“Life Can Only Be Understood Backwards; But It Must Be Lived Forwards”: Review of Mystic River

Review of Mystic River, USA 2003, directed by Clint Eastwood.

Review by Franco Ferrarini, gastroenterologist and film reviewer.

Review contains plot spoilers.

Based on the eponymous 2001 novel by Dennis Lehane, “Mystic River” is one of the darkest and probably best of Clint Eastwood movies. The story might be well known to those who read the book, however the film’s opening scene is key for understanding its multitude of themes. Three children, Dave, Sean and Jimmy (later on seen as adults played by Tim Robbins, Kevin Bacon and Sean Penn), are having fun in a Boston’s outer borough street printing their names in wet cement. A man appears out of nowhere, stops his car by them, and begins chastising them for their conduct. He shows them a police badge and orders Dave to get into the car where another man, supposedly a clergyman, welcomes him with a smile. Dave is subsequently locked away and abused for 4 days by his two abductors until he manages to break away.

After a 25-year break, the three men still have not left their home town, and they are now shaken by the killing of Sean’s daughter Katie (Emmy Rossum) in suspicious circumstances. The adult Dave is an anxious, depressed, and fragile man whose only purpose in life is playing baseball with his son. He fully believes that his adult life has been shaped by his childhood trauma; in a dramatic conversation with his wife Celeste (Marcia Gay Harden) he says: ‘Dave’s dead. I don’t know who came out of that cellar, but it sure as s**t wasn’t Dave! The thing is…once it’s in you, it stays’.

Childhood trauma, especially of sexual and/or physical nature, is a well-known cause of post-traumatic stress disorder and medically unexplained neurological symptoms (Karatzias T et al 2017). Alterations in the gut microbiota may be at the basis of these conditions; Sudo et al (2004) found that germ-free mice subjected to restraint as a form of stress exhibited an enhanced response of the hypothalamic-pituitary-adrenal axis compared to gnotobiotic mice. These alterations are partly corrected by reconstitution of the microbiota at an early developmental stage, but not at a later stage. One might therefore hypothesize, based on a recent study by Hantsoo L et al (2019) in humans, that stress-induced alterations in the composition of the intestinal microbiota may explain the permanent effects of childhood stress on adult behaviour.

Apart from exploring the impact of childhood stress on adult behaviour, the film also raises interesting questions with regards to metaphysical issues such as ‘Fate and Destiny’. The ancient Greeks used the former term to indicate a future that cannot be modified because it was already defined by the Gods, contrary to ‘Destiny’ which is a future that can be modified by humans. Fate seems to dominate the life course events of Eastwood’s film characters, the children’s names printed indelibly in cement are a testimony to this. Early on we come to believe that Dave’s future has already been marked by the childhood abuse he suffered. This despicable event has also significantly influenced Sean’s and Jimmy’s future: Sean becomes a police officer in an effort to combat the evil that triggered his pal’s life-long suffering. Jimmy’s reaction is completely different; he becomes the leader of a gang of low-life criminals and believes in ‘delivering justice by taking the law in hands’. Jimmy ends by killing Dave as he mistakenly thought that Dave was Katie’s killer. Fate plays a decisive role again in the three men’s lives as Katie’s killing itself was a predetermined price for one of her father’s earlier sins.

One may also wonder about the symbolic significance of the Mystic River, which accepts the dead bodies of Ray and Dave. It may well be a metaphor for Mother Nature, who covers the atrocities that humans do but nonetheless maintains its quiet course. The river was a witness to the tragic lives of three men forever scarred by their childhood trauma. Aptly put by Sean: “Sometimes I think, I think all three of us got in that car”. Soren Kierkegaard, Danish philosopher, once said: “Life can only be understood backwards; but it must be lived forwards”. If only, the three men could have heard that, and practised it.



  1. Karatzias T et al, Organic vs. functional neurological disorders: The role of childhood psychological trauma. Child Abuse Negl 2017; 63:1-6.
  2. Sudo N et al, Postnatal microbial colonization programs the hypothalamic-pituitary-adrenal system for stress response in mice. Physiol 2004; 558:263-75.
  3. Hantsoo L et al, Childhood adversity impact on gut microbiota and inflammatory response to stress in pregnancy. Brain Behav Immun 2019; 75:240-250.

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