Desmond O’Neill on the medical and ethical themes in Prometheus

Desmond O'NeillSwitching off can be hard in medicine. No matter where one turns, the observational reflex kicks in, prompted by the goitre of the newscaster or the Bell’s palsy of the bank teller. And we can run but they won’t hide, as I found out at a late night outing to Prometheus, the latest instalment of the Alien movie series. Surely this was the sure-fire antidote to a hectic week in the hospital, a blissful 140 minutes of escapism immersed in the first mega-movie of the summer.

Yet within minutes, despite being now many billions of miles from Earth, we were so bombarded by medical and ethical themes that I began to feel like Ripley confronted by yet another alien. Infertility, surgical robotics, chimerism, life extension and existential inquiry followed each other in a dizzying sequence, but with a light touch and a smart script that was entertaining, thought-provoking and suspenseful by turn.

In an updating of the Chariot of the Gods, a dippy but popular book from the 1960’s relating cave paintings and phenomena such as the Nazca lines in Peru to a theory that aliens gave us technologies and religion, we are on an expedition to find an alien source for human life. In other references to the 1960’s, the eery android David, tending the crew who are in deep sleep for the long journey—shades of 2001, A Space Odyssey—models himself on Peter O’Toole in Lawrence of Arabia, even dying his hair blonde while monitoring their dreams.

Having arrived at the alien planet, David conspires to impregnate the heretofore infertile heroine with an alien, and her horrified recourse to the robotic surgery machine is droll and brilliantly executed. She keys in a request for a Caesarian section: it signals back that it is only programmed for men. In perhaps the most accurate use of the phrase in cinematic history, she quickly keys in “removal of foreign body.” She hops on the table and scanning, incising, removal of the squid-like alien with an ironically obstetrical forceps, and stapling of the incision follow in a brilliantly choreographed and tense sequence. A delightful coda is provided by David who meets her, bloodied and exhausted, and drily observes: “I didn’t know you had it in you.”

The essence of the film is that the alien civilization, known as the Engineers, have indeed created human life in one of their many forays to Earth, but have now been hoist on a petard of their own making. All but one have perished due to a biological warfare agent (a suitably revolting and, in the tradition of the Alien series, male-violating squid/snake) they were due to bring to Earth.

A counter-plot arises when it transpires that the sponsor of the human’s expedition is an ageing industrialist, hoping to gain longevity from the secrets of the Engineers and manipulating events through David. Predicable mayhem ensues: the aged industrialist discover the meaning of hubris in a suitably graphic manner, and the last surviving Engineer and the biological agent fuse to form a novel being—the eponymous alien of the sequels.

But it is on prompting reflections of our origins that the film transcends its thriller genre, and despite the hokum we leave the cinema reflecting on the existential. Through the leitmotif generated by David in his use of the line from Lawrence of Arabia: “In the desert is nothing, and no man needs nothing,” we find that an unremitting faith in science and the mechanistic fails virtually everyone (and every species) in the film.

Yet David is clearly ill at ease with the heroine’s dreams of childhood with her missionary father as well as her wearing a cross on a chain, which he removes.  In the final scene, before heading off as the sole survivor to find the Engineer’s planet, she retrieves her cross, a surprising gesture from the director Ridley Scott, who is on record as regarding organised religion as a great evil.

But perhaps what he is really signalling is the universality of our innate spirituality, regardless of religion, the elements of which have been described as hope, the search for meaning, and a relationship with a higher force, whether nature or a God (1).  William Blake may have found Heaven in a flower, but it is Ridley Scott who has subtly teased out human spirituality in an unthreatening and thought-provoking way in a summer blockbuster.

1) Vachon et al. J Palliat Med 2009;12:53-9.

Des O’Neill is a consultant physician in geriatric and stroke medicine