemicals injected in the body to fight diseases. After 606 tries, he finds a magic bullet to combat syphilis, arsphenamine (commercialized as Salvarsan) and calls this substance 606. However this discovery seems to be short-lived as 38 patients die of arsenic poisoning contained in the substance. Later his laboratory developed a more soluble and diluted formula, with less severe side effects. The arsenic compounds were  substituted by penicillin for the treatment of syphilis in the 1940s.

Ehrlich’s history is narrated along “Dr Ehrlich’s magic bullet”, a 1940 autobiographical film directed by William Dieterle. His discovery of staining techniques and the development of the serum to combat diphtheria, working with his colleague Emil von Behring, are remarkable – and indeed saves the lives of many children during the epidemics of the disease. Later, while working with good results with Sahachiro Hata on 606 for syphilis, Ehrlich (Edward G. Robinson) is forced by medical practitioners to release the drug for commercial use. He hesitates from a scientific point of view, but concedes in light of  the urgency of treatment. The drug is produced in large scale in Europe, and Ehrlich ends  up being judged by 38 deaths caused by 606. He is defended in court by his colleague Emil von Behring, who claims that despite these deaths, 606 was a success in many cases against a disease that was considered incurable until then.

Near his death, the world is on the verge of a war, and Ehrlich gives a speech to his trainees and collaborators in his bed:

“606 works, we know. The magic bullet will cure thousands. The principle upon which it works will serve against other diseases, many others, I think. But there can be no final victory against diseases of the body unless diseases of the soul are also overcome. They feed upon each other, diseases of the body, diseases of the soul. In days to come, there will be epidemics of greed, hate, ignorance. We must fight them in life as we fought syphilis in the laboratory. Fight. Fight. You must never stop fighting.” (*)

Virna Teixeira

(*) Peter E. Dans. Doctors in the Movies: Boil the Water and Just Say Aah (Medi-press: Bloomington, Illinois, 2000).

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STILLNESS AND SPEED IN ANDY WARHOL’S WORK

Andy Warhol produced more than seventy films during his life, later often in collaboration with other producers. His early films were made while his studio, the Factory, was being created, and were experiments in silent film. His silent early films are: Sleep, Empire, Eat, Haircut (N.1), all produced in 1963, Kiss (1963-1964), Blow-Job (1964), and Henry Geldzahler (1964), and some Screen Tests. In those silent movies, the camera is still, with occasional slight zoom. Warhol achieved this effect of stillness through the resource of silent speed.

Sleep (1963) was Andy Warhol’s first long film, in which he used his first camera, a 16mm Bolex. It starred Warhol’s then boyfriend John Giorno sleeping for five hours 21 minutes. The film is made up of a complex editing, and it was shot in different sessions over a few days.

Sleep begins with the image of Giorno’s breathing abdominal movements and face in an uncommon take. Due to the complex editing process, the slow repetition split into reels, the lack of sound and the lack of linear narrative, this film is a strange experience to watch. Long periods of the same image are followed by jumpy changes to different close-ups of Giorno’s body: his head, his knee, his chest, the lower buttocks, and the upper part of his legs. There is an element of homoeroticism, but in some moments where Giorno’s body is still, the film seems to progress to a kind of evocation of death. Critic Henry Geldzahler perceived in Sleep an intimate understanding of John Cage’s work, especially in the repetitive aspects.

John Giorno commented in an interview that Warhol had chosen to film him because he slept too much. Andy Warhol, by the other hand, reveals his own motivations in the books he wrote about the sixties and about his philosophy: people around him (and he himself) were too high on amphetamines (speed) to sleep, and everybody was continuously sleep deprived. In the Philosophy of Andy Warhol he comments:

Another thing I couldn’t understand was all those people who never slept who were always announcing: “Oh I am hitting my ninth day and it’s glorious!” So I thought, “Maybe it’s time to do a movie about somebody who sleeps all night. But I only had a camera that had three minutes on it, so I had to change the camera every three minutes to shoot three minutes. I slowed down the movie to make up for all the three minutes I lost changing the film, and we ran it at a slower speed to make up for the film I didn’t shoot.

The fact coincides with the first epidemics of amphetamines in the U.S.(Rasmussen, 2008). Warhol started to use amphetamine in early 60’s to control his weight. His favorite speed was a powerful tablet named Obetrol (containing up to 10mg of methamphetamine, 5mg of original Benzedrine-style amphetamine, adding subjective ‘buzz’). He reportedly enjoyed Dexamyl as well.

In Popism, he mentions his sleep deprivation:

I could never finally figure out if more things happened in the sixties because there was more awake time for them to happen in (since so many people were on amphetamine), or if people started taking amphetamine because there were so many things to do that they needed to have more awake time to do them in. It was probably both…I only slept two or three hours a night from ’65 through ’67.

The morning one of his crazed former actress Valerie Solanas shot him in 1968, he was filling his Obetrol prescription, and he continued taking amphetamines until he died in 1987 (Collacelo, 1990).

REFERENCES:

Andy Warhol and Pat Hackett, Popism: The Warhol Sixties (Orlando: Harcourt Brace Jovanovitch, 1980), p. 33.

Andy Warhol, The Philosophy of Andy Warhol: from A to B and back again, (London: Pan Books, 1975), p. 14.

Colacello, Bob, Holy Terror: Andy Warhol Close Up (New York: Harper Collins, 1990).

Rasmussen, Nicholas, On Speed: the Many Lives of Amphetamine (New York, London: New York University Press, 2008).

Virna Teixeira