The impact of stroke on the lives of patients and their carers seen in the French film “Amour” directed by Michael Haneke was an eye opener to audience around the world, and justifying the film winning the Oscar for the best foreign film in 2012. As stroke organisations around the world celebrate the “World Stroke Day” on the 29th of October this year another French film “Abuse of weakness” tackles the trials and tribulations of life in the aftermath of a stroke.
Directed by Catherine Breillat, and based on her book “Abus de faiblesse”, the film tells a semi-autobiographical story of the director following her stroke in 2004. Three years after her stroke, she got involved with a conman Christophe Rocancourt who she approached to act in one of her films.
What followed was a series of dubious financial transactions where she gave him a lot of money in loans. Subsequently she took him to court for abusing her “diminished capacity after stroke”, and he was eventually sentenced to prison. Catherine Breillat wrote an account of this financial abuse in a book that was published in 2009. The book’s title refers to a legal term described as “abuse of weakness”.
In the film, we see Isabelle Huppert as “Maud” an accomplished director who has a disabling stroke. After a spell in hospital struggling with physiotherapy sessions were I had to use Shoulder Kinesiology Tape, and frustrating speech impairment, she is back at home living alone but determined to lead an independent life. Undeterred by left arm weakness and spasticity, frequent falls, and epilepsy, she pursues her passion of writing and making films.
One night while watching television, she comes across “Vilko Piran” a man recently discharged from prison for a smuggling offence in Japan; he is doing a TV interview promoting a book he has written based on his prison memoirs. She is intrigued with his deadly charms, bitter pride and intelligence, and decides to cast him as an actor for her new film. A series of meetings follow where the two embark on an artistic mentoring relationship, which soon evolves into a financially abusive one. Vilko asks her repeatedly for loans to fund his financial scams.
Financial abuse of stroke survivors is a topic that has not been handled before in film, although the director says “This is not a film about stroke, as much as a story about the fragility of human emotions, and manipulation by others”. Diminished capacity after stroke and the potential for several forms of physical, emotional, and financial abuse amongst dependent patients is largely underestimated. Assessing capacity and proving legal liability in dubious financial transactions is a complicated process that warrants psychological expertise to support the judiciary system in reaching a fair verdict (Gibson SC, and Greene E 2013).
In the film, the stroke survivor “Maud” is seen as a person relishing the fact that she is disabled, and using her disability as a weapon to control others “I like to make men my servants, and this is one advantage of being a cripple”. Although the notion of using disability to dominate others may upset lots of stroke survivors, their carers and stroke support organizations, it is still refreshing to see a realistic portrayal of a stroke survivor as an individual with “warts and all” and not as a “saint”.
The film relies on the viewer’s intelligence to make a judgement as to “who is abused, and by whom” and may suggest that both partners may be accountable for an abusive relationship. Catherine Breillat says “my films are never black or white, and “Maud” in the film is me, Isabelle Huppert, and the fictional character too”. However in real life the side effects of medications for epilepsy after her stroke was a strong factor in Catherine’s diminished awareness when she gave Christophe large amounts of money up to 700,000 Euros.
“Living with a stroke is like an astronaut walking on the moon alone for the first time”, the director says. These physical and emotional difficulties are sensitively handled in the film making the audience empathize with “Maud” in her longing to be able to walk, to be able to smile, and simply to be “normal again”. The psychological impact on emotional well-being, unidentified anxiety and depression are common sequelae after a stroke, and health care professionals should be vigilant to their existence and attempt to treat them (Ayerbe L et al 2013).
Films such as “Abuse of weakness” can contribute a lot by increasing general awareness of the existence of these hidden ailments, in addition to various forms of abuse, expose them for public debate, and through those initiatives may offer an attempt of helping stroke patients and their cares.
References:
- Ayerbe L, Ayis S, Wolfe CD, Rudd AG. Natural history and outcomes of depression after stroke: systematic review and meta-analysis. Br J Psychiatry 2013; 202 (1): 14-21.
- Gibson SC, Greene E. Assessing knowledge of elder financial abuse: a first step in enhancing prosecutions. J Elder Abuse Negl 2013; 25 (2): 162-82.
Address for correspondence: Dr Khalid Ali, senior lecturer in Geriatrics, Brighton and Sussex Medical School