Medicines Moving Pictures

Rochester Studies in Medical History

Senior Editor: Theodore M. Brown
Professor of History and Preventive Medicine
University of Rochester
ISSN 15262715

The Mechanization of the Heart:

Harvey and Descartes
Thomas Fuchs
Translated from the German
by Marjorie Grene
The Workers Health Fund in Eretz Israel
Kupat Holim, 19111937
Shifra Shvarts
Public Health and the Risk Factor:
A History of an Uneven Medical
Revolution
William G. Rothstein
Venereal Disease, Hospitals and the
Urban Poor: Londons Foul Wards,
16001800
Kevin P. Siena
Rockefeller Money, the Laboratory
and Medicine in Edinburgh
19191930: New Science
in an Old Country
Christopher Lawrence

Health and Wealth:

Studies in History and Policy
Simon Szreter
Charles Nicolle, Pasteurs
Imperial Missionary:
Typhus and Tunisia
Kim Pelis
Marriage of Convenience:
Rockefeller International Health
and Revolutionary Mexico
Anne-Emanuelle Birn
Medicines Moving Pictures:
Medicine, Health, and Bodies in
American Film and Television
Edited by Leslie J. Reagan,
Nancy Tomes, and
Paula A. Treichler

Medicines Moving
Pictures
Medicine, Health, and Bodies in
American Film and Television
Edited by
LESLIE J. REAGAN, NANCY TOMES,
AND PAULA A. TREICHLER

UNIVERSITY OF ROCHESTER PRESS

Copyright 2007 by the Editors and Contributors

All rights reserved. Except as permitted under current legislation, no
part of this work may be photocopied, stored in a retrieval system,
published, performed in public, adapted, broadcast, transmitted,
recorded, or reproduced in any form or by any means,
without the prior permission of the copyright owner.
First published 2007
University of Rochester Press
668 Mt. Hope Avenue, Rochester, NY 14620, USA
www.urpress.com
and Boydell & Brewer Limited
PO Box 9, Woodbridge, Suffolk IP12 3DF, UK
www.boydellandbrewer.com
ISBN-13: 9781580462341
ISBN-10: 1580462340
ISSN: 15262715
Library of Congress Cataloging-in-Publication Data
Medicines moving pictures : medicine, health, and bodies in American
film and television / edited by Leslie J. Reagan, Nancy Tomes, and Paula
A. Treichler.
p. ; cm. (Rochester studies in medical history, ISSN
15262715 ; v.10)
Includes bibliographical references and index.
ISBN-13: 978-1-58046-234-1 (harcover : alk. paper)
ISBN-10: 1-58046-234-0
1. Medical personnel in motion pictures. 2. Medical personnel on
television. 3. Medicine in motion pictures. 4. Medicine on television.
5. Motion picturesUnited States. 6. Television programsUnited
States. I. Reagan, Leslie J. II. Tomes, Nancy, 1952 III. Treichler,
Paula A. IV. Series.
PN1995.9.P44M42 2007
791.436561dc22
2007014113
A catalogue record for this title is available from the British Library.
This publication is printed on acid-free paper.
Disclaimer:
Printed
in the in
United
States version
of America.
Some images
the printed
of this book are not available for inclusion in the eBook.

To view these images please refer to the printed version of this book.

Contents
List of Illustrations

vii

Acknowledgments

ix

Introduction: Medicine, Health, and Bodies in

American Film and Television
Leslie J. Reagan, Nancy Tomes, and Paula A. Treichler

Part 1: An Emerging Genre

1

More than Illustrations: Early Twentieth-Century

Health Films as Contributors to the Histories of Medicine
and of Motion Pictures
Martin S. Pernick
Celebrity Diseases
Nancy Tomes

19
36

Part 2: Educational Entertainment,

Entertaining Education
3

Syphilis at the Cinema: Medicine and Morals in VD Films

of the U.S. Public Health Service in World War II
John Parascandola

71

Medicine, Popular Culture, and the Power of Narrative:

The HIV/AIDS Storyline on General Hospital
Paula A. Treichler

93

Mandy (1952): On Voice and Listening in the (Deaf)

Maternal Melodrama
Lisa Cartwright

133

Projecting Breast Cancer: Self-Examination Films and the

Making of a New Cultural Practice
Leslie J. Reagan

163

vi

contents

Part 3: Defining Authenticity, Exercising Authority

7

American Medicine and the Politics of Filmmaking:

Sister Kenny (RKO, 1946)
Naomi Rogers

Passing or Passive: Postwar Hollywood Images of Black Physicians

Vanessa Northington Gamble

From Expert in Action to Existential Angst:

A Half Century of Television Doctors
Joseph Turow and Rachel Gans-Boriskin

10 Hollywood and Human Experimentation: Representing

Medical Research in Popular Film
Susan E. Lederer

199
239

263

282

11 Technicolor Technoscience: Rescripting the Future

Valerie Hartouni

307

Suggestions for Further Reading

321

List of Contributors

325

Index

329

Illustrations
1.1 Still from The Temple of Moloch (1914)
2.1 Christy Mathewson at Saranac Sanitarium, Journal of the
Outdoor Life (1922)
2.2 Cartoon from St. Louis Star (1921)
3.1 U.S. Public Health Service publicity poster (1944)
5.1 Still from Mandy (1952)
6.1 Filmstrip of Breast Self-Examination (1950)
6.2 Still from Breast Self-Examination (1950)
6.3 San Diego movie theater (ca. 1955)
6.4 Sacramento audience viewing Breast Self-Examination (ca. 1955)
7.1 Elizabeth Kenny examining a child, Minneapolis (ca. 1943)
7.2 Mary McCarthy, Elizabeth Kenny, and Rosalind Russell (1943)
7.3 Cary Grant, Mary Kenny, and Elizabeth Kenny (1943)
7.4 Elizabeth Kenny reading the special press book prepared
by RKO (1946)
7.5 The Story of The Wedding Gown that waited
RKO billboard, Times Square (1946)
8.1 Albert Johnston Family
8.2 Mel Ferrer and Beatrice Pearson in Lost Boundaries (1949)
8.3 Sidney Poitier and Stephen McNally in No Way Out (1950)

27
43
44
78
153
168
170
174
175
203
207
208
217
221
241
246
253

Disclaimer:
Some images in the printed version of this book are not available for inclusion in the eBook.
To view these images please refer to the printed version of this book.

Acknowledgments
This book began as an excited conversation that then led each of us into new
intellectual territory and to new friendships. We have seen the real intellectual
benefits of collaboration and of bringing together scholars from different fields.
Through talking and writing together, we recognized health media as a genre of
its own and saw it as a field that intersects across many areas of scholarship. We
thank our co-editors for the hard intellectual labor and the good humor that
make this interdisciplinary collaboration possible.
The editors wish to thank Ted Brown for supporting this book and choosing to
include it in his series at the University of Rochester Press. We thank Elizabeth
Fee, Director of the History of Medicine Division at the National Library of
Medicine, for promoting scholarly attention to images and moving pictures and
for encouraging this project. We are indebted, too, to the expert staff of the HMD
who oversee its astonishing archival materials as well as to David Serlin who, with
Fee, organized the 2003 NLM Symposium on Visual Culture. Medicines Moving
Pictures has benefited from the support of the Research Board of the University
of Illinois at Urbana-Champaign, a source of invaluable assistance to scholars on
campus and interdisciplinary areas of research. We appreciate, too, the interest
in moving pictures shown by our colleagues in the History of Science and
Medicine Reading Group sponsored by the Illinois Program for Research in the
Humanities. We appreciate the comments of the anonymous reviewers of the
book in its manuscript stage and in the books final stage, the support of the
Science, Technology and Society Center and the Beatrice Bain Research Group,
both at the University of California at Berkeley. Many thanks to Jeff Clements,
librarian at the American Cancer Society, for his help with photographs. And at
the University of Rochester Press, our greatest debt is to our editor Suzanne
Guiod, for her enormous talent and commitment to helping us make this book
happen. Thank you to Janet Golden, Mike Murphy, Cary Nelson, Anne Nesbet,
Sarah Projansky, Roswell Quinn, Daniel Schneider, and Chris Sellers.
We are grateful to our colleagues, students, and families for their interest in
and support of this project. With notepads in one hand and popcorn in the
other, we hope to watch many more of medicines moving pictures with all of
you.

Introduction
Medicine, Health, and Bodies in
American Film and Television
Leslie J. Reagan, Nancy Tomes,
and Paula A. Treichler
Since the early twentieth century, Americans have learned about health, disease,
and doctors by going to the movies. American films have featured physicians as
popular protagonists, establishing the iconic images of heroic doctors and biomedical scientists still prevalent today. Many of us are familiar with the classic
Hollywood doctor films Arrowsmith, Dr. Ehrlichs Magic Bullet, Madame Curie, Men
in White, and the Dr. Kildare movies.1 Television, beginning in the 1940s and
1950s, has proven an equally hospitable home for doctor, health, and medical
shows.2 Dr. Kildares successful translation from film and radio to television made
the doctor show a staple of prime time scheduling, with each era producing
diverse images of physicians (Ben Casey, Marcus Welby, Doctor Quinn, House)
and institutions (Medical Center, M*A*S*H, St. Elsewhere, ER, Greys Anatomy). In
the new millennium, the doctor show has not only survived but continues to
flourish, combining comedy, romance, and drama in its plotlines. Diseases and
disabilities, too, have imprinted their images through iconic portrayals: tuberculosis (Greta Garbo in Camille), alcoholism (Ray Milland in The Lost Weekend),
deafness and blindness (Patty Duke as the young Helen Keller in The Miracle
Worker), leukemia (Ali McGraw in Love Story), autism (Dustin Hoffman in Rain
Man), and HIV/AIDS (Tom Hanks in Philadelphia).3
Health, medicine, and bodies dominate in less glamorous moving picture formats and genres as well. Instructional films on sensitive topics such as personal
hygiene, illicit drugs, and sexually transmitted diseases have long been a rite of
passage for the American high school student. Health-related videos and now
DVDs have been central to the self-help industry since the 1970s. In the workplace, films and videos provide instruction in new techniques and safety procedures

introduction

to diverse groups, from neurosurgeons to automobile mechanics. Finally, makers of film and television documentaries have used their craft to change public
attitudes toward specific diseases and health problems. The concerns of each
generation are reflected in its documentary classics: for example, the World War
II film To the People of the United States (1944), on venereal disease; Edward R.
Murrows Harvest of Shame (1960), on the plight of migrant workers; docudramas
such as The Ryan White Story (1989) and And the Band Played On (1993), on AIDS;
and Spike Lees When the Levees Broke (2006) about Hurricane Katrina.
As this brief catalogue of medicines moving pictures suggests, American medicine and mass media intersect in many significant ways. Medicine provides
media with reliably popular content and expertise while media provide medicine with modern communication systems for the powerful delivery of its messages. This symbiotic relationship between two of the most powerful industries
of the twentieth century has been and continues to be productive and profitable
for both. Although not always harmonious, medicine-media partnerships have
generated a huge volume of material across all mass media formats and genres.
Viewed by many, medicines moving pictures have influenced cultural representations of physicians, health, and disease, as well as health-related public debates
and controversies. The productions themselves, only now beginning to be systematically explored, constitute an extraordinary record of the connections,
conflicts, and ongoing coincidence of interests between media and medicine.
Medicines moving pictures represent a rich cultural and historical archive that
deserves serious scholarly attention.
This book provides that attention in the hopes of stimulating still more
research on medicines moving pictures, with their various formats, myriad topics, and special constraints. As the title suggests, our focus here is on health,
medicine, and bodies as represented in different forms of electronic media.
Studying these materials has been conceptually and practically difficult because
it is dispersed across so many media genres and formats. Although many healthrelated films have been loved (or sometimes laughed at) by their audiences, they
have largely been ignored by film and media scholars, including historians. To
counter that neglect, this volume brings together historians of medicine and
media/communications scholars who are interested in medicines moving pictures, yet whose discipline-based research rarely appears in the same places and
publications.4
Although the authors in this volume come at the subject of health-related
moving pictures from many different angles, their work suggests the usefulness
of considering medicines moving pictures as a genre. We believe it is a genre
defined not only by its topics, but, as we outline in this introduction, by its
unique relationship to the medical profession and science. The representations
and messages of medical productions are closely supervised by official medical
and biomedical authorities; at the same time, the media industry has a long history of concern for representing these subjects with accuracy. As a consequence,

introduction

medical film and television productions, whether conceived as entertainment or

education, can be usefully viewed and analyzed as a unique genre.
We use medicine in our title in its broadest sense to include all participants
in the medical and health care arena: patients as well as physicians; clinicians
and biomedical scientists; nurses, social workers, public health practitioners,
and non-physician healers; technicians, volunteers, activists, government officials, celebrities; and even laboratory animals. Thus, medicine in this volume
is not narrowly construed as the province of physicians, biomedical scientists, or
the American Medical Association alone. The essays here illuminate individuals
and groups across a wide spectrum of health-related issues and settings. At the
same time, we acknowledge that the medical profession has been the single most
important constituency influencing and patrolling media renditions of health
subjects, and has effectively shaped popular and public definitions of health,
medicine, and disease.5 Indeed, this power is a defining characteristic of what we
identify as the health and medical film genre.
The genre of medicines moving pictures is not limited by format. While the
essays in this volume give most attention to Hollywood films and television productions, they also discuss newsreels, educational film, and video. Although, as
a genre, health-related films are by no means limited to the United States, this
volume focuses primarily on the American scene, with the expectation that
more comparative work will be done in the future.6 The moving pictures analyzed here date from different periods of the twentieth century and cover a
range of topics and formats. Each essay provides a close reading of specific moving pictures. Analyses include production, distribution, genre, and changing
formulas and tactics, as well as the changing contexts in which they were viewed
and interpreted.
Uniting all of these medical pictures, whether in the form of a training film,
newsreel, cartoon, or Hollywood movie, is the power of moving pictures, that is,
the power to make bodies move across the screen. This crucial characteristic of
filmobservable motion over timemakes movies and television special. To
observe and capture movement, manipulate the moving image at various
speeds, slow it down and freeze it, and make it appear that a real event is happening now: these are the qualities that fascinated the pioneers of photography, film, and television as they learned to see and represent objects and
bodies moving through time and space.7 Equally important for our purposes,
these moving pictures have been produced at a time not our own, thus becoming fruitful objects for historical analysis and new insights.
These health-related pictures also moved in the sense that they were shown and
watched almost everywhere. Audiences gathered in many different and often
unexpected spaces to watch movies, just as they did later with television.8 Healththemed films were no exception. They appeared on the big screen in movie theaters and as short features preceding the main attraction. For example, in 1915,
a National Tuberculosis Association film was shown in the Universal Film

introduction

Companys theaters across the country, with millions estimated to see it every
week.9 But health films were also shown in many other places as well, including
classrooms, family living rooms, churches, factories, and buses converted into
mobile theaters. This books cover illustration shows a group of high school students watching an American Cancer Society (ACS) film in their biology class.10
At one level, our title is meant to emphasize the fact that these materials quite
literally moved around as they were distributed to different screens and different audiences. Filmsbig hefty reels packed and shipped in circular tinstraveled for decades through the mail, in cars and trucks, and in peoples hands to
be shown in myriad places. Health films moved through womens clubs and networks, voluntary health movements and labor unions, schools and churches.
Once shown, they were returned to libraries and public health offices to be
shipped out again to new audiences.11
We want to draw attention, too, to their constant movement across different
media. As Nancy Tomes shows in her essay, that movement sometimes involved
interplay between older forms of print culture: stories moved from the pages of
magazines and newspapers to the scripts used by filmmakers. They also refused
to stay stationary in a single type of media: health-themed programs moved
among media formats, from book to film, film to television, video to DVD, classroom film projectors to Internet websites, and websites to iPods. In various
forms, medicines moving pictures have moved into hospital waiting rooms and
doctors offices, where short films may be shown to distract or educate waiting
patients. They also move in the sense that patients bring to their medical
encounters questions and information gleaned from movies, soap operas, documentaries, and talk shows.
Medicines pictures are moving, moreover, in their depiction of emotions
onscreen and in their ability to move audiences to tears, laughter, fear, and sympathy. Film scholar Linda Williams argues that melodrama is the primary mode
of American film. Melodrama has, others would add, dominated American television as well.12 Many of the pictures analyzed by contributors to this volume
from venereal diseases to Hollywood biopics, television primetime dramas, and
daytime soapsemploy melodrama to tell stories of danger, disease, and death.
Provoking audiences to tears, and often to financial donations, these medical
media productions were moving indeed.
Educational films often have an additional task: to move their audiences to
adopt new health-related practices. Indeed, early audiences had to learn that the
film they were watching was intended to model actions they were now to perform themselves. Sex education films, writes Roger Eberwein, often used scenes
in which the films dramatize the conditions of their own reception. A VD film
shows servicemen going to the canteen to watch a VD filmin fact, the same
film that the real servicemen are themselves in the process of watching. A sex
education film shows a seventh-grader being asked to start the projector and
show a sex education film. The American Cancer Society film Breast Self-Examination

introduction

(1950) similarly embeds within itself a scene of an audience of women watching

a similar film. Yet, as Leslie J. Reagan shows, more is going on here than the simple modeling of a procedure. The film models for the viewer the ideal modern
patient and the ideal movie viewer.13
Many health and medical media similarly try to move audiences to adopt a perspective or take action with regard to a current health controversy. Susan E. Lederers
essay, for instance, shows how both research scientists and anti-vivisectionist
activists lobbied the film industry to reflect their opposing ideological views.
Animal rights activists successfully inserted animal protection measures into the
Hays Production Code; the biomedical research community used films in a
larger campaign to defeat a California state referendum designed to restrict the
acquisition and use of animal research subjects. Paula A. Treichlers essay notes
several strategies through which the soap opera General Hospital used its AIDS
storyline to integrate fictional and real individuals, events, and activities (like
fundraising for AIDS research).
While the use of pictures in our title emphasizes the visual, we also recognize sound and silence to be crucial components of film and television. A new
awareness of Deaf culture and disabilities movements have encouraged greater
attention to sound and its significance in the mass media. Sound and silence
appear in this volume in Lisa Cartwright and Reagans analyses of two very
different sets of films from the post World War II period, one produced in
Hollywood for entertainment, the other a joint effort by a voluntary group and
government agency for educational purposes. Silence and speaking, these essays
show, tell audiences as much as camera shots, lighting, and costumeespecially
about subordination and power, dependence and independence.

A Distinctive Genre
Created for diverse audiences and purposes, and for viewing in a wide variety of
settings, medicines moving pictures have a long history. The first movie theaters
opened in the United States in 1905; within two decades, some thirteen hundred films on doctors, health, and medicine had been produced. Many touched
on topics that provoked controversy and excited viewers, such as abortion, birth
control, mental illness, sexual hygiene, marriage, childbirth, euthanasia, and
eugenics.14
Medical films attracted producers, writers, actors, and cinematographers who
wanted to make them, and commercial sponsors and theatre owners who
wanted to show them. Health professionals, social commentators, journalists,
government and military officials, philanthropic organizations, reformers, educators, and ministers and priests wanted to harness and control their influence.
Perhaps most importantly, audiences showed a keen interest in health-themed
fare, an interest that fueled the perception of such films as profitable as well as

introduction

influential. Since the early twentieth century, health activists have used the
allure of popular entertainment to attract audiences. The ACS and other health
organizations knew well the publics enthusiasm for film and worked to stimulate that interest and then tap it for their own educational, recruitment, and
fundraising purposes. As a 1940s American Cancer Society guidebook declared,
Everyone likes to see movies.15
Early venereal disease (VD) films illustrate the peculiar dilemmas created by
the precocious success of medicines moving pictures. As Martin S. Pernicks
essay demonstrateswith parallels in John Parascandolas discussion of World
War II filmsthere was widespread consensus prior to World War I that VD was
bad for the military and that its eradication was imperative. But the translation
of this agenda into effective educational materials for American troops was
complicated and divisive. VD films provoked arguments over whether moving
pictures should invoke moral or medical authority, or both, to convey their message; should the overall agenda be one of fighting infection, as Eberwein puts
it, or fighting sin? The wartime context enabled filmmakers and their advocates to equate VD prevention and treatment with the war effort, patriotism, and
victory over a deadly enemy.16 When the crisis was over, however, longstanding
debates were reopened. Thus, no sooner had President Woodrow Wilson finished commending his returning troops on their dual victory over Germany and
the unseen enemy of venereal disease, than a backlash of morality and squeamishness gained strength. Ultimately, as Pernick recounts, many of these films
came to be banned, censored, shelved, or restricted to specific audiences and
venues.
After World War I, new forms of censorship gradually limited the making and
showing of films with sexual, medically explicit, or otherwise unduly distressing themes and images. As Tomes shows in her essay, debates over film censorship reflected older arguments focused on print media about what subjects
should be banned from polite discourse. Pernick traces that process whereby
commercial theatrical feature films were gradually limited to the goal of entertainment, while other films were classified as non-theatrical. The divisions
created by censors, as he shows, came to constitute individual genres (educational, industrial, animated, and so on).17 By the end of the twentieth century,
as Treichler shows in her essay, another popular (and presumed feminine)
genrethat of the daytime television soap operaoffered an avenue around
the silence of federal officials and television censorship with its frank portrayal
and discussion of AIDS.
In the 1920s and 1930s, medicine and media both felt the effects of the postwar moral backlash. The question of whether to restrict or ban certain kinds of
health themes in film proved divisive in both industries. Some physicians
grasped the unparalleled power of this new medium to reach large audiences,
and a few, like famed obstetrician Joseph De Lee, were eager to explore its possibilities. Others considered any popular media treatment of medicine to be

introduction

inherently undignified; they worried that airing medicines professional secrets

via the mass media would engender public anxiety, revulsion, hypochondria,
and quackery, and that it might provoke calls for the external regulation of the
profession.

Blurring the Boundaries: Entertaining Education and

Educational Entertainment
As Pernick suggests, one response to the troublesome allure of medicines
motion pictures was to sharpen the distinction between entertainment and education. Thus, commercial Hollywood studio films came to be strictly dedicated
to the provision of entertainment while all other films, including those containing disgusting, unpleasant, though not necessarily evil subjectstrue of many
health and medical filmswere placed in the catchall category non-theatrical.
While health and medical media were rarely banned outright, as explicit (and
not so explicit) sexual material often was, their separation from feature films
had a profound impact on all aspects of production, distribution, and reception.
The impact of this division is evident today in the ways that scholars studying
health-themed films divide themselves and their subjects. Yet as the essays in this
book demonstrate, the divide between education and entertainment media productions has never been as clear as industry guidelines and textbooks have
claimed. An entertainment film may not deliberately set out to educate, nor its
viewers to be educated, but as they engage with film and other moving pictures, their interaction with the media text is rarely solely entertaining or educational. Too rigidly enforcing the distinction between entertainment and
education limits our ability to grasp the significance of these media.
While often associated with postmodern culture, the blurring of fact and fiction is by no means a recent invention. Adolf Nichtenhauser made exactly that
point in his unparalleled History of Motion Pictures in Medicine, a manuscript
he completed around 1950 but never published. In the process of categorizing and discussing thousands of theatrical and non-theatrical health and
medical films produced throughout the country, Nichtenhauser identified what
made this genre so distinctive. As he recounted the excitement of scientists,
physicians, and filmmakers as they explored the potential of film to present science and medicine dynamically and realistically, he also identified the numerous cinematic strategies and tactics they developed over decades to achieve
verisimilitude.18
One such pioneer in medical filmmaking was the prominent Chicago obstetrician and gynecologist, Dr. Joseph B. De Lee. De Lee soon discovered that one
could not simply aim a camera at a surgical operation and start filming. Rather,
as his published papers emphasized, laborious techniques were required to
achieve the appearance of realistic representations of medical conditions, facts, and

introduction

procedures. De Lee sought camera operators who understood surgery and cinema, high production values in all aspects of the filmmaking process, and patients
who both illustrated the condition being shown and were attractive to the camera.
Accuracy required artifice when it was to be translated to the screen. In short,
De Lee concluded, one has to provide a bit of Hollywood in the operating room.19
The medical film genres commitment to accuracyas well as the voyeuristic
interest of lay and professional audiences in the body and its diseases,
injuries, and tragediesled to the frequent intermingling of fictional, acted
material, and documentary, live material. Thus, fictional dramas included
documentary footage as part of their efforts to achieve accuracy. Scientists in
their laboratories and nurses and doctors in their clinics might appear in a fictionalized Hollywood account, as the films discussed by Lederer and Naomi
Rogers reveal. Similarly, individuals actually afflicted with a disease or disability
may be worked into fictional storylines. A disabled child, a U.S. president with
polio, a composer with a brain tumor, and an afflicted athlete all appeared in
Hollywood movies; people living with HIV/AIDS appeared in daytime drama.
The Hollywood biopic about Sister Kenny, Naomi Rogers shows, borrowed
footage of real healed children with polio from a Kenny Foundation training
film and, in turn, the Kenny Foundation used clips from the commercial
Hollywood film to raise funds for the foundation. One Hollywood movie about
a black physician included documentary footage of Harlem, a realistic device
that Vanessa Northington Gamble shows produced an inaccurate portrait of the
black community and distorted, indeed rewrote, the true-life story of the doctor
on which the film was based.

Audiences
Until relatively recently, film experts and social analysts have envisioned the
effects of film to be extremely powerful, predictable, and essentially uniform
across audiences. Mass media were believed to suppress individuality and independent thought, seamlessly transmitting their mesmerizing messages from producers to passive receivers with little modification or distortion. The belief in
such strong media effects is sometimes called the inoculation or hypodermic model of communication and mass media. The entrance and popularity of
television intensified this vision of drugged anonymous masses passively receiving
their hypodermic of propagandistic messages.20 But this static, one-directional
model gradually changed as we learned more about mediation, representation,
media codes and conventions, the contexts that create meaning, and what audiences bring to the media experience.21
The history of medicines moving pictures provides strong support for a more
complex understanding of how audiences respond to media productions. Healththemed movies were clearly calibrated to reach different audiences. One key

introduction

division has been that between lay and professional audiences. In her essay in this
volume, Reagan examines this division by comparing two American Cancer
Society films on breast cancer, one produced for women, the other for physicians.
Her analysis shows systematic differences in images, narration, emphasis, and
language. The conventions governing health and medical media productions
ensured that lay and professional audiences would see different representations
of the body, health, and disease. Similarly, the ACS and other producers of public health education films took great care to target audiences by race and gender.
Spanish language films were produced for Mexican and Puerto Rican populations. Girls and boys, women and men watched movies made specifically for their
gender and age, and often for their ethnicity and class as well.
Although medical moviemakers crafted messages they hoped their audiences
would adopt, audiences were unpredictable. In the 1917 pro-euthanasia eugenics film, The Black Stork, the role of the physically and mentally defective youth
was so well acted that it inspired audience sympathy and compassion rather
than revulsion. Post-1950s anti-drug films, produced to scare teenagers by
depicting the horrors and degradation of drug abuse, often had the opposite
effect. Most kids ignored the shock aspect of the films, reports Skip Elsheimer.
Unrealistic portrayals of a drugs effects sometimes actually tempted kids to try
them. Bored kids wanted to experience the trippy hallucinations that these
films approximated.22
Indeed, it was apparent from the very beginning that audiences did not
respond in uniform or predictable ways to medicines moving pictures, an
observation that stimulated early investigations into media effects. In the
early 1920s, the behavioral scientists John Watson and Karl Lashley conducted
pioneering studies to determine womens responses to explicit films about VD,
finding that they approved of them. When psychiatrist Louis Berg charged in
the 1940s that radio soap operas caused women listeners to have serious medical problems, he provoked the radio networks to commission systematic
research that largely exonerated the soaps.23 Health groups such as the
National Foundation for Infantile Paralysis and the American Cancer Society
also conducted detailed audience research. Not surprisingly, they found that
audiences responses varied according to their own identities and experiences.
Gamble finds that black and white audiences of the Negro problem films of
the late 1940s and early 1950s did not see them in the same way. Likewise,
Cartwright points to how hearing and deaf audiences, as well as girls and adult
women, might differently interpret representations of deafness in popular
movies.
In moving important social issues such as racism and disability to the forefront
of public debate, the mass media also performed the function of agenda setting.24 During and after World War II, Hollywood expanded its entertainment
brief to produce feature films for mass audiences on such social issues as antiSemitism (Gentlemans Agreement, 1947), labor conditions in mining (Salt of the

10

introduction

Earth, 1953), mental illness (The Snake Pit, 1948), and racism (Home of the Brave,
1949). These films did not necessarily aim to solve the problems they presented,
but to expose them. In a similar spirit, recent films have explored modern activities surrounding the use of new technologies, as Valerie Hartouni shows in her
essay on the 1997 film, Gattaca.

Realistic Drama
A key feature of medicines moving pictures as a genre, we argue, is the dedicated effort of producers, writers, and the people on filmwhether actors or
real peopleto produce accurate images and information. Accuracy is itself a
construction produced through selection, cinematic techniques, and artifice to
achieve verisimilitude that emphasizes some truths over others. Nevertheless,
most of medicines moving pictureswhether they are educational, documentary, news, or entertainmentstrive for accuracy in at least their conformity to
accepted scientific knowledge and standard medical practices. The texts themselves frequently signal their own legitimating credentials through stylistic and
linguistic devices, their scientific or clinical style and language, the expertise of
the narrator or consultant, the portrayal of recognized institutions, and the seal
of approval from recognized health or medical organizations. All of these
devices legitimate the authenticity of these texts and strengthen their educational and persuasive powers.
Nonetheless, health and medical media, despite authoritative oversight and
their claims to indisputable scientific truth, are at the same time shaped by the
cultural conditions of their production. Documentaries, for example, often use
stock footage or staged scenes to establish a seemingly literal and value-free
background for a story on a given disease or public health project: a story on
cholera opens with shots of open sewers in slums or shantytowns; in Yesterday, we
first see the protagonist, an African woman with AIDS, as a tiny speck moving
slowly across a vast distance toward the camera (and toward the clinic where
shes heading); a panoramic shot of mountains of asbestos surrounding an
active mine opens a documentary on the magic minerals devastating health
effects.25 Such visual shorthand efficiently activates tropes with which audiences
are familiar (and, indeed, expect).
Visual shorthand may also invoke less obvious but equally entrenched cultural
narratives about race, sex, class, and values, that in turn serve to legitimate the
activities being documented.26 In her essay on celebrity diseases, Tomes explores
how gendered conventions shaped cinema portrayals of deadly diseases such as
TB and cancer. Public Health Service films use of stock footage of pastoral black
life in the rural South, Parascandolas essay shows, served to suggest the populations ignorance and thus reinforced racist stereotypes about syphilis among
African Americans. Anti-VD messages to African Americans, Public Health Service

introduction

11

officials suggested, should be simple and plain enough for them to understand,
use their own language, and feature biblical references and hymns.27
By the 1950s, organized medicine had grown skillful in shaping how
Hollywood represented physicians, scientific research, and medicine. Indeed,
the overall influence exerted by the medical profession was unique in the film
industry. Hollywoods deferential attitude is a characteristic feature of the genre
of medicines moving pictures. As Joseph Turow and Rachel Gans-Boriskin make
clear in their essay on the evolution of doctor shows on television, media desire
for accuracy matched medical desire for control and led to close relationships
among the media industry, health care professionals, and organized medicine.
Wary of legal or political conflict with a powerful profession, most of the writers
and producers of medical films and television programs consulted regularly with
medical experts, provided scripts for review, and altered their products according to medical advice and criticism. In the case of television (with its more modest budgets), organized medical groups furnished hospital space for sets in
exchange for even greater control over doctor and medical center shows. And a
successful formula certainly evolved. As Turow and Gans-Boriskin argue,
Hollywood over the years has periodically updated the formula to reflect wider
cultural change: the magisterial credit sequences and earnest scripts of the earlier shows have given way to fast-paced tracking shots, rock soundtracks, culturally diverse and sexually embroiled ensemble casts, and concern for hot button
ethical and policy issues. Nonetheless, the shows retain the basics of the formula.
Medical experts do not always have it their way, however. From the beginning,
commercial productions have managed to feature romantic and emotional
storylines and provide happier outcomes than clinical wisdom might predict.
Although typically recuperated by a larger narrative of scientific progress, serious scientific and medical programs at times reveal internal conflicts among
experts with great accuracy. At the same time, different films define experts in
various and sometimes unorthodox ways. As several essays indicate, philanthropic foundations, health-related agencies, and activist movements could create headaches for Hollywood and its medical consultants by lobbying for
perspectives that challenge conventional definitions and understandings. The
celebrities whose personal stories publicize, legitimate, and celebrify diseases,
and the activist groups that generated interest in specific diseases and civil
rights, have often redefined the expert and have challenged medical definitions of accuracy. In the end, box office numbers and audience share continue
to speak loudly, too, disputing and redrawing what counts as accurate.

More Than Just Illustrations

To illustrate these varied themesmedicines motion pictures as a distinct
genre, the blurring of education and entertainment, the diversity of audience

12

introduction

response, and the search for realistic dramawe have organized this volume
in the following way. The book begins with two essays by Martin S. Pernick and
Nancy Tomes on the emergence of medical movies in the early decades of the
twentieth century, and the changing relationships among public health, popular disease narratives, and the Hollywood films that they represent. The next set
of essays, by John Parascandola, Paula A. Treichler, Lisa Cartwright, and Leslie J.
Reagan, look at mass media representations of specific diseases and disabilities,
and interrogate the traditional education/entertainment divide. The final series
of essays, by Naomi Rogers, Vanessa Gamble, Joseph Turow and Rachel GansBoriskin, Susan E. Lederer, and Valerie Hartouni explores the nature of accuracy and authority in medical movies. Analyses throughout the volume discuss
disease conditions, patient experiences, medical perspectives, racial, class, and
gender dynamics, and bodies and disabilities. Most of the essays likewise deal
with film and television production, content, reception, distribution, and context and change over time. The book ends with a select bibliography of scholarship on medicines moving pictures for readers interested in understanding the
topic more deeply.
We hope that this volume helps those collectors and archivists who are working
to preserve this invaluable historical material. Fortunately, some of medicines
forgotten moving pictures are today getting new life through documentaries,
websites, and late-night cable channels, while archives such as those at the
National Library of Medicine, the University of California at Los Angeles, the
University of Michigan, the University of Rochester, and Vanderbilt University
increasingly work to restore and make available selected old films and television
shows.28 Unfortunately, other moving pictures have disappeared into attics, forgotten storage rooms, or dumpsters. Even these may be rescued by film collectors, come to light during building renovations, or show up on eBay. Perhaps, if
we are fortunate, they will be digitally scanned or otherwise preserved for new
audiences in the future.29
We hope this volume will inspire readers to watch the genre of medicines
moving pictures with new and deepened comprehension, sophistication, and
appreciation.30 Their appeal is rooted in their concentration on the body and
its journey through life to death: the diseases, injuries, and sexualities of that
journey, its emotions and fears, hopes and joys. Like the genre, these essays too
are about the body: its power to change lives; its fate as society and culture find
ways to stratify and manage individuals and populations; its signs and meanings
in sickness and in health; and its representation in moving pictures. No matter
how sanitized for the public, how masked by professional stoicism and clinical
distance, how controlled by medical science, how carefully placed on
the screen, the centrality of the body and its care is what animates all of these
materials.
Interests beyond scholarship speak to the timeliness of these moving images,
and the interdisciplinary approaches they invite. They help us better to

introduction

13

appreciate the complexities of health and disease in the United States and their
representations in media. Today we have urgent reasons to be concerned about
the nations health and its health care system; the future of medicine and the
health professions; the changing role of patients, communities, activists, and
self-help movements; and the volume of health and medical information and
images flooding established and new media sites. In the media-rich, personalized viewing environments of the early twenty-first century, medicines past and
present moving pictures have never been more significant.

Notes
1. In the 1950s alone, more than four hundred films centered around doctors and
disease and further codified the staple themes, scenes, and conflicts of these movies
and their cinematic representations. Richard Malmsheimer, Doctors Only: The
Evolving Image of the American Physician. (Westport, CT: Greenwood Press, 1988). For
more information about the movies in this book, see the Independent Movie
Database, www.imdb.com.
2. Joseph Turow, Playing Doctor: Television, Storytelling, and Medical Power (New York:
Oxford University Press, 1989), and Turow, Media Today: An Introduction to Mass
Communication (Boston and New York: Houghton Mifflin, 2003).
3. Television too has contributed memorable movies about doctors, health, and
disease: Brians Song about cancer; And the Band Played On about the AIDS epidemic;
Miss Evers Boys about the Tuskegee Syphilis Studies; Heartsounds about heart disease
and heart attacks; Unnatural Causes about the disabling effects of Agent Orange
among Vietnam veterans; and Something the Lord Made, about the pioneering surgical
treatment of blue babies.
4. The growing public interest in medical topics and the rise of video, cable and
satellite television, DVDs, the Internet, and other media formats and outlets for
health-related media has only increased the complexity of analyzing these materials.
See, for example, Anne Karpf, Doctoring the Media: Reporting on Health and Medicine
(London: Routledge, 1988); and Vicki Freimuth, Huan W. Linnan, and Polyxeni
Potter, Communicating the Threat of Emerging Infections to the Public, Emerging
Infectious Diseases 6:4 (JulyAugust 2000): 337.
5. On the overall social authority of the medical profession in the twentieth century, see Paul Starr, The Social Transformation of American Medicine (New York: Basic
Books, 1982).
6. For an insightful transnational analysis of public health films, see Kirsten
Ostherr, Cinematic Prophylaxis: Globalization and Contagion in the Discourse of World
Health (Durham, NC and London: Duke University Press, 2005).
7. Jennifer Tucker, Nature Exposed: Photography as Eyewitness in Victorian Science
(Baltimore, MD: Johns Hopkins University Press, 2005); Marita Sturken and Lisa
Cartwright, Practices of Looking: An Introduction to Visual Culture (New York: Oxford
University Press, 2001); Lisa Cartwright, Screening the Body: Tracing Medicines Visual
Culture (Minneapolis: University of Minnesota Press, 1995); Jonathan Crary,
Techniques of the Observer: On Vision and Modernity in the Nineteenth Century (Cambridge,
MA: MIT Press, 1990).

14

introduction

8. Anna McCarthy, Ambient Television: Visual Culture and Public Space (Durham, NC
and London: Duke University Press, 2001).
9. Reported in Richard Harrison Shryock, National Tuberculosis Association,
19041954: A Study of the Voluntary Health Movement in the United States (New York:
National Tuberculosis Association, 1957), 160. See also Martin S. Pernick, Thomas
Edisons Tuberculosis Films: Mass Media and Health Propaganda, Hastings Center
Report 8:3 (June 1978): 2127; Graeme Turner, Film as Social Practice, 3rd ed.
(London and New York: Routledge, 1999).
10. This volumes cover shows biology students watching the American Cancer
Society (ACS) film, From One Cell. Photo in Learning to Live, Cancer News 9:4 (Fall
1955): 3. In Milwaukee, the ACS division turned a bus into a movie theater called a
Cancer Cinema Cruiser for showing ACS films; a sidewalk sign advertised that the
movies were free. See the photo in ACS, Annual Report, 1959, 8, box 1813, American
Cancer Society Archives (hereafter cited as ACSA), Atlanta, GA; see also Leslie J.
Reagans essay in this volume. Robert C. Allen points out that early movies were not
only shown in working-class, immigrant neighborhoods as in New York City, but in
tents, amusement parks, the local opera house, YMCA hall [and] public library
basement, in From Exhibition to Reception: Reflections on the Audience in Film
History, in Annette Kuhn and Jackie Stacey, eds., Screen Histories: A Screen Reader
(Oxford: Clarendon Press, 1998), 15; Lynne Curry, Modern Mothers in the Heartland:
Gender, Health, and Progress in Illinois, 19001930 (Columbus: Ohio State University
Press, 1999).
11. See Leslie J. Reagans essay in this volume.
12. Linda Williams, Melodrama Revised, in Nick Browne, ed., Refiguring American
Film Genres: History and Theory (Berkeley: University of California Press, 1998), 4288;
Christine Gledhill, Genre and Gender: The Case of Soap Opera, in Stuart Hall, ed.,
Representation: Cultural Representations and Signifying Practices (London: Sage
Publications, 1977), 33786.
13. Quotation from Robert Eberwein, Sex Ed: Film, Video, and the Framework of Desire
(New Brunswick, NJ: Rutgers University Press, 1999), 63; Reagan in this volume.
See also Faye D. Ginsburg, Lila Abu-Lughod, and Brian Larkin, eds., Media Worlds:
Anthropology on New Terrain (Berkeley and Los Angeles: University of California
Press, 2002); Christine Gledhill, ed., Home is Where the Heart Is: Studies in Womens
Melodrama and The Womans Film (London: British Film Institute, 1990); Hall, ed.,
Representation.
14. For a general overview of these developments, see Martin S. Pernick, The Black
Stork: Eugenics and the Death of Defective Babies in American Medicine and Motion Pictures
since 1915 (New York: Oxford University Press, 1996).
15. ACS, Field Army Leaders Guide [1940s], box 1836, ACSA.
16. Eberwein, Sex Ed, 64; Allan M. Brandt, No Magic Bullet: A Social History of Venereal
Disease in the United States Since 1880 (New York and Oxford: Oxford University Press,
1987). As Paula A. Treichler observes in her essay in this volume, the impact of antiHIV/AIDS messages in the United States has been surprisingly strong given that they
have not been linked to powerful overarching ideas such as war or patriotism.
17. On early twentieth-century movies, genre creation, and censorship, see Pernick,
Black Stork; Steven J. Ross, Working-Class Hollywood: Silent Film and the Shaping of Class
in America (Princeton, NJ: Princeton University Press, 1998); Eric Schaefer, Bold!
Daring! Shocking! True!: A History of Exploitation Films, 19191959 (Durham, NC:
Duke University Press, 1999); Robert Sklar, Movie-Made America: A Social History of

introduction

15

American Movies (New York: Random House, 1975); Shelley Stamp, Movie Struck Girls:
Women and Motion Picture Culture after the Nickelodeon (Princeton, NJ: Princeton
University Press, 2000); Gregory D. Black, Hollywood Censored: Morality Codes, Catholics
and the Movies (Cambridge: Cambridge University Press, 1994); Frank Walsh, Sin and
Censorship: The Catholic Church and the Motion Picture Industry (New Haven, CT: Yale
University Press, 1996).
18. Adolf Nichtenhauser, A History of Motion Pictures in Medicine, unpublished
manuscript, circa 1950, in the Adolph Nichtenhauser History of Motion Pictures in
Medicine Collection, MS C 380, Archives and Modern Manuscripts Program, History
of Medicine Division, National Library of Medicine, Bethesda, MD.
19. Joseph B. De Lee, Sound Motion Pictures in Obstetrics, Journal of the Biological
Photographic Association 2, no. 60 (193334). Nichtenhauser reports in A History of
Motion Pictures in Medicine that De Lee at one point visited major Hollywood studios hoping to get technical support for his projects, but training films for physicians
were not on the agenda of Hollywood moguls. Indeed, De Lee observed that many
bits of Hollywood were necessary to ensure quality. Because the patient must not be
harmed nor put at undue risk, the patient appearing in the final film was often a
composite of multiple patients (in one case, De Lee had to do 15 caesarean sections
to make one picture). In addition, the patient must be attractive and photograph well,
and must also be representative of the clinical problem being demonstrated. Because
De Lee was chiefly interested in filming specialized obstetrical techniques and surgical
procedures, both physician and film crew had to be prepared for non-photographic
complications and even real emergencies. In the days before the availability of stock
footage and collections of pre-recorded sounds, a further challenge was involved in
creating and synchronizing images and sounds. To record a baby crying might require
the medically and ethically dubious course of allowing the crying to continue until sufficient sound was recorded, or even taking steps to provoke the crying in the first place.
20. David Morley, Unanswered Questions in Audience Research, The
Communication Review 9:2 (2006): 10121.
21. Karpf, Doctoring the Media; James W. Carey, Communication as Culture: Essays on
Media and Society (Winchester, MA: Unwin Hyman, 1989).
22. Pernick, The Black Stork, 145; Skip Elsheimer, The Educational Archives, Vol.
One: Sex and Drugs, pamphlet accompanying DVD set of social guidance films
from A/V Geeks Educational Film Archive available from www.avgeeks.com.
23. On media effects, see Denis McQuail, Mass Communication Theory: An Introduction
(London: Sage, 1984); Karl S. Lashley and John B. Watson, A Psychological Study of
Motion Pictures in Relation to Venereal Disease Campaigns (Washington, D.C.: United
States Interdepartmental Social Hygiene Board, 1922). On Louis Berg, see Max
Wylie, Dusting Off Berg, Printers Ink (February 12, 1943), 44; James Thurber,
Soapland, in The Beast in Me and Other Animals (New York: Harcourt Brace, 1973),
191260; and Robert C. Allen, Speaking of Soap Operas (Chapel Hill: University of
North Carolina Press, 1985).
24. McQuail, Mass Communication Theory.
25. See Alice: A Fight for Life, Yorkshire Television, 1982, broadcast on PBS in the
United States on Nova, in 1984, as Asbestos: A Lethal Legacy; and the discussion in
Karpf, Doctoring the Media, 23334.
26. John Fiske, Introduction to Communication Studies (New York: Routledge, 1990);
Paula A. Treichler, How to Have Theory in an Epidemic: Cultural Chronicles of AIDS
(Durham, NC: Duke University Press, 1999).

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introduction

27. In 1938, the PHS produced the famous film, Three Counties Against Syphilis,
focusing on public health information and intervention programs in three Georgia
counties. This is the project that, when funding was cut, morphed into the Tuskegee
syphilis study. Quotations as cited in John Parascandolas essay in this volume.
28. Medicines moving pictures may also be found at the Library of Congress, the
National Archives, the Smithsonian, and other university and public libraries and
archives. Martin S. Pernick curated the collection at the University of Michigan; see
the website: http://www.lsa.umich.edu/history/healthfilms/healthfilms.html. See
also the DVD accompanying the new edition of Joseph Turows textbook, websites
Google, Video Google, Facets Multimedia, the Rick Prelinger archive, and the A/V
Geeks archive online. The Criterion film collection on DVD provides newly remastered, pristine prints of classic films. The DVDs typically include multiple audio and
subtitle tracks and excellent commentary tracks by film historians, media scholars,
directors, actors, production designers, and other specialists (e.g., a biographer of
the specific director); some also feature original scripts, letters, and sketches pertaining to the production, still photos, and other background materials.
29. Even digitalization, once seen as the solution to problems of storage, deterioration, preservation, transfer, and loss, presents its own problems.
30. Many of the media texts discussed in Medicines Moving Pictures are available to
view, borrow, rent, or buy in videotape or DVD format through public and college
libraries, stores, catalogues, archival collections, and the Internet.

Part 1

An Emerging Genre

Chapter One

More than Illustrations

Early Twentieth-Century Health Films as
Contributors to the Histories of
Medicine and of Motion Pictures
Martin S. Pernick
In the early twentieth century, the founding decades of the film industry,
American motion picture companies produced an astonishing number and
variety of health-related motion pictures for lay audiences.1 Every conceivable
medical issue: childbirth to mercy killing, polio to pediculosis, appeared on
screen. By the end of the silent film era in 1927, more than 1,300 health-related
films had been produced; many were seen by audiences of several million at a
time when movies were the unrivaled medium of visual mass communication.
A broad assortment of organizations and individuals made health films.
Government producers of medical movies included not only health departments, but also education, agriculture, commerce, and law enforcement and
military officials at the federal, state, county, and municipal levels. Many other
films were sponsored by private organizations such as the National Tuberculosis
Association, the YWCA, the Red Cross, the Rockefeller Foundation, and the
Metropolitan Life Insurance Company. Individual health crusaders, from prominent reformers like Margaret Sanger to more obscure practitioners like
Connecticut dentist Dr. Alfred Fones, also made films shown locally and nationally.2 Perhaps most surprisingly, commercial producersfrom Thomas Edison
and Pathe to Walt Disneymade health-related movies, both on their own initiative and under contract to government and private sponsors.
These films were shown in a wide variety of venues. Ordinary commercial
movie houses included them as part of their regular programs, especially in the
1910s. For those too poor or too isolated to patronize even the nickel movie
theaters, urban health departments sponsored free outdoor exhibitions in city
parks and vacant lots, while in rural areas projectors on trucks or railroad cars

20

an emerging genre

showed health films on the sides of barns. Organizations, businesses, and

schools also showed health films on their own premises, or in rented theaters.
Audience motives for attending health films spanned the spectrum from
curiosity to compulsion. Feature-length health dramas, especially those on controversial topics like sexually transmitted diseases or eugenics, could fill commercial theaters at standard admission prices of around twenty-five cents.
Audiences also often paid to attend theaters that included short health films
along with newsreels, cartoons, and other short subjects, accompanying the
entertainment features that presumably were the main draw. Free showings also
attracted large audiences of those unable or unwilling to pay for health films.
The New York City Health Departments annual series of outdoor summer
health films in city parks in the mid-1910s reportedly drew thousands of viewers
per night.3
Other audiences were more or less willing captives. School children reportedly constituted an eager audience when school films were a novelty, but attendance was usually required. Major industrial firms, including National Cash
Register, U.S. Steel, and Ford Motor Company, rewarded or required employee
attendance at company sponsored health and safety movies. And by World War
I, the U.S. military ordered all armed forces personnel to watch films on topics
from fallen arches to fallen women as a mandatory part of basic training.
Health was presented in virtually all motion picture formats, at a time when
the distinctions among different film genres were still being constructed. Many
early health films were theatrical melodramas, with health messages worked into
the dramatic plot. But health topics also appeared in formats ranging from
newsreels to slapstick comedies to filmed classroom lectures.
For decades, most of these films were considered lost; the very fact that many
of them ever existed had been forgotten.4 Simply to learn how many and what
kinds of health-related films were made required laborious page-by-page searching of medical, movie industry, and mass-circulation periodicals. But over several
decades, my research assistants and I rediscovered many of these films, and
assembled a research collection of more than 150 examples, a keyword-searchable
catalog of which is available online.5
Historians have begun to use such films to study a wide range of specific medical history topics. Old health films are employed as particularly vivid and novel
sources to exemplify the dramatic changes that took place in twentieth century
medicine and public health; they provide striking new illustrations for a story
whose plot is already known from standard written sources.
However, health films can do more than simply illustrate. For example, motion
pictures constitute a unique source for studying the role of visual appearance and
physical movement in representations of health and illness. In addition, the production and regulation of health films were intended to change, not simply illuminate, both the medical and movie world. From their very beginnings health
films sought not just to illustrate, but also to shape history.6

more than illustrations

21

This chapter explores some of these distinctively cinematic dimensions of

medical history, using examples from five specific films. Following a brief introduction to each of these motion pictures, they will be used to show how early
health films helped shape the history of four specific issues:
1.
2.
3.
4.

What causes, and what is to blame, for disease?

How much power should the medical profession have?
What do health and disease look like?
What health topics are fit for public viewing?

The films we will use to explore these issues are the 1914 tuberculosis film The
Temple of Moloch, the World War I venereal disease films Fit to Fight and The End
of the Road, the 1922 high school biology film The Science of Life, and the 191627
eugenics film The Black Stork.7
In The Temple of Moloch, the doctor-hero fails to persuade the owner of a poorly
ventilated pottery factory to clean up the dust that is making his workers susceptible to tuberculosis. The doctor likewise fails to convince the family of a former employee to clean and disinfect their home properly. The doctor does win
the romantic interest of the factory owners teenage daughter, but when he publishes a newspaper expos of the factory conditions, she breaks off their budding
relationship. Only when the workers children contract tuberculosis and pass it
on to the owners children does the boss comply with medical advice to clean up
the plant. The doctor cures the daughter and the boss blesses their renewed
romance with a large donation to the doctors anti-tuberculosis crusade.
The Temple of Moloch was part of an annual series of films produced by Thomas
Edison and by Universal Films from 1910 to 1917 for the National Tuberculosis
Association. Like most American films prior to 1915, it ran only one reel, about
twelve minutes in length. It was shown as part of the regular fare at commercial
theaters when first released, but continued to be shown by schools and health
organizations nationwide for many years thereafter.8
Fit to Fight opens with a long and graphic display of advanced syphilis lesions.
These scenes are followed by the main story, which traces the lives of five
young military recruits. Of the five, only the hero, Billy Hale, remains free of
venereal infection. A former college athlete, his health is the result of combining a modern education with the physical and moral self-control provided
by sports training discipline. The other men who lack one or more of these
qualities all get syphilis, though in different ways. A former professional boxer
has physical strength, but without education or self-discipline, he gets infected
by a prostitute. On the other hand, an innocent young farm boy, given a traditional moral upbringing with stern warnings against wild women, avoids
prostitutes. But because he lacks a scientific understanding of germs, he doesnt
recognize the danger in a small lip sore, and catches syphilis from a seemingly
innocent kiss.

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an emerging genre

Fit to Fight was produced for the U.S. War Department Commission on
Training Camp Activities in 1918 by a collaboration of numerous health and
social reform organizations, from the anti-VD American Social Hygiene
Association to the U.S. Public Health Service. About one hour in length, it was
shown to over a million military men. After the war, an edited version, Fit to Win,
was shown to civilian theater audiences around the country.
The same coalition of agencies that produced Fit to Fight for men also produced The End of the Road, a film of approximately ninety-minutes intended for
women war workers. The End of the Road traces the lives of two childhood playmates, Vera and Mary. Veras strict Victorian mother refuses to answer her questions about sex, leaving her an ignorant and thus defenseless victim of an
infected seducer. Marys progressive mother, however, explains where babies
come from, and when Mary grows up, she rejects marriage for a career as a
nurse. In that calling, she meets many different women, all with VD, some of
whom take violent revenge on the men who infected them. Vera, infected and
abandoned, turns to Mary who persuades her to see a surgeon. He cures her
with an operation, and she joins the ranks of factory workers helping the war
effort. Mary and the surgeon volunteer for duty overseas, where, during a lull in
the shelling, she finally accepts his marriage proposal. Like Fit to Win, The End of
the Road was shown in civilian movie theaters after the war. Both also provoked
growing opposition from censors, who banned them from most commercial
movie houses after 1920.9
Censorship did not end federal sponsorship of sex hygiene films, but it did
move their exhibition from theaters to high school classrooms. The first major
product of this shift was The Science of Life, a three-hour series funded by the
Army and produced by animation pioneer Paul Bray for the U.S. Public Health
Service. Work on The Science of Life began as part of the wartime VD campaign,
an attempt to reduce the large number of civilian recruits who tested positive for
syphilis before they entered the military. But by the time the series was released
in 1922, it had expanded to an entire health and biology course on film. It
began with the evolution of life and the development and reproduction of
simple and complex plants and animals. Subsequent reels traced the role of
microbes and their animal and human carriers in causing human diseases. The
next to last topic was human reproductive physiology and sexually transmitted
diseases, presented in parallel but separate versions for boys and for girls. The
final reel included heredity and eugenics. The series was distributed nationally
for fifteen years, and may have continued in use long after.10
The Black Stork dramatized the actual cases of Chicago surgeon Harry
Haiselden, who from 1915 to 1918 publicly permitted or accelerated the
deaths of several infants he considered eugenically unfit to live. In the film,
Claude, who has an unnamed inherited disease, ignores graphic warnings from
his doctor (played by Dr. Haiselden himself), and marries his sweetheart, Anne.
Their baby is born defective and needs immediate surgery to save its life, but

more than illustrations

23

the doctor refuses to operate. After God provides Anne with a horrific vision of
the childs future of misery and crime and his future brood of defective offspring, she agrees with the doctors advice to withhold treatment, and the
babys soul leaps into the arms of a waiting Jesus. The film was produced by
Wharton Brothers, a commercial studio affiliated with film giants Hearst
and Pathe. Made in late 1916, it opened in early 1917 at a time when
Dr. Haiseldens actual cases were still in the news. Like the VD films, The Black
Stork was often banned by censors, but it continued to be shown around the
country for at least a decade. In 1927, it was re-released with a new prologue
under the title Are You Fit to Marry?11

Etiology and Blame: Science, Causality, and

Moral Responsibility
Health films like these played a crucial role in shaping early twentieth-century
concepts about who and what was responsible for disease. Early twentiethcentury scientific discoveries attributed disease to newly identified specific
microscopic agents: bacteria, hormones, vitamins, genes, toxins, and others.
These new disease causes radically challenged older etiologies in two related but
distinct ways. First, the increased specificity of these new etiologies attributed
disease to particular clearly targeted causes, rather than broad general factors
such as poverty or filth. Second, these supposedly objective, impersonal, and
technical new causes seemed to refute older medical explanations that blamed
disease on moral failings, either the transgressions of specific individuals or the
collective sins of society. The new science taught that germs, not filth or sin,
caused sickness.
Most early health motion pictures explicitly promoted and celebrated these
new discoveries. The effort to publicize these novel causes of disease was a major
motive for the production of health education films. Yet while these films
emphasized aspects of the new etiology, they also retained many older causal
concepts as well. Although they attributed disease to specific new microscopic
agents, they simultaneously blamed older general causes like filth. They continued to assess who to blame, and in assigning guilt, they emphasized individual
responsibility rather than structural or systemic failures. When someone gets
sick in these films, it is usually a specific persons fault, though the guilty party is
often someone other than the victim.
In mixing technical etiology with personal blame, health films in part simply
reflected tensions within early twentieth-century medical concepts of causation.
The new laboratory sciences often overlapped with older social and moral explanations for disease, producing a complex transformation rather than a sharp
break from the past.12 Indeed, for some progressives, sciences objectivity was
itself the source of ethical obligation: to be objective meant to be impartial, fair,

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an emerging genre

and just; thus, to obey scientific prescriptions was a moral duty. Efforts to separate causality from morality have never been fully successful.13
But these tensions within early twentieth-century concepts of disease causation were not just illuminated, but selectively magnified, by being projected on
the screen. Films promoted blurring of old and new causes, andfor a variety
of reasonsblamed individuals for both. The need to represent complex new
concepts in visually recognizable images encouraged filmmakers to translate
new ideas into familiar ones. Filmmakers also felt their mediums ability to
attract interest and to motivate change required appeals to the audiences emotions, even when promoting the claim that science was objective. The specific
conventions of melodrama, its flamboyant histrionics and clearly labeled heroes
and villains, led health dramas in particular to emphasize moral and emotional
messages, and to focus on the role of individuals who caused disease to strike
innocent loved ones.
One film that combined bacteriology with general sanitation was The Temple of
Moloch. Although the doctor explains that germs cause tuberculosis, the film
also names dust, as well as the lack of ventilation, exercise, and rest as the
source of disease. The Science of Life reel on The Fly as a Disease Carrier virtually
equates dirt and disease germs. One scene shows flies depositing bacteria on
a culture plate, but the next intertitle calls the source of the germs filth of the
most loathsome description.14
The Science of Life also exemplifies how health films mixed technical causes and
moral responsibility. Its sex hygiene reel, titled Personal Hygiene for Young Men,15
attributed syphilis to spiral shaped germs, displayed in technically-sophisticated,
live-action, dark-field micro cinematography. Yet it also blamed the disease on
promiscuous sex relations. The film featured schematic but physiologically upto-date animated diagrams of how hormones affect the body, followed by titles
attributing numerous diseases to the stupid and childish habit of masturbation. Both Fit to Fight and The End of the Road feature characters whose traditional
moral training but lack of scientific knowledge causes them to get infected. Their
point is not that science has replaced morality, but that both scientific information and morality are necessary to prevent diseases. Both films argue that parents
have a moral obligation to provide their children with scientific sex education.
In specifying what is to blame for disease, each film discussed in this chapter
points to particular individuals, not to broader social structures. Sometimes the
guilty individual is the sick person himself. Personal Hygiene for Young Men warns
that men who have promiscuous sex will get venereal disease. But more often,
these films blame some other individual rather than blaming the victim. The
Temple of Moloch blames a greedy boss for the workers TB. Fit to Fight, the VD film
for male soldiers, blames women, both prostitutes and the seemingly innocent.
Perhaps more surprisingly, Personal Hygiene for Young Men does not blame
women. Instead, like The End of the Road, this film for young men indicts men for
infecting innocent women and children.

more than illustrations

25

In each of these films, parents are held responsible for the diseases of innocent children. The Temple of Moloch blames a greedy boss and an ignorant
workers wife for tuberculosis in their children. In The Black Stork, when
Dr. Haiseldens character contemplates a child labeled defective, he says the
child is not to blame. Instead, he points to the guilt of his ancestors and
blames them for reproducing. Like most other films on eugenics, The Black Stork
promoted an expansive view in which heredity is defined not as genetic causation but parental responsibility. Early health films thus actively blurred the distinctions between new specific and older general causes, while they selectively
emphasized individual responsibility for both.

Mental Inoculation: Film Propaganda

and Professional Power
The early twentieth century constituted a critical period in relations between
medical experts and the public. The eras new and increasingly technical discoveries about the causes and prevention of disease roughly coincided with a
professional revolution, including new licensing laws, and a new medical curriculum based on the methods of the new science. At the same time, vast social
transformations in immigration, industrial mechanization and consolidation,
and urban growth all combined to emphasize both the difficulty and the
urgency of communicating expert medical advice to the masses. One response
was simply to force people to follow medical orders. Thus, in 1905, the U.S.
Supreme Court first ruled that a competent adult could be fined or jailed for
refusing to be vaccinated.16 A wide range of new compulsory health laws followed, from mandatory premarital blood tests for syphilis, to the compulsory
sterilization of the retarded.
But the development of new media of mass persuasion, especially the movies,
offered an alternative solution: propaganda. As defined by health filmmakers,
propaganda did not imply deception or distortion. It meant the use of information to influence public opinion and behavior. In their minds, what distinguished propaganda from information was not the content but the intentthe
desire to control the audiences response. Dr. H. E. Kleinschmidt, a pioneer
medical moviemaker for both the TB and VD Associations, defined health propaganda as mental inoculation whose avowed goal was will-control.17 This vision
of propaganda thus appealed to many of the early twentieth-century social
reformers who identified themselves as progressives. They saw it as a way to balance the power of technical expertise with the value of majority rule; an attractive middle ground between technocracy and dumb-ocracy, a modern
technological method to produce popular compliance with expert advice, without the need for direct coercion. Their films attempted to persuade people to

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an emerging genre

change both their actions and their attitudes. They promoted the virtues of personal hygiene and demonstrated the specific techniques involved; they advocated cleaning filthy tenements and unsafe factories; and they taught a general
faith in science and deference to scientific experts.
Did such efforts at mass persuasion work? Motion pictures clearly made an
impression on people when moving pictures were new. In the 1970s I interviewed veterans who still remembered scenes from health movies they had seen
in basic training during World War I.
To measure the effectiveness of health movies, the federal government in
1919 funded an elaborate study by psychologists John B. Watson and Karl
Lashley of Johns Hopkins University. Watson, the founder of modern behaviorism, and his disciple Lashley, showed World War I VD films to several thousand viewers, and followed the effects for up to two years. Perhaps not
surprisingly, they concluded that the films impact on sexual behavior was negligible. But audiences retained the scientific information for long periods, went
to the doctor more frequently, and expressed increased trust in medical science. Apparently, these audiences were selective in their responses to health
propaganda, and were more willing to adopt the films general faith in modern
technical experts than they were to follow those experts specific preventive
advice.18
The complexities and ironies of medicalization propaganda were dramatized
in many health films themselves. In one particularly rich example from The
Temple of Moloch, the hero, a young tuberculosis specialist, fails to convince a factory owner to clean up the dust that is causing TB among his workers. He gets
a similar rebuff when he visits a sick worker and tries to teach the family how to
sweep the dust from their floors (see figure 1.1). When he suggests taking the
baby away to a fresh air camp, the outraged mother grabs the infant out of his
hands.
On one level, these scenes dramatize the enormous new social power of medicine. The medical expert is portrayed as the only impartial alternative to the selfdestructive ignorance and greed of both labor and capital. Housekeeping and
childrearing, once the instinctive skills of women, have become technical tasks
requiring male medical instruction. The doctors expert gaze enables him to see
the hidden seeds of illness long before lay people recognize the problem.
Failure to follow expert advice is promptly punished by disease.
But these scenes also argue that the power of film is stronger than, and necessary for, the power of medicine. The repeated failure of the doctors lectures
provides justification for the film itself, implicitly contrasting the audiences
experience of films propagandistic power with the ineffectuality of the doctors
efforts at instruction. Such dramatizations of media power help to understand
why many progressive-era doctors expressed deep ambivalence about health
films, recognizing motion pictures as both necessary for, and rivals to, medical
authority.19

more than illustrations

27

Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 1.1. A male physician instructs housewife not to sweep dust onto her
baby. The Temple of Moloch (1914).

By personifying objective science as a male doctor, these scenes also conflated

middle-class masculinity with objectivity, leaving no room for workers or women
to claim scientific expertise. But in real life, such housekeeping demonstrations
were much more likely to be the work of a female visiting nurse, social worker,
or public school teacher than a male physician. Male doctors did not actually
want to monopolize the job of sweeping the slums; they only played that role in
the movies.

Visual Representations of Health and Disease

Connections between health and beauty can be traced to antiquity, but the
early twentieth century experienced profound changes in both the intensity
and the content of their relationship. Links between health and beauty became
more frequent, and the specific traits considered healthy and beautiful
changed.20

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an emerging genre

As the premier visual medium of the era, film not only illustrated, but profoundly influenced both the importance and the content of health aesthetics.
Films promoted the association of beauty with health, taught audiences to identify specific visual stigmata of disease, and disseminated images that exemplified
healthy beauty as a mix of modern, efficient, streamlined motion and older,
romantic emotion.
Health films explicitly equated beauty with health, and ugliness with disease.
An attractive appearance goes hand in hand with health, explained The Science
of Life.21 In the most extreme version of this view, aesthetic preferences were simply natures guide to choosing a fit mate.22 As a visual medium, films promoted
the connection between health and beauty more strongly than did other sources
of medical information. For example, unlike filmmakers, most American medical scientists emphasized intelligence as more important than beauty in choosing a healthy spouse.23
But while they linked health and beauty, many medical filmmakers were skeptical that truly healthy beauty could be recognized by the untrained eye. They
were appalled by decadent artists, from Edgar Allen Poe to Oscar Wilde, who
made unhealthy bodies seem attractive. Thus medical filmmakers did not simply
endorse existing aesthetic preferences; they actively attempted to improve
them. One leading health promoter and eugenicist, Yale professor Irving Fisher,
explained that careful propaganda was needed to unconsciously favorably
modif[y] the individual taste . . . in mate-choosing.24
What specific aesthetic standards did progressive-era health films promote?
Often, their representations of health and disease presented conflicting aesthetic standards, an ambivalent mix of modernism and romanticism.
The Science of Life emphasized stark mechanical images. It urged The Woman
of Tomorrow to develop strength and beauty through vigorous exercises,
demonstrated by a short-haired woman whose hard, flat body was accentuated
by stark, black tights and knee-level photography.25 An attractive body also was
explicitly equated with a sleek streamlined locomotive, whose beauty became
manifest in powerful motion and efficient function. Photographed in a lowangle tilt shot that swept upward from wheel level, the engines sharp clean lines
and powerful mass appeared starkly silhouetted against the sky.26
Films did not simply illustrate this modernist health aesthetic; they helped to
create and shape it. Motion pictures emphasized vision and motion. Film made
it possible to display and dissect the beauty of bodily action. The desire to depict
the poetry and science of motion contributed to the invention of the cinema. In
turn, the new technology of film helped reinforce new medical concepts that
redefined the healthy body in terms of physiology, not anatomy, as active function, not just static form.27
However, these explicitly modern representations did not completely replace
older, romantic images of healthy beauty. The Science of Life cut back and forth
between its starkly modern images and depictions of health and fitness as a

more than illustrations

29

longhaired, round-cheeked young woman in static calm repose, photographed

as glowing with cleanliness and natural sunlight in gauzy soft focus.28
While The Science of Life simply juxtaposed these opposite images, successive
editions of The Black Stork shifted from naturalistic to mechanical depictions of
beauty. The original 1916 version emphasized the naturalistic modernism of
Thomas Eakins. Healthy beauty was illustrated by athletic adolescents in outdoor settings: five naked boys diving into a swimming hole, a woman in a swimsuit doing handstands on the beach. This edition explicitly attacked machine
aesthetics, using a speeding motorcar to represent not modern beauty but the
unhealthy false allure of the fast life. Yet, when the film was re-released in
1927, industrial modernism dominated. The sequence linking fast cars to loose
living was deleted, the outdoor sports were retained but deemphasized, and
lengthy new scenes were added portraying beauty as a massive new automobile,
owned by a professor of heredity.
This ambivalent aesthetic vision exemplified what Thomas Mann called a
highly technological romanticism, the uneasy mix of past and future values that
underlay the early twentieth century faith that modern science would create a
romantic utopia. The vision of healthy beauty created by the new technologies
of physiology and film attacked but still sometimes depended on the emotional
power of romantic aesthetics.29
Films not only linked health with beauty, they often equated ugliness with disease. Many films dramatized the shocking ugliness of disease victims, in an effort
to make the causes of disease seem repulsive. The army VD film Fit to Fight began
with a full reel of grotesque closeups of syphilitic lesions. The Black Stork did the
same with genetic diseases. Links between ugliness and disease also often drew
on representations of other human differences as ugly and diseased, including
class, race, sex, and nationality. The first example of hereditary disease presented in The Black Stork is a close-up of a deformed black child. Portraying
others as ugly was part of labeling them as sick, while diagnosing others as
diseased reinforced the perception of them as repulsive.
Such efforts to link disease, ugliness, and otherness, however, could be undercut by viewers who constructed alternate meanings for these images. For example, many reviewers of The Black Stork reported that the films exhibition
of deformed bodies evoked pity, or even fascination, rather than disgust.
Disregarding the intertitles that labeled one character an abyss of abnormality
filled with criminal desires, critics consistently praised the actor for making
this character appealing, even noble.30
Other viewers found that scenes intended to make disabled people look repulsive instead made the film itself repellent and revolting. Such critics often
praised the films educational and social value, but they found it aesthetically
unacceptable.31 Noted film reviewer Louella Parsons complained that it was
neither a pretty nor a pleasant picture, because it shows poor, misshapen
bodies of miserable little children.32 Such critics concluded that anyone who

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an emerging genre

wanted to see such films must be sick, suffering from a morbid perversion of
the aesthetic senses. They shared the filmmakers desire to pathologize ugliness,
but feared that displaying ugly diseases would only create diseased audiences, by
spreading the sick desire to see sickening images.33

Aesthetic Censorship of Health Films and the

History of Film Genres
These unintended aesthetic responses were one important reason films about
health and disease often ran afoul of the censors, especially in the years after
World War I. The incredible variety of health topics shown on the silent screen
gradually diminished during the 1920s, as increasingly powerful film censors
went far beyond policing sexual morality, to include what I term aesthetic censorship, much of which was aimed at eliminating unpleasant medical topics
from theaters.34 In 1918, the Pennsylvania film board, headed by historian Ellis
P. Oberholzer, adopted a list of unduly distressing topics banned from commercial theaters. It explicitly included not only sexually-transmitted diseases, but
any gruesome physical conditions, surgical operations, death, eugenics, and
insanity. By 1930, these prohibitions were standardized in the first Hollywood
Production Code, which added a catchall restriction on disgusting, unpleasant,
though not necessarily evil subjects that was used to eliminate almost any depiction of actual disease or medical treatment.35
Aesthetic censorship was not the only reason for the decline in theatrical
health films, and it did not end the production of health-related films for lay
audiences. But it did greatly circumscribe the content of such films, and increasingly relegated them to non-theatrical settings like classrooms and army camps.
Of course, censors aesthetic objections to medical films cannot be totally separated from their moral concerns with sex and violence. Some health topics,
such as VD and childbirth, were seen as inherently sexual. More generally, to
censors looking for sex and violence, almost any depiction of the human body
can seem sexual; almost any depiction of disease or its treatment can seem violent. And since banned films were assumed to be sexy, even medical films censored purely for aesthetic reasons became sexy-by-association.36
Yet aesthetic censorship cannot simply be reduced to an extension of moral
censorship. Even though The Black Stork contained nudity and near-nudity,
censors complained much more about its aesthetic rather than its sexual
content.37
Aesthetic censorship of medical films also played an important, virtually
unrecognized role in creating the boundaries that defined the classical
Hollywood entertainment film. The censors who drew sharp new distinctions to
separate entertainment from education, exploitation, industrial, and propaganda
the newly defined genres into which medical films were now categorizedwere

more than illustrations

31

thereby creating the shape of mainstream film history, a history defined in significant ways by its exclusion of medical movies.

Conclusion
From their origin, health films not only illustrated but helped shape the histories of both medicine and motion pictures. Early films magnified the tensions
between objective and moral explanations for disease, and between specific and
general causal agents. At the same time, they helped to promote increased
emphasis on individual rather than structural responsibility. Motion pictures
promoted medicines social authority, but made medical power dependent on
the mass media. Films linked health and beauty, and promoted a modern aesthetic of mechanical motion, in uneasy conjunction with a romantic aesthetic of
nature and emotion. In turn, aesthetic criticism of health films helped to create
new film genre distinctions and censorship regimes that assigned health and
entertainment to separate categories, sites, and audiences, from the 1920s
through the 1960s.
These examples are more suggestive than exhaustive. They are presented to
stimulate further thought about the possible significance of medical moving
images, not to compile a definitive list of how health films altered history. They
do, however, demonstrate that, from the start, health movies played their own
important and distinct roles in history.

Notes
1. By health-related, I mean any film for lay audiences that included a significant
effort to convey a particular point of view about a health or medical topic. Thus, I
would not include a film simply because a main character gets sick, unless I could
show that the film was intended to present a particular medical message about that
persons illness. This is an admittedly blurry and subjective definition, necessary in
part to avoid imposing present-day genre conventions on a world in which such the
boundaries separating such film categories as educational, exploitation, documentary, propaganda, newsreel, and entertainment had not yet taken shape.
2. Fones pioneered dental hygiene both in clinical practice and in preventative
education. See Alyssa Picard, Making the American Mouth: Dental
Professionalization, Dental Public Health, and the Construction of Identity in the
20th Century United States, unpublished PhD dissertation, University of Michigan,
2004, pp. 18691.
3. Philip P. Jacobs, Tuberculosis in Motion Pictures, Journal of the Outdoor Life 9
(1912), 3025, and photo p. 249; The Screen Takes Leading Part in War on
Tuberculosis, Reel and Slide (July 1919), 15.
4. It has been estimated that copies no longer exist for more than half of the
American feature films made before 1950. That figure only includes those films cur-

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an emerging genre

rently known to researchers. Discovering documentary records of films whose very

existence had been forgotten will increase the number of lost films, as will the continued disintegration of old fragile original films. On the other hand, lost films
turn up in places from thrift shops to private collections, a process increasingly aided
by Internet cataloging.
5. http://www.lsa.umich.edu/history/healthfilms/healthfilms.html [hereafter
UM-HHFC]. There is no general history of early health films. The preceding
overview is based on the materials located in the UM-HHFC.
6. In his pioneering study of science popularization, John Burnham argued that
mass media health education undermined science by promoting an emotional
superstitious faith in medicine, instead of explaining science as a method of discovery. Burnham, How Superstition Won and Science Lost: Popularizing Science and Health in
the United States (New Brunswick, NJ: Rutgers University Press, 1987). This chapter
shows that the effects of film on medicine were more complex: sometimes creative
as well as destructive, and often a bit of each. Further, though films did highlight the
impossibility of fully dichotomizing science and values, they did not create it.
7. I chose these five because I have researched them in depth, and because they
give some sense of the range of health film formats and contents. They are in no
sense, however, a representative sample. The discussion uses several portions of my
previously published work on these individual films, newly juxtaposed to draw new
or broader comparative conclusions about the roles of health films as a group (see
note 26).
8. Martin S. Pernick, Thomas Edisons Tuberculosis Films: Mass Media and Health
Propaganda, Hastings Center Report 8 (June 1978), 2127. I obtained a copy of the
film from the late film collector Paul Killiam, and helped arrange for deposit of a
copy for public viewing at the American Red Cross Archives in Washington, D.C. It
may also be viewed at UM-HHFC.
9. There is a relatively extensive literature on these films. See Robert Eberwein,
Sex Ed: Film, Video, and the Framework of Desire (New Brunswick, NJ: Rutgers University
Press, 1999); Stacie Colwell, The End of the Road: Gender, the Dissemination of
Knowledge, and the American Campaign Against Venereal Disease During World
War I, Camera Obscura 29 (May 1992), 91129; Eric Schaefer, Bold! Daring!
Shocking! True!: a History of Exploitation Films, 19191959 (Durham, NC: Duke
University Press, 1999); Alexandra M. Lord, Naturally Clean and Wholesome:
Women, Sex Education, and the United States Public Health Service, 19181928,
Social History of Medicine 17 (December 2004), 42341; Nancy Bristow, Making Men
Moral: Social Engineering During the Great War (New York: New York University Press,
1996).
I found and arranged for the preservation of the only surviving footage from Fit
to Win. It may be viewed at UM-HHFC. A relatively complete but out-of-sequence
jumble of footage from The End of the Road is at the NA reel 200.200. An abridged
version, with good continuity, is at the Museum of Modern Art Film Collection in
New York.
10. Martin S. Pernick, Sex Education Films, U.S. Government, 1920s, Isis 84
(December 1993), 76667. The full Science of Life series is available at the U.S.
National Archives Film Division in College Park, MD [hereafter NA], Record Group
90, reels 1426. They may also be viewed at UM-HHFC. Also see New York Times,
November 15, 1923, 10; American Journal of Public Health (December 1922), 1033;
American Journal of Public Health (September 1923), 737; Journal of Social Hygiene

more than illustrations

33

(January 1928), 14; Records of the New York State Motion Picture Division, New
York State Archives, Albany, NY, Box 2565, Folders 12,471 and 12,493, including a
clipping from the New York Herald, April 15, 1923; Records of the United States
Public Health Service, U.S. National Archives, Record Group 90, File 1350. Thanks
to Peter Laipson and Aloha South for locating the NA manuscripts.
11. Martin S. Pernick, The Black Stork: Eugenics and the Death of Defective Babies in
American Medicine and Motion Pictures since 1915 (New York: Oxford University Press,
1996). I found and arranged for preservation of the only surviving print; it may be
viewed at the UM-HHFC. Also see Pernick, Defining the Defective: Eugenics,
Aesthetics, and Mass Culture in Early 20th-Century America, The Body and Physical
Difference: Discourses of Disability, eds. David T. Mitchell and Sharon Snyder (Ann
Arbor: University of Michigan Press, 1997), pp. 89110.
12. Nancy Tomes, The Gospel of Germs: Men, Women, and the Microbe in American Life
(Cambridge, MA: Harvard University Press, 1998).
13. David Hollinger, Inquiry and Uplift: Late Nineteenth Century American
Academics and the Moral Efficacy of Scientific Practice, in The Authority of Experts,
ed. by Thomas Haskell (Bloomington: Indiana University Press, 1984), 14256;
Sylvia Tesh, Hidden Arguments: Political Ideology and Disease Prevention Policy (New
Brunswick, NJ: Rutgers University Press, 1988).
14. NA reel 90.23.
15. NA reel 90.24.
16. Jacobson v. Commonwealth of Massachusetts, 197 U.S. 11 (1905).
17. H. E. Kleinschmidt, Educational Prophylaxis of Venereal Diseases, Social
Hygiene 5 (1919), 27. Of course in (post)modern hindsight, the distinction breaks
downinforming includes persuading that the information is true.
18. John B. Watson and Karl Spencer Lashley, A Consensus of Medical Opinion
Upon Questions Relating to Sex Education and Venereal Disease Campaigns,
Mental Hygiene 4 (October 1920), 769847; Lashley and Watson, A Psychological
Study of Motion Pictures in Relation to Venereal Disease Campaigns, Journal of
Social Hygiene 7 (1921), 181219.
19. Annette Kuhn first noted that early sex education films propagandized for sex
education without actually providing much information, Cinema, Censorship and
Sexuality 19091925 (London: Routledge, 1988). The point is not limited to VD,
however. To promote reliance on professional expertise, many health films emphasized the bad consequences of failing to follow medical advice, without actually providing much medical information in the film itself.
20. Beth Haiken, Venus Envy: A History of Cosmetic Surgery (Baltimore, MD: Johns
Hopkins University Press, 1997). For Europe see the works of Sander Gilman, such
as Picturing Health and Illness: Images of Identity and Difference (Baltimore, MD: Johns
Hopkins University Press, 1995).
21. General Personal Hygiene, NA reel number 90.26.
22. Albert Wiggam, Fruit of the Family Tree (Garden City, NY: Garden City Publishing,
1924), 272, 279. For Haiselden see Chicago American (December 2, 1915), 2. This
view still surfaces in media accounts of modern evolutionary studies. Natalie Angier,
Why Birds and Bees, Too, Like Good Looks, and Not Just a Beauty Contest, New
York Times, February 8, 1994, B5, B8; Jane Brody, Ideals of Beauty Seen as Innate,
New York Times, March 21, 1994, A6. For current theories on the evolution of beauty
see, David M. Buss, The Evolution of Desire (New York: Basic Books, 1994); R. W. Smuts,

34

an emerging genre

Fat, Sex, Class, Adaptive Flexibility, and Cultural Change, Ethology and Sociobiology 13
(1992), 52342.
23. Although film popularization sometimes undermined science, in this case filmmakers arguably came closer to Darwinian concepts of fitness than did the many doctors and scientists who equated fitness with intelligence. While neither beauty nor
intellect guaranteed the fitness of a mate, physical attractiveness was probably a
better predictor of reproductive success than was intelligence, given the widely noted
negative correlation between I.Q. and rates of reproduction. Pernick, Black Stork,
pp. 7173.
24. Irving Fisher and Eugene Lyman Fisk, How to Live, 12th ed. (New York: Funk and
Wagnalls, 1917), 322. See also Wiggam, Fruit of the Family Tree, 275; Michael Guyer,
Being Well-Born (Indianapolis, IN: Bobbs-Merrill, 1927), 438.
25. Personal Hygiene for Young Women, NA 90.24.
26. General Personal Hygiene, NA 90.26. This paragraph and the remainder of this section are taken from Pernick, Defining the Defective, pp. 9394, 97.
27. Charles Musser, The Emergence of Cinema (New York: Scribner 1990); Francois
Dragognet, Etienne-Jules Marey (New York: Zone, 1992); Marta Braun, Picturing Time:
The Work of Etienne-Jules Marey (Chicago: University of Chicago Press, 1992). Thanks
to Rebecca Zurier for helping me think through these ideas.
28. Personal Hygiene for Young Women, NA 90.24. This distinctive aesthetic mix culminated in The Way to Strength and Beauty, a 1925 German film shown in the United
States, which combined dramatically modern steep-angle cinematography with
scenes of both classical and primitive Teutonic athletes. The film was produced by
UFA; it is available from the U.S. Library of Congress. See also Fit: Episodes in the
History of the Body (Straight Ahead Films, 1993); Lois Banner, American Beauty (New
York: Knopf, 1983); Martha Banta, Imaging American Women (New York: Columbia
University Press, 1987).
29. Mann used the phrase to describe the really characteristic and dangerous
aspect of National Socialism, quoted in New York Review of Books, January 30, 1986,
21.
30. Chicago Tribune, April 2, 1917, 18; New York Dramatic Mirror, February 17, 1917,
32; Wids Film Daily, April 5, 1917, 220; Motion Picture News, February 24, 1917, 1256.
The responses of ordinary viewers are hard to document, but these movie reviewers
and film censors demonstrate that such unauthorized interpretations were often
made.
31. Exhibitors Trade Review, February 24, 1917, 836; Motography, February 24, 1917,
424. For similar mixed reviews see New York Dramatic Mirror, February 17, 1917, 32;
Motion Picture News, February 24, 1917, 1256. Wids Film Daily, April 5, 1917, 22021.
32. Rival critic Kitty Kelly called it the most repellent picture she had ever seen.
Parsons in Chicago Herald, April 2, 1917, 11; Kelly in Chicago Examiner, April 4, 1917,
8. The Chicago Tribune admitted the ideas may be all right, but found the film as
pleasant to look at as a running sore. Pursuing such clinical metaphors to the limit,
Photoplay called the film so slimy that it reminds us of nothing save the residue of a
capital operation. Chicago Tribune, April 2, 1917, 18; Photoplay 12 (June 1917), 155.
33. The National Board of Review of Motion Pictures advisors repeatedly used such
language to describe the films audiences as sick. See National Board of Review of
Motion Picture Records at the New York Public Library for the following: Andrew
Edson of New York Citys Education Department, November 17; U. G. Manning,
November 18; Jonathan Dean, November 18; Ernest Batchelder, November 22;

more than illustrations

35

Maude Levy, November 20; W. L. Percy, November 21; and Robbins Gilman,
November 23; all 1916, all in Box 103.
34. Pernick, Medical Films, Censorship: A World Encyclopedia (London: Fitzroy
Dearborn, 2001), II: 81516. On surgery see Susan E. Lederer, Repellent Subjects:
Hollywood Censorship and Surgical Images in the 1930s, Medicine and Literature 17
(1998), 91111.
35. The first Production Code of the Motion Picture Producers and Directors of
America (1930), which synthesized state lists of forbidden topics, labeled surgical
operations a repellent subject, and included a catch-all restriction on all other
disgusting, unpleasant, though not necessarily evil, subjects, that was used to eliminate most other graphic or unpleasant depictions of medical issues. Garth Jowett,
Film: The Democratic Art (Boston: Little, Brown, 1976), chapters 5, 7, and 10. Code of
1930 reprinted pp. 46872. On pre-code films and the rise of censorship see also
Francis Couvares, Hollywood, Main Street, and the Church: Trying to Censor the
Movies Before the Production Code, American Quarterly 44 (December 1992),
584615; Stephen Vaughn, Morality and Entertainment: The Origins of the Motion
Picture Production Code, Journal of American History 77 (June 1990) 3965; Edward
De Grazia and Roger K. Newman. Banned Films: Movies, Censors and the First
Amendment (New York: R. R. Bowker, 1982).
36. B. A. Towers, Health Education Policy 19161926: Venereal Disease and the
Prophylaxis Dilemma, Medical History 24 (1980), 7087; Kuhn, Cinema, Censorship
and Sexuality, and The Power of the Image (London: Routledge & Kegan Paul, 1985).
37. Pernick, Black Stork, p. 66.

Chapter Two

Celebrity Diseases
Nancy Tomes
For anyone familiar with the film classic Pride of the Yankees, the story strikes a
familiar note: A famous baseball star returns to the ballpark after fans learn that
he has been diagnosed with a fatal disease. One sports writer describes the
moment: A king walked out of the shadows of the past into the brilliant spring
sunshine . . . yesterday, and 30,000 loyal subjects paid him the tribute of a
roaring acclaim that no crowned monarch could ever know. The doomed star
was honored, the account continues, as one of the great figures of a great game,
as an athlete who had worked a clean, open road from start to finish and who
had fought back death as courageously as he had fought back the leading batsmen of his pitching prime. Readers might well assume that this passage
described Lou Gehrig, the Yankee first baseman forced to retire in 1939 after
being diagnosed with amyotrophic lateral sclerosis, known to this day as Lou
Gehrigs disease. But in fact the king referred to in this article was not the
fabled Yankee Iron Horse but rather New York Giants pitcher Christy
Mathewson, who retired from baseball with tuberculosis in 1920. Like Gehrig,
Mathewson was widely revered as the model of a strong, clean-living player. Like
Gehrig, his struggles against a deadly disease were written about as an inspiring
tale of courage. But only the most erudite of baseball fans recognize his name
today, and TB never became widely known as Christy Mathewsons disease.1
These two tales of baseball players stricken by life threatening illnesses introduce the historical problem that this essay explores, namely the role of the mass
media, particularly the moving picture, in creating a new kind of celebrity disease story. In the early 1900s, the convergence of human interest journalism and
popular health education brought about what I will term the celebrification of
disease, that is, the conscious recruitment and deployment of famous people to
promote public awareness of specific diseases. This chapter explores the rise of
this new celebrity disease phenomenon.
Mention almost any serious affliction today, and most Americans are likely to
be able to identify a celebrity who suffers from it, whether Alzheimers (Ronald
Reagan), diabetes (Mary Tyler Moore), or Parkinsons disease (Michael J. Fox).
Celebrity associations played a particularly crucial role in the AIDS epidemic,

celebrity diseases

37

most notably with Rock Hudsons death in 1985, Magic Johnsons HIV positive
diagnosis in 1991, and Tom Hankss sympathetic portrayal of a person with
AIDS in the 1994 film Philadelphia. Through benefit concerts, congressional testimony, and public service advertisements, figures from the world of sports,
entertainment, and politics have come to exercise a powerful influence on disease awareness. Thus their role in the world of disease advocacy and politics warrants serious attention from scholars of both media history and medical history.2
As a contribution to such an effort, this essay tries to identify the beginnings
of the celebrity disease association in the interwar decades. Starting with the
anti-TB societies, who were the first to recruit exemplary patients as a means to
arouse the public conscience, I use a series of case studiesChristy Mathewsons
TB, Franklin Delano Roosevelts polio, Lou Gehrigs ALS, and George
Gershwins brain tumorto probe the impact of new forms of media, in particular moving pictures, on popular representations of celebrity and deadly diseases. In each of these cases, a person already well known in the realms of
politics, sports, or entertainment developed a life threatening disease. The
course of their illness became a matter of intense journalistic interest; with the
exception of Mathewson, their stories also became the subject of Hollywood
films. From news coverage of their illness, the films made about them, reviews of
those films, and contemporary biographical accounts, I explore how their
stories were used to address a central dilemma of modern experience: that
despite remarkable advances in modern science, even healthy, strong adults
might be felled by mysterious diseases.3
These stories about early celebrity patients also serve well to illustrate the
changing cultural context of disease representations. Although film seemed to
multiply the possibilities for more realistic portrayals of the illness experience,
those portrayals remained deeply constrained by preexisting conventions about
what was proper to reveal about a persons bodily travails. Deeply held notions
of privacy, popular aversion to clinical detail, and highly gendered notions of
character all had a powerful impact on media representations of dread disease.
Hence, as we shall see, newsreel footage never showed Roosevelt in a wheelchair,
and neither Pride of the Yankees nor Rhapsody in Blue (the musical version of
Gershwins life) dwelt on their main characters actual demise. The role of gendered conventions is also strikingly apparent. The most famous real-life celebrity
patients of the interwar period were all men. In contrast, those women who
became best known as celebrity patients were famous (and conspicuously
healthy) actresses playing not living personages but fictional characters: Greta
Garbo as Marguerite Gautier in Camille and Bette Davis as Judith Traherne in
Dark Victory.4
Each of these interwar celebrity stories is so unique that it is difficult to generalize about their meanings. Still, read together, their distinctive twists and
turns provide useful insights into the celebrification of traditional narratives about
disease and death. They raise critical questions about why some celebrities

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an emerging genre

disease experiences became the focal point for attention while others did not,
and why some diseases seem to attract more public attention than others. By
examining these case studies against the backdrop of both media history and
disease history, we can discern important shifts in the representations of specific
diseases and trace the emergence of a new kind of patient-centered disease narrative. The shaping and reshaping of celebrity disease stories as they moved
from news media to feature film also allow us to probe the shifting boundaries
between news and entertainment. Finally, these stories can be used to reflect on
the limits of celebrification, particularly the absence of famous advocates for
highly stigmatized diseases such as syphilis and schizophrenia.5

From Fame to Celebrity

The twentieth century notion of celebrity represents the modern mass-mediated
incarnation of the much older and venerable concept of fame, as historian
Charles Ponce De Leon has put it. The concepts of both fame and celebrity are
intimately bound up with the history of media: from the early modern print revolution onward, technological and cultural changes have combined to create
increasingly competitive markets for news and entertainment, which in turn
have encouraged widening conceptions of those individuals and activities
thought to be of public interest. From an eighteenth century focus on politicians, clergymen, and military heroes, the early nineteenth-century penny press
expanded the cast of newsworthy characters to include less savory types such as
criminals, sporting men, and actors. The post Civil War explosion in numbers
and competitiveness among both newspapers and magazines simply heightened
the pressure to fill more pages with stories about society, sports, and theater
personages.6
With the advent of film and radio, celebrity figures became even more numerous and powerful in their appeal; radio conveyed the uniqueness of their voices
to millions of listeners, while newsreels and photoplays captured their distinctive
styles of movement as well. Perhaps the most important effect of the new electric media was their capacity to generate national, as opposed to local or
regional, celebrities. Similar to the way mass production and intercontinental
railroads allowed the creation of national brands of consumer goods, the maturation of national radio networks and Hollywood movie studios produced a
class of super-celebrities as familiar to Americans in Kansas as to those in
Connecticut.7
As important as film and radio were to the creation of the modern celebrity,
however, they by no means supplanted the influence of the older print media.
The movie and radio industries both depended heavily on newspaper and magazine publicity to attract audiences and showcase their stars, while newspapers
and magazines sought to attract readers by carrying gossip columns and film

celebrity diseases

39

reviews. This merger of old and new media forms in the 1920s fostered an ever
more aggressive pursuit of the newsworthy individual, well exemplified by the
media frenzy surrounding Charles Lindberghs flight from New York to Paris in
1927. As Lindbergh was perhaps the first to experience fully, becoming a media
celebrity brought with it an intense scrutiny of every facet of ones life. No deed,
good or bad, might be overlooked, and the wrong kind of notoriety had the
power to end careers, as it did films stars such as Fatty Arbuckle and Mabel
Normand who became involved in much-publicized sex and murder scandals.
Moreover, once public figures became the focus of media attention, they
enjoyed less and less ability to control what could be written about them.8
Inevitably, this scrutiny of celebrities extended beyond their romances and
divorces to include their illnesses and deaths. At one level, interest in famous
peoples health crises merely continued a venerable tradition of curiosity about
sufferings of exemplary individuals. From medieval saints tales to nineteenth
century statesmens funerals, narratives about public figures ailments had long
served to communicate religious and moral lessons about how to be a good person and how to die a good death. But the multiplication of celebrity stories and
the volume of clinical detail available to describe them raised troublesome
issues about privacy and good taste. Debates about how much to tell about a
public figures health problems occurred as part of a broader argument about
the proper limits of print discourse. The rise of the so-called new journalism in
the 1880s and 1890s precipitated a fierce battle between the party of exposure versus the party of reticence, as Rochelle Gurstein has termed them.
Journalists argued that the public had both an interest in and a right to know
about scandals, sex crimes, and the like, while self appointed guardians of the
public taste decried the publication of unsavory details about famous peoples
personal lives.9
Press coverage of presidential health issues illustrates well the growing tensions over a public figures right to privacy versus the publics right to know
about their state of health. As James Patterson has noted, former President
Ulysses S. Grants illness and death in 1885 was the exception to the general
rule of secrecy surrounding presidential health; the extensive coverage of
Grants decline represents one of the few occasions that newspapers broke with
public reticence about discussing cancer in the late nineteenth century. Yet sitting presidents continued to enjoy an extraordinary degree of privacy about
their health, evident in the concealment of Grover Clevelands bout with oral
cancer in 1893 (despite surgery that left him with a prosthetic jaw) and
Woodrow Wilsons disabling stroke in 1919. To be sure, presidential bodies
were by no means exempt from growing media scrutiny; as Deborah Levine has
shown, William Howard Tafts efforts to lose weight during and after his presidency attracted national attention in the early decades of the twentieth century.
Yet serious presidential health problems would remain surrounded by secrecy
well into the 1960s.10

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an emerging genre

The journalistic treatment of other famous peoples illnesses is more indicative of the slow and steady repeal of reticence taking place in the first third of
the twentieth century. This trend reflected not only the growing appeal of
human-interest journalism but also the effect of other developments that broadened discussions of disease: the rapid expansion of popular health education
and the growing scope and sophistication of health-related advertising. The
Progressive Era veneration of science inspired massive public health campaigns
to disseminate useful knowledge about how to avoid infectious disease. Public
health reports and press coverage, first of filth diseases such as cholera and
typhoid, then of TB, introduced a graphic new level of discussion about previously unmentionable details of personal hygiene such as defecation and spitting.
Building on those public health initiatives, commercial interests sought to turn
anxieties about health into motivations to buy their products and services.
Advertising campaigns became a powerful force for widening the boundaries of
what bodily experiences and ailments might be mentioned in print. By the
1920s, detailed discussions of mouth hygiene, body odor, constipation, and even
menstrual functions were to be found in the advertising sections of daily newspapers and mass circulation magazines.11
Both nonprofit and for profit groups also promoted the use of the celebrity
testimonial. Public health reformers began to invoke the tragic experiences of
famous people such as Abraham Lincoln and Queen Victoria who had lost loved
ones to typhoid fever to stress the importance of better sanitation. Turn of the
century anti-TB societies sought to associate their work with famous people in
various ways. In the for profit sector, nineteenth century proprietary medicine
makers pioneered the use of the personal testimonial. By the 1920s, the
celebrity testimonial had become an advertising standard; society ladies and
women film stars appeared in cosmetic ads, while male athletes and movie stars
endorsed cigarette brands and shaving products. Thus by the 1920s, the
celebrity testimonial had become a powerful form of promotion for a wide variety of public and private goods.12
Both developmentsthe detailed discussion of physical symptoms and
the use of the celebrity testimonialdid not proceed without criticism. Selfappointed guardians of good taste decried the elaboration of bodily minutia,
especially in commercial advertising, while the use of the celebrity testimonial
had become so ubiquitous by the late 1920s that advertising professionals feared
it had lost its effectiveness. Meanwhile, the limits of what could and could not be
discussed in print or shown on film became the subject of heated debates.
Voluntary advertising codes and movie censorship guidelines, such as the
famous Hays Code, adopted in 1930 and enforced starting in 1934, attempted
to set the boundaries of good taste and to prevent the portrayal of repellent
subjects, as the Hays Code termed them. These debates over what body parts
could be referenced in interwar forms of mass media attest to how common
such representations had become by that period.13

celebrity diseases

41

The Combakkers: Christy Mathewson and TB

Among voluntary health organizations, the celebrity testimonial was first used
by the early anti-TB societies, who developed many new forms of health publicity in the early 1900s. Founded in 1904, the National Tuberculosis Association
(now the American Lung Association) was the trendsetter in this regard.
Borrowing heavily from contemporary advertising and marketing techniques,
the NTA and its local affiliates showed great ingenuity in designing popular education campaigns about the white plague, then the leading cause of death.
They were the first public health group to use films as an educational medium,
and pioneered modern fundraising efforts with their annual Christmas seal campaigns, which began in 1907.
In all their activities, the anti-TB societies showed a keen appreciation of the
personal testimonial. Local societies recruited prominent politicians and doctors from the community to serve on their governing boards, while the NTA
went after bigger names, enlisting former Presidents Grover Cleveland and
Theodore Roosevelt to serve as honorary vice presidents. As they became
increasingly sophisticated, the Christmas seal campaigns featured more and
more famous people: for example, winsome children were sent to sell stamps to
the president and First Lady, as well as silent film stars such as Jackie Coogan.14
Along similar lines, the anti-TB societies began to publicize the lives of exemplary individuals afflicted with the disease. Finding public figures willing to be
identified as consumptives was a more difficult task than lining up local dignitaries to support the annual Christmas seal sale. Given that enormous stigma still
attached to having TB, outing a consumptive, so to speak, was not to be done
lightly. Yet such a revelation could be very helpful: if people who were much
admired were so identified, they could make the disease seem less fearsome to
the public. To this end, anti-TB advocates hoped that famous personages might
be willing to renounce their right to privacy in order to stimulate public awareness of the disease.
The first consumptives freely willing to publicize their health histories in this
fashion were physicians. As self professed men of science, they presumably felt
a particular duty to share their stories, and also enjoyed some degree of immunity from concerns about their contagiousness. The most celebrated of early
physician-patients was Edward Trudeau, founder of the Saranac Lake cottage
sanatorium, whose biography nicely blended elements of heroism, hopefulness,
and accomplishment. Trudeau had contracted the disease while nursing a dying
brother; told he had only months to live, he went to his beloved Adirondacks to
die, only to recover unexpectedly and become a well known promoter of the
sanatoriums fresh air cure. Both Trudeau and Saranac became familiar figures in popular portrayals of TB; other celebrities were soon drawn to the
Adirondacks to take the cure, among them the author Robert Louis
Stevenson.15

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an emerging genre

In the 1920s, the anti-TB movement embraced a more free wheeling, Jazz-age
style of testimonial that presented the disease with a lighter touch. A good example
is Nina Wilcox Putnam, who published her disease memoirs in the 1922 Saturday
Evening Post. The author of several books and Broadway plays, Putnam provided a
humorous account of her bout with TB, focused chiefly on her weight loss, which
left her so thin that I could have worked as a model in a spaghetti factory, as she
put it. Liberally sprinkling her story with slang, she wrote that she had no idea how
sick she was until I threatened to pull a Camille, a reference to Alexander
Dumass famous story about the doomed courtesan Marguerite Gautier, which by
this time had not only inspired Giuseppe Verdis celebrated opera La Traviata,
but also several versions for the silent screen. In the same lighthearted tone,
Putnam recounted her recovery, which she attributed to strictly following her doctors orders, and passed on to readers her rules of healthy living. Quite unlike the
staid tone of Trudeaus autobiography, Putnams breezy memoirs recast the consumptives experience in terms seemingly well suited to the Jazz-age generation.16
Baseball star Christy Mathewsons illness provided an even more promising
opportunity to promote the anti-TB cause. In contrast to Nina Wilcox Putnam,
Mathewson was a truly national celebrity, made famous by the growing popularity of professional baseball. A long time pitching star for the New York Giants
and inventor of the fade away pitch, Mathewson was a favorite of both fans and
sportswriters. At a time when many baseball players had unsavory reputations as
hard drinkers, womanizers, and cheaters (especially after the Black Sox World
Series scandal of 1919), Mathewson was the epitome of the clean-cut, wholesome athlete, the idol of a city and the pride of a nation, in the words of sportswriter Grantland Rice. Young boys (among them Lou Gehrig) prized their
Christy Mathewson trading cards, and when the Baseball Hall of Fame opened
in 1936, he was one of the first five inductees.17
Because star athletes performance was so dependent on their physical condition, sports writers and fans paid especially close attention to their favorite players
aches and pains. Thus by the spring of 1920, the newspapers had already reported
that Mathewson suffered from a heavy cold, and all fandom was worried, in the
words of one journalist. The announcement in August that Mathewsons heavy
cold was in fact TB constituted a major sports story, made all the more poignant
by the conjecture that he had contracted the disease while on leave from baseball
to fight overseas in World War I. Sports writers emphasized Mathewsons resolve
to recover and repeated his gallant claim, I will surely beat this game. As one
wrote, the old scout has that White Plague Guy swinging like a gate, and hell
strike him out just to show his fellow-sufferers how to battle this overrated cuss.18
Anti-TB advocates eagerly picked up on the Mathewson story, which offered a
promising entree to a male audience thought difficult to reach with conventional health publicity. The NTAs popular health magazine, Journal of the
Outdoor Life, published several articles on Mathewsons treatment. As befit a
celebrity patient, he went to Saranac Lake, which by the 1920s had become

celebrity diseases

43

Americas best-known sanatorium. The stories stressed the celebrity patients

many virtues: his cheerfulness, which one article noted puts to shame a grumbler; his willingness to follow rules (which he attributed to his baseball discipline); and his manly hobbies, which included becoming an expert checkers
player, inventing a baseball board game, and hunting partridges (see figure 2.1).
By 1923, the Journal could happily report that Mathewson had recovered sufficiently to return to baseball as a manager for the Boston Braves. It was in that
capacity he returned to face his old team, the New York Giants, inspiring
Grantland Rices tribute to King Matty quoted at the beginning of this essay.19
For anti-TB advocates interested in reaching a broader male audience, Christy
Mathewson was the ideal celebrity spokesman. Possessed of a good, clean image
before becoming ill, he adapted well to the demands of sanatorium treatment, and
most importantly, he got better. As such, his life offered just the kind of inspiring
narrative that anti-TB advocates wanted to share both with other patients and with

Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 2.1. Photo of Christy Mathewson as model patient at Saranac

Sanatorium that appeared in the NTAs Journal of the Outdoor Life, 1922.

44

an emerging genre

Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 2.2. Cartoon showing young boy inspired by Mathewsons story, which
originally appeared in the St. Louis Star, 1921.

the larger public (see figure 2.2). The good Mathewson could do by sharing his
story seemed far to outweigh the breach of privacy it required. As Helena Lorenz
Williamss 1924 article, The Come-Back of Christy Mathewson, reported, he at
first felt reluctant to relay the personal details of his case, fearing to make misleading statements that may confuse other patients. What changed his mind was
the opportunity he saw to convey a message to the outside world, a message that
would be an inspiration to patients and those close to them. The article concluded with a touching description of the Halloween party Mathewsons wife was
planning for him, with housewifely pride, to which she invited, as a guest of
honor, the doctor who once gave Mr. Mathewson six weeks to live.20
Had Mathewsons story continued on this optimistic note, perhaps it would
have remained more central to the anti-TB message. But sadly, Mathewson soon
relapsed and died at Saranac on October 7, 1925, putting an end to the publicity

celebrity diseases

45

value of his celebrity story. Perhaps having linked his experience too closely to
the idea of a comeback, anti-TB advocates found it difficult to spin his tale differently after his death. Moreover, the kinds of print vehicles that made him a
celebrity, such as sports writers columns and photographs on the sports page,
had a very short life span; with no biopic to immortalize him, Christy Mathewsons
image soon faded from public attention.21
Mathewsons fadeaway no doubt reflected the fact that TB itself was becoming old news, in a sense. By the mid-1920s, increasingly accurate mortality data
showed quite clearly that the white plague was no longer first among the captains of death, as John Bunyan once referred to it. As death rates plummeted,
due to improving living standards and preventive measures, TB was increasingly
typecast as a skid row disease, most common among the very poor. The public
health vacuum created by the declining rates of TB would not be filled by campaigns against the new leading causes of death, cardiovascular disease and cancer, but rather by another, rarer form of infectious disease, infantile paralysis, to
be discussed in the next section.22
Although Christy Mathewsons story inspired no film equivalent to Pride of the
Yankees, TB did achieve a certain cinematic immortality in the interwar period,
albeit of a highly romanticized kind. Probably the most famous celebrity TB
patient of the era was a fictional character: Marguerite Gautier as played by Greta
Garbo in George Cukors 1936 remake of the Dumas classic. As Nina Putnam
Wilcoxs reference to pulling a Camille makes evident, the story line was already
a very familiar one to early twentieth century movie audiences. The specifics of
what ailed Marguerite Gautier were little emphasized in the film. Elegantly languid and husky-voiced, Garbo underplayed the telltale symptoms of pulmonary
TB, foretelling her doom by by no more outward signs than the slight cough,
as the New Republic reviewer noted. Looking so beautiful that it is hard to believe
she has so much as a cold in the head, another observed, Garbo wisely minimizes Marguerite Gautiers famed cough and noted with amusement that her
low cut gowns showed off her sunburned shoulders, a nice, modern touch. Film
reviews never mentioned the word consumption, much less TB. Rather, the
reviewers saw the film as a message about love and the nobleness of a womans
self sacrifice. As reviewers (and likely audiences as well) understood, there was no
intent in Camille to present a realistic view of the disease.23
That Marguerite Gauthier rather than Christy Mathewson became the celebrity
personification of the interwar TB patient seems preordained by gender conventions that made the dying consumptive most easily pictured as a beautiful woman.
Whatever discomfort viewers might have experienced watching a dying woman on
screen was offset not only by the highly stylized performance of her demise, but
also Garbos off-screen reputation both as the screens first lady and dramatic
phenomena of our time, and a person with a keen sense of private dignity. Thus
a fictional heroine from the past played by a famous actress in the present became
perhaps the best-known interwar personification of the TB sufferer.24

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an emerging genre

Just a bit lame: Franklin Delano Roosevelt and Polio

In the summer of 1921, a year after Christy Mathewson left baseball for Saranac
Lake, Franklin Delano Roosevelt began his tenure as one of the most famous
celebrity patients of the twentieth century. Like Mathewson, his illness attracted
interest from the press from the outset, but unlike Mathewson, he survived and
managed to return to politics at a time when being a cripple disqualified a person from full adult life. Skillful use of the radio and newsreels proved essential
to what his biographer Hugh Gallagher terms Roosevelts splendid deception,
namely underplaying the extent of his disability. Electronic media also allowed
Roosevelt to become the prototype of the modern celebrity patient who successfully converted his fame into a much broader advocacy program on behalf
of others with his ailment.25
At the time their histories intersected, both Roosevelt and polio were public
figures of some note. The ambitious, wellborn son of an old Hudson River family, Roosevelt had enhanced his name recognition by marrying the niece of his
distant cousin Theodore, then president of the United States. At the time he
became ill, Roosevelt had just completed an unsuccessful run for the vice presidency on the Democratic ticket; despite defeat, Roosevelt had campaigned well
and seemed destined for further chances at higher office. Thus the news that
the rising political star had contracted poliomyelitis attracted immediate press
interest. By 1921, polio was a newsworthy subject in its own right. A 1916 epidemic of the mysterious new disease had hit hard in east coast cities, especially
New York City, leaving hundreds dead and many more paralyzed. Along with the
influenza epidemic of 191819, polio underlined the limits of modern science
and public health when faced with deadly new infectious diseases.26
So intense was journalists interest in Roosevelts illness that the conscious effort,
on his and his familys part, to hide the extent of his disability had to begin
immediately, while he was still at Campobello. Roosevelts aide Louis Howe
tricked the reporters who came to cover his removal to a New York City hospital
into showing up at the wrong place, so that the celebrity patient could be placed
in the waiting yacht, his trademark cigarette holder and jaunty smile in place,
before greeting them. The glare of publicity followed Roosevelt to Warm
Springs, Georgia, where his arrival in 1924 to visit the spa there brought a crowd
of fifty townsfolk to greet him at the station. Only a few weeks later, an Atlanta
Journal political reporter showed up to write a story about the spas famous
patient; the piece, titled Franklin D. Roosevelt Will Swim to Health, presented
a rosy picture of Roosevelts progress, along with that of another swimmer, the
bathing beauty Annette Kellerman who had had polio as a child. Widely
reprinted across the country, the article resulted in a sudden influx of polio sufferers to Warm Springs, which in turn prompted Roosevelt to buy the spa in
1926 and begin to use his political connections to raise money for its upkeep.
Similar to the way Edward Trudeau turned an Adirondack mountain camp into

celebrity diseases

47

a prominent treatment center for TB, Roosevelts patronage transformed Warm

Springs into an important center for polio therapy.27
Roosevelts full return to public life in 1924 coincided with a new media age
marked by the coming of radio and the talking picture, and as has often been
noted, his mastery of the new media would be central to his political success. But
while radio allowed Roosevelt to make effective use of a confident, distinctive
speaking voice left unaffected by polio, film presented a formidable challenge
to a paraplegic trying to sustain the illusion that he was only a bit lame. As
Gallagher has argued, Roosevelts splendid deception required the active
complicity of journalists not to reveal the true extent of his paralysis. From the
late 1920s onward, the press observed an informal agreement that Roosevelt
would not be photographed or filmed in ways that made evident the extent of
his paralysis.28
This gentlemans agreement is all the more remarkable given that it coincided
with the heyday of the motion picture newsreel. Starting in the 1920s, newsreel
companies competed fiercely, sometimes quite underhandedly, to get the most
arresting footage of newsworthy events, from natural disasters to baseball games.
Significantly, Roosevelts informal agreement with the press supposedly began
when a newsreel cameraman approached him as he was being helped out of a
car during the 1928 gubernatorial campaign. Roosevelt apparently said, No
movies of me getting out of the machine, boys, and from then on the press
corps complied with his request. Photographers and newsreel cameramen who
tried to break that agreement found their view blocked by other journalists, or
their film seized by Secret Service agents. As a consequence, media coverage
worked to support rather than undermine Roosevelts image as an almost fully
recovered polio victim. Newsreels, whose stock in trade was their ability to portray newsmakers in motion, invariably showed Roosevelt in a commanding position, either sitting upright or standing at a podium. Film representations of
Roosevelt captured his facial animation, journalist Victor Cohn later noted,
along with the cheerful tossings of the head, the upward-thrusting gestures of
the hand while masking his body, particularly the stillness of his wasted legs.29
Roosevelt not only managed to perpetuate the splendid deception, he also
deployed his growing fame so as to create an anti-polio movement in his
celebrity wake. From the earliest days of his illness, he demonstrated a resolve to
raise public awareness about infantile paralysis and to expand the treatment
options available to his fellow polios. As he once told a group of surgeons, my
whole objective was to make the country as conscious about polio as it is about
TB. To this end, Roosevelt not only successfully exploited his own fame, but also
used it to draw in other electric celebrities to promote the anti-polio cause.30
The anti-polio crusade began as efforts to raise money for the Warm Springs
treatment facility. Having spent much of his personal fortune to purchase the
dilapidated spa, Roosevelt turned to wealthy friends and political connections to
raise money for its renovation and operation. He set up the Warm Springs

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an emerging genre

Foundation in 1927 to keep its finances and management separate from his personal affairs, and asked his former law partner Basil OConnor to manage it. In
1937, OConnor and his associates set up the National Foundation for Infantile
Paralysis (now known as the March of Dimes), a voluntary health organization
modeled on the lines of the NTA. Using publicity methods that made the
anti-TB societies seem dowdy in comparison, the polio crusade grew rapidly
even in the midst of the Great Depression. One key reason for its success was the
extensive use of radio and film stars to promote the polio cause.31
The celebrification of polio is well illustrated in the history of the Birthday
Balls. As the Depression began to cut into contributions for Warm Springss
upkeep, a New York public relations expert named Carl Byoir had the inspiration to sponsor a nationwide series of Birthday Balls, to be held on the evening
of the presidents birthday, January 30. Guests gave donations in exchange for a
chance to hobnob with local celebrities. Introduced with extensive publicity in
January 1934, the first round of Birthday Balls netted over a million dollars for
the Warm Springs facility. As the annual balls grew more and more elaborate,
the proceeds began to be split, with seventy percent going to the local community to build treatment facilities, and thirty percent going to the Warm Springs
Foundation. In 1936, when Roosevelts friend George Allen took over the
Birthday Ball planning, he decided that the balls needed glamour; and
recruited big Hollywood stars, among them Jean Harlow, Ginger Rogers, and
Robert Taylor (fresh from his starring role in Camille) to make the rounds of
the Washington, D.C. balls, escorted by First Lady (and avid movie fan) Eleanor
Roosevelt. As one of Allens associates later recalled, the movie star thing grew
like wildfire. They started to come in droves. . . . We practically had to beat them
off with a stick. Thereafter appearances at the Birthday Balls became a popular
tradition among the largely pro-New Deal stars of the decade. As the entertainment trade paper Variety wrote of the 1938 balls, Hollywood, Broadway and the
radio biz joined hands in the celebrations, for which they received gobs of
publicity and pats on the back as their reward.32
The celebrity connection also shaped the next major innovation in polio
fundraising, the March of Dimes. By 1937, the problems associated with tying
the polio cause too closely with a sitting president had started to become evident. Not only was Roosevelt an increasingly controversial figure, but on a more
practical level, the Birthday Ball concept limited contributions to donors who
could attend them. Supposedly it was at a polio fundraising meeting on MGMs
Hollywood lot that performer Eddie Cantor came up with the idea for the
March of Dimes (a tongue-in-cheek play on the title of the popular newsreel
series, the March of Time.) In response to on-air requests from Cantor and
other radio stars, listeners mailed more than three million dimes to the
White House in 1937. Eventually the March of Dimes radio campaign supplanted the Birthday Balls as the main focal point of the National Foundations
fundraising.33

celebrity diseases

49

Finally, the power of celebrity was also reflected in the adoption of an annual
poster child for the March of Dimes campaign. Charitable groups such as the
American Red Cross, the NTA, and the Society for Crippled Children, had long
realized the value of incorporating children into public appeals, both as
fundraisers and as fund recipients. In NFIP fundraising, the president was often
shown in photographs surrounded by young, attractive polio victims. In 1938,
the noted commercial artist Howard Chandler Christy, creator of the famous
I want you Uncle Sam poster, drew a poster featuring a saint like F. D. R. surrounded by angelic children, in the words of one contemporary. Eventually
artistic renderings of the child victim gave way to photographs of real children,
as the NFIP inaugurated the selection of a poster child to feature in annual
March of Dimes publicity. The poster child campaigns mark the beginning of
what might be termed a reverse celebrity effect: having the presidents disease
turned ordinary children into celebrities themselves.34
Unlike Roosevelt, whose braces and wheelchair were never shown on film, newsreels portrayed child polio sufferers in more realistic ways. For example, a January
1944, segment of Paramount News, titled Thank you Audience! Your dimes
helped, featured a lovely seven-year-old girl named Sue Ann, who wore braces
and used canes to walk toward the audience and thank them for their dimes. Im
only a little girl, she said in a sweet voice, and maybe I should be seen and not
heard, but for what youve given to the March of Dimes, I wanted to say thank you
from the bottom of my heart, and blew her audience a kiss. As Victor Cohn noted
of the poster child idea, it was a tactic with the punch of a sledgehammer.35
Film clearly played an influential role in shaping Franklin Delano Roosevelts
career as a celebrity patient, and polios identity as a celebrity disease. It should
be noted, however, that it was the newsreel and not the photoplay that dominated Roosevelts image in the moving pictures. Unlike Lou Gehrig and George
Gershwin, whose lives were turned into biopics after their deaths, Roosevelts
polio remained artistically off limits for a much longer period, perhaps reflecting the greater reserve about invading a presidents privacy. Thirteen years after
Roosevelts death, Dore Scharys play Sunrise at Campobello opened on Broadway
in 1958; even then, Schary wrote and asked Eleanor Roosevelts permission
before staging the play. The film version, starring Ralph Bellamy and Greer
Garson, was released in 1960. The subject of polio did inspire a biopic soon after
Roosevelts death, but it was that of the Australian born nurse Elizabeth Kenny
who pioneered a new rehabilitation therapy for polio victims. (Naomi Rogers
discusses the 1946 film Sister Kenny elsewhere in this collection.)36

The Gamest Guy: Lou Gehrig and ALS

In 1939, at the height of polios celebrity treatment, the baseball star Lou
Gehrig was stricken by another mysterious paralytic disease, amyotrophic lateral

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an emerging genre

sclerosis. Like Roosevelt, his image became closely linked with his ailment. Like
Roosevelt, he also became a hero to the forgotten men struggling to outlast
the Great Depression. But in other ways, their stories had different outcomes:
not only did Gehrig die, but his ailment remained in the shadow of polio, failing to become a disease celebrity in its own right. No voluntary health organization would be founded to combat ALS until nearly three decades after his
death. Still, due to the hardier forms of mass media used to record it, Gehrigs
story would remain both a familiar part of sports history and a model patients
story.
Like Roosevelt, Gehrig was an electric celebrity whose achievements on the
baseball diamond were celebrated not only in print journalism but also by radio
and newsreel coverage. By the late 1930s, the top baseball players enjoyed fame
comparable to Hollywood movie stars, at least among American men. At the
time he became ill in 1939, the thirty-six year old first baseman had been a baseball celebrity for over a decade. Like Mathewson, Gehrig personified the milk
drinking, early-to-bed kind of player, a foil to more flamboyant teammates such
as Babe Ruth and Joe DiMaggio. Cast as a baseball Horatio Alger, Gehrig was
born poor and knew what it is to struggle, as Current Biography reported in
1940, the only surviving son of poor immigrant parents. Joining the Yankees in
1925, he became one of the fabled Murderers Row who won the 1927 World
Series, and earned the nickname the Iron Horse for his dependability, playing
a record 2,130 consecutive games and appearing in seven World Series, before
his illness forced him to retire.37
As with Christy Mathewsons heavy cold, the first signs of Gehrigs fatal illness were noted by sportswriters long before his illness was diagnosed. Starting
midway through the 1938 season, Gehrig began to experience difficulty hitting
the ball, starting speculation that he might be past his prime. During the next
years spring training, sportswriters watched closely to see if his hitting slump
would continue. When it did, they began to write his batting obituaryfor all
the world to readbefore the season even started, as Time magazine reported
in May 1939, Gehrig benched himself that same month, again with extensive
coverage in the press, and announced that he was going to the Mayo Clinic to
find out just what was the matter with him and when he reasonably could expect
to play ball again, as his biographer, Frank Graham, wrote.38
A celebrity institution on the order of Saranac Lake and Warm Springs, the
Mayo Clinic was the logical place for a celebrity with a mysterious ailment to go
in 1939. Brothers and surgeons Charles and William Mayo had assembled a staff
at the clinic founded by their father in 1899 in Rochester, Minnesota, with the
reputation as the most distinguished medical detectives in the country, maybe
the world, recalled Eleanor Gehrig in her memoirs. Under Charles Mayos special care, Gehrig was given the works, as he termed it. After six days of tests,
the clinics chief diagnostician Harold Harbein wrote a short letter released
to the press, stating that Gehrig had amyotrophic lateral schlerosis, a rare

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51

neuromuscular disorder that he defined in lay terms as a form of chronic

poliomyelitis (infantile paralysis).39
Lou Gehrigs ALS diagnosis, like Christy Mathewsons TB, constituted a major
sports story. Soon after he returned from the Mayo Clinic to a bench job with
the Yankees, he was honored with an elaborate appreciation day on July 4, 1939.
Attended by the Mayor Fiorello LaGuardia and U.S. Postmaster General James
Farley, along with Babe Ruth and the other surviving members of the famed
1927 World Series team, the event was broadcast over the radio and filmed by
an army of newsreel photographers. Gehrig ended his short speech of thanks
(which sportswriters would later dub baseballs Gettysburg Address) with the
lines, I may have been given a bad break, but I have an awful lot to live for. With
all this, I consider myself the luckiest man on the face of the earth. A sportscaster commented as Gehrig left the field, I have written about a lot of game
guys in my time. But there goes the gamest guy of them all.40
Media accounts of Gehrigs final years emphasized the exemplary dignity and
courage he showed in the face of a debilitating disease. Let go by the Yankees at
the end of the 1939 season, he turned down opportunities to appear in night
clubs, films, or advertisements because, as a sketch in the 1940 Current Biography
put it, he believes in working for what he gets. Instead, Gehrig accepted Mayor
LaGuardias offer to serve as a parole board commissioner, and worked diligently at the position for as long as he could. He apparently endured the last
stages of his illness with stoic good will, receiving visits from other celebrities,
such as the actress Tallulah Bankhead. After his death on June 2, 1941, Gehrig
had a celebrity funeral, complete with flowers from President Roosevelt, flags
lowered to half mast in New York City, and fans lining up for hours to say
goodbye.41
But despite his stellar performance as a quiet hero (the title of his first biography, published in 1942), Gehrig could not make ALS a celebrity disease as
Roosevelt had done with polio. A rare and mysterious disorder then as now, ALS
left both the press and the sports-loving public confused about its distinctive
characteristics, a confusion that the Mayo Clinics attempts to describe it as a
chronic form of polio only compounded. As Graham wrote in his 1942 biography, Few could pronounce the name of the disease, even fewer comprehend
the nature of it. Reflecting the common misunderstanding that it was an infectious disease, he continued, It was incredible that that fine, big body could harbor the frightful germ that robbed a man of his strengthof his life, perhaps.42
The polio confusion led to a embarrassing episode in 1940, when during a
Yankees batting slump, Jimmy Powers, the sports editor of the New York Daily
News, suggested that Gerhig had infected the team with a mass polio epidemic.
Furious, Gehrig responded with a million dollar libel suit against Powers and the
Daily News Syndicate Company, asking restitution for the mental anguish and
loss of reputation caused by the article. Powers apologized for the incident,
expressing regret that he had gotten snarled up in medical controversy and

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an emerging genre

confirming that Gehrig has no communicable disease and was not suffering
from the mysterious polio germ that supposedly played havoc with the Yankee
ball club. The suit was dropped.43
Like Roosevelt, Gehrig tried to be an inspiration to other ALS sufferers, seeking out the best treatment available, undergoing experimental injections of
vitamin E at the Mayo Clinic, and corresponding with other ALS patients to
compare notes on their symptoms. But there was no parallel to Roosevelts
swimming therapy or similar rehabilitation programs that gave polio survivors
a chance to return to active lives. Affecting adults, not children, ALS was simply
too rare and dispiriting a disease to inspire the kind of response that the
National Foundation for Infantile Paralysis was able to mobilize in the 1930s. Yet
ALSs identity as Lou Gehrigs disease remained very strong, in part, due to
simple convenience: Lou Gehrigs disease was much easier to pronounce than
the tongue-challenging amyotrophic lateral sclerosis. But it also reflected the
enduring appeal of the film version of Gehrigs life, the 1942 Pride of the Yankees,
which lent his celebrity patient-hood a new kind of celluloid immortality.44
RKO Pictures took the chance of immediately turning Gehrigs story into a
biopic, despite the fact that it was a ticklish job, as a review in Time magazine
noted, given that some 80,000,000 U.S. baseball fans knew Gehrig or his picture by sight and had virtually canonized him since his death. The movies
producers dealt with that challenge by having Gehrig played by Gary Cooper,
then one of Hollywoods most popular leading men. As film critic Manny Farber
noted in 1943, Cooper was immediately recognizable as the old fashioned hero,
one of two idealized personalities then dominant in American movies. (The
other was the cynical, hard boiled type played by Humphrey Bogart.) Both character types, Farber observed, shared successful lives of extreme action, free of
the routine matter of existence, which are carried out in dramatic places like a
night club in Casablanca . . . or on the baseball field at Yankee Stadium. While
providing the untroubled string of physical victories that Hollywood feels
Americans need and desire, the old-fashioned hero often had a faint tinge of
tragedy latent in his personality that meant either he or his wife had to die at
the end of the picture.45
Pride of the Yankees delivered precisely that combination. The film featured relatively few baseball re-enactments; Cooper knew nothing about baseball, and
sportswriters ridiculed his performance of Gehrig, saying he threw like a woman.
Instead the movies strength rested on Coopers ability to impersonate the strong,
shy, good-natured immigrants son. The script also played up the athletes intense
love and devotion, first for his mother and then for his wife Eleanor, thus making
the baseball story more appealing to women viewers. As one reviewer observed,
the love story between Gehrig and his wife is solemnized by the fact that its
unhappy ending is known to almost everyone from the beginning. Yet the character of ALS had little place in the plot. Much as Garbo only sketched the symptoms of TB in Camille, Cooper barely hinted at the physical weakness that came

celebrity diseases

53

with the disease. Instead the film ends with Gehrigs famous speech, two years
before his death. The avoidance of clinical detail is all the more striking given the
other touches of realism in the film, such as having Babe Ruth play himself, and
the use of actual newsreel footage of the 1939 ceremony.46
The generally favorable reviews of Pride of the Yankees referred only in passing
to the illness that killed him, as one reviewer put it, and dwelt primarily on the
films narrative of uplift. No one saw the movie, or the publicity surrounding it,
as an opportunity to call attention to the specific identity of ALS. The films messageLou discovers that death is close. Bravely he faces what is in store, as
another reviewer summed it uprequired no clinical exegesis or extended
deathbed scene. Perhaps the image of stoic male courage in the face of undeserved illness remained all the more powerful for its restraint.47
For whatever reasons, the story of Lou Gehrig and Pride of the Yankees became
staples of American sports legend. Among his many screen successes, Gary
Cooper noted that this film was one of his most popular roles; when he was touring overseas during World War II, service men often stopped him and asked him
to deliver Gehrigs speech from the movie. With the televised movie reruns, Pride
of the Yankees became a perennial sign of spring, appearing every year like an
Easter mystery play. Thus through the medium of film, professional sports first
celebrity patient achieved a unique kind of immortality.48

Dark Victory: George Gershwin and Cancer

Compared to his contemporaries Roosevelt and Gehrig, George Gershwin presents a much less durable linking of celebrity and disease. Whereas many
Americans today are aware that Roosevelt had polio and Gehrig had ALS, few
know that Gershwin, one of the most successful twentieth-century American
composers, died from a brain tumor at the age of thirty-eight. At the same time,
his story has many elements of a celebrity disease episode: his illness prompted
dramatic measures to try to save his life, his death became national news, and his
biography was eventually made the subject of a feature film, the 1945 Rhapsody
in Blue. But for a variety of reasons, both Gershwin and the disease that killed
him aroused much more ambivalence than either Roosevelts polio or Gehrigs
ALS. As a popular songwriter who aspired to be a serious composer, he symbolized a Jazz Age about which many Americans had mixed feelings. As a Jew who
achieved his fame in the entertainment industry, his celebrity persona had less
appeal than the patrician politician Roosevelt or the immigrant athlete Gehrig.
Perhaps most importantly, he was felled by cancer at a time when the stigma surrounding that disease still stifled public discussions about it.
Born to Russian Jewish immigrant parents in New York City, Gershwin began
to play the piano at the age of twelve; while still a teenager, he began to earn
money as a song plugger, a rehearsal pianist, and vaudeville performer. In 1919,

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an emerging genre

Gershwin achieved his first fame when the popular singer Al Jolson turned his song
Swanee into a national hit. Over the next decade, Gershwin partnered with his
lyricist brother Ira to write songs for Broadway shows, among them Lady Be
Good, Funny Face, and Of Thee I Sing. He also composed orchestral pieces,
including Rhapsody in Blue (1924), the Concerto in F (1925), and An
American in Paris (1928), as well as the opera Porgy and Bess (1935). By the mid1930s, Gershwin was widely recognized as perhaps the most talented composer
the United States had ever produced. At the same time, his mixing of musical
genres aroused great ambivalence; classical music devotees thought his work too
heavily inflected by popular music, while fans of his Broadway show tunes did not
appreciate the more avant garde sound of Porgy and Bess.49
At the time he became ill, Gershwin had just relocated to Hollywood. Perhaps
as a distraction from the glum economic news, light-hearted films with singing
and dancing did particularly well during the Great Depression, prompting a
migration of Broadway songwriters to Hollywood. In the spring of 1936, RKO
producer Samuel Goldwyn (who would later turn Gehrigs life story into a
biopic) hired George and Ira Gershwin to write the music for several Fred
Astaire films, including Shall We Dance and Damsel in Distress, both released in
1937. Renting a stylish Spanish mansion with a pool and tennis court, the
Gershwins became a part of the glamorous Hollywood social scene; bachelor
George romanced several female stars, chief among them Paulette Goddard, the
soon-to-be ex-wife of Charlie Chaplin.50
It was during a concert with the Los Angeles Philharmonic in February 1937
that Gershwin first displayed the symptoms of his illness, losing his place for several bars during a performance of his Piano Concerto in F. Family and friends
at first attributed his complaints about headaches and dizziness to the stress of
working with the notoriously difficult Goldwyn. As the symptoms worsened,
Gershwin went to the Cedars of Lebanon Hospital, the hospital of choice among
film stars, for diagnostic tests; when they showed no organic illness, he went
home and began seeing a psychoanalyst every day. Growing increasingly confused and lethargic, he eventually lapsed into a coma on July 9 and was readmitted to Cedars of Lebanon, where a spinal tap revealed the presence of a
glioblastoma, a very fast growing type of brain tumor.51
The events of the next twenty-four hours reveal another facet of the celebrity
disease phenomena, namely the extraordinary medical resources that the
famous might command in an emergency. Gershwins family mobilized influential friends all over the country to find the best possible neurosurgeon to operate on him. They were referred first to Harvey Cushing, a medical superstar on
the order of the Mayo Brothers, only to find that he had retired; Cushing
directed them to the Johns Hopkins neurosurgeon Walter Dandy. When Dandy
turned out to be vacationing aboard the governor of Marylands yacht,
Gershwins friends contacted the governors office and the White House
for help, and both the U.S. Coast Guard and the Navy searched for the yacht.

celebrity diseases

55

But by the time Dandy was found and taken to an airport, Gershwins doctors
felt they could wait no longer to operate, so an eminent local neurosurgeon was
called into perform the surgery. The operation began late on July 10; Gershwin
died five hours later, on July 11, never having regained consciousness.52
Radio announcers broke into network programming to announce the news of
Gershwins death. Large memorial services soon followed, included a nationally
broadcast concert featuring such musical luminaries as Irving Berlin, Cole
Porter, and Bing Crosby. While obituaries duly noted that Gershwin had died
from a brain tumor, none made an effort to acquaint readers with the nature of
cancer in general or brain tumors in particular, a reluctance consistent with the
cancerphobia widespread in the 1930s. Nor did Gershwins story inspire the
same clear-cut character lessons that would later dominate media portrayals of
Lou Gehrig.53
The music critics assigned the task of writing Gershwins obituaries were highly
ambivalent about his work. Some hailed his passing as evidence of Jazz Ages passing, while others used the occasion to deride his ambition to leave Broadway
behind and write serious music. Fittingly he died working for Sam Goldwyn, as
an editorial commented in Commonweal. A memorial concert on the first anniversary of his death prompted another critic to complain that the audience
hummed along with the Rhapsody in Blue and American in Paris, but to
rejoice that the rest of the evening was Gershwin at his best; not the Gershwin of
symphonic gropings and inexpert orchestrations, but the Gershwin of effortless,
ingratiating song, in musicomedy and cinema. Concluding that he had done his
best work in the 1920s, another concluded, This is a book we may close and say,
in the idiom of its best pages, So hes gone, and let him go, and God bless him.54
Nor did Warner Bros. 1945 film version of Gershwins life, Rhapsody in Blue,
immortalize its subject as successfully as Pride of the Yankees did Gehrigs. The
leading role was played not by a superstar such as Gary Cooper, but a relatively
unknown Italian American actor named Robert Alda, who as one critic
observed, was much less virile, eloquent and Jewish than Gershwin. The films
appeal rested largely on the performances of Gershwins music by his friends
and colleagues, including Oscar Levant, Paul Whiteman, and Al Jolson. As with
Pride of the Yankees, the plot depended on the audiences knowledge that
Gershwin was doomed to die young; many scenes invoked the theme of the creative genius burning himself out. Aldas portrayal of Gershwins final months was
slightly more detailed than Coopers of Gehrig; he clutched his head and
showed emotional distress briefly before collapsing at the piano, but the words
cancer and tumor were never spoken. Nor did reviews fill in the details; as
one in Commonweal noted, the film thankfully does not dwell on Gershwins
untimely death.55
In a more indirect way, Gershwins death contributed to the making of a far
more famous film about a person dying of cancer, the 1939 Dark Victory. Based
on an earlier Broadway play, the screenplay about an aimless young socialite

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an emerging genre

named Judith Traherne who develops a brain tumor had been circulating
around Hollywood for some time. While several studios and actresses had
expressed an interest in it, the controversial cancer subject matter seemed too
difficult to handle; told that his leading woman star Bette Davis wanted to do the
film, Jack Warner supposedly refused, saying Who is going to want to see a picture about a girl who dies?56
Although Daviss memoirs made no reference to it, it is likely the publicity surrounding Gershwins death played a role in her eventual triumph over Warners
objections. The screenplay bears out this conjecture, for in an important early
scene, screenwriter Casey Robinson used Gershwins story to explain a key element of the plot, namely why the doctor-hero Frederick Steele was giving up his
lucrative practice in brain surgery to go do cancer research in Vermont.
Standing over his desk, Steele tosses a florists bill at a medical colleague, saying
it is for flowers for my last patient . . . a gifted young composer. He continues,
The night before the operation, he started to write a new song and, well, maybe
you read the papers . . . The operation was a brilliant success, but the patient just
happened to die. While Robinson took creative license with the facts of
Gershwins last hours (he was in no condition to be composing a song the night
before his operation), the exaggeration served to better characterize a brain
tumor as a suitable affliction for a highly creative person.57
Perhaps indirectly, then, Gershwins death facilitated the making of the first
major motion picture to focus on a doomed cancer patients experience. To be
sure, other characters had died on screen many times over, but not from cancer,
and not with such a combination of clinical detail and emotional intensity. Viewed
even today, after films such as Love Story and Terms of Endearment have familiarized
audiences with more clinical portrayals of death by cancer, the film still packs
quite an impressive emotional wallop. Like Coopers performance as Gehrig,
Bette Daviss portrayal of Judith Traherne carries the film. Already a two-time
Oscar winner when she made the film, the role of Traherne became one of her
most famous, and her own personal favorite. Although Davis always looks lovely,
her portrayal of physical and emotional torment is much more detailed than
Garbos in Camille. With the camera work helping the audience share her bouts
with doubled and then fading eyesight, Davis appears vulnerable and frightened,
especially in the hospital scenes. Angry at her fate, she behaves less than nobly
before redeeming herself in the last part of the picture. Moreover, Dark Victory
makes an effort to educate the audience about the nature of Judiths affliction. To
be sure, the clinical exegesis is brief, and as befit medical propriety in the 1930s,
comes not from the lay characters in the film, but from Judiths doctor-lover,
Frederick Steele. Still, in comparison to films such as Camille or Pride of the Yankees,
the films direct discussion of disease process is quite striking.58
Casting the heroic patient-sufferer as a beautiful woman clearly facilitated this
frankness. Dark Victorys unusual story line reflected the interwar genre of the
womans film, that is, a film centered on a female heroine designed to appeal

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57

to female audiences. Its success set other studios to copying the formula, using
other diseases and other actresses, but with less critical and popular success.
While Dark Victory marked a milestone in film treatments of terminal disease, its
possibilities for replication remained limited by the formula of the womans
film. Still, the films success may well have helped contribute to a lessening of
cancers stigma, at least for women.
Dark Victory appeared at a time when public reticence about discussing cancer
was beginning to abate. In 1936, the American Society for the Control of Cancer
(later renamed the American Cancer Society) founded its Womens Field Army
to develop a more aggressive and emotionally appealing program of education
for the general public, as one contemporary account explained. Lacking any
presidents or athletes willing to participate in its fledgling publicity campaigns,
cancer societies instead started in 1938 to found Cured Cancer Clubs, composed of ordinary people willing to be publicly identified as cancer survivors.
While not as successful as the polio poster child campaign, the club idea represented a concerted effort to break down what one contemporary described as
the fear complex surrounding cancer. In the late 1940s and 1950s, the cancer
experiences of other celebrities, including sports stars such as Babe Ruth and
Babe Dedrickson Zaharias, would gradually begin to attract more publicity to
the anti-cancer crusade.59

Legacies
As these interwar episodes suggest, the advent of radio and sound pictures
opened up new possibilities for using the lives of famous people to explore the
personal and cultural meanings of dread disease. This process was by no means
a straightforward reproduction either of celebrity experience or disease patterns. In traditional print media as well as in the new moving pictures, journalists shied away from explicit references to symptoms, emphasizing character
lessons rather than clinical explanations. Clearly the gender of the sufferer was
very important. The best-known real life celebrity patients of the interwar
period were all men; the two most famous, Roosevelt and Gehrig, both faced
forms of paralysis, perhaps a fitting affliction for a generation of American men
struggling to survive the Great Depression. Their real life sagas neatly fit popular culture plot lines favoring men of action brought low by an unearned fate
that allows them to become heroes. In contrast, the best-known women celebrity
patients were fictional characters played by famous (and healthy) screen stars,
Greta Garbos Marguerite Gautier and Bette Daviss Judith Traherne.
Whether in real life or film, narratives about famous patients addressed a common set of collective anxieties and fears: while modern society glorified the
importance of individual success, it guaranteed no exemption from the unpredictability of fate. For celebrity patients, this uncontrollable fate was embodied

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an emerging genre

in a mysterious and potentially fatal disease that, science, for all its many
advances, could not explain. By bravely facing up to their undeserved and
unavoidable bad breaks, to use Gehrigs term, celebrity patients provided a
new kind of secularized model to replace the saintly patients and good deaths
featured in an older, religiously oriented literature. The new modern American
needed new modern models of how to bear up under physical debility and
emotional pain. Watching famous people, already admired and liked for their
accomplishments, grapple gracefully with the worst life could offer, either in
real life or in a well-done screenplay, filled a deep-seated need for reassurance.
At the same time, these mass mediated versions of disease and death were
heavily edited, either by disguising the extent of the persons debility, or having
a healthy actress portray the progress toward death while looking fabulous in an
evening gown. Thus, ironically, they probably contributed to a different sort of
anxiety, namely the sort that ordinary people afflicted with polio, ALS, or cancer might feel when their own experience proved to be the opposite of glamorous. The celebrity disease phenomena had another drawback as well: the
ailments deemed appropriate to deliver reassuring or character building messages were not necessarily the most common ones. For example, among infectious diseases, TB was still by far the more common cause of death in the 1930s,
yet the anti-TB societies found themselves thoroughly overshadowed by the dramatic appeal of polio. Seemingly by chance, a mysterious epidemic disease targeting innocent children had a charismatic, well-connected adult victim in the
White House, just as radio and newsreels made possible a new kind of celebrity
disease crusade. Just as randomly, Lou Gehrigs appeal as a celebrity patient spotlighted an ailment so rare and mysterious that it was unable to move out of
polios celebrity shadow.
Other vagaries of the interwar celebrity disease culture are worth noting for
future study. For example, the interwar period produced a number of compelling films about mental illness and alcoholism, such as The Snake Pit and The
Lost Weekend, yet celebrities suffering from mental illness or alcoholism did not
eagerly step forth to serve as celebrity spokespeople for groups trying to combat
the stigma of either affliction. Similarly, when Surgeon General Thomas Parran
embarked on his pathbreaking campaign to publicize venereal disease in the
late 1930s, he did not attempt to recruit famous people who had suffered from
syphilis or gonorrhea. Instead, the celebrity spokesman for the anti-VD campaign became the African American boxer Joe Louis, who would knock out
syphilis, a choice that reflects the deep-seated racism of the era, which associated
people of color with sexually transmitted diseases. (The infamous Tuskegee
syphilis study was begun in the same era.) Meanwhile, cardiovascular disease,
the most common cause of death in the interwar period, remained largely neglected. Heart attacks and strokes simply did not lend themselves to the same
kind of dramatic popular crusades or Hollywood treatments given to other, less
common ailments.60

celebrity diseases

59

Even as they hailed the power of the new mass media to focus awareness on
important health problems, interwar commentators sensed the drawbacks of the
new celebrity-style disease advocacy. As more disease causes vied for publicity,
their appeals began to compete and overlap in confusing ways. As a 1941 article
on cancer education asked, With each leaflet, radio program, or other item,
questions must be asked: Will this catch the interest of the public? Will it reassure, rather than frighten? Is it certain not to precipitate morbid, neurotic concerns with disease? Will it encourage [a] reasonable optimist? As the celebrity
endorsements became more common, cynics noted how little the movie stars
appearing at fundraising parties actually knew about the disease they were raising money to fight. By the 1940s, the custom of celebrity endorsements had
become such a part of the Hollywood image-making scene that the comedian
George Gobel could joke that if he doesnt find a cause to plug soon, all the
good diseases will be taken.61
With the advent of television, these vagaries and contradictions only multiplied.
The celebrity-studded telethon, first used by Jerry Lewis in 1966 to raise funds for
the Muscular Dystrophy Association, ushered in a new and powerful form of
fundraising. The growing demand for television programming facilitated not only
the rebroadcast of Hollywood classic films, such as Camille and Pride of the Yankees,
but also the multiplication of made-for-TV movies based on the me and my disease formula. Similarly, cable television in the 1980s and the Internet in the mid1990s would further multiply the avenues for celebrity disease advocacy.
These media transformations helped further to erode the concepts of privacy
and revulsion at clinical detail still evident in interwar portrayals of life-threatening
diseases. Since the 1970s, Americans have grown increasingly used to more
graphic, medically sophisticated discussions of disease process and symptom.
This in turn has facilitated a dramatic expansion in both disease advocacy and the
entertainment value of the me and my disease storyline. The power of the right
celebrity, cause, and publicity vehicle has only intensified since the time when
Franklin Delano Roosevelt pioneered the role of celebrity disease advocate.
Indeed, due to the heightened power of mass media, celebrity appeals nowadays produce results far more powerful than the interwar cases discussed here.
Diagnostic centers can anticipate a spike in screening requests for diseases after
a well-known person (or their spouse) discloses that they suffer from it. For
example, gastroenterologists reported a twenty-percent increase in colonoscopies after Today show co-host Katie Couric campaigned to promote early
screening for colon cancer. To combat the cancer that killed her husband in
1998, Couric underwent an on-air colonoscopy to convince her viewers that the
procedure was not painful. Likewise, actor Christopher Reeve, who suffered a
devastating spinal cord injury in a 1995 riding accident, became an effective
spokesperson for embryonic stem cell research, helping to convince the Bush
administration not to ban such research completely in 2001. Finally, celebrity
disease has become a potent marketing tool as pharmaceutical companies have

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an emerging genre

recruited famous people to appear in the direct-to-consumer advertisements for

prescription drugs. For example, seven time winner of the Tour de France and
cancer survivor Lance Armstrong now appears in Bristol-Myers-Squibbs promotions for the prostate cancer drugs that saved his life.62
Without diminishing their accomplishments, the power that celebrities such
as Couric, Reeve, and Armstrong can wield in both popular and public realms
of disease awareness has its drawbacks. In a world of finite resources, the
celebritys ability to influence media time, public willingness to get screenings,
federal research policy, and prescription drug choices is valuable indeed; but
letting a star system based in politics, sports, and entertainment affect the distribution of those resources is not likely to be either fair or rational. The growing importance of the celebrity disease phenomena inevitably contributes to
the confused, fragmented way that health care priorities are currently set.
Advocates for the disabled also point to the ways that celebrity crusades reinforce rather than diminish the stigma attached to being differently-abled.
A case in point is Jerry Lewis, who activists accuse of promoting in his telethons
profoundly demeaning and patronizing views of the very group he supposedly
wants to help. Other critics take issue with the exploitative features of the
poster child strategy dating back to the interwar polio campaign, noting that
it creates a compound of pity, fear, and hope that burdens people who have
disabilities.63
For all their intent to inspire and reassure, celebrity patient sagas inevitably
create unrealistic expectations. People with life threatening ailments may feel
that they will never live up to the heroic narratives popularized by disease advocacy campaigns and feature filmmakers since the 1930s. However sensitive or
well done, no mass mediated representation can ever do justice to the bodily
and emotional pain suffered by the individual or family facing the end stages of
a disease such as AIDS, cancer, or ALS. Thus patient and family members alike
tend to feel inadequate when measured against these narratives, which make
ones inability to stand pain gracefully, endure the frustrations of debility, or
win the battle against death all the more difficult to accept.64
In 1955, writing about the anti-polio movement, Victor Cohn observed, The
drives for funds to prolong life and happiness will often be attacked as multipliers of fear, he wrote, but We might thank them instead for arousing our
consciences. Fifty years later, the celebrity disease phenomena present no less a
sense of mixed blessings. Still, such is the power of celebrity in modern
American culture that its links with dread disease are little likely to disappear.
The fundamental tension they reflectbetween the glorification of individual
achievement and the unpredictable nature of undeserved diseaseensure that
we will continue to be fascinated by celebrity disease stories. Our only choice
is to become more critically aware of that power, especially by tending to
those people and diseases that the fickle dynamics of celebrity inevitably leave
overlooked.65

celebrity diseases

61

Notes
1. Grantland Rice quoted in [anonymous], King Matty, Journal of the Outdoor Life
20:8 (August 1923), 29091; quotes are on p. 290. One of Gehrigs biographers
claimed that Gehrig was possibly the first victim to have a disease named after him,
a macabre form of immortality. See Ray Robinson, Iron Horse: Lou Gehrig in His Time
(New York: W. W. Norton and Co., 1990), 259. In fact, that distinction belongs to a
Mrs. Mortimer, for whom Mortimers disease, a form of lupus vulgaris, was named
in 1898. Diseases named after the patients who suffered from them, as opposed to
the physicians who discovered them, are quite rare; of the four listed in Wikipedia,
Gehrigs disease is the only one widely known. They include, in addition to
Mortimers disease, Christmas Disease, a type of hemophilia named in 1952, and
Hartnups disease, a genetic disorder named in 1956.
2. I completed this essay without having read Barron Lerner, When Illness Goes
Public: Celebrity Patients and How We Look at Medicine (Baltimore, MD: Johns Hopkins
University Press, 2006), a new, in-depth look at the celebrity patient phenomena.
While I anticipate that our arguments will be complementary, I trust this essay still
performs a useful service in its focus on the transition from print to electronic mass
culture, and the interplay among different types of media. For a more contemporary
work on celebrities and disease, see Paula A. Treichler, How to Have Theory in an
Epidemic: Cultural Chronicles of AIDS (Durham, NC: Duke University Press, 1999.)
Sociologists have begun to look at the role of celebrities in social movements more
generally. See, for example, David S. Meyer and Joshua Gamson, The Challenge of
Cultural Elites: Celebrities and Social Movements, Sociological Inquiry 65:2 (May
1995), 181206.
3. In choosing the cases for this essay, I make no pretense of having been comprehensive in my coverage of the many representations of disease to be found in interwar educational films, newsreels, and feature films. I exclude important film genres,
including health educational films and popular films with doctors as main characters, that did much to shape popular attitudes toward medicine and disease. (Other
essays in this volume do look at those issues.) Because I am interested in how the
celebrity disease phenomena represented an unhinging of medical from lay interests, I deliberately looked for narratives centered on the experiences of famous
patients rather than doctors. My criteria for selection were simple: someone already
famous in some popular domain (politics, sports, or entertainment) had to be
stricken with a catastrophic illness; their illness and its outcome had to be considered
national news; and moving pictures had to play some central role in the media portrayal of their illness.
4. I am not arguing here that famous womens illnesses were entirely overlooked in
the early 1900s, but that they did not attract the same degree of media attention.
One woman who comes to mind as a possible exception is Helen Keller. But her case
is not like those of Roosevelt, Gehrig, and Gershwin, in that she was not famous at
the time she became ill, but became so only two decades later. Still, I think her story
reflects the same general trends toward a new kind of patient-centered illness narrative that I describe in this paper. On Kellers life, see Dorothy Herrmann, Helen
Keller: A Life (New York: Alfred A. Knopf, 1998). Note that in Noel Fabricant, 13
Famous Patients (New York: Chilton Co., 1960) all the patients were men; they
included Gershwin and Roosevelt, along with Hitler, Freud, and Gandhi.

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an emerging genre

5. I explore related issues about cultural mechanisms of attention in my article,

Epidemic Entertainments: Disease and Popular Culture in Early-Twentieth Century
America, American Literary History 14:4 (Winter 2002), 62552.
6. Charles L. Ponce de Leon, Self-Exposure: Human-Interest Journalism and the
Emergence of Celebrity in America, 18901940 (Chapel Hill, NC: University of North
Carolina Press, 2002), 13. The subject of celebrity has attracted considerable scholarly attention in recent years. Among the works I found useful in thinking about the
celebrity disease phenomena were: Leo Braudy, The Frenzy of Renown: Fame and Its
History (New York: Oxford University Press, 1986); Gary Alan Fine, Difficult
Reputations: Collective Memories of the Evil, Inept, and Controversial (Chicago: University
of Chicago Press, 2001); Jib Fowles, Starstruck: Celebrity Performers and the American
Public (Washington, D.C.: Smithsonian Institution Press, 1992); P. David Marshall,
Celebrity and Power: Fame in Contemporary Culture (Minneapolis: University of
Minnesota Press, 1997); and Ponce de Leon, Self-Exposure. Richard Brookhiser
argues that George Washington was the first modern celebrity in Celebrity
Conquers America, American Heritage 49:4 (July/August 1998), 3037. On the antebellum penny presss widening of newsworthy characters, see Patricia Cline Cohen,
The Murder of Helen Jewett (New York: Alfred A. Knopf, 1998), and Andie Tucher, Froth
and Scum: Truth, Beauty, Goodness, and the Ax Murder in Americas First Mass Medium
(Chapel Hill: University of North Carolina Press, 1994). On changing notions of privacy in relation to disease, see the excellent essay by Amy Fairchild, The
Democratization of Privacy: Public-Health Surveillance and Changing Conceptions
of Privacy in Twentieth-Century America, in History and Health Policy in the United
States: Putting the Past Back In, eds. Rosemary Stevens, Charles E. Rosenberg, and
Lawton R. Burns (New Brunswick, NJ: Rutgers University Press, 2006), pp. 11129.
7. My conception of electric celebrity is obviously indebted to Marshall
McLuhan. See Marshall McLuhan, Understanding Media: The Extensions of Man, with
an introduction by Lewis H. Lapham (Cambridge, MA: MIT. Press, 1994). In studies
of celebrity culture, film has received far more attention than radio, although the latter medium is starting to attract more attention. See Michelle Hilmes and Jason
Loviglio, eds., Radio Reader: Essays in the Cultural History of Radio (New York:
Routledge, 2002).
8. The new ferocity of interwar celebrity coverage, particularly in the Lindbergh
case, is well documented by Ponce de Leon, Self-Exposure. On the Arbuckle scandal,
see Fatty Arbuckle and the Creation of Public Attention, in Fine, Difficult
Reputations, pp. 13066. On the case of Mabel Normand, see note 20.
9. Rochelle Gurstein, The Repeal of Reticence (New York: Hill and Wang, 1996) and
Ponce de Leon, Self Exposure. The new journalism of the Pulitzer-Hearst era is not
to be confused with the new journalism of the 1960s and 1970s associated with
Tom Wolfe and Gay Talese. On traditional narratives of dying and death, see
Philippe Aries, The Hour of Our Death (New York: Alfred A. Knopf, 1981). On nineteenth century statesmens funerals, see John Wolffe, Great Deaths: Grieving, Religion,
and Nationhood in Victorian and Edwardian Britain (New York: Oxford University Press,
2000).
10. James Patterson, The Dread Disease: Cancer and Modern American Culture
(Cambridge, MA: Harvard University Press, 1987), esp. 111, 3637. On press coverage of Presidential illnesses, see Kenneth R. Crispell and Carlos F. Gomez, Hidden
Illness in the White House (Durham, NC: Duke University Press, 1988); Robert
H. Ferrell, Ill-Advised: Presidential Health and Public Trust (Columbia, MO: University

celebrity diseases

63

of Missouri Press, 1992); and Robert E. Gilbert, The Mortal Presidency: Illness and
Anguish in the White House (New York: Basic Books, 1992). On the Wilson case, see
also John Milton Cooper, Disability in the White House: The Case of Woodrow
Wilson, in The White House: The First Two Hundred Years, eds. Frank Freidel and
William Pencak (Boston: Northeastern University Press, 1994), pp. 7599. On Tafts
weight loss program, see Deborah Levine, Patient Narrative and Obesity: President
William H. Tafts Letters with His Physician, 19001915, paper delivered at the
annual meeting of the American Association for the History of Medicine, May 2006.
11. On the intersection of popular health education and advertising, see Nancy
Tomes, The Gospel of Germs: Men, Women, and the Microbe in American Life (Cambridge,
MA: Harvard University Press, 1998), esp. 11723, 16168; and Tomes, Epidemic
Entertainments, esp. 63842. On advertisings role in expanding print discussions
of bodily functions, see Jackson Lears, Fables of Abundance: A Cultural History of
Advertising in America (New York: Basic Books, 1994), esp. 16295. On the widening
discourse about bowel functions, see James C. Whorton, Inner Hygiene: Constipation
and the Pursuit of Health in Modern Society (New York: Oxford University Press, 2000).
On the hygiene of menstruation, see Joan Jacobs Brumberg, The Body Project: An
Intimate History of American Girls (New York: Random House, 1997), esp. 2955.
12. On the sanitarians invocation of deaths in famous peoples families, see Tomes,
Gospel of Germs, 4852. On the use of testimonials in advertising, see Roland
Marchand, Advertising the American Dream: Making Way for Modernity, 19201940
(Berkeley, CA: University of California Press, 1985), 96100, and Kathy Peiss, Hope
in a Jar: The Making of Americas Beauty Culture (New York: Metropolitan Books/Henry
Hold and Co., Inc, 1998), 13740, 17475.
13. For a good introduction to the repellent subjects provisions in the Hays Code,
see Susan E. Lederer, Repellent Subjects: Hollywood Censorship and Surgical
Images in the 1930s, Literature and Medicine 17 (1998): 91113.
14. Tomes, Gospel of Germs, 11334. The use of local and national celebrities is amply
documented in the associations publication, Journal of the Outdoor Life. At its founding in 1904, the society was called the National Association for the Study and
Prevention of Tuberculosis. The name was shortened to the NTA in 1918; it became
the American Lung Association in the 1950s.
15. Trudeaus story was often featured in anti-TB literature; his autobiography nicely
illustrates the physician-patient style of narrative. See Edward Trudeau, An
Autobiography (New York: Doubleday Page, 1916). Lawrence Flick, founder in 1892
of the first anti-TB society, the Pennsylvania Society for the Prevention of
Tuberculosis, was another recovered doctor-consumptive.
16. Nina Wilcox Putnam, How Do They Get That Weigh? Journal of the Outdoor Life
19:10 (October 1922), 34042, and 19:11 (November 1922), 37175. It was
reprinted from the Saturday Evening Post of May 13, 1922. Quotes are from pp. 340,
342. Camille was filmed five times between 1917 and 1936, according to James
P. Cunningham, Camille, The Commonweal 25:14 (January 29, 1937), 388.
17. Grantland Rice quoted in King Matty, p. 290. For a short summary of his
career, see Christy Mathewson, www.BaseballLibrary.com, downloaded September 13,
2003.
18. John Daly, Matty Wins Again, Journal of the Outdoor Life 19:9 (September
1922), 3045. The quote is from p. 304.
19. The articles included King Matty, Daly, Matty Wins Again, and Mattys
Beating This Game, Journal of the Outdoor Life 18:4 (April 1921), 91.

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an emerging genre

20. Helena Lorenz Williams, The Come-Back of Christy Mathewson, Journal of the
Outdoor Life 21:2 (February 1924); quotes are from pp. 7576, 82.
21. The case of film star Mabel Normand makes for an interesting contrast to the
Mathewson story. Famous for her work with director Mack Sennet and actor Charlie
Chaplin in the early Keystone Kop comedies, Normand did her best-known work
after she was diagnosed with TB in the 1910s. But her wild lifestyle and eventual association with scandal, including two different murder cases, probably made her an
unappealing candidate for celebrity spokesperson. Her illness was discussed in the
influential fan magazine Photoplay, which referred to Normands impending death
from TB as the final chapter in the life of a tragic, helpless little figurethe most
tragic of all Hollywoods broken idols. See Adela Rogers St. John, The Butterfly
Man and the Little Clown, Photoplay, July 1929, reprinted in Barbara Gelman, ed.,
Photoplay Treasury (New York: Bonanza Books, 1984), 13638; quote is on p. 136. See
also James R. Quick, Mabel Normand says Goodbye, Photoplay, July 1929, Ibid,
18284.
22. On the changing image of TB, see Barron Lerner, Contagion and Confinement:
Controlling Tuberculosis Along the Skid Row (Baltimore, MD: Johns Hopkins University
Press, 1998).
23. Camille: Rebirth in Pictures, New Republic, March 24, 1937, 211; Camille,
Time, January 18, 1937, 24. In their fine 1993 documentary The Peoples Plague,
Diane Garey and Lawrence R. Holt contrasted scenes from Camille with pictures of
actual TB patients to underline the films unrealistic portrait of the disease. Censors
guidelines, which forbade the inclusion of graphic detail thought to be too sensational, may well have played a role in limiting the clinical realism of interwar feature films. On the censors and medical issues, see Lederer, Repellent Subjects;
Susan E. Lederer and John Parascandola, Screening Syphilis, Journal of the History
of Medicine 53 (1998): 34570; and Martin S. Pernick, The Black Stork (New York:
Oxford University Press, 1996).
24. Camille: Rebirth in Pictures, 211.
25. My account of Roosevelts celebrity patient experience is heavily indebted to
Hugh Gallagher, FDRs Splendid Deception (New York: Dodd, Mead & Co., 1985).
26. The best single volume biography is still Frank Freidel, Franklin D. Roosevelt:
A Rendezvous with Destiny (Boston: Little, Brown, 1990). On the 1916 polio epidemic,
see Naomi Rogers, Dirt and Disease: Polio before FDR (New Brunswick, NJ: Rutgers
University Press, 1992).
27. For accounts of these incidents, see Gallagher, Splendid Deception, pp. 1719,
3444.
28. Gallagher uses the phrase a bit lame on p. 96. On Roosevelts advantage in
using the radio, see Gallagher, pp. 9293; on the problems he faced with film, see
pp. 9396. For all the clever ramping and stage management done in both Albany
and Washington, the extent of his disability had to be evident on many an occasion,
including the very public fall he took at the 1936 Democratic Convention on the way
to deliver his acceptance speech. And despite his reputation as a skilled manipulator
of the media, Roosevelt had a very contentious relationship with the press, who were
little inclined to give him an easy time.
29. Victor Cohn, Four Billion Dimes (Minneapolis: Minneapolis Star and Tribune
Press, 1955), 33. The incident with the newsreel reporter is cited in Gallagher,
pp. 9394. The story first appeared in John Gunther, Roosevelt in Retrospect (New York:
Harper, 1950). On the newsreel, see Raymond Fielding, The American Newsreel,

celebrity diseases

65

19111967 (Norman, OK: University of Oklahoma Press, 1972), and Raymond

Fielding, The March of Time, 19351951 (New York: Oxford University Press, 1978).
30. Quoted in Gallagher, Splendid Deception, 146.
31. For the history of the NFIP and the March of Dimes, see Gallagher, F.D.R.s
Splendid Deception, 14552; David Oshinsky, Polio: An American Story (New York:
Oxford University Press), esp. 4360; Tony Gould, A Summer Plague: Polio and Its
Survivors (New Haven, CT: Yale University Press, 5484; and Jane Smith, Patenting the
Sun: Polio and the Salk Vaccine, 7276. The Foundation changed its name to The
March of Dimes in 1978, a move that reflected its shift to a broader focus on birth
defects.
32. Cohn, Four Million Dimes, 44; Show Biz Aided Plenty for B.O. at F.D.R. Fetes,
Variety February 2, 1938, p. 2. On the Birthday Balls, see Gallagher, F.D.R.s Splendid
Deception, 14648; Gould, A Summer Plague, 6061, 63, 72; and Oshinsky, Polio, 4754.
33. On the March of Dimes, see Cohn, Four Million Dimes, 5153; Gallagher, F.D.R.s
Splendid Deception, 15052. On the need to distance the anti-polio movement from an
increasingly controversial president, see Gould, A Summer Plague, 7274.
34. Christys illustration is described in Cohn, Four Million Dimes, 61. The use of
poster children began in the 1940s. See Oshinsky, Polio, esp. 8283. See also the website developed in conjunction with the NPR series produced by Laurie Block,
Beyond Affliction: Inventing The Poster Child at http://www.npr.org/programs/
disability. Downloaded on September 13, 2003.
35. Thank you, Audience! Your Dimes Helped, Paramount News, January 1, 1944;
No. 200 PN 3.53, Motion Picture, Sound and Video Unit, NARA; Cohn, Four Million
Dimes, 61.
36. Sunrise at Campobello, at www.geocities.com/arojann.geo/campobello.html,
accessed August 8, 2008. Both the play and film versions provide a romanticized
account of Roosevelts bout with polio, ending with his famous Happy Warrior
speech nominating Al Smith for president in 1924.
37. Iron Horse, Time, May 15, 1939, 32; Lou Gehrig, Current Biography, ed.
Maxine Block (New York: H. W. Wilson Col., 1940), 33032, quote on p. 332. My
account here is based primarily on Ray Robinson, Iron Horse: Lou Gehrig in His Time
(New York: W. W. Norton and Co., 1990). Since completing this article, a new biography of Gehrig has been published, Johnathan Eig, The Luckiest Man: The Life and
Death of Lou Gehrig (New York: Simon and Schuster, 2005).
38. Iron Horse, 33; Frank Graham, Lou Gehrig: A Quiet Hero (New York: G. P. Putnams
Sons, 1942), 206.
39. Eleanor Gehrig and Joseph Durso, My Luke and I (New York: Thomas Y. Crowell
Co., 1976), 6; Graham, Lou Gehrig, 207. Harbeins letter is reprinted in Robinson,
Iron Horse, 258. The Mayo Clinic developed what was then a new approach, the medical group practice in which patients could be seen by specialists in every field.
40. Robinson, Iron Horse, 264; Graham, Lou Gehrig, 219. The reference to Gehrigs
speech as baseballs Gettysburg address line appears in Robinson, Iron Horse, 264.
The guest list appears on 262.
41. Lou Gehrig, Current Biography, 332. For a contemporary account of the reaction to Gehrigs death, see In Memoriam, Time, June 16, 1941, 63. For details
about the funeral, see also Robinson, Iron Horse, 27374.
42. Graham, Quiet Hero, 208.
43. For a discussion of this incident, see Robinson, Iron Horse, 26970. Fifty years
later, an episode of the television situation comedy Seinfeld had the character of

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an emerging genre

George, who works for the Yankees, fear he will catch ALS by putting on Gehrigs
uniform. My thanks to Ziv Eisenberg for bringing this episode to my attention.
44. For details of his treatment and correspondence with other patients, see
Robinson, Iron Horse, 259.
45. Pride of the Yankees, Time August 3 1942, 74; Manny Farber, The Hero, New
Republic, October 18, 1943, 521.
46. Pride of the Yankees, 74. On the making of the movie, see Robinson, Iron
Horse, 27578. The sportswriters crack about throwing like a woman is on p. 277.
47. Two Strikes, The Commonweal, July 31, 1942, 35253; quote on p. 352.
48. The tradition of rerunning Pride of the Yankees every spring and servicemens
requests to have Cooper repeat Gehrigs speech are both mentioned in Robinson,
Iron Horse, 278.
49. I consulted the following biographies of Gershwin: David Ewen, George Gershwin:
His Journey to Greatness (Englewood Cliffs, NJ: Prentice-Hall, Inc., 1970); Edward
Jablonski, Gershwin: A Biography (New York: Doubleday, 1987); Edward Jablonski and
Lawrence D. Stewart, The Gershwin Years (Garden City, NY: Doubleday, 1973); and
Charles Schwartz, Gershwin: His Life and Music (New York: The Bobbs-Merrill Co.,
Inc., 1973) For a good summary of the varied criticisms Gershwins work provoked,
see Jablonski, George Gershwin, xixv.
50. For an account of Gershwins move to Hollywood, see Jablonski, Gershwin,
292320.
51. Gershwins final illness has been recounted many times in many places. The bestdocumented account is in Jablonski, Gershwin, 310, 314, 31825. Additional detail is
provided in Schwartz, 28082. Gershwins personal assistant Paul Mueller wondered
if the strange electrical gadget that he used to combat his hair loss may have caused
the brain tumor. See Jablonski and Stewart, The Gershwin Years, 26223, 295.
52. See Jablonski, Gershwin, 32223. Note the details of the frantic search for Dandy
were widely reported at the time. See for example George Gershwin Who
Rhapsodized Jazz Dies in Hollywood at Age of 38, Variety, July 14, 1937, 53.
Gershwins brain tumor has continued to interest physicians. See for example
Fabricant, 13 Famous Patients, 193201; and Louis Carp, George GershwinIllustrious American Composer: His Fatal Glioblastoma, in American Journal of
Surgical Pathology 3:5 (October 1979), 47377.
53. On the cancerphobia of this era, see Patterson, Dread Disease, esp. 11113. He
notes that in 1937, graphic photographs published in a Life magazine article about
cancer provoked protests from angry readers who claimed to be revolted by the
subject.
54. [Editorial], The Commonweal, July 23, 1937, 316; The Man I Love, New Republic,
July 21, 1937, 29394; quote on p. 294.
55. Manny Farber, Plenty of Nothin, New Republic, July 23, 1945, 103; Fascinating
Rhythms, The Commonweal, July 6, 1945, 286. Like Pride of the Yankees, the movie had
celebrity friends of Gershwin play themselves, including the pianist Oscar Levant and
orchestra leader Paul Whiteman. On the making of the film, see Ewen, George
Gershwin, 3056. Gershwin fans tend to think the best film tribute to him was An
American in Paris, the 1951 musical starring Gene Kelly, which won the Academy
Award for best picture. See Ewen, George Gershwin, 3067; Jablonski and Stewart, The
Gershwin Years, 317.

celebrity diseases

67

56. The history of the play and the film are given in Bernard F. Dick, Introduction:
The Art of Dying Well, Dark Victory (Madison, WI: University of Wisconsin Press,
1981), 942. The Warner quote is given on p. 18.
57. Dick, Dark Victory, 75.
58. On Daviss work in Dark Victory, see Barbara Leaming, Bette Davis: A Biography
(New York: Simon and Schuster, 1992), 15764. On the films unusual frankness
about cancer, see Dick, Dark Victory, 3538.
59. Cancer Contest Winners, Hygeia 19 (January 1941), 2527, 6667; quote is on
p. 25; Isaac F. Marcosson, Cured Cancer Club, Hygeia 17 (1939): 69496. Gretchen
Kruegers work on childhood cancer suggests interesting parallels to the polio
poster child phenomena: as she shows, cases involving children with cancer were
among the first to attract popular attention. The story of journalist John Gunthers
son, who died of a rare brain tumor in 1947, became one of the earliest cancer memoirs. See Gretchen Krueger, Death Be Not Proud: Chdilren, Families, and Cancer in
Postwar America, Bulletin of the History of Medicine 78 (2004): 83663.
60. There has been little work on movie treatments of mental illness, other than
Krin Gabbard and Glen O. Gabbard, Psychiatry at the Cinema, 2nd ed. (New York:
American Psychiatric Press, 1999). On Parrans anti-syphilis campaign, see Allan
Brandt, No Magic Bullet (New York: Oxford Press, 1987), 12260. On Joe Louis, see
Lauren Rebecca Sklaroff, Constructing G. I. Joe Louis: Cultural Solutions to the
Negro Problem during World War II, Journal of American History 89:3 (December
2002), 95883.
61. Cancer Contest Winners, 25; Gobel is quoted in Cohn, Four Million Dimes, 127.
Smith, Patenting the Sun, 8283, discusses the criticisms of the NIPFs publicity
techniques.
62. On Couric, see John ONeill, Lining Up for Healthy Colons, New York Times,
July 15, 2002, F6. On Reeves advocacy, see Jerome Groopman, The Reeve Effect,
New Yorker, November 10, 2003.
63. Quote is from Laurie Block, Beyond Affliction: Inventing The Poster Child at
http://www.npr.org/programs/disability. Downloaded on September 13, 2003. See
also the very interesting essay by Rosemarie Garland Thomson, Seeing the Disabled:
Visual Rhetorics of Disability in Popular Photography, in The New Disability History,
ed. Paul K. Longmore and Lauri Umansky (New York: New York University Press,
2001), 33574.
64. The burdens of the traditional polio story are evident in accounts of post-polio
syndrome. See Gould, A Summer Plague, 20526.
65. Cohn, Four Million Dimes, 134.

Part 2

Educational Entertainment,
Entertaining Education

Chapter Three

Syphilis at the Cinema

Medicine and Morals in VD Films of the U.S.
Public Health Service in World War II
John Parascandola
In a speech delivered in January 1999, Surgeon General David Satcher indicated
that while generals and admirals in the military rely on ships or aircraft or troops
as their source of power, the Surgeon General of the Public Health Service
relies on sciencethe best available scienceto manage and advance the
nations health. Dr. Satcher added that his recommendations to the administration and to the nation on health are always made on the basis of good, sound
science, and not on opinion, politics, or religious beliefs. Noting that this has
been a longstanding tradition of surgeons general of the past, he acknowledged,
It has not always been an easy task.1
It will come as no surprise to students of the history of medicine that it indeed
has not always been an easy task to establish public health policies on the basis
of scientific knowledge alone, without the intervention of social, political, economic, or religious considerations. In fact, history has shown that science cannot be completely separated from socioeconomic concerns with respect to
public policy decisions. This paper will try to illuminate this point by examining
the difficulties encountered by the U.S. Public Health Service (PHS) and one of
Dr. Satchers predecessors, Surgeon General Thomas Parran, in balancing medical and moral concerns in the PHSs venereal disease education campaign during World War II. The focus of the paper will be the venereal disease (VD)
education films produced or distributed by the PHS, with emphasis on the content of the films and the reaction to them rather than on form and production
issues.2
The PHS had been operating a VD program since World War I, when concern
over the number of army recruits infected with syphilis or gonorrhea led congress to enact a law which created a Venereal Disease Division in the PHS. With
the end of the war, congress lost interest in the venereal disease problem and

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funding for this purpose declined dramatically.3 Thomas Parran later wrote,
Congress apparently thought the spirochetes of syphilis were demobilized with
the army. As he put it, more accurately, no further thought whatever was given
to syphilis and the first national public health effort came to an untimely end.4
When Parran was appointed surgeon general of the PHS in 1936, however, he
wasted no time in launching a new national campaign against venereal disease.
Parran had served as chief of the PHS Venereal Disease Division earlier in his
career and had never lost interest in the subject. In the early 1930s, he was
detailed by the PHS to New York to serve as health commissioner of that state,
and he made venereal disease a priority of his administration. In one well-known
incident, Parran made headlines in 1934 when he canceled a radio address at
the last minute because he was told that he could not mention syphilis or gonorrhea by name on the air.5
Parrans articles in magazines and his 1937 best-selling book, Shadow on the
Land, were instrumental in breaking down the taboo in the popular press
against the frank discussion of venereal disease. He sought to focus the battle
against venereal disease on scientific and medical grounds, rather than placing
the major emphasis on moral or ethical views concerning sex.6 Parran certainly
did not completely ignore moral issues related to sex, but in the words of
historian Allan Brandt, Though he sought to avoid offending the social hygienists [who emphasized behavioral reform], Parran downplayed the moral
argument.7
Parran also played a key role in the passage of the National Venereal Disease
Control Act in 1938. The act provided federal funding through the PHS to the
states for venereal disease control programs, and supported research into the
treatment and prevention of venereal disease. As a part of its efforts to combat
venereal disease, the PHS launched an educational campaign that involved issuing posters, brochures, and other publications on the subject, a campaign that
was stepped up when the United States entered the war in December of 1941.
Motion picture films were among the weapons in the anti-VD arsenal developed
by the PHS during this period. In 1942, PHS physician James A. Dolce wrote to
a colleague, We feel very strongly that motion picture films are a most important medium for health education. He continued, well-written and produced
films not only command large audiences, but, as you know, actually instill more
information into observers than does any other teaching aid.8
The technology of the motion picture had been applied to medicine for
research and teaching purposes since the early days of cinematography. Health
education films were being produced in the United States in the years before
World War I, but the entrance of the country into the war served as a stimulus
to the creation of such films, especially for use by the military. Given concerns
about the impact of VD on the nations fighting men, it is not surprising that VD
education films were among those produced. The army collaborated with the
War Department Commission on Training Camp Activities and the American

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Social Hygiene Association, for example, in the production of motion pictures

about VD such as The End of the Road and Fit to Fight.9
Although by 1914 the Public Health Service was filming some of its activities,
such as quarantine and laboratory work, it appears that these efforts were
designed to create a record of this work rather than for use in organized teaching. When World War I ended, however, the PHS did become involved in the
screening, if not the production, of VD films. Modified versions of the army
films Fit to Fight (with its title changed to Fit to Win) and The End of the Road were
shown to civilian audiences under the auspices of the PHS. Controversy over the
showing of these motion pictures to general audiences, as well as attempts to
exploit their sexual content by some exhibitors, led to the federal government
turning over the responsibility for the screening of these films to the American
Social Hygiene Association.10
In 1921, the PHS authorized the Bray Studios to produce a series of films on
biology, communicable disease, and sex and personal hygiene for school children. The PHS provided the scenarios for these films, and also supervised their
production. A total of twelve motion pictures were produced in the series, which
was given the general title of The Science of Life. Included in this group were two
sex education films, Personal Hygiene for Young Women and Personal Hygiene for
Young Men. Consisting largely of titles interspersed with some pictorial material,
the sex education films focused on abstinence and control of sexual urges. Very
little attention is given to VD in these films, with no significant discussion of the
nature of venereal diseases and no mention of any form of prophylaxis.
Although The Science of Life series was widely used in American schools, the
films on sex hygiene were not (according to the producer) well received by
school authorities, who saw it as the role of the parent rather than the teacher
to instruct children about sex.11
As noted above, Thomas Parran initiated a vigorous campaign against VD
when he became surgeon general of the PHS in 1936. Just a year after he
assumed the office, Parran arranged for the PHS to collaborate with the
American Medical Association (AMA) in the production of Syphilis: A Motion
Picture Clinic (1937). This eighty-minute sound film, however, was not aimed at
the general public, but at clinicians. It consisted of several segments featuring
leading syphilologists lecturing on various aspects of the disease: essentially a
group of talking heads, with occasional visual presentations or demonstrations. PHS also released two silent VD films that year, Syphilis of the Central
Nervous System: A Preventable Disease (aimed at health professionals) and Syphilis:
Its Nature, Prevention and Treatment (aimed at lay audiences). The annual report
of the PHS for fiscal year 1938 indicated that this latter film was in great
demand.12
These early films were not very sophisticated from a cinematic point of view.
In the case of the film designed for lay audiences, Syphilis: Its Nature, Prevention,
and Treatment, a PHS staff member later called it amateur in nature. He also

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noted that although useful in its time, the film had become outdated and outmoded by 1940. It was silent, and has been described as a slide lecture rather
than a film. The fact that this film was in great demand in 1938 may be more
a reflection of the paucity of good VD education films for lay audiences than of
the quality of the product.13
In that same year, 1938, PHS produced a motion picture that made much better use of the film medium, Three Counties Against Syphilis. The film tells the story
of a PHS syphilis control program developed in 1937 in three counties in southeastern Georgia, aimed at rural African Americans. PHS sponsored a mobile
trailer clinic that traveled through these three rural counties and provided
blood tests and treatment for syphilis. The film documented the program, but
presumably could also have been used as a VD education film, to spread the
message that syphilis can be diagnosed and cured.
Recognizing that it was not in a position to develop professional-quality films
on its own, the PHS contracted with the Department of Agriculture (USDA) to
produce Three Counties Against Syphilis. A PHS staff member explained in 1937
that the USDA had a very complete motion picture unit upon which it spends
several hundred thousand dollars a year, and that its staff included people with
experience working for commercial film studios. He believed that PHS could
retain more control over the production and make the film more cheaply
through the USDA than by contracting with an industrial film company.14 It was
also at this time that the USDA commissioned documentary filmmaker Pare
Lorentzwhose critically-acclaimed film on the dust bowl crisis, The Plow that
Broke the Plains, had been released in 1936to produce a film on the Mississippi
River and flood control. The product delivered by Lorentz, The River (1937),
was, in the words of one film historian, well photographed, skillfully edited, and
enhanced by the rousing score from Virgil Thomson.15
The suggestion for making a film about the trailer clinic apparently came
from Raymond Vonderlehr, then head of the PHS Venereal Disease Division.
Vonderlehr also suggested that PHS use the opportunity, while filming the clinic
activities in Georgia, to shoot some footage that could be used to revise the silent
film for lay audiences (presumably Syphilis: Its Nature, Prevention and Treatment)
to make it suitable for a black audience. I can find no evidence, however, that
such a revised film was produced in the period before the end of World War II.16
It is ironic that at the same time that PHS was operating this free clinic for
African Americans, it was also conducting the infamous Tuskegee syphilis experiment. The Tuskegee study grew out of an earlier PHS effort to diagnose and
treat blacks in the rural south for syphilis. When funds for this effort evaporated
at the beginning of the Great Depression, the unfortunate decision was made by
the PHS to continue to study a group of African American men in Alabama without treating them (and without their informed consent), in order to follow the
natural course of the disease. Film historian Robert Eberwein has argued that
Three Counties Against Syphilis documents a betrayal of trust. He notes that the

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film provides evidence of how African Americans trusted and depended on

white doctors in the Georgia mobile clinic, while at the same time that trust was
exploited for research purposes in the neighboring state of Alabama.17
Although the mobile clinic project of the late 1930s was a worthy endeavor,
the racism of the period is evident in the story of the clinic and of PHS efforts
to develop films and other VD education materials for blacks. PHS officer Leroy
Burney, a future surgeon general of the PHS, was in charge of the mobile clinic
program, and also served as medical supervisor on Three Counties Against Syphilis.
In an article on the clinic published in 1939, Burney exposed his own biases
concerning African Americans. For example, he noted that as promiscuous as
these people are, it is difficult to track down the source of an infection. He also
suggested that the moral code of the African American might not be as stringent as that of whites. Burney believed that the Negro can be taught, slowly, the
facts about syphilis. He also thought that the movie is probably our best
medium of education of the Negro, but was unhappy with the available VD education films.18 He noted, We have not found any movie on syphilis suitable for
a Negro audience. In his view, Movies available are not simple and plain
enough for them to understand. He concluded, The viewpoint must be different and the dialogue done in their own language.19
Other PHS staff members, commenting over the next few years on the need
for a good VD film for black audiences, also expressed concerns about making
sure that the films were pitched at a level suitable for such audiences. One
staffer spoke of the problem of placing the script at the proper intellectual
level, especially if the film were to be shown to both northern and southern
blacks.20 Another staff member referred to the type of film needed as follows:
By its utter simplicity and by judicial use of biblical references, authentic hymns, and
a completely honest, though cleaned up, picturization of Negro life in the rural
South, the effects of venereal diseases and the part played by the county health department, I believe we could make this a really outstanding film. Its educational value for
venereal disease control programs among Negroes would be extremely great in my
opinion.21

Three Counties Against Syphilis emphasizes the important role played by African
American churches and pastors in the syphilis control campaign in Georgia. The
films ends with the Hampton Institute Choir and Glee Club singing the spiritual
Walking in the Light while scenes of the clinic and its patients fill the screen.
Philip Broughton, who directed the film, had gone to Hampton, Virginia, specifically to record the voices of the choir for this purpose.22 There is no dramatization or dialogue in Three Counties Against Syphilis; rather, the film is a
documentary with rousing narration and music in the Lorentz mode. In fact, a
medical film historian later described the film as being . . . an imitation of Pare
Lorentz documentary style.23

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The film was clearly made as documentation of the Georgia program, presumably to encourage the development of similar projects. The motion picture
itself states that it is not the story of the disease syphilis, but of a program to
stamp it out. The mobile clinic is referred to as a demonstration syphilis control
project that could serve as a test program for other areas. It appears, however,
that the film was also used for the purposes of public health education about the
disease, as PHS records indicate that it was shown widely. The 1939 annual
report of the PHS indicated that forty-three copies of the film were available for
loan through various sources, and that the film was being shown at the New York
Worlds Fair. The annual report for 1941 reported that the film was shown
20,667 times in that year. As late as 1943, a PHS staff member noted that the
film was still extremely popular.24
As the conflict in Europe intensified and the prospect of American involvement became more likely, efforts to prepare for war increased, as did concerns
about venereal disease as it might affect the military and essential defense industries. The Academy of Motion Picture Arts and Sciences, which had begun producing motion pictures for the War Department on a non-profit basis, was
approached by the federal government in April 1941 about the prospect of the
Academy making a film on venereal disease for the PHS. The Research Council
of the Academy agreed to produce the film, and Darryl F. Zanuck, the councils
chairman, decided to supervise the production.25
On August 18, 1941, the Research Council issued a press release announcing
that it was making a documentary film on sex hygiene, entitled Know for Sure, for
the PHS. The film was to be directed by Lewis Milestone and made at 20th Century
Fox Studios. The script was written by John Sutherland from information provided
by the PHS. The motion picture was designed to be shown to defense workers in
airplane factories, ammunition plants, and other civil defense organizations.
Although the press release did not state this explicitly, it is evident from other documents that the film was meant to be shown only to male workers. (A version of the
film omitting the scenes involving male genitalia and the use of prophylactics was
later produced for use with female or mixed audiences.) Because the director,
actors, and others contributed their professional services, PHS was able to obtain a
professional-quality film at the relatively modest cost of $15,000. No cast credits
were given in the film, but the Hollywood actors who appeared in it included J.
Carrol Naish, Tim Holt, Samuel Hinds, Ward Bond, and Hattie McDaniel (whose
role combined stereotypes of the African American woman. In other words, she
played an Aunt Jemima type who worked as a maid in a brothel).26
The film weaves together several stories through the interaction of two physicians. It opens with a vignette about Tony, a stereotypical Italian immigrant,
complete with accent and an emotional temperament. Tony is excited about the
birth of his first child, but is devastated when the baby boy is born dead, the victim of congenital syphilis. When the excitable Tony learns that he gave syphilis
to his wife, who passed it on to the unborn child, he threatens to kill himself with

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a knife. The doctor calms him down and convinces him that he and his wife can
be cured of the disease and have children in the future.
Other stories in the film deal with men who contracted syphilis through prostitutes or pick-ups, and with a syphilitic man who is robbed of his money and
his health by a quack doctor. Although the film warns of the dangers of casual
sex, emphasizing that a woman might look clean and still have the disease, it
is not overly moralistic in its tone. The film devotes substantial attention to
methods for minimizing the risks of contracting VD in such situations. Men are
encouraged to wear a rubber, and the film provides explicit instruction on how
to use a condom. Detailed instructions are also given, with a visual demonstration, on how to cleanse the genitals after sex. The film also emphasizes the
importance of seeking medical attention if one notices a sore or some other
symptom that might indicate syphilis. One can only know for sure by getting a
blood test. The fact that syphilis is curable with the proper medical treatment is
also an important part of the films message (see figure 3.1).
As one might expect, the PHSs decision to emphasize prophylaxis in Know for
Sure came in for criticism from those who preferred an approach to VD education that involved a conservative sexual morality focused on abstinence from sex
outside of marriage. For example, Dr. Walter Clarke, the director of the
American Social Hygiene Association, which waged its own campaign against
VD and collaborated with PHS on several efforts, complained to Raymond
Vonderlehr about the depiction of prophylactic methods in the film.
Vonderlehr replied, our belief was and still is that a certain number of men are
going to find and use opportunities for extramarital sex relations no matter
what happens. He wrote, As I see it, an important part of our job is to prevent
infection. In his view, Teaching men how to protect themselves from venereal
disease does not imply that we condone sexual promiscuity no more than teaching soldiers how to protect themselves against poison gas proves that the Army
wishes to encourage the use of such gas by the enemy.27
Although the film did point to prostitution as a major source of infection,
Clarke apparently thought that more attention should have been given to this
subject on moral grounds. Vonderlehr favored the repression of prostitution,
but he distinguished between the moral and public health aspects of the problem in his response to Clarkes criticism of Know for Sure. He wrote, Strictly
speaking, our only interest in prostitution lies in its role as the most important
carrier of infection. As he saw it, Morals and self control are important in our
purview simply because of their preventive value. He concluded, If all men
invariably protected themselves, then, from a public health standpoint, prostitution unlimited would not concern us as health officers, even though we might
strongly object to it on other grounds.28
The executive officer of the Montana State Board of Health also raised a
concern about whether the film might encourage sex immorality and birth
control. PHS physician E. R. Coffey replied that the PHS believed that the need

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Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 3.1. Publicity poster for U.S. Public Health Service VD education
campaign, 1944.
for enlightenment on methods of preventing VD outweighed other considerations and that he was confident that those who saw the picture would understand that the objective was not to encourage immorality but to emphasize
methods that would prevent the spread of VD.29

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79

In fact, the PHS considered prophylaxis to be an essential message of Know

for Sure. Coffey even referred to it in a letter as the prophylaxis film. Howard
Ennes, a health education specialist for PHS, emphasized in 1942 that there
was no question in his mind that considerable emphasis must be given to prophylaxis in PHS VD films.30 In responding to criticism of the film from the VD
subcommittee of the Philadelphia Defense Council, Vonderlehr wrote that the
films primary educational message was the use and importance of prophylaxis. He objected to the removal of the prophylaxis section of the film, as suggested by the Philadelphia group. Vonderlehr went on to defend the film by
indicating that the PHS had already received a large number of favorable
responses to the film.31 When asked by an army major if Know for Sure would
not have been more complete if it had devoted some of its message to continence as a means of preventing VD, George Parkhurst of the PHS Venereal
Disease Division replied: At the time this picture was made, however, it was
felt that since numerous other films had laid particular emphasis on continence but had given no dramatic and effective emphasis to prophylaxis, the
dangers of quack treatment, and the urgent need for early diagnosis and treatment, our film should devote its full length to these neglected aspects of the
subject.32
PHS was well aware that the decision to focus on prophylaxis would make the
film controversial. In order to minimize this criticism, PHS decided to distribute
the film through local health agencies (it was assumed that these agencies in
each state would buy prints of the film). Even the sixty-five prints to be distributed directly by PHS would be loaned only on the endorsement of local health
agencies. E. R. Coffey explained in a letter to Vonderlehr: The purpose of this
arrangement is to forestall unnecessary criticismwhich is sure to fall on any
motion picture treating prophylaxis. He continued, Also, when the film is used
in restricted groups under proper supervision, its effect can be supplemented by
information from the local authorities and the subject matter better related to
local situations.
Coffey suggested that a prophylaxis pamphlet be given to audiences seeing
the film so that they would have something to take away that could give more
detailed information than the film could. He believed that in this way the lesson of the film can be driven home and the argument for prophylaxis, etc.,
clinched. As we have seen, this arrangement did not forestall all criticism of the
film, although it may well have limited such criticism.33 The evidence indicates
that Know for Sure was well received by other organizations, e.g. the army, the
navy, the American Public Health Association, and the Venereal Disease
Commission of the Michigan State Medical Society.34
Vonderlehr and others in the PHS had been interested in encouraging the
large commercial motion picture studios to produce public health education
films since at least the late 1930s, because they recognized that Hollywood-made
films would be of exceptionally high quality from a production standpoint. They

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must have taken satisfaction in obtaining the cooperation of these studios in the
production of Know for Sure. The contrast between commercially-produced films
and the homegrown variety was probably clarified for the PHS in 1942, when
it released the film Fight Syphilis in ten- and twenty-minute versions. The shorter
version was aimed at individuals, and stressed avoiding exposure to and getting
proper treatment for the disease. The longer version, intended for civic leaders,
added a section on the role of the community (education, clinics, etc.). The film
was apparently made at the request of the Coordinator of Inter-American
Affairs, and was produced in English and Spanish versions, the latter intended
for use in Latin America.
Howard Ennes and Judson Hardy of PHS were voicing serious concerns about
the value of the film not long after it was produced. Hardy described the film as
being up to 1920 standards of photography, lighting, acting, and directing, and
noted that it comes nowhere near reaching the standards of our previous productions. He complained that the PHS, which had financed Fight Syphilis, was
not adequately consulted in the choice of the producing agent or in the making
of the film (presumably the Coordinator of Inter-American Affairs oversaw the
production). These views were later reinforced by a critique of the film probably written by medical film historian Adolf Nichtenhauser, which stated that the
film contained outdated information, made no reference to prophylaxis, and
only vaguely indicated that the disease is curable (thus presenting audiences
with a discouraging view). The film was also described as a rather diffuse and
wordy sermon with scattered visual accompaniment, a type of presentation that
makes retention difficult.35
PHS may have been happy to turn back to Hollywood again for another collaborative project in 1943. In 1940, Warner Bros. had released the biographical
film Dr. Ehrlichs Magic Bullet, the story of the German-Jewish physician Paul
Ehrlich, played by actor Edward G. Robinson. Ehrlich, the founder of modern
chemotherapy, had introduced the drug Salvarsan (the magic bullet of the
title) for the treatment of syphilis in 1910. Organic arsenic compounds like
Salvarsan were still the method of choice for the treatment of syphilis at this
time, although all that was about to change as penicillins effectiveness against
the disease was in the process of being demonstrated.36
Warner Bros. had encountered difficulty in the production of this film
because of the Motion Picture Code, sometimes called the Hays Code after Will
Hays, president of the Motion Picture Producers and Distributors of America.
The code, developed in the 1930s, explicitly prohibited screen depictions
involving sexually transmitted disease. The studio managed to secure a special
executive order from Hays allowing it to proceed with the film. The studio had
to agree to certain conditions, however, such as reducing the number of references to syphilis to a minimum, and not distributing any advertising or publicity
material on the subject of sex hygiene or venereal disease in connection with the
screening of the film.37

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Although the PHS approached Warner Bros. as early as 1941 about the possibility of producing a shorter version of the film for use in venereal disease education, the project did not come to fruition until two years later. In 1943,
Warner Bros. and the PHS produced a thirty-minute version of the film that
focused on the portion of the story that dealt with Ehrlichs discovery of
Salvarsan and its use against syphilis. The adapted version of the film, entitled
Magic Bullets, was added to the PHS inventory of educational films. Raymond
Vonderlehr was convinced that Magic Bullets would be one of the most effective
weapons in our educational arsenal, perhaps because of the films compelling
story, excellent cast, and high-quality production values. Susan E. Lederer and I
have discussed Dr. Ehrlichs Magic Bullet and the PHS version of the film in detail
elsewhere.38
Magic Bullets was not a typical venereal disease education film, and did not discuss such controversial topics as prophylaxis and prostitution. Given the fact that
it was derived from a Hollywood film that had survived the Hays Code, it is perhaps not surprising that Magic Bullets (which included no sexual references)
does not appear to have led to any significant criticism of the PHS. The services
next involvement with Hollywood, however, would be a different story.
PHS had another opportunity to cooperate with Hollywood in the production
and distribution of a VD education film at about this same time. The project
appears to have been initiated in the fall of 1942 as the result of a conversation
between Lawrence Arnstein, executive secretary of the California Social Hygiene
Association, and noted producer-director Walter Wanger about the possibility of
Wangers making a VD film for the American Social Hygiene Association or the
PHS. Wangers production company, Walter Wanger Productions, was affiliated
with Universal Studios. Arnstein then discussed the matter with Parran and
Vonderlehr at the Hot Springs National Conference on Venereal Disease Control
in October. The PHS leaders thought this a splendid opportunity to obtain a
film suitable for release through theatrical, entertainment, motion picture channels.39 Wanger wrote to the surgeon general near the end of the year to offer to
donate his services in making a really outstanding film about venereal disease,
as Vonderlehr put it in a letter to a colleague. Vonderlehr went on to say: Mr.
Wangers idea is to make a film that would be shown in commercial theatres
throughout the country, and he believes he can obtain the free services of many
of Hollywoods outstanding writers, actors, and technicians. He concluded, The
possibility of reaching an enormous audience through a really outstanding film
written, directed and produced by the very best talent in the motion picture field
is, in our opinion, an unparalleled educational opportunity.40
Wanger indicated that he was interested in the project only if he could have a
free hand in making the film, although the PHS noted that it would reserve the
right to review the medical content. According to Vonderlehr, Wanger viewed
the film largely as a Hollywood contribution to the war effort and emphasized
that it would have to be acceptable for showing in commercial theaters.

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Vonderlehr was not sure whether or not the film would cover the subject of prostitution and promiscuous girls.41
PHS had long been interested in the production of a VD education film that
could be shown in commercial theaters. This venue would provide access to a
much larger and broader audience than was available through limited screenings arranged by health departments, employers, and similar groups. Such a
film, of course, would have to be suitable for mixed gender audiences and could
not contain sexually explicit material if there was any hope of getting it shown
in theaters. As early as 1938, Vonderlehr reminded a physician at the Metropolitan
Life Insurance Company that motion picture houses existed for entertainment
rather than for education, and that they would be more likely to show educational films that had dramatic value.42
Since the PHS did not believe that it could appropriately negotiate a contract
to make a film with a particular studio, Wanger, Arnstein, and Leroy Burney,
who had been assigned as the PHS technical consultant on the film, approached
the California State Health Department to seek their involvement. The department agreed to negotiate the contract with Wanger, and the PHS indicated that
it would cover the expenses involved so long as they did not exceed $50,000. It
was also agreed, however, that the PHS would have the right, if the film met with
its approval, to sponsor the film for national theatrical distribution through the
Office of War Information (OWI) and for use through the various state health
departments. Wanger envisioned that the film would be shown in theaters as a
short along with the usual double feature.43
The script developed by Wangers organization was read and approved by the
California State Health Department, the PHS, the Office of War Information, and
the army. Production was begun in the fall of 1943, and the film, entitled To the
People of the United States, was completed in January of the following year.
Hollywood star Jean Hersholt donated his services to play the protagonist, an
army doctor. Other actors who participated in the film included Robert Mitchum
and Noah Beery, Jr. The film begins with introductory statements by U.S. Army
Surgeon General Norman Kirk and by PHS Surgeon General Parran. It then
moves to a scene involving American bombers taking off from an airfield on a
wartime mission. A disappointed bomber pilot, grounded because he has syphilis,
watches the planes leave. He is concerned that he will never fly again, but an army
doctor (Jean Hersholt) explains that syphilis is treatable and that the pilot can be
cured. Much of the rest of the film is devoted to a comparison of syphilis rates and
attitudes towards the disease in the United States versus Scandinavian countries.
The openness in talking about venereal disease in Scandinavia is contrasted with
the American practice of not discussing the problem in public. Americans are
encouraged to confront the disease openly. Except for a final statement from
Parran, the film ends with scenes of farmers, factory workers, soldiers, athletes,
Boy Scouts, bright, fresh looking girls, and healthy vigorous boys, with the music
building to a rousing fade, while Hersholts voice intones:

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The children who follow us must inherit health, and freedom, and happiness . . . The
Scourge of Disease must be wiped from the land, and then there will be a new day
ahead . . . A day without insidious, lurking evil sicknesses, a day without a useless hypocritical attitude which refuses to name a germ, yet permits the horrible devastation
caused by it . . . Syphilis! Say it . . . Learn about it! Have a blood test to make sure you
havent got it! And, working together, well stamp it out.44

By December, 1943 the film had been completed, and the PHS was basically satisfied with the product, although indicating that some alterations might be
needed. Parran wrote to the California Department of Health about purchasing
prints of the film for distribution. He saw the film as being extremely valuable
for use in an intensified national program of public education and information
on venereal disease which will begin early in the new year, sponsored by the
PHS with the cooperation of the Office of War Information and other agencies.
Parran also spoke of initiating negotiations with OWI for possible national commercial theater distribution.45
In January, Stanton Griffis, chief of the OWIs Bureau of Motion Pictures,
viewed the film at the request of the PHS and recommended that it be accepted
as part of the OWI program and released as soon as possible. Griffis expressed
the view that the picture has been brilliantly made. He did not see anything in
the film that could offend man, woman or child, except a prude still wandering
in the haze of a social viewpoint of bygone days. Griffis asked Parran to send
him an enthusiastic letter of recommendation for the film to break down
exhibitors resistance. Parran complied, emphasizing in his letter that the film
dealt with one of the nations most serious health problems, and adding: For
this reason I feel that every man, woman, and child in the United States should
be given the opportunity of seeing this film. He argued, The nations motion
picture exhibitors will perform a courageous and patriotic service by cooperating with the United States government in exhibiting TO THE PEOPLE OF THE
UNITED STATES.46
But in spite of the enthusiasm of the PHS and the OWI, and Griffiss conviction that there was nothing in the film to offend anyone, To the People of the United
States immediately ran into trouble. In early March, the Legion of Decency,
established by the Catholic Church to evaluate whether or not films were
morally objectionable, reviewed the film before it was to be released and
protested against it to the OWI and the PHS. While admitting that venereal disease was a threat to the war effort, the legion did not think that movie theaters
were the appropriate venue for dealing with the problem. Burney and J. R.
Heller of the PHS, along with William Snow of the American Social Hygiene
Association, met with Monsignor John McClafferty and other members of the
legion to discuss the matter. The legion representatives indicated that they
opposed theatrical release of the film because it violated the Motion Picture
Codes strictures against sex hygiene and venereal disease as appropriate

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subjects for motion pictures, it would pave the way for a flood of pictures by
producers who do not hesitate to avail themselves of every opportunity for lurid
and pornographic material for financial gain, and it failed to stress the fact
that promiscuity is the principal cause for the spread of venereal disease.
Although admitting that the film was essentially dignified and restrained in its
treatment of the subject presented (e.g., there were no scenes depicting syphilis
lesions, sexual organs, or prophylaxis methods), the legion asked the PHS not
to sponsor it for theatrical release on the grounds noted above.47
Parran decided to turn to the PHS Advisory Committee on Public Education
for the Prevention of Venereal Diseases, which was made up of clergymen,
health professionals, and teachers, for advice on how to handle the situation. He
called an emergency meeting of the group. The committee recommended that
in view of the opposition from the legion and other groups, it would not be wise
for the Public Health Service to sponsor national theatrical release of this film.
It was thought that any other course of action might endanger the whole program of venereal disease education and might even have harmful effects on
other vital and important public health activities throughout the nation. The
advisory committee did suggest, however, that with minor changes the film
would be suitable for controlled distribution through state and local health
departments, voluntary health agencies, and similar organizations. In particular,
the committee recommended that some attention be given to the influence of
moral standards on the spread of disease. The group was concerned that if no
reference was made in the film to moral issues, it might appear to some that the
PHS was condoning sex promiscuity.48
Parran decided that it was best to accept the committees recommendations.
Wanger was naturally disappointed that PHS would not sponsor national theatrical distribution for the film, and asked Parran to reconsider his decision. The surgeon general again consulted the committee, which stood by its original
recommendations. In his reply denying Wangers request, Parran noted that it
was difficult for him to explain in detail all of the supremely important factors
involved in the decision of the committee and his own reasons for abiding by the
committees recommendations. He did, however, offer the following justification:
The Committee states that the problem concerns a great deal more than whether or
not a particular film shall be released. They feel that for the government to sponsor
theatrical release now is to incur the danger of arousing controversy which will involve
the Public Health Service, the Federal Security Agency, the Office of War Information, the
Army, and various religious, teaching and medical groups. At this particular time, when
many important elements of our population are in a state of indecision and anxiety, it
is believed any action on our part which would tend to add to the general atmosphere
of conflict and controversy would be unwise.49

Parran also indicated to Wanger, as an additional justification, that the committee was beginning a survey of the entire field of venereal disease education

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85

in order to determine the extent to which promiscuity and moral standards

should be dealt with in the educational efforts of official health agencies. In this
connection, Parran did defer to the concerns of the Legion of Decency in the
revision of To the People of the United States before it was released for the controlled
distribution mentioned above. One major alteration to the film was made before
distribution: Parrans brief speech at the pictures end was revised. In deference
to the concerns of the legion and other critics of the film, Parrans new closing
words emphasize promiscuity as a major cause of VD and give credit to various
groups combating this problem.50 He wrote, Here, we have told only part of the
story of venereal disease control. Untold is the fine work our churches, schools
and social agencies are doing to prevent the promiscuity which spreads infection. He continued, It is important to remember that the only sure way for the
individual to avoid infection is to avoid exposure. The essential message was,
Learn the facts: With knowledge and intelligent action the people of America
can eradicate the venereal diseases.51
Concerned about the damage that a controversy over the film might inflict on
the PHS venereal disease campaign and other programs, Parran elected to yield
to religious and social pressures on this issue. He recognized that the film, which
he thought was excellent, would not be seen by as many people if it were not
shown in commercial theaters, but he accepted the compromise position of limited distribution to appease the Legion of Decency and other critics. Parran had
already shown his willingness to tackle controversial issues by his frank discussions of venereal disease and his vigorous campaign to control it, but he was
enough of a politician to recognize when it would be wise to give ground. In this
case, the conservative approach of the Catholic Church towards sex education
prevailed over purely scientific and public health concerns with respect to the
distribution of the film.
It is not that Parran, who was himself a Catholic, believed that moral factors
were unimportant in sexual matters and the control of venereal disease. The
PHS under Parran cooperated with social and religious groups in the campaign
against venereal disease. The surgeon general believed, however, that PHS had
to view the subject primarily from a public health viewpoint. In a 1944 letter
defending the PHS against criticism of its VD education campaign, Parran
explained that the PHS campaign was based upon scientific facts. He noted that
the educational materials used emphasized the medical and public health
aspects of VD control because the teaching of sexual morality is the function of
the home, the church, and the school, and that health agencies were responsible for dealing with venereal diseases as dangerous contagions. He added that it
should be possible, using available scientific methods, to eradicate these diseases
in our lifetime, a timetable that may be well in advance of any major changes
in the sex habits of the population as a whole. Finally, he argued that those who
criticized the effort to educate the public about venereal diseases have a
tremendous job of their own in gaining acceptance for the way of life that would

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prevent them. As demonstrated by the case of To the People of the United States,
however, Parran was not always successful in keeping moral concerns from
trumping public health considerations.52
This case was not the only time that Parran and the PHS ran afoul of the
Catholic Church. About six months after the controversy over To the People of the
United States, Catholic organizations such as the Catholic War Veterans and the
Knights of Columbus attacked a brochure that had been developed as a part of
the PHS venereal disease education campaign. The brochure was being distributed by the War Advertising Council, a non-profit organization of advertising
executives, to national advertisers, advertising agencies, and newspapers in the
hopes that they would run public service announcements using illustrated copy
provided in the brochure. Catholic groups opposed the action of the council,
characterizing the brochure as indecent, repulsive, and un-American, and also
criticizing it for its offensive frankness.53 Yielding to this pressure, the council
withdrew its support for the PHS VD campaign.54
Two other films should be at least briefly mentioned in this overview of the
PHS venereal disease education films of World War II. The films discussed thus
far were geared either to male audiences or to mixed audiences. It was not until
1945 that the PHS produced a VD film aimed specifically at female audiences.
That film was entitled A Message to Women and was produced for the PHS, in
cooperation with the Tennessee Department of Public Health, by Hugh
Harmon Productions. A Message to Women was a twenty-minute color film
employing professional actors. It told the story of Peggy Parker, a young, single
woman who learns from her doctor that she has contracted gonorrhea. The doctor chastises Peggys mother for not providing her with appropriate information
about sex and venereal disease. The rest of the film focuses on Mrs. Parkers
attendance at meetings of her club and a hygiene association where the dangers
of VD are discussed, thus providing an opportunity for educating the film audience on this subject.
The film was designed to be shown to womens organizations, service clubs,
and older teenage groups. An important part of the films message was that
venereal disease strikes without regard to family position or background. It
attempts to correct the view of respectable girls (and their mothers) who think
that VD is not one of their problems. Cinema historian Robert Eberwein has
pointed out that A Message for Women was one of the few films of the period in
which a woman afflicted with VD was not depicted as a prostitute or a so-called
pick-up. There is no discussion in the film of preventive measures such as the
use of condoms. Basically, the only form of prevention promoted is abstinence.
As Eberwein has noted, the film warns women that the only way to remain free
of venereal disease is to avoid sex outside of marriage.55
The second film, Venereal Disease Rapid Treatment Center, is a special case. Like
Three Counties Against Syphilis, it was intended more to document and explain a
PHS program rather than for general VD education. But while the former film

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87

apparently did find significant use as an educational vehicle, there is little evidence suggesting that Venereal Disease Rapid Treatment Center was utilized in this
way. It does not generally appear on the usual distribution lists of available
health education films of the period, both lists issued by PHS and film catalogs
issued by other agencies.56
The standard course of therapy for syphilis at the time involved weekly
injections of arsenic and bismuth drugs for a year or more. It is not surprising that under these circumstances there was a significant rate of noncompliance by patients. By the early 1940s, so-called rapid treatment methods
requiring from five days to several weeks had been developed, with the drugs
being administered by intravenous drip or multiple injections. This intense
treatment had to be carefully monitored because it involved an increased risk
of untoward reactions. The intravenous drip method required hospitalization
of the patient.57
In 1943, as a wartime emergency measure, the PHS established a series of
rapid treatment centers to provide intensive arsenicbismuth treatment for
those with infectious syphilis (and sulfa drug treatment for those with gonorrhea).
Many of these centers were located near military camps in the United States,
and in some cases they occupied former Civilian Conservation Corps camps.
Several of the facilities were operated directly by the PHS, and others were
operated by state or local health agencies or institutions, with financial and
technical assistance from the PHS. Late in the war, as it became more available,
penicillin began to replace the arsenic-bismuth drugs as a therapeutic agent for
syphilis.58
It is clear from PHS documents that the original intent of these centers was to
quarantine and treat infected prostitutes. There was a particular concern that
these women would not be likely to comply with the onerous arsenicbismuth
treatment regimen on an outpatient basis. So-called loose women with venereal
disease were also targeted. The patient population of these centers was
thus overwhelmingly female, although some centers accepted men and even
children.59
The film Venereal Disease Rapid Treatment Center was clearly intended to
describe, and probably to justify, the program. The center depicted in the film
was exclusively for women. The film stressed the fact that the centers were hospitals rather than prisons, and that they provided a far better option for sexual
offenders than jails. The women are depicted being treated, receiving vocational
training to encourage them to earn a living without resorting to the sale of sex,
and indulging in recreational activities such as dancing.
The rapid treatment centers designed for women were part of a broader philosophy, not unique to the 1940s or to the United States, that placed a large
share of the blame for the spread of venereal disease on women, especially
women who worked as prostitutes and those who were considered promiscuous.
As historian Mary Sponberg has pointed out, there is a long tradition in Western

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culture of viewing women as the source of venereal disease, and over the course
of the nineteenth century attention was specifically focused on prostitutes as vectors for VD.60 With respect to films, Annette Kuhn, writing about sexuality and
cinema in the period 190925, has noted that: VD propaganda films, with whatever degree of sympathy, construct sexually active women as the principal causes
of venereal infection.61
The issues confronting Parran and his colleagues in their campaign against
syphilis in the 1940s seem remarkably similar in some ways to those faced by
Surgeon General C. Everett Koop and the PHS in dealing with the AIDS epidemic in the 1980s, though of course there were also profound differences
between the two cases. Controversies over how to educate the public about the
disease reveal common concerns between the two periods. How explicit should
educational materials be with respect to discussions of sexual matters? Should
educational materials emphasize prophylaxis, such as the use of condoms, or
stress abstinence as a protection against VD? In the intervening four decades
between the two campaigns, these matters had still not been resolved, nor are
they settled today. Sex education can be hazardous to the health of a surgeon
generals career, as witnessed by the dismissal of Joycelyn Elders after her public
comments about masturbation.62 The 2001 surgeon generals report on sexual
health, published shortly before the end of David Satchers term as surgeon general, was also the source of controversy.63
In the revised edition of his history of venereal disease in the United States,
published in 1985, historian Allan Brandt added a chapter on the AIDS epidemic. Reflecting on the lessons of the past, Brandt noted that the analogues
which AIDS posed to the broader history of sexually transmitted diseases in the
United States were striking. He went on to point out that while history is not a
predictive science and AIDS is not syphilis, the historical record can aid our
understanding of the process by which disease is characterized and handled. A
knowledge of the earlier history of venereal disease can serve to remind us that
the response to AIDS, will not be determined strictly by its biological character;
rather, it will be deeply influenced by our social and cultural understanding of
disease and its victims. Brandt adds, Even our scientific understanding of the
disease will be refracted through our cultural values and attitudes.64
Although it is not at all clear how successful the films discussed in this paper
were in helping to control the spread of venereal disease during World War II,
the PHS certainly saw them as being among the most effective weapons in their
educational arsenal. Whatever their impact at the time, however, these films
provide us today with one of the most vivid sources for our understanding of
how the nations primary health agency struggled to balance scientific and medical information with social and cultural values in trying to control a public
health problem during World War II. What was shown in these films, as well as
what was omitted, reflects this delicate balance. In walking this fine line, Thomas
Parran and his colleagues at the PHS could not always satisfy all of their critics.65

syphilis at the cinema

89

Notes
1. David Satcher, speech delivered at a meeting of the Reserve Officers Association,
Washington, D.C., January 25, 1999 (a copy of the text is in the biographical folder
on Satcher in the historical reference files of the Public Health Service Historian,
Rockville, MD).
2. For a discussion of VD education films from more of a cinematic point of view,
see Robert Eberwein, Sex Ed: Film, Video, and the Framework of Desire (New Brunswick,
NJ: Rutgers University Press, 1999).
3. Allan M. Brandt, No Magic Bullet: A Social History of Venereal Disease in the United
States Since 1880, expanded edition (New York, Oxford: Oxford University Press,
1987), 12326; Ralph Chester Williams, The United States Public Health Service,
17981950 (Washington, D.C.: Commissioned Officers Association of the United
States Public Health Service, 1951), 58992.
4. Thomas Parran, Shadow on the Land: Syphilis (New York: Reynal and Hitchcock,
1937), 85.
5. The story of the cancellation of Parrans radio address is recounted in numerous sources. See, for example, Brandt, Magic Bullet (n. 3), 122.
6. Brandt, Magic Bullet (n. 3), 12223, 13842.
7. Brandt, Magic Bullet (n. 3), 140.
8. James Dolce to Philip Broughton, June 27, 1942, 1942 folder, General Classified
Records, 193644, Group IX, General Files, 1350 (Motion Pictures), Public Health
Service Records, Record Group 90, National Archives, Washington, D.C. The PHS
records are housed in the Archives II facility in College Park, MD. All materials from
RG 90, National Archives, cited in this paper are from this general group unless otherwise noted.
9. Adolf Nichtenhauser, A History of Motion Pictures in Medicine, unpublished
typescript, ca. 1950, MS C 380, History of Medicine Division, National Library of
Medicine, Bethesda, MD, 1079, 196209; Theodore Blank, An Historical Survey
of the Development of the Use of AudioVisual Materials in Venereal Disease
Educational Programs, 19001949, D. Ed. dissertation, Boston University, 1970,
195215, 26171; Eberwein, Sex Ed (n. 2), 2135.
10. Nichtenhauser, History (n. 9), 109, 21112, II, 8182.
11. Ibid., II, 98110; Martin S. Pernick, Sex Education Films, U.S. Government,
Isis 84 (1993): 76668. For a general overview of sexual education for adolescents in
America, see Jeffrey P. Moran, Teaching Sex: The Shaping of Adolescence in the 20th
Century (Cambridge, MA: Harvard University Press, 2000).
12. Nichtenhauser, History (n. 9), IV, 17985; Blank, Survey (n. 9), 614; Annual
Report of the Surgeon General of the Public Health Service of the United States for the Fiscal
Year 1938 (Washington, D.C.: Government Printing Office, 1938), 13233.
13. Howard Ennes, Jr. to Raymond Vonderlehr, July 17, 1940, Fight Syphilis folder,
Record Group 442, Acc. # 4NS4429358, Box 2, National Archives Southeast
Region, Morrow, GA. All materials from RG 442 cited in this paper are from this collection unless otherwise noted.
14. Philip Broughton to Paul de Kruif, July 19, 1937, V.D. Film folder, RG 90,
1350, NA (n. 8).
15. John Fell, A History of Films (New York: Holt, Rinehart and Winston, 1979),
29596.

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16. J. D. Reichard to Raymond Vonderlehr, December 8, 1937, and Vonderlehr to

Reichard, December 11, 1937, V.D. Film folder, 1350, RG90, NA (n. 8).
17. The best book on the Tuskegee syphilis experiment is still James Jones, Bad
Blood: The Tuskegee Syphilis Experiment, new and expanded edition (New York: Free
Press, 1993). See also the more recent book edited by Susan Reverby, Tuskegees
Truths: Rethinking the Tuskegee Syphilis Study (Chapel Hill: University of North Carolina
Press, 2000). For Eberweins views on the PHS film and the Tuskegee study, see
Eberwein, Sex Ed (n. 2), 4750.
18. Leroy E. Burney, Control of Syphilis in a Southern Rural Area, American Journal
of Public Health 29 (1939): 100614. The quotations are from pp. 1009 and 1014.
See also Blank, Survey (n. 9), 51220.
19. Burney, Control (n. 18), 1007. Burney himself mimics African American
speech in his comments, making reference to blacks replying yes suh, yes suh when
asked if they understood what the clinic doctor had told them, although Burney
thought that in most cases the talks fall on deaf ears (ibid., 1009).
20. Howard Ennes to Leroy Burney, March 15, 1939, 1939 folder, 1350, RG 90, NA
(n. 8).
21. Judson Hardy to Raymond Vonderlehr, January 23, 1943, V.D. Film folder,
1350, RG 90, NA (n. 8).
22. Philip Broughton to Robert Oleson, August 16, 1938, V.D. Film folder, 1350,
RG 90, NA (n. 8).
23. [Adolf Nichtenhauser?], Film Notes, eightpage typescript, undated, box 25,
Adolf Nichtenhauser papers, MS C 277, History of Medicine Division, National
Library of Medicine, Bethesda, MD.
24. Annual Report (n. 12), 1939, 131; Annual Report (n. 12), 1941, 141; Hardy to
Vonderlehr (n. 21).
25. Gordon Mitchell to Arch Mercy, May 12, 1941, Know for Sure folder, General
Classified Records, 193644, Group X, National Defense, 194046, 1350 (Motion
Pictures), Public Health Service Records, Record Group 90, National Archives,
Washington, D.C.
26. Press release, August 18, 1941, attached to letter from Gordon Mitchell to
Raymond Vonderlehr, September 22, 1941, ibid.; D. A. Dance to E. R. Coffey, August 20,
1942, 1942 folder, 1350, RG 90, NA (n. 8); two-page typescript description of the
film, Know for Sure folder, RG 442, Box 2, NA SE Region (n. 13).
27. Raymond Vonderlehr to Walter Clarke, February 28, 1942, V.D. Film folder,
RG 90, 1350, NA (n. 8). Vonderlehr expressed the view to Parran that since prostitution interferes with the effectiveness of venereal disease control, it should be
repressed. Raymond Vonderlehr to Thomas Parran, March 17, 1941, 1943 folder,
0425 (Venereal Disease), RG 90, NA (n. 8).
28. Raymond Vonderlehr to Walter Clarke, February 28, 1942, V.D. Film folder,
1350, RG 90, NA (n. 8).
29. W. F. Cogswell to E. R. Coffey, April 4, 1942 and Coffey to Cogswell, April 10,
1942, Know for Sure folder, National Defense, RG 90, 1350, NA (n. 25).
30. E. R. Coffey to Knox Miller, November 14, 1942, 1942 folder, and Howard
Ennes, Jr. to L. C. Stoumen, May 27, 1942, Know for Sure folder, 1350, RG 90, NA
(n. 8).
31. Raymond Vonderlehr to John Stokes, March 24, 1942, Know for Sure folder,
National Defense, RG 90, 1350, NA (n. 25).
32. George Parkhurst to John Ankeny, February 24, 1944, ibid.

syphilis at the cinema

91

33. E. R. Coffey to Raymond Vonderlehr, December 23, 1941, 1942 folder, 1350,
RG 90, NA (n. 8).
34. Howard Ennes, Jr. to Raymond Vonderlehr, February 26, 1942, 1942 folder,
1350, RG 90, NA (n. 8); Blank, Survey (n. 9), 793.
35. Judson Hardy to Raymond Vonderlehr, December 19, 1942, 1942 folder, RG 90,
NA (n. 8); [Adolf Nichtenhauser?] DraftFight Syphilis, twopage typescript,
undated, Nichtenhauser Papers (n. 23).
36. On Ehrlich, see John Parascandola, The Theoretical Basis of Paul Ehrlichs
Chemotherapy, Journal of the History of Medicine and Allied Sciences 36 (1981): 1943.
On the use of penicillin, see John Parascandola, John Mahoney and the
Introduction of Penicillin for the Treatment of Syphilis, Pharmacy in History 43
(2001): 313.
37. On the Motion Picture Code, see Gregory D. Black, Hollywood Censored: Morality
Codes, Catholics and the Movies (Cambridge: Cambridge University Press, 1994).
38. Susan E. Lederer and John Parascandola, Screening Syphilis: Dr. Ehrlichs Magic
Bullet Meets the Public Health Service, Journal of the History of Medicine and Allied
Sciences 53 (1998): 34570.
39. Otis Anderson to Mary Switzer, April 3, 1944, V.D. Film folder, 1350, RG 90,
NA (n. 8).
40. Raymond Vonderlehr to Charles Taft, December 31, 1942, 1942 folder, 1350,
RG 90, NA (n. 8).
41. Ibid.
42. Raymond Vonderlehr to Donald Armstrong, August 1, 1938, 193738 folder,
1350, RG 90, NA (n. 8) and Frank Walsh, Sin and Censorship: The Catholic Church and
the Motion Picture Industry (New Haven, CT: Yale University Press, 1996), 179.
43. Anderson to Switzer (n. 39) and Raymond Vonderlehr to C. C. Applewhite,
March 24, 1943, Film Scripts re Venereal Disease folder, RG 442, Box 1, NA SE
Region (n. 13).
44. To the People of the United States script, To the People of the United States
folder, RG 442, Box 1, NA SE Region (n. 13).
45. Thomas Parran to Wilton Halverson, December 6, 1943, 1943 folder, 1350, RG
90, NA (n. 8).
46. Stanton Griffis to Francis Harmon, January 5, 1944; telegram from Stanton
Griffis to Leroy Burney, January 6, 1944; Parran to Griffis, January 7, 1944, To the
People of the United States folder, RG 442, Box 1, NA SE Region (n. 13).
47. Anderson to Switzer (n. 39) and Walsh, Sin (n. 42), 180.
48. Thomas Parran to Walter Wanger, March 16, 1944, To the People of the United
States folder, RG 442, Box 1, NA SE Region (n. 13).
49. Thomas Parran to Walter Wanger, March 31, 1944, ibid.
50. Ibid. See also Frank Walshs discussion of the controversy over the film in Sin
(n. 42), 17982.
51. To the People of the United States script (n. 44) and Thomas Parran to Wilton
Halvarson, April 11, 1944, To the People of the United States folder, RG 442, Box 1,
R. C. Williams, November 5, 1942, State Relations section, General Classified
Records, 193644, Group II, PHS Districts, 0425 (Disease and Conditions), Public
Health Service Records, Record Group 90, National Archives, Washington, D.C.
52. Thomas Parran to George Healy, Jr., September 16, 1944, 1944 folder, 0425,
RG 90, NA (n. 8).
53. Catholics vs. V.D. Frankness, Newsweek 24 (September 18, 1944): 8486.

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54. Catholics and Venereal Disease, The New Republic 111 (October 9, 1944): 446;
Shameless, Sinful, Time 44 (October 16, 1944): 5657.
55. A Message to Women brochure (Washington, D.C.: Public Health Service,
1946), My Story Magazine folder, RG 442, Acc. # 63A314, Box 3, NA SE Region
(n. 13); Annual Report (n. 12), 1946, 263; Eberwein, Sex Ed (n. 2), 9495 (the quotation is from p. 95).
56. For example, the Nichtenhauser papers (n. 23) contain several lists of PHS films
(Boxes 11 and 18) from the period which include the other 1940s PHS VD films discussed in the paper but not Venereal Disease Rapid Treatment Center (1945). See also
A List of Medical Films Which May be Used in Professional Training (Washington, D.C.:
Veterans Administration, 1947) and Health Films Catalog: An Annotated List (New
York: Educational Film Library Association, 1947).
57. On the rapid treatment of syphilis, see Louis Chargin and William Leifer,
Massive-Dose Arsenotherapy of Early Syphilis by Intravenous Drip Method,
A.M.A. Archives of Dermatology 73 (1956): 48284. See also Rudolph Kampmeier,
Syphilis Therapy: An Historical Perspective, Journal of the American Venereal Disease
Association 3 (1976): 98108.
58. On the rapid treatment centers, see Odin W. Anderson, Syphilis and Society:
Problems of Control in the United States, 19121914, Research Series 22 (Chicago:
Center for Health Administration Studies, Health Information Foundation, 1965),
1920; U.S. Public Health Service Outlines Policies and Responsibilities toward
Rapid Treatment Centers, Journal of Social Hygiene 29 (1943): 23940; Donna
Pearce, Rapid Treatment Centers for Venereal Disease Control, American Journal of
Nursing 43 (1943): 65860. On the introduction of penicillin to treat syphilis, see
Parascandola, John Mahoney (n. 36).
59. See, for example, Pearce, Rapid Treatment (n. 56); Wilson T. Sowder, Latest
Information about the CCC Camps for Infected Prostitutes, Florida Health Notes 34
(1942): 15859; William G. Hollister, The Rapid Treatment Center: A New Weapon
in Venereal Disease Control, Mississippi Doctor 21 (1944): 31619; R. A. Vonderlehr
to R. C. Williams, November 5, 1942, State Relations section, General Classified
Records, 193644, Group II, PHS Districts, 0425 (Disease and Conditions), Public
Health Service Records, Record Group 90, National Archives, Washington, D.C.
60. Mary Sponberg, Feminizing Venereal Disease: The Body of the Prostitute in NineteenthCentury Medical Discourse (New York: New York University Press, 1997).
61. Annette Kuhn, Cinema, Censorship, and Sexuality, 19091925 (London:
Routledge, 1989), 63.
62. President Clinton Fires Elders, Washington Post, December 10, 1994, A1.
63. Surgeon Generals Call to Action to Promote Sexual Health and Responsible Sexual
Behavior (Washington, D.C.: Office of the Surgeon General, United States Public
Health Service, 2001).
64. Brandt, Magic Bullet (n. 3), 199200.
65. Copies of the PHS venereal disease films discussed in this paper are at the
National Archives, Archives II, College Park, MD, and/or the National Library of
Medicine, Bethesda, MD.

Chapter Four

Medicine, Popular Culture,

and the Power of Narrative
The HIV/AIDS Storyline on General Hospital
Paula A. Treichler
The continuing crisis of the global HIV/AIDS pandemic and other emerging
infectious diseases makes it imperative to reinvigorate and sustain effective mass
media education and intervention efforts in health and medicine. This chapter
examines the well-planned effort from 1995 through 1999 on the U.S. daytime
television soap opera General Hospital to educate viewers about HIV/AIDS. To situate my discussion, I sketch media representations of the epidemic, the evolution
of the soap opera within its radio and television homes, its changing critical
reception, and General Hospitals place in the television soap world. I then employ
a hybrid method of textual analysis to illustrate the AIDS storyline, presenting
several key scenes that span the story arc. I discuss the specific cultural work
they accomplish and identify the special characteristics of the soap opera genre
that contribute to the educational and entertainment functions of the GH effort.
In conclusion I suggest that soap operas can carry out educational tasks that are
distinct from but no less important than those of scientific journals, network news
coverage, official mass media public health campaigns, and other media forms. I
also suggest that the power of the HIV/AIDS storyline on General Hospital derives
in part from the ideological ambiguity required of commercial U.S. television.

HIV/AIDS, Media, and Representation

By the beginning of 2006, more than twenty-five million people worldwide had
died of AIDS, a global total unimaginable in 1981 when the first official cases
were reported in the United States; during 2005, roughly four million people
were newly infected with HIV and nearly three million died of AIDS.1

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While the mass media are repeatedly found to be the single most important
source for information about the HIV/AIDS epidemic worldwide, relatively few
countries have developed coordinated media education campaigns and even
fewer of these campaigns have been definitively shown to be effective.2 Though
past media health campaigns have successfully provided U.S. citizens with critical information about health and epidemic disease, no comprehensive, coordinated national plan for AIDS media education has ever been put in place. While
this failure is conventionally attributed to the negative and non-media friendly
gay plague connotations of HIV/AIDS, sophisticated modern media would
have had no trouble finding ways to communicate messages about the epidemic.
More directly responsible was the 1980 election of President Ronald Reagan
and his conservative administration together with the rise of the far right and
Christian conservatism; continuing attacks on secular institutions like the
Centers for Disease Control and Prevention crippled AIDS prevention efforts
from the beginning. Indeed, to this day, official U.S. government communications about the epidemic, like most efforts at the state level, remain sporadic,
euphemistic, contradictory, targeted to the wrong people, or distorted by political interests.3
In the absence of national leadership and agenda setting, mainstream U.S.
media coverage of the AIDS epidemic could have helped fill the gap. Yet coverage was initially sparse and fitful, often triggered by perceived threats only marginal to the epidemics real challenges. Spikes in coverage in 1983, 1985, and
1987 were precipitated, respectively, by the ersatz routine household contact
scare, Rock Hudsons announcement in June 1985 that he had AIDS, and the
heterosexual spread of AIDS panic. Such stories, criticized for sensationalism
and contributing to needless fears among the public, nevertheless raised awareness, slowly but steadily ratcheted up overall media coverage, and forced the
media industry itself to regard AIDS as an authentic news story. Hudsons
announcement, for example, increased the average number of stories per
month in major media outlets from 18 to 111 and increased newspaper coverage by 270 percent.4 By the time basketball superstar Magic Johnson announced
in November 1991 that he was HIV-positive and retiring from the game,
HIV/AIDS was a staple topic within several distinct media beats.5 This mainstream coverageby then broad, vast, and relatively consistentwas judged by
the Kaiser Family Foundation in the first of two comprehensive longitudinal
studies to have done a fairly good job of educating the American public about
HIV/AIDS.6 Certainly by 1990 many Americans could rather reliably recite the
AIDS 101 litany (caused by a virus; transmitted via unprotected sexual intercourse with an infected partner, contaminated blood products or syringes, from
infected mother to fetus; preventable but not presently curable; may be fatal)
and the most egregious moral panics of the 1980s appeared to have subsided.
The second Kaiser study, AIDS at 21, confirmed earlier findings but found
coverage of the domestic epidemic starting to decrease in the mid-1990s; only

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stories concerned with business or the global epidemic increased.7 The availability of effective anti-retroviral drug regimens beginning in 1996, making
HIV/AIDS more manageable if not curing it, may explain some of this change.
But as media coverage decreased, so did the publics view that HIV/AIDS was an
urgent health problem; in turn, consumer education decreased as a component
of news stories, and soon even the AIDS 101 catechism faltered: by 2000, four
in ten Americans thought HIV could be transmitted by kissing, one in five by
sharing a drinking glass, and one in six by touching a toilet seat. By 2006, the
epidemics twenty-fifth birthday, editors and news reporters had to work harder
than ever to keep audiences engaged in a story that may not meet editorial criteria for news as clearly as it once did.8
Meanwhile new cases of HIV and AIDS continue to occur in the United
States.9 Moreover, even if a preventive vaccine were found tomorrow, HIV/AIDS
is not the only epidemic disease that poses serious health threats: SARS, Avian
flu, and other emerging infectious diseases have become global health concerns
while even in Americas information age society the old sexually transmitted
diseases, along with plenty of new ones, continue to endanger health, especially
young womens health.10 Clearly AIDS 101-type messages are still important:
that condoms, for example, protect against more than HIV. Just as important is
sustained conversation about epidemics, infectious disease, and public health
conversation involving diverse individuals, communities, institutions, nations,
and mass media producers and practitioners. But if HIV/AIDS no longer counts
as news, how are these messages to be communicated? How is this conversation to be brought about and maintained?
Several general problems hinder any effort to reshape HIV/AIDS and other
health media interventions. First, media stories may not be precise in their use
of health, public health, health care, health care system, health professions, organized medicine, and other related but not interchangeable terms.
Likewise, the technical meanings of terms like epidemic, chronic, and negative test results may not be clearly disentangled from their everyday meanings.
The media, too, can mean many different things. The term media is often
used interchangeably with news, and national news reporting is what most
studies of the media examine.
Second, quantitative studies of media health coverage, like the two longitudinal Kaiser studies cited above, use computerized content data based on primetime network news and major U.S. daily newspapers.11 Largely invisible in such
studies are the many alternative, specialized, and community-based media outlets that were among the first to identify and report the phenomena that came
to be known as HIV and AIDS. This includes, notably, a number of medical, public health, gay, and community news outlets whose front-line reporting helped
combat the absence of national leadership and mainstream media coverage,
raise an alarm, and circulate information through populations believed to be at
greatest risk for HIV.12 Because they are not official, such outlets were rarely

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counted in studies of news reporting about AIDS and had little influence on
the developing understandings of the nature and scope of the epidemic.
Third, quantitative studies primarily assess content and quantity of media coverage. To take just one example, studies of press coverage of Magic Johnsons
HIV announcement typically identify the prominence of the story (e.g., front
page, top of the broadcast, or elsewhere); its length (number of paragraphs or
minutes); how it is classified (e.g., as news, sports, feature, lifestyle); how many
stories appear over a given span of time; and possibly some ballpark qualitative
information (is he portrayed negatively or positively? Does the story highlight heterosexual transmission? Is there a consumer education component?
and so on). We learn little about the narratives themselves, their lexical choices,
metaphors, sources, emotional valence, and accompanying images. Put differently, research on media coverage, like media coverage of health, typically pays
scant attention to the complex apparatus of representation.13
Fourth, conventional studies of the media largely ignore entertainment
media, including primetime programs on national networks.14 An Early Frost, a
high quality made-for-TV movie broadcast nationally on NBC in 1985, was one
of the earliest media projects to educate the public about the AIDS epidemic;
though widely praised by television commentators, it would not have shown up
in typical studies of AIDS media coverage.15 Nearly twenty years later, an
episode of the prime-time dramatic series The West Wing delivered a technical,
equally potent lesson about the quest by countries in Africa to obtain generic
anti-retroviral AIDS drugs; an earlier episode had been able to make the U.S.
census important and suspensefulsomething few news media outlets even
attempted.
Finally, despite decades of research on the effects of media on individuals and
groups, we do not really know for certain how much, how effectively, and in
which ways the mass media might genuinely contribute to renewed health education efforts about HIV/AIDS. What we do know is that people are hungry for
information about medicine, science, and health that promises to help them live
their lives and more skillfully negotiate the seemingly endless floods of complicated and contradictory health messages washing over them. Seeking, sometimes desperately, to stay afloat, they look for sources that will help, including
those that exist below the official radar.
This was made clear in 1981 (coincidentally the same year that the first official cases of AIDS were reported in the United States) when the New England
Journal of Medicine published Health and Medicine on Television by famed
media scholar George Gerbner and his colleagues at the Annenberg School of
Communication at the University of Pennsylvania. To the considerable dismay
of the Journals learned readers and the major news reporters who picked up the
story, the article reported that many Americans gain their medical and health
information not from their physician or the medical profession but from the
media. And they dont necessarily get it from widely respected media like the

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New England Journal of Medicine, Nova, or even the New York Times. Popular media,
and above all television, were major sources of information. Most shocking of all
was the profound influence of TV soap operas. It may well be, the researchers
concluded, that daytime serials are the largest source of medical advice in the
United States.16
We cannot doubt the potential of the mass media to communicate with the
public in unparalleled ways: in the 2002 Kaiser study, 72 percent of the U.S. public surveyed identified the mass media (including television, newspapers, and
radio) as their most important source of information about HIV/AIDS.17 The
Centers for Disease Control and Prevention reports that 88 percent of the
American public obtains health information from television. Among some populations, the percentage is even higher.18 And by no means are serious prime-time
dramas like The West Wing alone in educating audiences and shaping their views
on significant topics. Michael X. Delli Carpini and Bruce A. Williams, studying
media influences on attitudes toward the environment, found that out of three
hundred allusions by focus group participants to media sources of their information, only one (a reference to George H. W. Bush) would have been identified in traditional studies of the media. In contrast, most references were to
made-for-TV movies, sitcoms, talk shows, music videos, womens magazines,
tabloids, and the like (and this was before the explosion of the World Wide Web
and the Internet).19
The narrative power of entertaining fictions is one source of the legendary
distrust expressed toward literature and art by scientists, philosophers, physicians, and other proponents of rationality and objectivity.20 But this is the
twenty-first century, not Platos Republic: entertainment narratives cannot be
banned by decree in todays vast and diverse global media empire. A more useful course is to accept the real world we live in and examine how these narratives
work, how they are used by their audiences, and what contributions they may
actually and potentially contribute to entertainment and education about
HIV/AIDS.21 In this essay I examine the narrative power of the soap opera genre
and in particular the HIV/AIDS narrative on General Hospital.

Entertainment, Education, and the Daytime Serial Genre

The Oxford English Dictionary Supplement defines soap opera as a radio or television serial dealing especially with domestic situations and frequently characterized by melodrama and sentimentality.22 The term soap opera (paralleling
horse opera, the genre designation for westerns, and space opera for science
fiction) came into use in the 1930s, when soap and detergent manufacturers
were early sponsors of daytime radio serials. These fifteen-minute tragedies,
wrote a critic in a 1938 review in the Christian Century, I call soap tragedies . . .
because it is by the grace of soap that I am allowed to shed tears for these

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characters who suffer so much from life.23 American radio soaps were first
broadcast in the early 1930s; by 1940, they represented 90 percent of all commercially sponsored daytime broadcast hours. That they remain a staple of daytime programming is demonstrated by the record of The Guiding Light, which
has been running continuously on radio or television since 1937.24
In the United States, writes Robert C. Allen, a leading scholar in the field, the
term soap opera itself marks out the serials ironic relationship both with
high art and the dirt soap is bought to eliminate.25 Despite the highbrow connotations of opera, soaps are not generally associated with opera or any other
form of high culture. Serialized drool, wrote a commentator in 1940; formless, unresolving, unending, said a TV critic in 1961.26 Their feminist reclamation still in the future, soaps were traditionally gendered feminine, dismissed as
sentimental claptrap, and sometimes simply equated with womens television.
Soap fansperceived as desperate housewives, lovesick teens, or crazed stalkers
were disparaged and despised.27 Given the separation of education from entertainment media, the modernist evaluation of high culture over popular culture,
and the association of soaps with entertainment, low culture, and femininity, it
is unsurprising that soap operas were long considered not merely low culture
butin the words of Ien Ang in her classic 1985 study of the prime-time soap
opera Dallasthe lowest of the low.28
This was certainly the conviction of New York psychiatrist Louis Berg who, in
1942, launched a ferocious and widely publicized attack on daytime serials.
Empirical evidence, he claimed, demonstrated that soap operas directly precipitated negative reactions in their impressionable female audience: acute anxiety,
tachycardia, arrhythmia, increased blood pressure, profuse sweating, tremors,
vasomotor instability, nocturnal frights, vertigo, and gastrointestinal problems.
No matter that these severe maladies were psychosomatic in origin (triggered,
that is, by no identifiable organic cause but by the continuous crises experienced
by characters on the shows), their effects were just as devastating. Indeed,
claimed Bergs pamphlet Radio and Civilian Morale, the devitalizing mental
state produced by soap operas was, in wartime, little short of treason.29 Fearful
that Bergs attacks would cause President Franklin D. Roosevelt to impose
wartime programming controls, the broadcasting industry commissioned Paul
Lazarsfeld and other respected social scientists to independently investigate
soaps effects. Bergs claims, based on a widely prevalent conception of mass
communication known as the inoculation, hypodermic needle, or magic
bullet model, ascribed immense power to modern media and presumed their
deterministic, direct, and inescapable effects on a passive, compliant public; as
the metaphors themselves suggest, this model of communication pervaded
modern medicine as well, likewise perceived by its practitioners as a tool too
dangerous for the public to access directly, safe only when mediated by experts
with knowledge, training, and skill.30 Drawing on their own more sophisticated
and socially inflected model of mass communication, a model that was to

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dominate communication research for the next several decades, Lazarsfeld and
his social science colleagues found soap operas effects considerably less monolithic and harmful than Berg had claimed. Other experts enlisted by the networks even testified to the positive effects of soap operas; a number of
psychiatrists claimed that soaps actually benefited their clients.31
Intrigued by Bergs fervor and the ensuing hoopla over soap operas, the writer
and humorist James Thurber undertook his own investigation for the New Yorker
magazine. The five-part 1948 series opened with this reported incident:
In the intolerable heat of last August, one Ezra Adams, of Clinton, Iowa, strode across
his living room and smashed his radio with his fists, in the fond hope of silencing forever the plaintive and unendurable chatter of one of his wifes favorite afternoon programs. He was fined ten dollars for disturbing the peace, and Mrs. Adams later filed
suit for divorce.
I have no way of knowing, continued Thurber, how many similarly oppressed
husbands may have clapped him on the back or sent him greetings and cigars, but I
do know that his gesture was as futile as it was colorful. He had taken a puny sock
at a tormentor of great strength, a deeply rooted American institution of towering
proportions.32

Thurber had some sympathy for Ezra Adams and even for Berg. But like others who set out to ridicule soap operas, Thurber found features to admire. For
example, by producing successful daytime programming, the creators and writers of soap operas had defied the conventional broadcasting view that daytime
radio was a wasteland. Sure, reasoned radio executives, millions of American
housewives acted as purchasing agents for the home and might respond well to
advertisements for household products. But they were notoriously all over the
place, upstairs and down, indoors and out, feeding the children, cleaning the
house, hanging up clothes in the yard, talking on the phone. There was no way
this mass of busy women could be made into an attentive audience.33 Pioneers
of soap opera set out to prove management wrong and soon filled the previously
fallow airwaves of daytime radio (featuring segments like Mouth Hygiene)
with stories carefully crafted for the intermittent listener.
These now legendary figures of early daytime drama, as familiar to soap scholars as the books of the Bible, were an interesting lot whose prodigious skill was
matched by acute attention to daytimes commercial potential. Given the charismatic aura now surrounding the first soap authors, its a little strange that serial
dramas as a genre continue to be associated with authorial anonymity; indeed,
this perceived absence of The Author may partly explain critics contempt for
the form.34 But authors they surely were. By the mid-1930s, write Madeleine
Edmondson and David Rounds in their breezy 1973 account, the world of radio
soaps was divided into three parts, ruled by the three most famous names in
soap history: Irna Phillips, Elaine Carrington, and the Hummerts. All three
appeared in Chicago (first home of soaps) at roughly the same time and

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dominated daytime serials in the United States to such an extent that they
determined and defined what soap opera unalterably became.35
As a writer himself, Thurber could only marvel at the productivity of these
innovators, day after day and week after week. In 1948, when he was writing
Soapland, thirty-six radio soaps were broadcast from New York, and a dozen or
more aired from other locations: If the more than four thousand scripts (eight
million words) of Just Plain Bill [the oldest radio serial then on the air] had been
saved, they would fill twenty trunks, and the entire wordage of soap opera to
date, roughly two hundred and seventy-five million words, would fill a goodsized library.36 Irna Phillips, noted for introducing professional characters into
her stories (doctors, ministers, lawyers, social workers), was said to turn out
three million words a year in her prime (sixty thousand a week). Before she
hired assistants, she dictated her scripts to a secretary and reportedly could dictate a thirty-minute script in precisely thirty minutes.37 The Hummerts, producing 6.5 million words per year and by 1938 filling one-eighth of all purchased
radio airtime, put together a whole publishing empire including a factory of
poorly-paid writers that turned out scripts like General Motors (a simile that
reinforced the perception of soaps as unauthored rubbish put together on an
assembly line). Communicating from their townhouse with writers and executives only in writing, the Hummerts prohibited overlapping dialogue, music, and
any other effects that might detract from the script, demanded absolute allegiance to their storylines, and, notoriously cheap, rewarded top personnel with
annual bonuses in the form of Christmas cookies. Their serene detachment
insulated them from the industrys ups and downs including the panic and
blacklisting of the McCarthy era; while others were hastily changing storylines
and firing suspect writers and actors, the Hummerts simply went about their
business.38
This history shaped the format of soap operas, secured their position in the
broadcast line-up, and determined elements of production, reception, and content. American soap operas made their transition to television in the 1940s (the
last radio soaps went off the air during Thanksgiving week in 1960) and soon
emerged as a favored daytime format for network television as well. In 1945
broadcasters issued a decree that daytime television be deliberately constructed
so as not to require the full attention of the audience; women, again, were the
viewers on whom the soaps depended and were fashioned to accommodate.39
Some radio soaps were adapted for television (when The Guiding Light celebrated its fiftieth television anniversary in 2002, it had racked up some thirteen
thousand episodes); others, including All My Children and General Hospital, were
created for daytime television. Beyond the number of hours they can fill, TV
soap operas have numerous virtues that appeal to network executives and commercial sponsors. In contrast to prime-time dramatic programming, soaps provide a steady, reliable profit base and are relatively economical to produce.
Though more expensive than radio because actors and actors must be visible,

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television soap stories nevertheless unfold in homes, offices, police stations, hospital waiting rooms, and other everyday spaces that require few elaborate sets or
costly location shooting.40 Likewise, as Allen notes, the daytime system of labor
relations is distinct from that of prime time: Soap operas are not star vehicles,
and actors bent on stardom (with a few notable exceptions) rarely stick around
long enough to get expensive. The real stars of soaps are families, communities,
and relationships. Tough professional actors make up the large ensemble casts
that constitute the communities of Pine Valley and Port Charles; they soon learn
to handle relentless daily production schedules without a fuss (even more
relentless on TV, where lines must be memorized rather than read). And if they
do fuss, the serial format is famous for providing, as Allen puts it, ample opportunities to dispose of recalcitrant actors/characters in narratively convenient
ways.41 This flexibility can also work to the advantage of some actors, for whom
the prolonged coma, the trip abroad, or the mysterious disappearance enables
them to arrange time off, do other work, have an operation, have a baby; for
women actors, whether in principal or supporting roles, soaps have long accommodated the kind of personal arrangements for childbearing and child raising
that are becoming standard workplace features.
Reviewing Search for Tomorrows television debut in 1954, TV Guide reported,
Frankly, tomorrow had better come soon for the characters on this show, before
they all lose their minds.42 But change was in the wind for the critical assessment of soap operas. Writer Dan Wakefields 1976 non-fiction book All Her
Children opened with a chapter called How I Got Hooked and the admission
I was a closet soap opera addict.43 As a schoolchild he had become addicted to
radio soaps, and would pretend to be sick when a Ma Perkins dnouement was
due.44 He warmed to television soaps more slowly, but in the 1970s he fell for All
My Children, Agnes Nixons popular television soap creation. After years of
ardent viewing, he decided to write a book about the show.45 His fan status and
frank allegiance proved excellent credentials for research but at times handicapped him as well: when he finally summoned the courage to interview Susan
Lucci, who plays the lovely but troubled vixen Erica Kane, he found with considerable embarrassment that the fan in him was dominating the professional
reporter, making him shake so much he could hardly hold his pen.46
Wakefields book captured the obsessive viewing habits of soap audiences
that would soon be confirmed by Gerbners New England Journal findings, but it
also heralded a new critical interest in soap opera that persists today. That the
prestigious British Film Institute published a 1980 collection of essays on the
British soap opera Coronation Street was another sign of change.47 Despite soaps
engagement with various contemporary issues, the growth of interest among
serious critics is primarily in the interpretation of the serial form. Certainly
soap plots continue to revolve around domestic life and domestic relationships,
and scripts consist largely of talk; this talk is still highly redundant both from
episode to episode and within a single episode, and the first-time viewers

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perception is still quite likely that nothing whatsoever happens. But where
famed media analyst Marshall McLuhan declared in 1951 that soap operas
were short on action, long on situations,48 feminist critic Tania Modleski
countered in 1982 that this was precisely the point: action on daytime serials is
less important than reaction and inter action.49 Modleski did not champion soaps
as feminist texts but pointed to the important relationship between the soap
opera text and its audience; following soap storylines, she argued, calls for
some of the same skills as a mothers domestic life. It is just such an interpretation, argues Charlotte Brundson, that initially drew feminist scholars to soap
opera. Soap opera and Womens Studies entered the academy together in the
early 1980s, and developed a certain symbiosis: soaps provided an excellent site
for the study of the female viewer (whether theorized as a textual construct or
investigated as a sociological fact, thus appropriate for both humanists and
social scientists); and as feminists took up serious scholarship on soap operas,
they gained more respect for the skills, competencies, and pleasures of conventional femininities.50
There is considerable debate over the key features of serial dramas, as Laura
Stempel Mumfords detailed discussion makes clear. She herself proposes the
following definition, arguing that it contains the elements that are necessary
and sufficient to constitute and delimit the object of study and make possible
an independent examination of genre, practices, and medium: A soap opera
is a continuing fictional dramatic television program, presented in multiple
serial installments each week, through a narrative composed of interlocking
storylines that focus on the relationships within a certain community of characters.51 Although Mumfords definition is flexible, it is not intended to
encompass all soap formats. For example, the open-ended narrative form of
U.S. soaps (where stories reach no permanent resolution) contrasts with the
closed soap format characteristic of Latin American telenovelas, in which narrative resolution may take a while but will ultimately happen.52 As Ana Lopez
writes, each telenovela has a beginning, middle, and end, and fans take pleasure
in this narrative closure. The same stars move from one to another story in new
roles, as in theatre repertory, and fans happily anticipate the next story with its
new ensemble of characters; actors in these productions, not inescapably identified with a single character over a period of years, can and do become mainstream stars.53 As Allen argues, the sheer volume of material generated by a
single U.S. soap opera makes textual mastery an impossibility, a problem exacerbated by any given storylines lack of definitive boundaries. Nor does a given
soap opera ever really end. Even when shows are cancelled, they expire into a
kind of limbo of unresolution, their ultimate meaning never fixed.54 This contributes to the sense that the soap world continues to exist whether the viewer
is watching or not; indeed, as Dorothy Hobson points out, this made it possible
for the British serial Crossroads to be cancelled in 1988, then resurrected in
2001.55

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Hobson, emphasizing the business of television, calls soap opera the ultimate 20th century mass media form in its dramatic, artistic, and cultural use of
realism, its role as a carrier of ideological messages into the home, and its importance to the broadcasting industry.56 U.S. soaps are clearly shaped by the nature
of U.S. television, both in form and function. Soaps were and continue to be
designed to sell and fill daytime programming slots; they are supported by and
structured to highlight commercial messages; they bring the public medium of
television into domestic space; their endless variations on a theme accommodate
the avid fan, the faithful viewer, the intermittent audience member, and the
novice. Thus what Thurber characterized as plaintive and unendurable chatter has come to be evaluated quite differently. Examining the semiotics of soap
operas, Robert Allen argues that they create meaning differently than most
other media forms and follow their own underlying rules. Novice soap viewers
perceive that nothing happens only because they lack long-term viewers
knowledge of a given soaps layered history and of the conventions that embed
moral value, unexpected drama, and life lessons in everyday soap events.57 A
soap accumulates meaning over timein some extreme sense, over all the
episodes since the shows inception. The engagement of viewers with these
never-ending texts is an important research area. For Hobson, the experience of
watching episodes of the British serial Crossroads with audience members
exploded the myth of the passive viewer and revealed the complexity of the
relationship between viewers and television programs.58 Moreover, the repetitions of the soap format function like the play-by-play commentary on sports
events, a parallel that Lee Harrington and Denise Bielby trace in some detail in
their study of soap fan culture.59 In sports presentations, too, repetition and
redundancy enable the viewer (or listener) to join mid-broadcast, figure out
quickly whats going on, and join the familiar ritual of synthesizing sameness
with difference.
In myriad ways, then, soaps efficiently communicate plot developments to
viewers whove missed an episode and enhance the sensation that the community of a given soap has a life of its own. Thus Bernard Timberg, in his rhetorical
analysis of camera movement on soap operas, describes the exhilarating experience of tuning in to General Hospital after an eighteen-month gap:
There they wereall my old friends and acquaintances from Port Charles . . . just as
they had been eighteen months before. It is true that several important events had
occurred since I last tuned in, but the people I had gotten to know . . . had not changed
in any fundamental way, and more importantly, the soap opera rite itself was exactly the
same. . . . Because of my previous knowledge of the plot, characters, and conflicting
moral principles in this soap opera, I was able to catch upwithin a single dayon all
the important developments.60

The distinctive rhetorical relationship [that] exists between television program

and viewer, argues Timberg, is in part established and maintained by the soap

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operas unique discourse patterns, including the specific camera and sound
conventions [that] structure the viewers experience of the soap opera world.61
The AIDS storyline on General Hospital enables us to examine in more detail how
the soap opera genre accomplishes its narrative work.

General Hospital
General Hospital was ABCs first successful daytime soap opera. Introduced on
April 1, 1963, the show brought several new features to the soap opera genre.62
Substituting medical storylines and a hospital community for the domestic dramas and extended families of most existing soaps, General Hospital, at least initially, provided a different pace and milieu. Fewer commercials breaks, for
example, made longer scenes and more plot development possible. The show
went to color in 1966, to forty-five minutes in length in 1976, and to an hour in
1978 when Gloria Monty became producer. Monty introduced editing, allowing
for faster cuts and transitions, and incorporated sound and camera techniques
from prime time television and cinema. Timberg recalls a dramatic GH moment
in the deadly Lassa Fever storyline from the early Monty era: an alarm suddenly sounds and patients and staff know that the hospital is now under quarantine. Borrowing the visual representation style of the Hollywood disaster epic,
the show treated viewers to a rare high angle birds-eye view of the entire staff,
frozen in postures of shock and disbelief. (It was this kind of experimentation
with the standard patterns, adds Timberg, that excited viewers and put General
Hospital in the number one position.)63
Despite General Hospitals focus on professional themes and hospital settings,
the show nonetheless centered on several large extended families in Port
Charles, New York, including the rich, powerful, and obnoxiously over-the-top
Quartermaines. Moreover, it was the 1981 love story of supercouple Laura
Webber Baldwin (played by Genie Francis) and Luke Spencer (played by
Anthony Geary) that brought General Hospital wider fame in the culture at
large, captured a daytime soaps highest ratings ever (30 million daily viewers),
climaxed in the cameo appearance of screen legend Elizabeth Taylor at Luke
and Lauras long anticipated wedding, and went down in history as a favorite
soap storyline of all time.64 Nevertheless, in addition to the Lassa Fever epidemic, General Hospital has produced some memorable and award-winning
health and medical storylines. In 1994, the series followed the death in a
car crash of B. J., the young daughter of two principal characters, and the
transplant of her heart to her cousin Maxie; B. J.s grave continues to be regularly revisited by those who loved her. Monica Quartermaines struggle with
breast cancer was just winding up as a major storyline when AIDS was
introduced.

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The HIV/AIDS storyline began in 1995, about fifteen years into the U.S. epidemic and more than one year before effective anti-retroviral medications were
made available. At this point, General Hospital was a leading daytime serial and
one whose audience members were regarded not merely as viewers but as fans.65
Though other soaps (and television shows more generally) had featured characters with HIV or AIDS, they usually appeared as innocent victims or onedimensional figures of threat to the principal characters, and who were then
quickly dispatched by disappearance or death.66 General Hospital, in contrast,
made AIDS a central theme and used it to educate and to explore the meanings
of the epidemic.
The AIDS storyline was built around the character of Robin Scorpio (played
by Kimberly McCullough), who first appeared on GH in 1985 at the age of
seven. Ten years later, she is in love with nineteen-year-old Stone Cates (Michael
Sutton), a relatively new arrival in Port Charles. Stone, introduced in 1993 as a
terrific-looking guy from New York City, is a former street kid now trying to clean
up his act; by the time he develops symptoms and is diagnosed with HIV/AIDS,
viewers have accepted him as a romantic young leading man and are invested in
his relationship with Robin. This relationship becomes the vehicle for education, involvement, and suspense.
An early scene in the story arc illustrates stock features of the soap narrative
form and their interaction with the HIV/AIDS storyline. Before his HIV diagnosis, Stones mysterious symptoms have dragged on for months, creating pain
and anxiety for him, Robin, their loved ones, the Port Charles community, and
the shows many fans. Wounded in a shoot-out, Stone shows up at General
Hospital accompanied by Robin. Dr. Kevin Collins (played by actor Jon
Lindstrom), the psychiatrist who in earlier episodes had ordered Stones blood
test and given him the unhappy news about HIV, now breaks the news to the hospitals chief of staff and star internist, Dr. Alan Quartermaine (Stuart Damon) in
the following exchange:67

Transcript 1. Breaking the News to Alan (April 1995)a

Stone, Robin, Kevin Collins, Alan Quartermaine, General Hospital Exam Room
Kevin: Shortly after New Years, Stone came down with a particularly virulent
flu bugchronic fatigue, sore throats, severe headaches, fevers, you name it.
[A WHITE W IN UPPER RIGHT OF SCREEN INDICATES WEATHER ALERT]
Alan: Shortly after New Years
Stone: I couldnt shake it.
Kevin: Well, shortly after that we discovered that Stone is dyslexic. Ive been
working with him and in the course of our sessions based on his continuing

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complaints, I suggested that he get a blood work-up. He agreed. He tested positive for HIV.
Alan: Dear God. [LOCAL ABC AFFILIATE ISSUES SEVERE WEATHER AUDIO
SIGNAL; VIDEO CRAWL ACROSS BOTTOM OF SCREEN INDICATES TORNADO WATCH FOR THE FOLLOWING COUNTIES. THIS CONTINUES
THROUGHOUT THE EPISODE.]
Kevin: Yes, well hes been digesting that diagnosis for a few days now. What
were trying to do right now is convince him to look at his optionssooner,
rather than later.
Alan: Thats good advice, Stone.
Stone: Look, I want to say something, but I dont want to offend anybody.
Alan: Dont worry about itwere a fairly tough-skinned group around here.
Stone: Dr. Quartermaine, Dr. Collins and Dr. Hardy were the ones who
suggested bringing you in, which is fine, except theres one thing that
concerns me.
Alan: By all means, lets hear it.
Stone: Well, what happened to me, I dont want it on the street. Im just not
ready for anybody that I know to start treating me like Im some kind of a
freak.
Alan: Listen, Stone, if theyre your true friends, they wont do that anyway. And
so far as Im concerned, you can put your mind at ease, because Im obligated by
oath not to divulge your medical condition without your consent.
Stone: I knew that, I guess I just needed to hear it from you. Okay, now that
you know, what comes next?
Alan: Information. How and when were you exposed?
(Two-shot: Stone looks at Robin, sighs; music begins on soundtrack)
Robin: I love you. Nothing could ever change that.
Close up on Stone. Relieved, he smiles at Robin. Music swells. CUT TO
COMMERCIAL.
****END OF SCENE****
a

All transcripts were prepared by the author, with assistance from Alice Filmer,
from VHS video-recordings of the television broadcast. The transcripts are
intended to give the reader a better idea than would a summary or paraphrase of
how these scenes unfold; they are of course selective, leaving out many elements a
shooting script would make visible, not to mention details of sound, set, costume,
and so forth that significantly contribute to the experience of the show.

The scene ends with the inevitable question to someone who is HIV positive:
How and when were you exposed to the virus? As the camera moves in and Stone
prepares to answer, the clinical question meshes seamlessly with the standard
closing of every soap segment with revelation or suspense. These beats, often
accompanied by prolonged close-ups and music, signal viewers that they must,

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in Frentzs phrase, stay tuned.68 Or, as Rick Altman observes in his analysis of
soap soundtracks, tune in: because television allows a certain liberty of circulation, sound cues function to italicize some screen events over others and
harmonize the flow of programming with the household flow on which it
depends.69 Just as a particular soaps theme music issues a siren song to its fans,
the scene-ending climactic chord, perhaps the best known and most parodied
sound convention of soaps, signals the crystallization of one problem and the
entrance of another.70 In the scene above, the news of Stones diagnosis is the
problem crystallized (Now that you know, says Stone, What comes next?)
Alans question heralds the next problem: How and when were you exposed?71
Second, Stone must answer Alans question. Whatever viewers may have had
time to dread or hope for during the commercial break, Stones story is not
going to feature terms like gay, bisexual, or men who have sex with men.72
Hes no angel: he began living on the New York streets with drug users when he
was twelve years old, first had sex at age thirteen, slept around (with girls) for
years, and had a girlfriend, Crystal, who was into hard drugs but not into condoms (Crystal, we also learn, died two years ago). But Stone never injected illegal drugs himself and he left Crystal four years ago because it was making me
crazy watching her kill herself. Acting responsibly, he then got an HIV test, and,
relieved when the results were negative, determined to clean up his act. Thus his
migration to Port Charles from the big city.73 Though viewed with suspicion by
Robins Uncle Mac (the police commissioner) and others, for he is still an outsider after all, he didnt do the really bad things that audience members would
be likely to condemn.74
Third, Stones back story therefore enabled General Hospital to circumvent
what Larry Gross calls the inherently problematic and controversial representation of homosexuality and/or gay men and women in media and still fulfill
what Joy Fuqua calls the contemporary soap opera genres structural and institutional imperative to maintain legitimacy by presenting timely narratives
through the (now conventional) social issue storyline.75 But the GH decision to
focus an AIDS storyline in the mid-1990s on a straight male adolescentone
directly connected to a beloved major characterdid not necessarily evade challenge: as research published in 2000 found, straight white males are consistently
under-studied in relation to HIV/AIDS, under-targeted by media messages, and
uninformed about HIV transmission, prevention, and treatment.76
A fourth theme is secrecy. Secrecy and silence animate HIV/AIDS stories,
including the troublesome issue of confidentiality. In this scene, Alan assures
Stone of total confidentialityan assurance with regard to HIV/AIDS that has
proved difficult to achieve in the modern hospital environment. But the
exchange dovetails with the needs of the soap opera genre, where secrets are the
coin of the realm.
Fifth, the soap formats elasticity allows the AIDS storylinelong a troublesome one for many media venues despite the quantity of coverage I cited

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aboveto be introduced like any other storyline: through a constellation of preexisting characters and ongoing, intertwined narratives. Among other things,
this means that viewers who find AIDS depressing or offensive cant change the
channel or turn off the television unless they want to miss all the other storylines
theyre involved in.77 On a related point, the scene illustrates the ease with which
a given episode can provide back story for viewers who are new or may have
missed an episode or more.
Sixth, the narrative economy with which a single soap scene or episode can
intertwine past, present, and future complicates the task of defining a specific
soap opera, bracketing a specific storyline, or even determining the text under
study. Take the HIV/AIDS storyline on GH. One can say that it began in early
1995 and continued to play out until Stones death. But doesnt it equally begin
when the lab finds out hes HIV positive? Or when Kevin and Stone himself find
out? Or when Robin (and we the viewers) find out? Or the doctors at General
Hospital? Or everybody? Or what about when he was originally infected, presumably three or four years earlier?78 And just because Crystal is already dead
doesnt mean she isnt, or couldnt be, part of this storyline.
Seventh, the long temporal trajectory typical of soap narratives blurs some of
the black and white representations of medicine and disease typical of other
media genres. These variations, interacting and alternating from week to week
and episode to episode, allow the emergence of positive and negative character
traits, idealization of and cynicism about medical progress, and the ups and
downs of Stones disease, constituting what Joseph Turow calls a more textured
portrait of disease and health care.79 And as for dramatic changes in character,
at which soaps excel, the two physicians who appear in this scene as fully compos mentis professionals will both before too long be stripped of their credentials and will be teetering on the edge of a vast physical and psychological abyss.
Eighth, General Hospital is set in the fictional community of Port Charles
loosely based on Rochester, New York, with a leading Rochester hospital the prototype for General Hospital itself. As Robert Allen has said, the soap world is
almost reality, operating as-if-it-were-real.80 Stones medical diagnosis and
treatment have been praised for their scientific accuracy, an educational mission
to which the producers pledged themselves. But other aspects of the health care
system are ludicrously portrayed. Rarely in his course of treatment, for example,
is Stone asked about his financial resources or insurance coverage.81 Not that
General Hospital is alone in taking liberties with health care reality: Therese
Joness 1997 overview of soaps treatment of illness and disease indicates that
physicians as characters are so plentiful that they outnumber patients by about
eleven to one.82 Some soap viewers, especially health professionals or health
journalists, may reflexively invoke the realist standard, but regular soap fans
seem fairly well equipped to distinguish the soap world from the real world.
Finally, this April episode described above aired during tornado season in East
Central Illinois and our local station posted an onscreen tornado watch message

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throughout most of the hour (which then appeared on my VHS copy).

Indicating that weather conditions for a tornado exist in the viewing area (a tornado warning means that a tornado has actually been sighted in the vicinity), this
message is but one of many everyday intrusions typical of television viewingin
this case one that may soon require the viewer to decide whether to prudently
evacuate to the bathtub or basement or continue watching the show (at least
until the power cuts out). In the case of soap opera episodes, historically broadcast once and once only, the choice for viewers was especially acute. For
researchers, such on-screen messages suggest the difficulty of obtaining a pure
television text.83
As these points of intersection played out over the following months, the GH
AIDS storyline sparked widespread media coverage and lively debate and speculation among fans on the GH online bulletin board. In the first few weeks after
Stones diagnosis, they addressed such topics as the difference between HIV and
AIDS; deaths of friends with AIDS; other shows with AIDS themes (One Life
to Live, Life Goes On); how well Stones physician broke the bad news; how well
the actor playing Stones physician handled the scene; whether the actors of GH
(or any soap) are up to such a demanding and serious storyline; what the actors
in real life think about AIDS, safe sex, drugs, and so forth; what the regulations
are regarding confidentiality and reporting; treatment options; and finally
whether the GH writers and producers would really kill off a beloved character
to AIDSor worse, two beloved charactersor worst of all: the whole city of Port
Charles!
Some of these topics point to the legendary interconnections among characters on soaps and audience members intimate knowledge of those connections.
The last topic, in particular, reminds us of the common truism about sexually
transmitted diseases: youre not having sex with just one partner, youre also having sex with all your partners sex partners, and all those partners partners, and
so on. When any long-time fan can actually put a face and name to those partners
going back yearsa soap like General Hospital can provide a potent and vivid representation of the messy realities of human sexual behavior.
The Internet gives todays TV scholar or critic considerable access to the views
of soap fans and opens a window to online fan culture.84 One message (or post)
on the General Hospital bulletin board spoke directly to the intimacy fans feel
toward the characters (I have edited these posts slightly): If GH is going to allow
Stoneand maybe Robinto contract the disease, they are taking this opportunity to show that HIV/AIDS can truly strike anyonenamely, the people we
love. Another participant wrote, It may be painful and scary to lose these
friends. As a young gay man I know what it feels like. If GH can evoke all these
feelings, maybe it will contribute to the eradication of this disease. A lot to ask
of a soap opera, I know, but we all have our responsibilities and GH seems to be
accepting theirs. Another fan replied: I agree that thats an important message. But I hope they can do it without infecting Robin. Of particular interest

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was whether suspense over Robins HIV status would play itself out in real time,
providing, as one fan put it, six months of uncertainty as everyone waits to see
if Robin has been infected while simultaneously dealing with the progression of
the disease in Stone.
And indeed, that is what the GH writers chose to do. At the end of this episode,
Robin reluctantly consents to be tested herself for HIV antibodies and friends
and fans wait anxiously to learn the results. The good news is, as she tells Stone
when she finds out, she doesnt have HIV (I came over to give you something
positive to think about, she says, in a negative sort of way.) The bad news is that
before Stone leaves the hospital, further blood tests reveal that his HIV infection
has already progressed to AIDS. He now sees no point in taking his medications,
let alone trying to be optimistic. But gradually he begins to adjust and can even
make a humorous Dallas reference: Maybe Ill just be like that dude in the
shower and realize that this whole year has been a bad dream. In June a memorable confrontation takes place. The nurses ball is an annual GH event written
into the show as an AIDS fundraiser put on by the hospital; though it preceded
the AIDS storyline, it now takes on special significance, and the spring 1995 ball
features cameos by real AIDS personalities: Jeanne White (mother of Ryan
White, the young man with hemophilia who had died in 1990) and Lee Mathis,
a real Hollywood actor diagnosed with HIV/AIDS.85 As the ball proceeds, A. J.
Quartermaine (played by Sean Kanan)Alans son and, as Nadja Michel-Herf
writes, the conservative nemesis of the generally tolerant younger Port Charles
generationmutters You gotta be an idiot to get AIDS.86 Stone challenges A. J.,
his knowledge undercutting A. J.s stereotypes and prejudices; he then discloses
that he has AIDS. This coming out moment ends the episode, and subsequent
episodes trace the reactions of other characters to the news.
Through all this, Robin is Stones pal, lover, and most upbeat supporter. In the
following scene, a few months after the hospital scene, Stone is moving into a
new place with the help of Robin, A. J.now at least able to be in the same room
with a person who has AIDSand his brother, Jason Quartermaine (played by
Steve Burton). Stone by this time is on a full course of treatment, and he
explains here what all his medications do. Keep in mind, as I said earlier, that
effective retroviral pharmaceuticals (i.e., protease inhibitors) were not made
available until a full year later.

Transcript 2. Stones Medications (July 13 1995)

Stone, Robin, A. J. Quartermaine, Jason Quartermaine, Stones new apartment
(Stone is unpacking bottles of medications and vitamins and setting them on the
counter. Robin enters with the two Quartermaine brothers. All three are carrying
boxes.)

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Robin: Okay, I have it. I have the box with the most important item of all.
(Places framed portrait of herself and Stone in formal dress on the desk in front of him).
Now youre home.
Jason: So, do you think we could have picked a hotter day for moving?
A. J.: No!
Stone: Hey, the hospitality bar is up and running. Have some water. (Passes out
bottles of water).
Jason: Thanks. (Opens bottle)
A. J.: Thanks. (Everyone opens bottles of water and drinks)
Jason: (Looking at bottles of meds Stone is setting out on counter) So, this is them.
Stone: Yeah, I was hoping to spare you guys the treat, but Im on a tight schedule so I gotta get these suckers down.
A. J.: Stone, do you want us to take off for a couple of minutes while you do
this?
Stone: Oh, no, thats okay, Im actually getting good at this stuff. Im thinking
of taking this act on the road.
Robin: (Rubbing Stones shoulders) You guys may not understand. This is a man
who couldnt swallow an aspirin without chewing it first.
Stone: You know what? Here we got your basic vitamins. We got your A, we
got your B, we got your B-complex for stress. Massive doses of C. Cayenne,
calcium, ginseng, and a handy dandy multi-mineral tablet just for good
measure. Whew! I gotta take twenty of these every morning and every night,
but since you caught me at the mid-day cycle, I get to spare you that little
display.
Robin: Ive been timing him. He can get the whole vitamin regimen down in
two minutes and thirty-two seconds. Were thinking about getting ready for
the Guinness Book of World Records.
(A. J. looks, then turns away. Walks slowly over to the couch and sits down)
Stone: Now here youve got your heavy duty pharmaceutical stuff. Nothing
about this stuff is over the counter. (Picks up bottles and empties out pills as he
talks) This stuff here, Bactrim, this humongous thing, luckily I only have to
take one of these a day, this stops me from getting pneumonia, which in my
condition could cause lights to go out . . . speaking of which, lights going out,
this stuff here stops me from going blind. Its hard to swallow and harder to
say: Gan-CY-clo-vir. Sorry, it doesnt stop me from going blind. Nothing I can
take can stop me from going blind, but it does slow down the process . . . and
I will take twelve of those every day for that little reprieve. Im so excited I can
hardly stand it. [Camera closes in on A. J., then returns to Stone] And now the world
famouswho knows if it works but well try it anywaymiracle drug AZT. Two
tablets three times a day, and to hedge all our bets because my T-cells have a
mind of their own, two 3TC twice a day.a Not because we want to but because
if we dont wed be dead. Now ladies and gentlemen, Im about to perform
this miraculous feat of getting all these things down. (Takes the handful of pills
and pours them into his mouth, takes a big drink of water from the bottle. Robin and
Jason clap)

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Robin: All right! (Stone takes a really big pill by itself, Jason starts drumming on the
table) Now you see it, now you dont! (Stone stands up and high fives with Robin
and Jason; camera moves to close-up on A. J.)
Stone: (Walks over to A. J. sitting on the couch and sits on the edge of a nearby chair)
Its okay, man, you get used to it.
A. J.: Not me, man. I dont know, I think Id just . . . grab a bottle of vodka,
jump in my car, and just let it take me right over a bridge . . . at a hundred
miles an hour.
Jason: Hey A. J., come on, get serious.
Stone: He is serious, man. (Stone comes over and puts his hand on A. J.s shoulder).
Dont kid yourself, man, I have considered all of my options.
Robin: (sighs) Oh, I hate this conversation(Stone looks at her)But I know
you have to go through this process, so go on.
Stone: (Background music begins) Ive been there, man. Ive thought about getting out. I mean, I dont know whats ahead of me. I know it gets worse. It gets
way worse. (Goes over and puts arms around Robin) But every time I think about
getting out, before it gets too bad, I stop and I take a look around and Im like
. . . Yeah. Not yet. Im not ready to leave. You know, right here, with you guys
in my room, were laughing, and my lady (he sniffles). Im not ready to say
goodbye. Not to anything. Not even to you, A. J. (Smiles and kisses Robin on
head).
***END OF SCENE***
a

The Food and Drug Administration approved the combination of AZT and 3TC
in November 1995, indicating that Stone is at this point receiving very new drug
therapy. Associated Press, FDA Panel Backs Use of New Drug for AIDS, New York
Times, 7 November 1995, B-9.

With a scene like this, long and wordy though it is, I would argue that television can rightly claim to educate even as it entertains. Indeed, I can think of few
comparable scenes in medical drama. The challenge here, of course, is to
demonstrate the burden of AIDS treatment even while making Stones list of
pills entertaining. So the writers make Stones pill-taking a test of adolescent
male performance, with Robin cheering him on. Her placement of the senior
prom portrait on the counter affirms their romantic relationship. Notably,
by developing its AIDS storyline around a straight white male character, General
Hospital targets a critical but widely neglected population.87 The scene shows
how skillful writing and acting (depending, perhaps, on your sympathy with the
soap genre) can use HIV/AIDS to fuse entertainment and education.
Personal tragedy, a perennial soap subtext, offers an opportunity for male characters to show the finer emotions like love and emotional support. (And, if focus

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groups are to be trusted, women audience members sigh wistfully, wishing it were
so in real life.88) Here, A. J.s distaste for illness and death also invokes an ongoing GH plot line: the differing characters of the two Quartermaine boys. The
good son, Jason, on his way to a career in medicine, is brave and knowledgeable
(So, he says to Stone, this is them.) The feckless A. J., in contrast, can hardly
watch at all. Stone puts up a brave front and duly lays out the array of medications including the drug AZT, which was still controversial in 1995. Interestingly,
even as he expresses implicit trust in his medical regimen, he is a bit skeptical and
ironic in sketching the function of each drug. (But he is taking them. When first
diagnosed, Stone told Robin, I wont be a guinea pig for this hospital. A bit
later, after a pep talk about staying healthy to counter AZTs side effects, he says,
Eat right, throw up, I cant wait. His adherence to his medication here shows a
significant change of attitude.) In this scene, the writers also take the opportunity
to raise the possibility of suicideor rather, let A. J. raise it, by saying that in
Stones situation hed drink a bottle of vodka and drive off a bridge. (Sure
enough, before too long, A. J. does get drunk and does drive off a bridge, putting
his passengerhis brother Jasoninto a prolonged coma from which he
emerges with total amnesia.) Stone says, Ive considered all my options but Im
not ready to say goodbye. The eye-level camera shots draw us, the viewers, into
this intimate conversation, reinforcing our participation in the characters lives.
In October, a brain biopsy determines that Stone has lymphoma, a sign of
end-stage AIDS; he is given three to six weeks to live. Hes now experienced (and
viewers have witnessed) many manifestations of a failing immune system as well
as side effects of treatment efforts. Hes weak and losing his eyesight; steroids
have made him emotionally unpredictable and even violent; pain medication
puts him to sleep; hes still recovering from brain surgery; and hes exhausted.
In the following scene, his hair just growing back from the biopsy, he tells Robin
he has decided against further treatment. Robin resists but Stone is adamant:
Im thinking about the quality of my life. Its the only call I can make right now.
I want whatever time I have left to be on my terms. Not screaming at people
because I want some drugdont cryand not so sick from chemo and radiation that I dont even know if youre in the room. And whatever time I have left,
I want to be here with you. They are then joined by Sonny Corinthos (actor
Maurice Bernard), a long-time character on the show who is both Stones surrogate father and a mob-connected multi-millionaire.
Transcript 3. End-of-life decisions (31 October 1995)
Robin with Stone in Stones hospital bed; Sonny arrives
Sonny: (Enters room holding two glasses with straws) Two colas on ice, at your service. I figure Ill pick you and Robin up first thing in the morning and move
you back into the penthouse.

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Stone: I think we oughta think about that, Sonny. I know you want me to be
at home and you to take care of me, but this thing could get really ugly and
maybe I should be at a hospice.
Sonny: No, no, waitwhatever you need, we can handle it at home. Thats
what home is for. Were gonna get you medical equipment, were gonna get
you a nurse whenever you need one. Thats for Robin and I so we can just give
you what you want when you want it. Were gonna do this right. Not that
theres anything right about this.
Stone: You are, man.
Sonny: (Nods and gets choked up) YeahumIll be right back. (Sonny reaches
out hand and grasps Stones hand. Sonny turns and leaves room. Stone rubs his head
and looks concerned)
Robin: Im gonna go see if hes okay.
Stone: Thank you. (Robin goes out to the hallway where Sonny is leaning against the
wall, crying. They hug one another).
***END OF SCENE***

Again we see men displaying emotion and vulnerability, modeling new technologies of masculinity for the 1990s. The scene articulates concern for quality of life
and patient autonomy (health issues illuminated in Positive: A Journey into AIDS, an
award-winning GH-related After School Special in which, among other things,
cast members visit an AIDS hospice). Robin, always a trooper, wants what Stone
wants, and no longer talks of fighting the disease. Like him, she has arrived at a
new understanding of this experience and is at a stage where she can, reluctantly,
accept Stones decision. While the dialogue hints that Stones dying may be difficult (This thing could get really ugly), he still looks goodthe short hair
becomes him. More significantly, the expenses of AIDS care are dismissed with a
wave of Sonnys checkbook. General Hospital never refuses care because someone
cant pay. And why should it: there are no have-nots among GHs patients.89
Just before Stone dies, with Robin and Sonny caring for him in Sonnys penthouse, comes a critical plot turn. Robin, whose earlier HIV assay had been negative, now tests positive.90 The show has taken pains to show Stone and Robin as
responsible: when they first fell in love and decided to have sex, they used condoms until Robin had tested negative for HIV (this took place, as did Stones initial HIV-negative test, mentioned in Transcript 1, before this essay begins);
assuming then that unplanned pregnancy was their main concern, they believed
Robins oral contraceptive afforded sufficient protection. The following scene,
in which Dr. Alan Quartermaine, Robins physician, visits Sonnys penthouse to
give her the bad news, provides an important lesson for viewers about the necessity for continued follow-up testing. It also offers an important lesson about gender. First, Robin vehemently denies the test resultshe doesnt feel sick, she

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wants to give Stone good news, shes already tested negative twice; she wants only
to return to caring for Stone. Alan, himself devastated by the news, waits out her
initial shock, then urges her to take care of herself. Shes now strong and healthy,
he argues, and she knows how to stay that way until theres a cure.
Transcript 4. Sonnys penthouse (13 November 1995)
Robin and Alan, Sonnys living room
Robin: I dont want to need a cure! I dont want this to be happening at all!
Alan: I understand.
Robin: [Quickly, matter-of-factly] Okay, Im HIV positive. I appreciate your
telling me. Ive got things to do now, starting with chocolate pudding, which
is Stones favorite all of a sudden. He can swallow it, digest it, and nobody
makes it right but me. Big secrethalf water, half milk. So, Im off to the
kitchen.
Alan: And what am I supposed to do, just leave you here to take care of Stone?
Robin: What can I tell you, he gets hungry. Thank you for stopping by. Ill be
in touch.
Alan: If you keep this up, youre gonna be in trouble.
Robin: Trouble. Hey, thatd be different.
Alan: You are different. You are not Stone. Are you listening? Are you hearing
me?
Robin: (Shakes her head with tears in her eyes) What do I do?
Alan: You go on, no changes, no big decisions for the next few months. Not
til this all sinks in. And I can see that its starting to sink in, and thats all I
wanted for now.
Robin: Good, cause as my mom used to say, First things first and whats first
is Stone. Sorry I got so freaky.
Alan: Freaky? You dont know the meaning of the word freaky until youve
lived as a Quartermaine. So, Im taking questions if you have anyOr I can
just hang out here and help you make chocolate pudding if you like.

Committed to her caretaking role, Robin, like many women with HIV, finds it
hard to take care of herself. Her line Im off to the kitchen invokes the conventional feminine role of food preparation, caretaking, and nurturing that she
has adopted. Kimberly McCullough, playing Robin, put it this way in an interview in Soap Opera Update: She doesnt have somebody there for her like Stone
has. She doesnt have her love to be there by her side and support her every second like Robin did for Stone.91 But by the time Alan asks Are you listening?
Are you hearing me? its obvious shes beginning to get the message.
A positive HIV test result is supposed to be delivered with compassion and
health advice, but only in Soapland do doctors offer to help make chocolate pudding. While General Hospital, as I noted earlier, originally promised a more

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masculine arena for action, its gender roles follow classic soap conventions. Just
as soap men are emotionally vulnerable and soap couples talk to each other more
frequently than real couples do, so too are soap physicians sensitive and interactive. Alans manner softens Robin and she apologizes for getting so freaky.
Though used somewhat differently, this is the same word Stone associated with
his HIV positive status in the initial hospital scene (I dont want people thinking
Im some kind of a freak, Transcript 1). Alans response jokingly invokes a familiar GH subtext: the freakiness of the Quartermaine family. As the scene continues, Alan offers to help break the news to Robins Uncle Mac. Wanting time to
digest her news privately, Robin asks him to promise not to share her test results
with her uncle or Stone, touching again upon the confidentiality of the doctorpatient relationship and the silence that so often surrounds a diagnosis of HIV.
Before he leaves, Alan returns to the subject of Robins health:

Transcript 5
Alan: And over the next few weeks, we need to sit down and discuss what it
means to be a healthy Robin, okay?
Robin: Safer sex, I know.
Alan: That always, and good food, and exercise, and if youre ever up in the
middle of the night and you need someone to talk to, you call me, okay, any
hour.
Robin: Okay. (After closing door behind him, Robin walks over and sits down on
couch. The camera moves in for a close-up as she begins quietly to cry).

The mention of safer sex is intended to bring home the lesson that oral contraceptives do not provide protection against sexually-transmitted disease, a fact
that surveys of public knowledge about AIDS continue to show is not universally
understood. Whether these lessons are sufficient is debatable. While Robins
exchange refers to safer sex, the word condom is not used herethough
both condom and abstinence have been used in previous episodes. Positive:
A Journey Into AIDS emphasized that the pill and the condom offer different
kinds of protection during penetrative sexual intercourse, and that only the
condom constitutes safer sex. We must hope that the soap genres legendary
repetitions and redundancies helped viewers understand this critical point. The
final moments of the scene illustrate another classic component of soap rhetoric. As the camera closes in on Robins face, we see the inner look in which the
implications, complications, and consequences of the scene come home to the
character. Such camera moves, argues Timberg, not only show us, in a realist
sense, how the character is reacting, but also tell us, the viewers, how we are to
feel about and engage with the narrative.92

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Shortly after Robin shares her bad news with Stone (weve never kept any
secrets from each other), they celebrate an early Christmas together. As Stone
comes closer to death, old friends come by to say farewell. Among others, actors
who have left the series (like singer Ricky Martin as Stones good friend Miguel)
return to addinthe words of Soap Opera Update, which gave these farewells a
Best Scene Awardsparks and energy to an already heart-wrenching story and
bring closure to Stones storyline.93 Stone dies in a touching scene that recalls
the death of Violetta in La Traviata, even to the last-minute resurgence of
strength and return of his vision: Robin, I can see you, he cries. Robin lies tenderly beside him while the soundtrack plays When Angels Cry, a 1995 Janis Ian
song about AIDS that has become Stone and Robins anthem. Wish Id never
heard, runs the refrain, Wish Id never heard/the power of a four-letter
word.94 As fans across the country cry along with the angels, millions of Kleenex
tissues become history, and so does Stones official storyline. Stones death provides a moment of resolution in the unfolding storylines of GH. This moment is
extended over subsequent episodes as no fewer than ten characters are shown
reacting to Stones death. While death in a soap is not always death, the AIDS
storyline is intended to convey serious lessons, so Stones death is for keeps. But
with its focus now shifted to Robin, the AIDS storyline remains alive.
The spring 1996 nurses ball features a memorial tribute to Stone, Sonnys
endowment of an HIV/AIDS wing to the hospital in Stones name, Robins
announcement that hers, too, is the face of HIV, and the contribution of a
panel for Stone to the AIDS quilt, a portion of which forms the visual backdrop for much of the show. Then the character Lucy Coe, played by the actor
Lyn Herring, sadly announces the death of the character John Hanley, played by
Lee Mathis, the actor with AIDS hired by GH for a small continuing role in the
AIDS storyline; unlike Michael Sutton as Stone, John Hanley has died in real
life as well as on the show, and Lucys announcement also serves as a tribute
from Lyn Herring to Lee Mathis. We then hear When Angels Cry for the
umpteenth time, this time sung by the real Janis Ian. As she sings, the camera
slowly pans the cast and characters with their red ribbons and their complex,
intertwined storylines, and we, too, are given leave to think about the power of
a four-letter word. Indeed, many powerful four-letter words may come to mind:
not just A-I-D-S and L-O-V-E, but perhaps even S-O-A-P. For certainly the driving
and unifying force behind all these efforts is the power of the serial soap opera
narrative to hold viewers attention, stimulate questions, and make them care.95

What Media Can Do about HIV/AIDS:

General Hospital and Beyond
Did the HIV/AIDS storyline on General Hospital succeed? Overall, I would argue,
General Hospital successfully provided an intimate window on the HIV/AIDS

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epidemic, showing the impact on a community, over time, of a life-threatening

sexually transmissible disease. GH brought education and entertainment
together by using a fictional love story as the vehicle for anti-STD education.
Stones experience opened discussion of situations and environments that
increase the likelihood of risk of HIV: unprotected sex, sharing needles during
IV drug use, life on the streets, and violence. Robins experience distinguishes
protection against pregnancy during sexual intercourse (oral contraceptives,
condoms) from protection against HIV (condoms only); teaches the lesson that
women must care for themselves as well as for others; and, over the next few
years, shows viewers an example of the HIV-positive healthy non-progressor
while educating them about new treatment regimens.96 Subsequent GH storylines have paid continuing attention to the problems associated with unprotected
sex, shown adolescents acting responsibly, and provided information about protection. The storyline offered many opportunities for HIV education, while the
soap genres repetition and redundancy underlined these messages. By drawing
upon a committed audience, the show could work the AIDS storyline into familiar conventions, language, and rules of soap storytelling to represent good and
evil, ignorance and enlightenment, self-reflection, and even the self-conscious
construction of reality, as when Stone refers to Bobby Ewings dream on Dallas.
Unlike a film, the TV soap format can flexibly incorporate new medical realities
(like changing treatment options) and respond to viewer and media responses.
Its almost real world can vividly demonstrate the long-term course of a disease
like HIV/AIDS and challenge, by showing imagined alternatives, what Frentz and
Ketter call televisions relentless presentation of sex-without-consequences.97
The HIV/AIDS storyline demonstrates the narrative power of the soap genre:
operating in very specific ways, a soap like General Hospital was able to carry out
educational tasks that are distinct from but no less important than those of scientific journals, network news coverage, official mass media public health campaigns, and other media forms. Media approaches to AIDS that seek primarily to
be entertaining run the risk of being shallow, simplistic, frivolous, or offensive,
sometimes all at once; but serious educational treatments, leaden with facts and
shaped by policy-driven messages, may also fail. It is important to recognize, then,
that the educational distinctiveness of the General Hospital project results in part
from the entertainment mandate of commercial American television.

Notes
Earlier versions of this essay were presented at the American Association for the
Advancement for the of Science annual meeting; Howard Hughes Fellowship in
Science Program annual meeting; Cultural Disciplinarities Conference at Cornell
University; Robert Wood Johnson Clinical Lecture Series, University of Chicago; the
Illinois Public Health Association annual conference, Springfield; the University of
Pretoria, South Africa; the University of Rochester; and the Annenberg School of

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Communication, University of Pennsylvania. For thoughtful comments and suggestions I thank Kal Alston, Anne Balsamo, Jim Barlow, Mary Crewe, Alice Filmer, Nadja
Michel-Herf, Cary Nelson, Roswell Quinn, Leslie Reagan, and Angharad Valdivia.
1. UNAIDS/WHO statistics as of May 2006 obtained via www.avert.org/
worldstats.htm on July 6, 2006. A study by two WHO scientists published November
28, 2006 projects even grimmer global statistics over the next twenty-five years, estimating that without more aggressive intervention, 120 million people could die;
based on recent HIV/AIDS data from more than one hundred countries, the study
emphasizes that previous long-term projections, based on 1990 data, continue to be
widely quoted, although they are substantially outdated; in particular, they substantially underestimated the spread of HIV/AIDS. Colin D. Mathers and Dejan Loncar,
Projections of Global Mortality and Burden of Disease from 2002 to 2030, Public
Library of Science Medical Journal accessed online at PLoS Med 3 (11) 2006: e442 DOI:
10.1371/journal.pmed.0030442.
2. A comprehensive international review in 1995 by June Flora and colleagues
found that few HIV/AIDS media campaigns and interventions, domestic and international, included meaningful assessment procedures and no campaigns
approached the gold standard criteria for design, reporting, and evaluation established in the multi-media California stop-smoking campaign nor its breadth in
directing interventions beyond the level of the individual (i.e., toward the community and society). See June A. Flora et al., Communication Campaigns for HIV
Prevention: Using Mass Media in the Next Decade, in Assessing the Social and
Behavioral Base for HIV/AIDS Prevention and Intervention, Workshop Background Papers
(Washington, D.C.: Institute of Medicine, 1995). The California campaign is discussed at length by Roddey Reid in Globalizing Tobacco Control: Anti-smoking Campaigns
in California, France, and Japan (Bloomington and Indianapolis: Indiana University
Press, 2005). See also John P. Pierce et al., Tobacco Control in California: Whos Winning
the War? An Evaluation of the Tobacco Control Program, 19891996 (A Report to the
California Department of Health Services, Cancer Prevention and Control Program,
University of California, San Diego, June 30, 1998).
3. Media campaigns (as studied by Flora et al. Communication Campaigns, Reid,
Globalizing Tobacco Control, and Pierce et al., Tobacco Control) typically represent
planned efforts funded by government agencies, foundations, and other not-forprofit institutions. Media coverage typically refers to the reporting of news events in
print and electronic media outlets, which in the United States are primarily commercial. The only United States government-sponsored communication directed to
all Americans was the booklet prepared by U.S. Surgeon General C. Everett Koop
and sent to all U.S. households in 1988. For discussion, see Paula A. Treichler, How
To Have Theory in an Epidemic: Cultural Chronicles of AIDS (Durham, NC: Duke
University Press, 1999). On public service announcements on HIV/AIDS during the
Clinton administration, see, for example, W. DeJong, R. C. Wolf, and S. B. Austin,
U.S. Federally Funded Television Public Service Announcements (PSAs) to Prevent
HIV/AIDS, Health Communication 6:3 (JulySeptember 2001): 24963.
4. James W. Dearing and Everett M. Rogers, The Agenda-Setting Process for the
Issue of AIDS, paper presented at the International Communication Association
annual conference, 28 May2 June 1988, New Orleans; Edward Alwood, Straight News:
Gays, Lesbians, and the News Media (New York: Columbia University Press, 1996), 234.
5. By the end of the 1980s, HIV/AIDS was regularly featured by reporters covering
medicine, public health, the health care system, and health policy; basic and clinical

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research; business and biotechnology, nursing, blood banks, tourism, the pharmaceutical industry, and life insurance; education, including sex education; law, including the correctional system; religion; culture, entertainment, lifestyle, and the arts;
politics; and international relations and foreign aid. Anne Karpfs 1988 book,
Doctoring the Media: Reporting on Health and Medicine (London: Routledge), is useful
in describing media frames, angles or perspectives that reflect consistent principles
of selection, emphasis, and presentation; no representation or reporting, Karpf
argues, is neutral. James Careys work eloquently argues that news reporting does not
so much reflect reality as construct a particular kind of social world; see, for example, James W. Carey, Why and How? The Dark Continent of American Journalism,
in Reading the News, ed. by Robert Karl Manoff and Michael Schudson (New York:
Pantheon, 1986). For more on media and HIV/AIDS, see Randy Shilts, And the Band
Played On: People, Politics, and the AIDS Epidemic (New York: St. Martins, 1987); James
Kinsella, Covering the Plague: AIDS and the American Media (New Brunswick, NJ:
Rutgers University Press, 1989); Alexandra Juhasz, AIDS TV: Identity, Community and
Alternative Video (Durham, NC: Duke University Press, 1995); David C. Colby and
Timothy Cook, Epidemics and Agendas: The Politics of Nightly News Coverage of
AIDS, Journal of Health Politics, Policy, and Law 16: 2 (Summer 1991): 21549; Vicki
Freimuth, Huan W. Linnan, and Polyxeni Potter, Communicating the Threat of
Emerging Infections to the Public, Emerging Infectious Diseases 6:4 (JulyAugust
2000): 33747; Dearing and Rogers, The Agenda-Setting Process; Edward Alwood,
Straight News; Douglas Crimp ed., AIDS: Cultural Analysis, Cultural Activism
(Cambridge, MA: MIT Press, 1988); Jan Zita Grover, AIDS: Keywords in Crimp ed.,
AIDS; DeJong et al, U.S. Federally Funded Television PSAs; Meredith Raimondo,
Corralling the Virus: Migratory Sexualities and the Spread of AIDS in the U.S.
Media, Society and Space 21 (2003): 389407; Linda K. Fuller, ed., Media-Mediated
AIDS (Cresskill, NJ: Hampton Press, Inc., 2002); and Daniel McGee, Millennium
Bugs and Weapons of Mass Fear in the 1990s: Dialogues Between Science and
Popular Culture, PhD diss., University of Illinois, Urbana-Champaign, 2003. For
general reference, see Joseph Turow, Media Today: An Introduction to Mass
Communication (Boston and New York: Houghton Mifflin, 2003); Jeremy G. Butler,
Television: Critical Methods and Applications (Mahwah, NJ and London: Lawrence
Earlbaum Associates, 2002); and Teresa L. Thompson et al, eds., Handbook of Health
Communication (Mahwah, NJ: Lawrence Earlbaum Associates, 2003).
6. Covering the Epidemic: AIDS in the Mass Media, 19811996 (Menlo Park,
CA: Henry J. Kaiser Family Foundation AIDS Media Monitoring Project, 1997;
Supplement to the Columbia Journalism Review, July/August 1997).
7. Mollyann Brodie, Elizabeth Hamel, Lee Ann Brady, Jennifer Kates, and Drew E.
Altman, AIDS at 21: Media Coverage of the HIV Epidemic 19812002 (Menlo
Park, CA: Henry J. Kaiser Family Foundation, 2003, with Princeton Survey Research
Associates International). The report is available on the Kaiser Family Foundations
website, www.kff.org, along with the earlier Kaiser study.
8. Brodie et al, AIDS at 21, 2.
9. At the end of 2003, an estimated 1,039,000 to 1,185,000 persons in the United
States were living with HIV/AIDS, with 2427 percent undiagnosed and unaware of
their HIV infection. M. Glynn and P. Rhodes, Estimated HIV Prevalence in the
United States at the End of 2003, National HIV Prevention Conference, June 2005,
Atlanta, GA, Abstract 595. In 2004, the largest estimated proportion of HIV/AIDS
diagnoses were of men who have sex with men (MSM), followed by adults and

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adolescents infected through heterosexual contact. The Centers for Disease Control
and Prevention home page estimates that approximately forty thousand U.S. citizens
continue to become newly infected with HIV each year.
10. The Centers for Disease Control and Prevention estimates that nineteen million new cases of sexually transmitted disease occur each year in the United States,
almost half of them among young people ages fifteen to twenty-four. Out of eleven
STDs on the CDCs website, the three most commonly reportedchlamydia, gonorrhea, and syphilisare all treatable; but many cases remain undiagnosed, unreported, and untreated. Cases of chlamydia and syphilis have increased in the United
States since 2000; while gonorrhea incidence has slightly decreased, the steady
increase in antibiotic resistance will threaten the treatment effectiveness of all three
diseases.
11. I use these studies only to distinguish quantitative from qualitative or combined
methods of studying media. The Kaiser Family Foundation carries out consistently
superior research on health, media, and medicine and uniquely explores the connections among them; its studies, programs, and support activities have stimulated
widespread recognition of the mass medias significant role in shaping public knowledge, attitudes, perception, and practices related to health. Many of the foundations studies use a combined approach to media analysis.
12. Matthew P. McAllister and Uriel Kitron, Differences in Early Print Media
Coverage of AIDS and Lyme Disease, in Fuller, ed., Media-Mediated AIDS (2002),
4362; Rodney Buxton, Broadcast Formats, Fictional Narratives, and Controversy:
Network Televisions Depiction of AIDS, 19831991, PhD dissertation, University of
Texas, Austin, 1992; Sasha Torres ed., Living Color (Durham, NC: Duke University
Press, 1998); Jos Esteban Muoz, Pedro Zamoras Real World of Counterpublicity:
Performing an Ethics of the Self, in Sasha Torres, ed., Living Color, 1998; ACT UP
NY/ Women & AIDS Book Group, Women, AIDS, and Activism (New York: ACT UP
NY, 1990); Edwin Diamond, The Media Show: The Changing Face of the News,
19851990 (Cambridge, MA: MIT Press, 1991); and Cathy Cohen, Boundaries of
Blackness: AIDS and the Breakdown of Black Politics (Chicago: University of Chicago
Press, 1999).
13. Richard Dyer argues that images of analyseshow many positive, how many
negative, and so ontend to be reductive and deadly unless tempered by a recognition of the complexity, elusiveness, and political dimensions of representation.
Richard Dyer, et al., eds., Coronation Street (London: British Film Institute, 1981). See
also Paula A. Treichler, Lisa Cartwright, and Constance Penley, eds., The Visible
Woman: Imaging Technologies, Gender, and Science (New York: New York University Press,
1999).
14. For example, the two comprehensive longitudinal studies by Kaiser, cited above,
are based on sampling prime time network news and major U.S. daily newspapers,
sources accessible on standard databases. But Kaiser also furnishes notable exceptions: a 2003 study examining portrayals of sex during the 20012 TV season randomly sampled 1,100 shows airing between 7 a.m. and 11 p.m. covering all genres
other than daily newscasts, sports, and childrens programming; so included are
movies, sitcoms, dramas, soap operas, talk shows, news magazines, and reality shows
found on ten networks representing a range of TV programmingABC, NBC, CBS,
and Fox, public television (PBS), a WB affiliate, the top basic cable networks
(Lifetime, TNT, and USA), and one premium cable network (HBO). Such a study
requires considerably greater research time and effort and is therefore unusual.

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15. Treichler, How To Have Theory. Press releases, however, generated some news
stories about the movie.
16. George Gerbner, Larry Gross, Michael Morgan, and Nancy Signorielli, Health
and Medicine on Television, New England Journal in Medicine 305:15 (October 8,
1981), 9014.
17. Brodie et al, AIDS at 21.
18. See, for example, C. H. Bradner, L. Ku, and L. D. Lindberg, Older, But Not
Wiser: How Men Get Information about AIDS and Sexually Transmitted Diseases after
High School, Family Planning Perspectives 32:1 (JanuaryFebruary 2000), 3338.
19. Michael X. Delli Carpini and Bruce A. Williams, Methods, Metaphors, and
Media Research: The Uses of Television in Political Conversations, Communication
Research (December 1994).
20. See Andrew Ross, No Respect: Intellectuals and Popular Culture (New York:
Routledge, 1989) and the introduction to the current volume.
21. My focus in this essay on U.S. media precludes discussion of the growing field of
global entertainment-education media projects designed to further social change.
I plan to address this topic in future publications, in particular the extraordinary
South African multimedia enterprise Soul City. Many of these projects are described
in Armind Singhal and Everett M. Rogers, Entertainment-education: A Communication
Strategy for Social Change (Mahwah, NJ: Lawrence Earlbaum Associates, 1999);
Armind Singhal and Everett M. Rogers, Combating AIDS: Communication Strategies in
Action (New Delhi/Thousand Oaks, CA: Sage, 2003); Marilyn J. Matelski, Soap Operas
Worldwide: Cultural and Serial Realities (Jefferson, NC and London: McFarland & Co.,
Inc., Publishers, 1999); and Hannah Rosin Life Lessons: How Soap Operas Can
Change the World, The New Yorker 5 June 2006, 4057.
22. For the current pedigree of melodrama, see Christine Gledhill, Genre and
Gender: The Case of Soap Opera, in Stuart Hall, ed., Representation: Cultural
Representations and Signifying Practices (London: Sage Publications, 1997), 33786; Lila
Abu-Lughod, Egyptian Melodrama: Technology of the Modern Subject? in Faye D.
Ginsburg, Abu-Lughod, and Brian Larkin, eds., Media Worlds: Anthropology on New
Terrain (Berkeley and Los Angeles: University of California Press, 2003), 11533; Jackie
Byars, All that Hollywood Allows: Re-reading Gender in 1950s Melodrama (Chapel Hill:
University of North Carolina Press, 1991); Peter Brooks, The Melodramatic Imagination:
Balzac, Henry James, Melodrama, and the Mode of Excess (New Haven, CT: Yale University
Press, 1976); Guy Barefoot, Gaslight Melodrama: from Victorian London to 1940s Hollywood
(New York: Continuum, 2001); and Marita Sturken and Lisa Cartwright, Practices of
Looking: An Introduction to Visual Culture (Oxford: Oxford University Press, 2001).
23. Soapy, an earlier term, indicates a tone or style that is smooth, bland, sickly,
sentimental. The OED cites George Bernard Shaws 1889 assessment of an actress
performance: her tone is just a bit soapy. Soap opera is a subcategory of serial
drama (adventure, mystery, and science fiction are other serial forms). See Raymond
Williams, Television: Technology and Cultural Form (London: Fontana, 1974) and
Keywords: A Vocabulary of Culture and Society (London: Fontana, 1975); Raymond
William Stedman, The Serials: Suspense and Drama by Installment (Norman: University
of Oklahoma Press, 1971); and John G. Cawelty, Adventure, Mystery, and Romance:
Formula Stories as Art and Popular Culture (Chicago and London: University of Chicago
Press, 1976).
24. Robert C. Allen, The Guiding Light: Soap Opera as Economic Product and
Cultural Document, in Horace Newcomb, ed., Television: The Critical View, 4th ed.

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(New York: Oxford University Press, 1987), 14163. See also Robert C. Allen,
Speaking of Soap Operas (Chapel Hill: University of North Carolina Press, 1985), and
Museum of Television & Radio, et al., Worlds Without End: The Art and History of the
Soap Opera (Boston: Harry Abrams, 1997).
25. Robert C. Allen, ed., To Be Continued . . .: Soap Operas Around the World (New York:
Routledge, 1995), 3.
26. Quoted by Allen, To Be Continued, 3; Marya Mannes, Massive Detergence,
Reporter July 6, 1961, 39.
27. Soaps have been called womens narratives on the basis of their presumed
audience, emphasis on interpersonal relationships, focus on strong female characters,
and perceived shapelessness of the text. See Deborah D. Rogers, Daze of Our Lives:
The Soap Opera as Feminine Text, Journal of American Culture 14:4 (Winter 1991),
2941. See also Lydia Curtis reference to womens television, that is, soap opera in
Cultural Studies, ed. Lawrence Grossberg, Cary Nelson, and Paula A. Treichler (New
York: Routledge, 1992), 92. An extended discussion is provided by Laura Stempel
Mumford, Love and Ideology in the Afternoon: Soap Opera, Women, and Television Genre
(Bloomington: Indiana University Press, 1995).
28. Ien Ang, Watching Dallas: Soap Opera and the Melodramatic Imagination (New York:
Methuen, 1985).
29. Louis Bergs attacks, referenced by most soap opera histories, began as a public
lecture and wound up in two self-published pamphlets distributed in 1942. See Max
Wylie, Dusting Off Dr. Berg, Printers Ink (February 12, 1943), 44; Allen, Speaking of
Soap Operas, To Be Continued; and Stedman, The Serials, 341. Bergs findings were discredited in part by the discovery that the physiological symptoms attributed to his
female patients had been obtained by cataloguing his own responses to two radio
soap operas for three weeks.
30. For the development of this view among Progressive Era intellectuals and professionals, see Gretchen Soderlund, Rethinking a Curricular Icon: The Institutional
and Ideological Foundations of Walter Lippmann, Communication Research 8 (2005),
30727.
31. Paul Lazarsfeld and Frank N. Stanton, Radio Research 194243 (New York: Duell,
Sloan and Pearce, 1944). Other studies are cited by Bruce Cook, Soap Springs
Eternal, American Film, November 1976 (accessed on actor Kate Mulgrews website
www.totallykate.com, August 2006); Allen, Speaking of Soap Operas, Stedman, The Serials;
and, Robert LaGuardia, Soap World (New York: Arbor House, 1983).
32. James Thurber, Soapland, New Yorker, May 15, 1948, 34. This five-part series
was reprinted in The Beast in Me and Other Animals (New York: Harcourt Brace, 1973),
191260.
33. Thurber, Soapland, 38.
34. Allen, Speaking of Soaps, 15.
35. Madeleine Edmondson and David Rounds, The Soaps: Daytime Serials of Radio and
TV (New York: Stein and Day, 1973), 4243.
36. Thurber, Soapland, New Yorker, 34. Soap writers sometimes posed for publicity
photos surrounded by piles of scripts (see Edmondson and Rounds, The Soaps, 134,
for an example).
37. Edmondson and Rounds, The Soaps, 45. Additional sources on soap history
include Manuela Soares, with original photographs by Mark Sherman, The Soap
Opera Book (New York: Harmony Books, 1978); Stedman, The Serials; Allen, Speaking
of Soap Operas; Peter Buckman, All for Love: A Study in Soap Opera (London: Salem

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House, 1984); and Mary Cassata and Thomas Skill, Life on Daytime Television: TuningIn American Serial Drama (Norwood NJ: Ablex, 1983).
38. Edmondson and Rounds, The Soaps, 58. The sheer quantity of product that
these shows represent continues to amaze everyone who studies them. By 1981,
Allen calculated that the twelve televised soaps then on the air collectively generated
fifty-five hours of programming each week or about 2,800 hours each yearthe
equivalent of nearly 2,000 feature films. In 2006, nine soap operas filled forty-five
hours of daytime programming per week (2,340 hours per year); round-the-clock
programming on the cable channel SoapNet includes soap talk shows and reruns of
current daytime soaps, syndicated daytime and prime-time serials (e.g., Port Charles,
Ryans Hope, Melrose Place, Dallas), and classic episodes from the past.
39. Rick Altman, Television Sound, in Newcomb, ed., Television, 56684. This viewing pattern remains true of womens viewingin prime time as well as daytime, and
among women who work outside as well as inside the home. Even today, despite a
changing audience (more men now watch) and stiff competition from cable television, VCRs and DVD recorders, and the Internet (drawing away viewers who are
capable of being counted by Nielsen and other television ranking services), networks
continue to perceive women aged eighteen to forty-nine as the key demographic
group for soap opera and for consumption of the soft goods products that sponsor
the programs.
40. Almost all the action in daytime serials, reported Gerbner et al. in Health and
Medicine on Television, 903, takes place indoors and consists of talk. Out of 844
conversations studied, 277 took place in living rooms; next most frequent locations
were, in order, doctors offices, business offices, and hospital rooms.
41. Allen, The Guiding Light, 143.
42. Edmondson and Rounds, The Soaps, 159.
43. Dan Wakefield, All Her Children (Garden City, NY: Doubleday & Company, 1976),
1.
44. Wakefield discovered in his senior year of high school that he was not alone in
his closet addiction. At an after-prom party, one of his friends let slip an allusion to
a character on Ma Perkins: it turned out his whole group of friends were secret fans
of the show.
45. In her conversations with Wakefield, Agnes Nixon traced the new respectability
of soap opera to the great success of the BBC serial Upstairs, Downstairs, broadcast in
the United States on PBSs Masterpiece Theater. (Other candidates are The Forsyte Saga
and Roots.)
46. Wakefield has been assured that Susan Lucci, in real life, is nothing like Erica.
Yet as he begins his interview, I can feel myself trembling. I am trying to ask questions and at the same time tell myself I am being embarrassingly silly. . . . The words
are Susans but the voice is EricasI have heard it as Ericas voice for almost four
years, theres no way its going to suddenly sound like this nice, friendly Susan-persons voice (All Her Children, 69). He takes his leave and stumbles out of the studio,
where he walks and walks. I remind myself I am not in Pine Valley. I am standing on
West Sixty-seventh Street in New York City, outside the ABC-TV studios. It is a cool
and pleasant autumn afternoon. And I am sweating like crazy (70). (Susan Lucci, in
her role as Erica Kane, illustrates the remarkable longevity of some soap actors and
characters. It was in 2001, twenty-five years after Wakefields book, that Lucci was
finally awarded a Daytime Emmy for her portrayal of Erica; she had at this point been
nominated sixteen times.)

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47. Richard Dyer et al., eds., Coronation Street (London: British Film Institute, 1981).
This collection also brought to television criticism the new field of cultural studies
with its focus on class as a central issue. See also Toby Miller, Hullo Television
Studies, Bye-Bye Television? Television and New Media 1:1 (2000), 38, and Elizabeth
Jensen, Television Gets its PhD, Los Angeles Times, 15 June 2003, Sunday Calendar
section, part 5, 1.
48. Marshall McLuhan, The Mechanical Bride (New York: Vanguard Press, 1951), 157.
49. Tania Modleski, Loving with a Vengeance: Mass-Produced Fantasies for Women (New
York: Archon, 1982).
50. Charlotte Brundson, The Role of Soap Opera in the Development of Feminist
Television Scholarship, in Robert C. Allen, ed., To Be Continued (1995), 4965, 49,
62. Brundson is interested in the juxtaposition of feminists and soap opera
because each noun connotes a different engagement with femininity; the essay
includes a timeline of feminist research on soaps that documents a range of theoretical and methodological approaches.
51. Mumford, Love and Ideology in the Afternoon, 1819.
52. Allen, To Be Continued, 26, notes the preference of social scientists, governments,
and other sponsoring agencies for the closed format, which enables them to impose
an ultimate and determinant message upon the text and define an object of study
in order to obtain research support for a finite project.
53. Ana Lopez, Our Welcomed Guests: Telenovelas in Latin America, in Allen, ed.,
To Be Continued, 25675.
54. Robert C. Allen, The Guiding Light: Soap Opera as Economic Product and
Cultural Document, in Horace Newcomb ed. Television, 14163, 149.
55. Dorothy Hobson, Soap Opera (Cambridge: Polity Press, 2003), 74.
56. Hobson, Previously On. . . .
57. Allen, The Guiding Light, 147. Baseball fans, weary of the complaint that nothing happens in baseball, may not use the word semiotics but they counter with
similar arguments.
58. Hobson, Soap Opera, 168. See also The Communication Review 9 (2006): 2 for several articles on audience research including David Morley, Unanswered Questions
in Audience Research, 10121.
59. C. Lee Harrington and Denise Bielby, Soap Fans: Pursuing Pleasure and Making
Meaning in Everyday Life (Philadelphia: Temple University Press, 1995). Harrington
and Bielby note that unlike sports fans, soap fans are considered dumb and/or dangerous and get no respect while the antics of sports fanshowever fanatic, obnoxious, or destructiveare seen as somehow natural, the high spirits of normal
American guys. This book is an example of audience studies, a lively scholarly field
distinct from survey research designed to support advertising and marketing. Other
examples include Constance Penley, NASA/Trek: Popular Science and Sex in America
(London and New York: Verso, 1996); Andrew Ross, No Respect; Henry Jenkins,
Textual Poaching: Television Fans and Participatory Culture (New York: Routledge,
1992); Abu-Lughod, Egyptian Melodrama; Purnima Mankekar, Screening Culture,
Viewing Politics: An Ethnography of Television, Womanhood, and Nation in Postcolonial
India (Durham, NC and London: Duke University Press, 1999); Ellen Seiter, et al.,
eds., Remote Control: Television, Audiences, and Cultural Power (London: Routledge,
1989); Ellen Seiter, et al., Dont Treat Us Like Were So Stupid and Nave: Toward
an Ethnography of Soap Opera Viewers, in Remote Control (1989); Nancy K. Baym,
Tune In, Log On: Soaps, Fandom, and Online Community (Thousand Oaks, CA, and

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London: Sage, 1999); Dafna Lemish, Soap Opera Viewing in College: A Naturalistic
Inquiry, Journal of Broadcasting and Electronic Media 29 (1985): 27593; Lisa A. Lewis,
ed., The Adoring Audience (New York: Routledge, 1992); Louise Spence, They Killed
Off Marlena, But Shes on Another Show Now: Fantasy, Reality, and Pleasure in
Watching Daytime Soap Operas, in Allen, ed., To Be Continued . . ., 18298; and
Barbara F. Sharf et al., Confronting Cancer on thirtysomething: Audience Response
to Health Content on Entertainment TV, Journal of Health Communication
1:2(1996):15772.
60. Bernard Timberg, The Rhetoric of the Camera in Television Soap Opera, in
Horace Newcomb, ed., Television, 16478, 165. For an interesting rhetorical analysis
of a different soap opera element, see Wikipedias entry on changes in One Life to
Lives opening title sequence since its 1968 inception.
61. Timberg, Rhetoric, in Newcomb, Television, 165, 164. This distinctive relationship is not universally honored. Where Sari Thomas (in Newcomb, ed.) emphasizes the continuous intimacy between soaps and their women fans, Michele
Mattelart, in From Soap to Serial, contends that the genre represents a kind of opiate for the female masses, its perceived viewing pleasures mere illusion. The very
name soap opera, she argues, crudely spells out the forms material origin and
its conscription in the battle between different commercial brandsand makes
unambiguously clear its twofold function: to promote the sale of household products, and to subsume the housewife into her role by offering her romantic gratification. But as Brundson notes in The Role of Soap Opera, other feminist scholars
have approached soaps differently. See, for example, the collection by Ellen Seiter,
et al., eds., Remote Control: Television, Audiences, and Cultural Power (London:
Routledge, 1989); Tania Modleskis 1982 Loving with a Vengeance, and Christine
Geraghtys Women and Soap Opera: A Study of Prime Time Soaps (Cambridge: Polity
Press, 1991). Jackie Byars, in All that Hollywood Allows: Re-reading Gender in 1950s
Melodrama (Chapel Hill: University of North Carolina Press, 1991), observes that the
camera close-ups typical of soap opera contrast favorably with the fragmentation of
female body images in virtually all other forms. Annette Kuhns research on
womens genres (e.g., Womens Pictures: Feminism and Cinema [London: Verso,
1994]) is joined by studies on soaps and melodrama by Jane Feuer (see her essay in
Museum of Television & Radio, Worlds Without End), Christine Gledhill, Genre and
Gender, and Lila Abu-Lughod, Egyptian Melodrama.
62. General Hospital had originally been envisioned as a prime time drama called
Emergency Hospital that was loosely modeled on ABCs then popular prime time medical drama series Ben Casey. Learning that NBC was launching The Doctors in prime
time, ABC daytime head Armand Grant renamed the show General Hospital and
revamped it for daytime. Popular soap chronicler Gerard Waggett notes that John
Bernadino, GHs first leading man, not coincidentally resembled Ben Casey lead actor
Vince Edwardsand notes also that The Doctors was itself revamped as a soap at the
end of its first year (it lasted ten years on daytime). As for General Hospital, well-known
soap writers Frank and Doris Hursley were hired from CBS to develop the show; they
are still listed in the credits. Claire Labine was the head writer when the AIDS storyline was initiated. Gerard J. Waggett, The Official General Hospital Trivia Book (New
York: Hyperion/ABC Daytime Press, 1997). For background see also Timberg,
Rhetoric, Wikipedia, and the ABC website Port Charles; Robert La Guardias The
Wonderful World of TV Soap Opera (New York: Ballantine Books, 1974) summarizes
early GH plotlines, 174209.

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63. Timberg, Rhetoric, 174. Monty expanded the usual role of the producer, taking a leading role in developing scripts and storylines, usually the province of the
head writer and/or the series creator. The character of Rita in the film Tootsie is said
to be modeled on Monty, while a fake hospital-based soap parodied on Melrose Place
had a producer named Gloria (Waggett 1997). She died in April 2006.
64. On General Hospitals fortieth anniversary in 2003, some critics designated it the
greatest soap opera of all time (CNet Networks Entertainment).
65. Harrington and Bielby (Soap Fans, 116) list characteristics that distinguish a soap
viewer from a soap fan (for instance, the viewer will watch video recordings of the
show but then tape over them while the fan will save tapes and catalogue them) as
well as differences among fans of different soaps. GH fans, while not reaching the
pinnacle of sophistication displayed by viewers of the primetime serial (or soap
noir) Twin Peaks (Peak Freaks), are nevertheless considered fairly savvy about the
nature and conventions of soap operas and able (unlike, runs the stereotype, fans of
Days of Our Lives) to exercise a certain critical distance from the events on the viewing
screen (see Harrington and Bielbys chapter 3). For example, one of the daily online
updates by fans I collected on the GH bulletin board describes a particularly torrid
love scene: The last shot was of candle wax dripping down to and off of a wooden
table (that its finish was possibly being ruined was undoubtedly the cliffhanger)
(Port Charles Online 3 December 1997).
66. See, for example, Buxton, Broadcast Formats; Sarah Schulman, People in
Trouble (New York: Penguin, 1991); Deborah D. Rogers, AIDS Spreads to the Soaps,
Sort of, in Suzanne Frentz, ed., Staying Tuned: Contemporary Soap Opera Criticism
(Bowling Green, OH: Bowling Green University Popular Press, 1992), 5759;
Rogers, Daze of Our Lives; Treichler, How To Have Theory in an Epidemic; and Simon
Watney, Practices of Freedom (London: Rivers Oram Press, 1996).
67. Kevin, a psychiatrist, is subjected to various jocularities by his medical and surgical colleagues, the real medical doctors. Told by Kevin of an emergency, for example, Alan Quartermaine asks, What kind of emergency? Someone just found his id?
68. Suzanne Frentz, ed., Staying Tuned.
69. In making this argument, Altman (Television Sound in Newcomb, ed.
Television) takes issue with Raymond Williams view that television programming is a
question of flow (Raymond Williams, Television [London: Fontana, 1974]).
Altmans view is that flow on U.S. television is always a function of its commercial mission to sell merchandise. While film, as he puts it, delivers programming to an
audience, television delivers an audience to advertisers. With this overarching raison
dtre, television can never afford to ignore household flow.
70. Hobson, Soap Opera, discusses theme songs; Timberg, Rhetoric, 168, discusses
the climactic chord.
71. The question of when has clinical relevance; the question of how is relevant
to such non-clinical issues as contact notification and the social support system available for the patients ongoing treatment and care.
72. Pertinent to AIDS media coverage are the ever-changing standards of what constitutes taboo language and images. Extensive media coverage of President Ronald
Reagans colon surgery is said to have made the airwaves safe for the term anal intercourse; social gatherings in the film Longtime Companion and the television sitcom Will
and Grace celebrated the supposed first gay kiss on television. See also Joy V. Fuqua,
Theres a Queer in My Soap!: The Homophobia/AIDS Story-line of One Life To Live,
199212 in Allen, ed., To Be Continued, 210. When Soap Opera Update asked its readers

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in 1995 What Taboo Subjects Are Too Taboo? (28 November 1995 p 45), 95 percent
said they would prefer not to see incest and 93 percent said homosexuality, but 60 percent said they were interested in how homosexuality would be treated on soaps.
73. A plot convention in both soap opera and HIV/AIDS narratives is that trouble
to the community comes from outside, and typically from big cities, with their
bright lights, dark streets, and urban diversions. Edmondson and Rounds, The Soaps,
61.
74. What will audiences condemn? What will the storyline support? The difficulty of
portraying bad actions on soaps is widely recognized by writers and producers.
Discussing soap treatments of rape and sexual assault, for example, Randee Dawn
notes that if the rapist isnt a principal character, you dont want to take time for a
police investigation, trial, and related mechanics. Yet its risky to make the rapist a
principal because its hard to redeem the character. When the act is truly horrendous, you dont want to see that person on-camera again. Randee Dawn, Out from
the Shadows, Soap Opera Digest, August 18, 1998, 4245.
75. Larry Gross, Out of the Mainstream: Sexual Minorities and the Mass Media, in
Seiter et al., eds., Remote Control, 13049, 130; Fuqua (1995) Theres a Queer in My
Soap!, 200. Critic Julie Lew, seeking some years back to explain the dearth of good
AIDS films and television programming, noted that the AIDS epidemic offered
everything a scriptwriter could wish for and concluded that in Hollywood, AIDS
still equals gay. Julie Lew, Why the Movies Are Ignoring AIDS, New York Times, 18
August 1991, Arts & Entertainment Section, 18. See also Deborah D. Rogers, AIDS
Spreads to the Soaps, Sort of. Edmondson and Rounds, in The Soaps, note that it was
during World War II that soap operas first took on the responsibility of engaging in
serious dialogue with listeners about real social problems; Eleanor Roosevelt even
appeared at the end of some broadcasts to sell war bonds.
76. Bradner et al., Older, But Not Wiser. After they leave high school, the study
concluded, most American men have little access to information about AIDS or sexually transmitted diseases, and little is known about what prevention efforts reach
men in their 20s; African American and Hispanic men, however, are more likely than
white men to know about AIDS. Significantly, all men in the study overwhelmingly
identified the mass media as their major source of AIDS information.
At the same time, its interesting to ask what difference it would have made had
Stone been given a bisexual or gay background. It is extremely hard to predict the
specific effects of a broadcast television decision of this kind. The 1992
AIDS/homophobia storyline on One Life to Live demonstrated, in Mumfords view,
that potentially disruptive figures can be introduced into the soap community without disaster. (Marla Cukor, however, writing in Soap Opera Update in 1995, pointedly
contrasted the still-stuck-in-a-time-warp world of daytime American soaps with
primetime serials like Melrose Place, in which the core character of Matt was that rarity in the soap world: Hes a homosexual with a storyline; Is America Ready for
Controversial Storytelling? Will Homosexuality End Michaels Run on All My
Children? November 28, 1995, 4445.) Moreover, it can be argued, I think, that gayness and transgression are not entirely eliminated from the GH storyline. The character of Stone presents certain ambiguities that may speak to viewers who think of
themselves as gay, lesbian, bisexual, or transgenderat the very least by raising
issues. His declaration in this scene that hes not ready yet to be seen as some kind
of a freak invokes the expectation of homophobia, perhaps his own as well as others; yet soon he will stand up to homophobia and bond with gay men with

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HIV/AIDS. Some viewers might also perceive the association of Stone with Rock
as a subtle message.
For general discussion of these topics, see Timothy F. Murphy and Suzanne
Piorier, eds., Writing AIDS: Gay Literature, Language, and Analysis (New York:
Columbia University Press, 1993).
77. Dorothy Hobsons 2003 book Soap Opera discusses the handling of controversial
storylines on British serials beginning in the 1990s, including Mark Fowlers HIV status on EastEnders (the production staff worked closely with the AIDS organization the
Terrence Higgins Trust to get the story right) and Coronation Streets artful development of a transsexual character who is now fully integrated into the shows community of characters (15759 and 15255).
78. In terms of the standards of realism for health-related shows often expected by
health care professionals, its relevant to note that the GH writers collapsed the
period of time between the first clinical symptoms, the diagnosis (the positive test
result), and the development of full-blown AIDS (which in Stones case comes
fairly soon after his diagnosis). A common practice in AIDS narratives, especially
those directed toward teens, is to conflate the period of HIV infectionoften long,
often asymptomaticwith AIDS itself; this, it is believed, raises the fear level and
makes the disease itself more real.
79. Joseph Turow, Television and Institutional Power: The Case of Medicine, in
Rethinking Communication: Paradigm Exemplars, Vol. 2, edited by Brenda Dervin, et al.
(Newbury Park, CA: Sage, 1990). Television doctors and medical dramas continue to
demonstrate, says Richard Malmsheimer, the continuing vitality and tenacious hold
of the well-established tradition of medical idealization Doctors Only: The Evolving
Image of the American Physician (Westport, CT: Greenwood Press, 1988), 134. While
the soap rule that no character can be purely good ensures that even doctors will
sometimes depart from conventional media doctor stereotypes, evil is virtually always
recuperated eventually by the overwhelming ideological commitment of soaps and
mainstream television to professionals as good.
80. Allen, To Be Continued, 10. Timbergs rhetorical analysis of camera and sound conventions notes specific shots that sustain or undercut the realist illusion. The pretense that the fictional story is part of the real world, notes Dorothy Hobson, creates
special problems when major real world events occur like Princess Dianas death or
9/11. It was unusual when EastEnders wrote in the Queen Mothers death for an
episode in April 2002, but it acknowledged an important moment of shared national
mourning. The Archers, a show created after World War II specifically to disseminate
modern agricultural information, was more equipped to incorporate topicality; within
a week of the UK outbreak of foot-and-mouth disease in February 2001, information
had been written into the script. Hobson, Soap Opera, 7477. On The Archers, see
Godfrey Baseley, The Archers: A Slice of My Life (London: Sidgwick and Jackson, 1971).
81. Longtime GH writer Robert Guza Jr. argues that realism should not be the highest obligation of every dramatic narrative in soap operarape statistics on a soap
opera, for instance, should not be required to match those of real life (quoted by
Dawn, Out from the Shadows, 43).
82. Therese Jones, As the World Turns on the Sick and the Restless, So Go the Days
of Our Lives: Family and Illness in Daytime Drama, Journal of Medical Humanities
18:1 (1997), 520, 10. Edmondson and Rounds, The Soaps, 168, note, likewise, that
it would be the labor of a lifetime to tabulate all the diseases to which soap flesh has
been subjected. Gerbner et al. (1981) note systematic statistical discrepancies

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between health on soaps and in real life. Malmsheimer makes the interesting point
that typical viewers see televisions most popular doctors far more often than they see
their own physicians (130). See also Philip A. Kalisch and Beatrice J. Kalisch, Images
of Nurses on Television (New York: Springer, 1983).
83. Before videotapes, DVDs, and TiVo enabled viewers to obtain, save, store, and
purchase television programming, television research was usually based on notes,
memory, and/or visits to archives like those at Vanderbilt and the Museum of Radio
and Television. But what is a pure text? If context contributes to the construction
and understanding of the text, the realities of the watched textwith commercials,
tornado warnings, and other interruptionsprovide important information.
Commercials give information about audience demographics, globalization, and cultural context that may be lost with DVDs. At the same time, a pristine, commercialfree DVD set of a season-long TV show, complete with stellar commentary tracks and
subtitles, provides additional but not the same information as the broadcast version.
Ethnographic observation of television viewing obviously provides yet another version of the text.
84. The posts and updates I cite in this essay (very slightly edited) are from main
General Hospital websites in the mid-1990s (online discussions and daily updates). Faye
D. Ginsburg, Abu-Lughod, and Brian Larkin, editors of Media Worlds: Anthropology on
New Terrain (Berkeley and Los Angeles: University of California Press, 2002), offer
examples of the media turn in anthropology. See also Singhal and Rogers,
Entertainment-education, for models of quantitative assessment of viewer response.
85. Lee Mathis advertised in trade papers that although he had AIDS he was healthy
and wanted to work. The GH producers hired him and created the small recurring
part of John Hanley, an actor with AIDS, for the AIDS storyline.
86. Najda Michel-Herf, This Disease Has Been Formatted to Fit Your TV Screen:
Education, Entertainment, and the AIDS Epidemic in Hollywood and on Network
TV. Unpublished 2001 New York University seminar paper in the authors
collection.
87. Again, this contrasts with most AIDS stories on soaps. Rogers, AIDS Spreads to
the Soaps, Sort of criticizes the three soaps with major AIDS stories as of that date,
which have in common one disconcerting element: all these AIDS plots . . . feature
patients who are women (57). Crystal White closely examines the representation of
AIDS in situation comedies featuring and directed toward young adult African
Americans; drawing upon a series of AIDS sitcom episodes broadcast by the UPN
Network during 20023 and rebroadcast as a block during HIV/AIDS Testing Week
in 2003, White carries out a detailed textual analysis of Girlfriends, a popular sitcom
centered around an ensemble cast of twenty-something African American women. In
an ambitious episode sequence, HIV/AIDS emerged as a central plot element in the
ongoing relationship among the women, and was used to explore, debate, and
explain AIDS issues of particular relevance to the young African American women
who constitute the shows primary audience demographic (A Textual Analysis of the
AIDS Episodes on the Sitcom Girlfriends. Unpublished 2003 research paper in the
authors collection).
88. See Harrington and Bielby, Soap Fans. Hobson, discussing soaps changing
stance toward male characters, identifies the 1990s as the first decade of men who
talk. But Wakefield quotes Agnes Nixon in the 1970s: I write a lot about friendship
partly in protest against those who say everyone is so tough and youre not supposed
to show emotion. Especially men (All Her Children, 74). Soap fan magazines regularly

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comment on the disparity between soap men and real men, noting that soaps occasionally introduce male storylines (e.g., Dallas-type corporate takeovers) to attract
male viewers and then expose them to the numerous desirable behaviors of soap
men (not the JR Ewing types). Henry Jenkins Textual Poaching chronicles production
of early soap newsletters, increasingly important as housewives began to disappear
as the leading demographic audience category for soaps.
89. See Allen, The Guiding Light, 146 on the pseudo reality of health statistics on
soaps. See also Joseph Turow and Lisa Coe, Curing Televisions Ills: The Portrayal of
Health Care, Journal of Communication (Autumn 1985): 3651, on the failure of U.S.
television in general to represent structural, systemic health care inequities. In one
rare (and thankfully brief) attempt during the AIDS storyline to portray the changing realities of U.S. health care, General Hospital is taken over by a health maintenance organization; the HMOs systemic impact is ignored and instead negatively
personified by a single unscrupulous and uncaring physician who refuses to perform
Stones brain biopsy on the grounds that managed care cant squander resources on
terminal patients. Structural dilemmas of equity and rationing of resources remain
invisible when a stock soap villain can step up to take the fall. As Mumford observes,
soap conventions of individualism sometime work to erase ideology. See also Joseph
Turow, Playing Doctor: Television, Storytelling, and Medical Power (New York: Oxford
University Press, 1989); Turow, Television and Institutional Power; and Turow and
Rachel Gans-Boriskin in this volume.
90. Robin in 1995 might well have tested positive; in 2006, it would be just as plausible. By the end of 2005, women accounted for 48 percent of all adults living with
HIV worldwide, and for 59 percent in sub-Saharan Africa. Young people (1524
years old) account for half of all new HIV infections worldwide (UNAIDS/WHO
website accessed July 2006). A 2003 study confirms earlier predictions in judging
HIV/AIDS to be a major health crisis for women worldwide and in the United States.
Alina Salganicoff, Barbara Wentworth, and Liberty Greene, Baby Boom to
Generation X: Progress in Young Womens Health, in The American Woman
200304: Daughters of a RevolutionYoung Women Today, ed. Cynthia B. Costello,
Vanessa R. Wright, and Anne J. Stone (chapter available on Kaiser Family
Foundation website). Many women have no idea they are infected until they develop
symptoms or become pregnant and are then tested for HIV. Robin had no symptoms
but was re-tested because Stone was diagnosed with HIV/AIDS.
91. Robin has just found out that shes HIV positive, and she couldnt feel more
alone as she goes through the stages of denial, anger and depression, wrote Soap
Opera Update in Robin Must Face Her Own Fate, November 28, 1995, 18. The
character of Robin is almost wholly positivesmart, kind, and good without being
goody-goody. After Kimberly McCullough left the show in 1999, she played quite different post-GH roles in such prime-time shows as Joan of Arcadia and Firefly; most
notably, on F/Xs hard-boiled cop show The Shield she played a pathological
liar/crack dealer with great spirit. She returned to GH in November 2005 as Robin,
now a Paris-trained physician. See the characters blog at Robins Daily Dose, with
fan comments.
92. The character of Joey Tribbiani on the situation comedy Friends is an aspiring
actor whose career high point is a short-lived role as Dr. Drake Ramore on the soap
Days of Our Lives. In one Friends episode, Joey (never the brightest light on the tree)
shares tricks of the trade with a class of aspiring soap opera actors and demonstrates how he achieves the inner look: Lets say Ive just gotten bad news. Well, all

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I do there is try to divide 232 by 13. He perfectly produces the look. (He adds,
To work in soap operas, some of you are going to have to become much more
attractive.)
93. Soap Opera Update. November 28, 1995, 57.
94. Janis Ian, When Angels Cry, Revenge audio CD album released May 16, 1995,
Grapevine. AIDS represents the power of a four-letter word; the last verse tells us that
love, like hope, is just a four-letter word. The middle verse explicitly challenges
the attack on gays and lesbians provoked by the HIV/AIDS epidemic.
95. A post on the GH fan website the following year (June 1997), was titled when
angels cry. A few lines suggest the intense fan involvement in the Robin-Stone-HIV
storyline: Ok people. What are you trying to do to me? I had finally overcome my
stone sadness, and then comes the nurses ball. And the stone talk. And all of a sudden Im back to square one. So what do I do, you might ask? Do I try to get over it,
moving on with my life? Oh no, I go dig up my Janis ian cd and start listening to
when angels cry over and over and over and over again. Fan website managed by
jeff @port-charles.com
96. A number of episodes include detailed discussion of the triple cocktail
combination treatment for HIV/AIDS, including a scene in which Jason questions
Dr. Alan Quartermaine, his father, about the implications of a paper in the latest issue
of the New England Journal of Medicine. The AIDS storyline has been extended in other
ways; notably when Kimberly McCullough returned to the show in November 2005 as
Robin (now a physician), an early scene showed her at a conference giving a talk
about the HIV/AIDS epidemic in sub-Saharan Africa.
97. Suzanne Frentz and Bonnie Ketter, Everyday Sex in Everyday Drama, in
Frentz, ed., Staying Tuned, 35.

Chapter Five

Mandy (1952)
On Voice and Listening in the (Deaf)
Maternal Melodrama
Lisa Cartwright
This essay is a reading of Mandy (directed by Alexander Mackendrick/Ealing
Studios, U.S. release title Crash of Silence), a 1952 British melodrama about a
Deaf girl who acquires oral speech through the efforts of a mother who defies
her husband by moving the girl to a public residential school for the deaf.1
The medicalization of deafness, while an important topic, is not what places
this essay within a volume on medicine and motion pictures. I suggest a set of
writings in psychoanalysis not previously mined for film studies through which
to rework some older ideas about female subjects, voice, and agency in feminist film theory. In the area of feminist film theory engaged with psychoanalytic theory, sight, hearing, and oral speech and language figure centrally in
ideas about how human subjects gain a sense of self and agency in the world.
Jacques Lacan has been the primary influence in this work. This chapter is
drawn from a larger project in which I propose that we look to psychoanalysts
who theorized development, ego, and subject formation outside the normative
model of the sighted and hearing child subject. The writings of the twentiethcentury psychoanalytic psychiatrists Heinz Kohut, Ren Spitz, Melanie Klein,
Donald Winnicott, and Andr Green are mined to suggest new ways of thinking about how psychoanalysis can help us to understand how children emerge
as social subjects. Although Andr Green is referenced only once in this essay,
his ideas about affect and representation are especially important to the
project from which this essay is drawn. The role of affect and the intersubjective relationship of child to maternal caregiver are important topics in this
discussion.
Deaf and mute female characters in the sound-era womans film have not
gone unnoticed in feminist film theory. Sarah Kozloff writes that

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Because they appear with surprising frequency in Hollywood cinema, mute characters
have attracted the attention of numerous critics. . . . Bridging the gap from silence into
sound is repeatedly thematized by American films, as if the medium compulsively
needs to repeat the transition of the mid 1920s.2

Kaja Silverman notes that in melodrama the mute role is prominent among
women characters. She describes Johnny Belinda (Warner Bros./First National/
Jean Negulesco, USA, 1948) as a talking cure film with a difference in which
the lead character Belinda (Jane Wyman) is confined to the register of the body
in learning some sign language, and ultimately is made to speak through her
vagina, issuing forth an illegitimate child whose inarticulate cry is Belindas surrogate voice.3 I want to note that in the melodrama the mute role is far more
prominent among girl characters than among adult women. Belinda, though
she becomes a mother, is very much a girl by dint of her age and her position as
a daughter living sheltered within the paternal home. She remains a womanchild to the end, exhibiting naivet regarding all things sexual even after she is
raped and conceives a child.
In the womans film, Mary Ann Doane wrote in her classic account of the
genre, little is left to language.4 Kozloff states, in an apparent contradiction
to this point, that melodrama is the domain of outspoken women, women who
talk too much,5 a factor that wrought havoc in movie theaters concerned about
the volume of patron noise making film dialog all but inaudible.6 In the films I
consider, both Doanes and Kozloffs observations are shown to be accurate,
with daughters and mothers in shifting, interconstitutive roles in relationship
to oral speech and silence. The two roles are clearly modeled in Singin in the
Rain, the well-known 1952 film that takes as its subject problems of gendered
voice in the coming of sound. In this film, the harsh-voiced, silent-era star Lina
(Jean Hagen) is voice-dubbed into the sound-film era by Kathy (Debbie
Reynolds), a female figure who is not only aesthetically pleasing in voice but also
morally upright, a good citizen. She stands in contrast to Lina, whose gnarly
voice signifies her crass working-class immigrant origins. Her voice is a signifier
of her trashy insubordination: like her voice, Lina cant be trusted. It is not a
surprise that in 1952, Kathys confident screen voice could comment that silent
film acting is a lot of dumb show, or that Lina might ask Kathy, What do you
think I am, dumb or something? equating, as Steven Cohan has observed, one
meaning of dumb (muteness) with another (stupidity).7 In 1952, the year
of the release of Mandy in Britain, to be orally silent was to be disempowered.
But not all female voices could win public right of place. For the semiotically
and psychoanalytically informed feminist film criticism of the 1970s and 1980s,
speech and voice were both literally and symbolically linked to womens access
to power and place. If, as Tania Modleski argues, the melodrama is fundamentally about events that do not happen; and . . . above all the word that was
not spoken, the Deaf melodrama is about precisely that struggle to articulate

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the word as a literal expression of the female subjects emergence into the
public sphere.8
In the British maternal melodrama Mandy, articulation of the word is literally
the means by which women, both the title character Mandy and her mother,
emerge as social subjects in the public sphere. The film tracks Mandy, played by
the child star Mandy Miller, as she emerges from her lonely, mute existence in
the sheltering Victorian home of her grandparents to her experience acquiring
oral speech in a school for the deaf. She is accompanied and supported by her
mother, Christine Garland (Phyllis Calvert), who functions both as narrator and
as joint lead protagonist, and who comes to voice both publicly and sexually
through the tribulations of her daughter. Reading Mandy in light of this connection of the word with female agency, Marcia Landy writes, by centering on
the issue of hearing and speaking, the film exposes the strategy whereby women
are rendered powerless.9 It is not only the child character of Mandy for whom
access to speech/power is at issue, then, but also, and more importantly,
Mandys mother, Christine. Landy continues, Though the film ostensibly presents the child as the one in need of acquiring language, it is the wife who must
gain access to it in order to free the child.10
Whereas for feminism, speech is both symbolic of and requisite for power, for
advocates of sign language use, mandating oral speech entailed compromise
and submission. Certainly it is through a quest to acquire the ability to speak that
Mandy achieves liberation from the isolation of the domestic sphere. But for a
child of six, separation from family and home and immersion in the public life
of an institution would be experienced as trauma. If there is liberation in Mandy,
Landy, Annette Kuhn, and Pam Cook all agree, it is first and foremost the liberation of Mandys hearing mother, Christine, and not of the girl Mandy.
In order to understand Mandys status relative to oral speech, it is necessary
to consider the status of voice in Deaf culture during the period of the films
release. Douglas Baynton writes that the reform movement against the teaching
of and in sign language and in support of exclusive instruction in lip-reading
and oral speech gained momentum in the late nineteenth century, reaching its
peak of influence after World War II, precisely the time of these two films
release in Britain and the United States. At this time, Douglas Baynton notes, an
estimated eighty percent of Deaf children in the United States were taught
entirely without sign language, up from forty percent at the turn of the
century.11
In Mandy, oralism is front and center: the film is set in the public contexts of
urban postwar Britain and the countrys network of Deaf schools. Margaret
Deuchar explains that Britains schools for the Deaf were free and compulsory,
oralist, and largely residential. This was despite the fact that the Education Act
of 1944 mandated some integration of Deaf students into nonresidential
schools. Mandy is set in this moment of educational reform. If the Victorian
British child was to be seen and not heard, by the post-World War II period the

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deaf and dumb child, to use the language of Mandy, was a social problem
requiring intervention by a Labor Party state educational system that had inherited a structure of public institutional management from the prewar regime.
The idea that the education of Deaf children was the responsibility of the state
was part of the broader postwar ethos of state responsibility for workforce habilitation. British Sign Language (BSL) thrived informally in communities outside
schools, Deuchar explains, as well as in some of the many schools established by
evangelical and Church of England missions to the Deaf, where sign language
was sometimes accepted and even promoted as a means of religious instruction.12 But the emphasis was on speech training for as many Deaf subjects as
possible.
Mandy was conceived as a fictional melodrama, though produced by a studio
(Ealing) and director (Alexander Mackendrick) experienced in the social problem film genre. The script took as its basis The Day is Ours, a British romance
novel of 1947 by Hilda Lewis. The novel, set in postwar England, chronicles the
psychic life of Christine, a wanton socialite raising a Deaf daughter whose birth
she experiences as punishment for her war-era promiscuity. Vain and materialistic, Christine is reminiscent of Mrs. Miniver, the protagonist of the prewar novelization and 1942 film about British maternal morality in the war era. In The
Day is Ours, Christine, shamed for lasciviously entertaining the troops, is branded
by husband and doctors as a hysteric who talks too much and who produces her
childs deafness: the obstetrician is obliged to use his forceps to extract the head
of the infant from the pelvis of his noncompliant patient. Christines resentment
about her future role as mother is such that she refuses to push. The mother
redeems her social standing, however, by competently putting the child, whose
deafness she describes as punishing, through speech education in a school for
the Deaf.
In the film, which follows the novel by half a decade, moral degradation is no
longer a strong feature of Christines character. She is cast from the outset as
morally righteous and without guilt. Though the film does portray her as narrowly avoiding an affair with the Deaf schools dashing renegade headmaster,
the flirtation is represented as part of her own coming to independent voice.
Their bond over Mandys oral speech education makes their union moral and
good. The cause of Mandys deafness is left uncertain rather than being attributed to the mothers behavior. Mandy is saved from the silent world her
mother imagines out loud through the efforts of a fully competent Christine, a
woman who risks her marriage and reputation to bring her daughter to voice.
In the analysis of sound in Mandy that follows, I consider the relationship
between mother and daughter as they together form an intersubjective identificatory figure for postwar British hearing audiences.
Christine Garlard is a political figure who advances in the new welfare state
through a public role carved out for women: moral caretaker. Regarding
womens relationship to citizenship in emergent welfare states including

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Englands, policy theorist Ruth Lister explains that central to those debates were
issues of maternal and child welfare as women in a wide range of countries
strove to translate their private responsibilities as mothers into public citizenship
claims.13 Christines function in this regard is not unique. Literary historian
Alison Light notes that between the world wars the romance genre narrowed to
signify fiction for working women and girls and veered toward mass entertainment.14 Mandy followed the pattern of Mrs. Miniver (MGM 1942), the British
pre-World War II newspaper romance serial turned popular war propaganda.
Light, referring to the serial as the snuff of a nation in arms, quotes Churchills
comment about the film version: Mrs. Miniver did more for the allied cause
than a flotilla of battleships. How did it become possible, Light asks, for the
mediations of a middle-class, middlebrow woman to speak for a nation?15
Similarly we might ask how Christine Garland makes the transformation from
the novels loose wartime hysteric and negligent mother to the standardbearer of the postwar welfare states maternal ethic of caring and responsible
citizenship.
Mandy gives us a child body without a voice and, through maternal voiceover
early in the film, a maternal voice without a body. Silverman writes
Because her [the mothers] voice is identified by the child long before her body is, it
remains unlocalized during a number of the most formative moments of subjectivity.
The maternal voice would thus seem be the original prototype for the disembodied
voice-over in cinema . . . [that has] become the exclusive prerogative of the male voice
within Hollywood film.16

In a flashback, typical of the maternal melodrama, that grants the mother narrative agency, Christine speaks directly to the viewer in the films opening scene.
She introduces her baby, Mandy, to film listeners in voiceover. In shot after shot
during this early portion of Christines voiceover monologue, the image track
shows the baby in close-up. Christine is visible for the most part only in frames
that include her hands lovingly attending to the baby. Her place off-screen (but
for her administering hands), and her authoritative, caring voiceover in the
opening minutes of the film evoke the style used in the films of child experts
Margaret Mead, Arnold Gesell, and Ren Spitz. These authorities demonstrate
their theories of child development and maternal caring through an instructional voiceover that, like Christines, directs our attention to the childs body.
Voiceover is a pointedly ironic means of representing the mother in a film
about a child who, listeners will soon learn, is stone deaf. In 1980, Doane
(drawing on the writings of psychoanalyst Guy Rosolato) asked the question, In
what does the pleasure of hearing consist? One answer she offered is that pleasure is situated in the divergence between present experience and the memory
of early satisfaction. Her example is infant memory of sound, precisely the sort
of memory we are invited to understand as lost to the child Mandy. Traces of

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archaic desires stemming from this early experience of hearing the maternal
voice are never annihilated in the adult subject, Doane explains. Memories of
the first experiences of the voice circumscribe the pleasure of hearing and
ground its relation to a phantasmatic body. For the child, she continues, physical space is defined initially in terms of the audible, not the visible.17 (This
point has yet to see the kind of interrogation it deserves relative to the film
soundtrack.) Doane goes on to describe female voice-off and voiceover using the
metaphor of a sonorous envelope.18 The term, which she draws from the writings of Didier Anzieu19 and Guy Rosalato,20 refers to the acoustical containment
of the listening body in a spatial field. This envelope of sound space is akin to
the field in which the infant experiences the voice of its mother, which is the
first model of auditory pleasure.21 Doane emphasizes the experience of viewer
containment and safety as deriving from the memory of this early prelinguistic
experience.
The psychoanalyst Heinz Kohut introduced a similar idea about the constitution of the blind childs sense of self through sound. He introduces the concept
of the tape recorder as an analogy to the mirror in the development of the
childs sense of a self. This is put forward through an observation of a child
caught on a film made by Anna Freuds partner Dorothy Burlingham and the
psychiatric social worker James Robertson. In the film, Kohut explains, the
expression of a child who is blind lights up at the sound of her own voice played
back to her on a tape recorder. Kohut suggests that the tape recorder acts as a
mirror, reflecting the child back to herself in a manner typically performed by
the mother.22 This relationship of maternal mirroring is familiar to film readers
through film theorys appropriation of Jacques Lacans concept of the mirror
phase.23 It is important to note that whereas in Lacans version the child is
between six and eighteen months old, Kohut describes a child old enough to
manipulate a recorder and understand its function. This child is therefore likely
to be much older, making this an example of a belated experience of narcissistic self-recognition. The (in this case auditory) mirroring response supports the
childs narcissistic pleasure in witnessing its own physical performance, an enactment that is fundamental to the emergence of a cohesive self. The vocal function of the maternal voice is an auditory self-playback that facilitates the
development of the blind childs sense of self. Further, if we note that the girl in
Burlinghams film is in fact an institutionalized child living without a mother, we
might speculate that the technology of maternal mirroring finds an acoustic surrogate in the audio recorder.
Three years after the release of Arthur Penns film version of The Miracle
Worker, Burlingham published an influential article on ego development in
blind children that would evolve into a book on blind and also sighted children
in circumstances such as twinning that also uniquely impact ego development.
Burlingham, lifetime collaborator of Anna Freud in work with homeless and
war-displaced children in Vienna and England, based her essay on observations

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at the Hampstead Nursery for Blind Children, which she ran through the mid
1970s. She considered problems of communication and pleasure, both from the
perspective of the mother and the perspective of the child: Blind infants need
more than the usual stimulation from the mother to respond to her, she noted,
adding that acoustic and tactile sensations do not seem to have the same arousing effects on the infant as visual ones.24 Her point is not the stereotypical one
about the primacy of vision; lack of vision in itself is not the problem she wants
to highlight. Rather, her concern is about synaesthesia: vision stimulates the
other senses, prompting the senses of hearing and touch to develop along with
sight.
Vision also comes into play as a problem, Burlingham suggests, for sighted
subjects interpreting the expressed affect of blind children. Blind childrens
expressions, Burlingham explained, tend to be hard to read because they are
not confined to the face as would be expected but rather are dispersed over the
whole body: The blind child uses his body and musculature to express pleasure
. . . in a manner which is more appropriate for the toddler stage, before communication of affect is confined to facial expression.25 The implication is that
the routing of affect primarily through facial expression is simply not present in
the blind child in the same way or to the same degree as it is in the sighted.
The U.S. physician Van Spruiell, in an unpublished paper recounting his
experiences working as a visitor at the Hampstead Nursery for Blind Children,
emphasized that the Hampstead analysts were especially taken with the question
of narcissism among the blind children. By thinking about congenitally blind
children, he explained, we might come to think new thoughts about normal
narcissism. And by thinking about narcissism we might see blind children in
new ways. He goes on to explain that what they learned was less about narcissism than about the inadequacy of the concept to describe ego formation. In
these children, he wondered, was there any self at allself to love?26 His conjecture, rather than leading him to wonder if the blind child develops an ego
properly, steers him to question the value of the very term narcissism which is so
central to psychoanalysis, from Freud to Lacan, with its connotations of visual
perception as a constitutive necessity of self. This idea is suggested in Lacans
concept of the mirror phase and in Kohuts suggestion that the most significant
interactions between mother and child occur in the visual area, with the childs
bodily display responded to by the gleam in the mothers eye, which is exultant and suggestivewe might even say projectiveof an image of the child in
its unity and totality.27 Burlinghams account of the blind childs development
stresses what the blind child does do toward constructing a concept of self in the
world, rather than constituting its blindness as a condition of developmental
lack that must be habilitated, coaxed into a state of becoming.
In an increasingly specular culture that makes appearance a mandatory constituent of a subjects emergence, children are not the only ones who require
mirroring technologies of accommodation. The sonorous or acoustic envelope

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concept introduced to film theory in Doanes essay of 1980 appeared much earlier in the film industry context. In 1941, at about the time that the selfplayback film described by Kohut was shot by Burlingham and Robertson, a
film industry trade essay described a playback system that was dubbed an
acoustic envelope. This system was piloted with the singer and film actor Paul
Robeson.28 The sound technician who is the author of this essay explains that
Robeson found that he could no longer hear himself sing in the new, larger theaters into which he was booked in order to hold his burgeoning audiences.
Robesons voice was lost to himself in these cavernous spaces.
As Doane notes, sound, unlike image, is simultaneously emitted and heard by
the subject. The maternal function of playback described by Kohut is the
medium through which the child comes to recognize itself as the source of the
sound it witnesses.29 Narcissism is thus, importantly, not an immediate relationship with the self but a mediated, proximal, and intersubjective relationship. But
the vast spaces designed for mass audiences afforded no inherent mechanism
for this kind of proximally mediated sound reflection. In effect, Robeson lost his
self in losing track of his own voice. The acoustic envelope filled this breach in
the acoustic mediation of self to self, offering to performers the experience of
an invisible, intimate and resonant acoustic field in which they could hear themselves sing within the cavernous space of a large theater. In the acoustic envelope, the speaker or singer is safely ensconced in a field in which his or her own
voice remains intimate and available for self-perception, even as that voice is
given over to a vast audience. In other words, this is an acoustic mirror, an instrument of reassuring self-perception that accommodates the alienating, eradicating effects of mass-audience performance technologies.
I cite this example of the acoustic envelope technology because it suggests
that performer self-perception was not always or easily achieved on a film set
where the technologies of architecture, miking, and the increasingly common
strategy of post-dubbing and playback interfered with this necessary narcissistic
cycle of self-perception. Cavernous theaters and location shooting, sets where
external sound broke in, all interfered with the reversibility of the voice
required for the performer to situation himself or herself in character. In
Doanes account, the infants self-perception requires the voice of the mother as
a device that defines and situates the infant within a world, a concept that echoes
Kohuts description of the mother as mirroring playback system.
In Mandys opening scene, the viewer is invited by Christines voice into a
secure narrative space, just as Mandy herself would be expected to derive a sense
of secure orientation from the voice of the mother within the diegesis. But
Mandy offers a breakdown of this acoustic logic not unlike the breakdown of
performer self-perception that Robesons acoustic envelope technology was
designed to fix: the two-year-old Mandy, the audience will learn shortly after this
idyllic opening set of shots, cannot hear her mothers voice. Hence she cannot
have oriented herself through sound to pass through stages of attachment to the

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mother and thus develop in ways imagined to unfold relative to maternal voice.
Christines competent voice may lead the audience through the narrative but it
is lost on the screen mothers most important audience: the child.
Mandy fails to begin to speak by age two as her mother believes she should
have. The symbiotic pair is then separated on the image track. We see Mandy
alone as Christines voiceover assumes an anxious edge, describing her daughters failure to speak. Doane remarks in a footnote that there are two kinds of disembodied voices: theological and scientific.30 In a strategy that will be repeated
in The Miracle Worker, Christines voiceover tone shifts from solicitous to clinically
descriptive as she discovers Mandys deafness in the opening scene, then offers a
few brief updates on her childs progression to speech in the remainder of the
film. The occasional voiceovers that punctuate the film after the opening scene
sound much like a documentary-style medical progress report.
Christines progress reports are the viewers first hint of the films affinity with
the social problem film, the style in which many reviewers saw it, and in which
Landy places it in her classic British Genres.31 In the typical social problem film,
the ubiquitous voices of famous men narrate didactic commentary on social
issues. Pascal Bonitzer has described the voiceover as representing a transcendent power, an authority that emanates from outside and over the image: The
voiceover is assumed to know: such is the essence of its power.32 In Britain and
the United States at mid-century, we find the convention of using celebrities as
moral pedagogues, public intellectuals of a sort, who expound on social problems. A disembodied James Agee, for example, performed the voiceover narration for The Quiet One (Janice Loeb and Sidney Meyer, 1948), a melodramatic
documentary about a troubled African American boy from Harlem who is mentally ill and has fallen mute, reportedly as a psychosomatic response to neglect
and abuse by his grandmother. Agees urgent voiceover provides a poignant yet
authoritative medical-educational narrative about the boys history and his
recovery of speech. The boy comes out of his shell when placed in a rural residential home where he is nurtured by a male social worker. In Britain, Richard
Burton performed the voiceover for Thursdays Children, a documentary about a
residential school for the deaf depicting children breaking into communication33 just a few short years before Burton and director Anderson themselves
would break into their own political voices as two of Britains notorious Angry
Young Men. Thursdays Children brought Anderson directly into the world of
national child welfare and moral regeneration: following this film he made
three neorealist-influenced spots for the National Society for the Prevention of
Cruelty to Children. Male voiceover in all these documentaries about child voice
and agency walks the line between intimate, empathic storytelling and distanced, factual register of medical-pedagogical progress: the quiet one, the
boy of the U.S. documentarys title, finally comes out of his pathological state of
withdrawal and speaks; Britains Thursdays children acquire oral speech and,
as Burton assures us, thereby gain access to Britains hearing working world.

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In Mandy, it is the fictional Christine whose first-person voiceover leads the

viewer along this borderline between sentimental fiction and clinical document,
from doldrums to cure, making the film appear almost like an instructional film
in some respectsan effect replicated ten years later in The Miracle Worker. If
Christines maternal voice is inflected with the authoritative tones of the socialproblem film in order to drive home the hard fact of Mandys deafness, then it
might also be said that the social problem films male narrators mimicked the
poignant and emotional cadences of the female voice aurally to stir the emotions of their listeners in maternal melodramas like Mandy.34 This humanitarian
appeal is achieved at the level of sound and voice, and attached to silent child
images. Mandy encourages empathic identification at the level of sound (voice),
eliciting a response of pity for the child.
In both Mandy and Miracle, mothers, not doctors, diagnose their childrens
deafness. Christine, based on her sharp observations of the child, performs
impromptu sensory tests to prove Mandys deafness to her husband, engaging
him as assistant in deductive experiments. This examination is conducted
through a process that splits sound and image. When Mandys head turns to
look up from her crib as her father enters the room, Harry Garland is assured
that his daughter must have heard him enter the room and therefore could not
be deaf. Christine, however, notes that it was a visual cuea shadowthat had
caught Mandys attention and not the sound of her fathers steps. Harry,
Christine commands, make her hear something she couldnt possibly have
seen. Mandy, gazing blankly at the camera, does not flinch as the listening audience undoubtedly does as Harry loudly crashes a metal tray to the ground
behind his daughters back, an act that inspired the films U.S. release title, Crash
of Silence. Harry follows this failed experiment by hysterically calling out his
daughters name, a performance that garners no response. By separating sound
from image in Mandys perceptual sphere, Christine proves to Harry the fact she
states with finality to her film audience: Mandy cannot listen. She pronounces the
girl really stone deaf and predicts, shell be dumb, too. A subsequent scene
in a doctors office where Mandys deafness is confirmed is superfluous, for
Christine has already proven the fact empirically.
This display of maternal diagnostic acuity is repeated in The Miracle Worker ten
years later. In the films opening scene, Kate Keller (Inga Swenson) administers
to her toddler daughter, who is convalescing in the nursery following a respiratory illness dismissed by a visiting doctor as a routine childhood ailment. In a
high-key close-up that renders her lovely face a fright mask, Kate coos ironically
in a sarcastic voice to the off-screen baby that her daddy should print an article
in the newspaper he publishes heralding the marvels of the modern medicine
that has failed to name his daughters illness.
In both of these films opening scenes, the childrens status as deaf and, in
Helens case, blind, elicits first horror, then shame. The shaming of the child in
the eyes of the mother, psychologist Silvan Tomkins suggests, is at the origin of

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the taboo on mutual looking between two subjects.35 He identifies as the paradigm of this kind of looking the interlocked gaze of the mother and infant, the
adoring mutual stare. The psychoanalyst Ren Spitz noted that, in his film
footage of nursing babies, the nursing infant does not remove its eyes for an
instant from the mothers face until it falls asleep, satiated.36 Proximity, epitomized in the contact of the breast inserted in the mouth (for Spitz a primal
cavity37), is the object of the taboo, not looking. We should take careful note of
this as a counterpoint or supplement to Lacans important point about the
childs (mis)apprehension of itself in the mirror. Film theory has been highly
attentive to the mirror moment, its replication in circumstances including the
cinema, and the misrecognition and splitting that it models. But we have been
less than observant in noting the evidence of negativity (not the same as misrecognition) on the part of the mirror in this moment. The caregivers pride in
the childs new-found ability, and her own responsibility in giving the child this
ground for the subjects formation may be evident, but we may also observe disappointment in the mirror-eyes of the caregiver, say, if the child fails to perform
within the terms of that ego-constitutive paradigm of recognition and misrecognition. The mother may see in the child the mirror image of her own failure to
inspire (mis)recognition in the child, and hence may instill in the child a sense
of shared shame over its lack of self-control and mastery.
Kate Kellers address to the baby is, of course, purely for the benefit of the listening audience, which is privileged with knowledge the screen mother does not
yet have: the child neither sees nor hears her. Kates monologue is thus, in effect,
a voiceover insofar as it has no diegetic receiver. Michel Chion expands on the
imagined relationship of infantile security inside the space of female voice, the
maternal acoustic envelope discussed earlier. He puts a sinister spin on the control over the spectator-as-infant that this model implies. Chion describes the intimate, closely miked female voice as a uterine nightmare in which the listener
as child is trapped, suffocating. Silverman, describing this sadistic twist to the
metaphor as a fantasy construction shared across film theory and film texts,
quotes from Chion:
In the beginning, in the uterine night, was the voice, that of the Mother. For the child
after birth, the mother is more an olfactory and vocal continuum than an image. One
can imagine the voice of the mother, which is woven around the child, and which originates from all points in space as her form enters and leaves the visual field, as a matrix
of places to which we are tempted to give the name umbilical net. A horrifying
expression.38

Chions metaphor of the uterine nightmare as deadly trap is an apt one for
describing The Miracle Workers representation of Helen and Kate in a state that
borders on madness. The psychoanalyst Robert Fliess, in Dream, Symbol, and
Psychosis, makes the astute observation that Freud very belatedly admitted the

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existence of delusions in dreams when he opened a chapter of his 1940 Outline

of Psycho-analysis with the statement that the dream, then, is a kind of psychosis.39 Kates mock-comforting maternal voice, its dry wit matched in this
scene with her frightfully lit face, dissolves into hysterical cries that resonate with
the inarticulate screams of Harry Garland in Mandy ten years earlier. Kates cries,
like Harrys, are expressions of horror and consternation motivated by her observation of her daughters lack of response. Helens eyes had remained motionless
during her dramatic ministrations. The fictional space of a comforting blanket of
maternal voice as theorized by Silverman and, earlier, by Rosolato and Doane
the tone and proximity that initially had lulled listenersbreaks down as listeners come to realize that these parents performances have gone unnoticed by the
screen child, who remains blank. With her shrieksexpressive vocalization that
is not speechKate Keller pulls listeners down with her into a nightmare fantasy
that imagines the mind of the prelinguistic child as one destined to be lost in a
world of non-meaning for far too long because of her loss of the senses of sight
and hearing. The child imagined in this fantasy may never emerge as a subject
insofar as, when the time comes, she will neither see herself as the gleam in her
mothers eye nor hear herself in the self-playback mechanism that is the mothers
enveloping voice. In short, she will remain without a self-image and without a
sense of herself as having voice and/as agency. This impending failure of the ego
properly to form in relationship to image and sound is the anticipated tragedy set
out in this scene of the film. As in Mandy, this opening scene sets up a narrative
movement toward the talking cure that will be performed by maternal surrogate
Anne Sullivan in the remainder of the film.
I emphasize with Silverman that this idea of a uterine night is a construction
evident in film and culture in which the mother is imagined to share the childs
undeveloped sensory and communicative abilities. These undeveloped or lacking abilities are imagined to exist across the mother-child couple and not just
in the child. This transposition is repeated in Chions use of the concept.
Silverman writes:
The opposition of the maternal voice to the paternal word attests to a quite remarkable
sleight of hand, although one which has become so frequently effected within recent
theory as to have become almost transparent. It attests, that is, to the displacement onto
the mother of the qualities that more properly characterize the newborn child. The
conceptualization of the maternal voice as a uterine night of nonmeaning effects a
similar displacement: once again the infants perceptual and semiotic underdevelopment are transferred onto the mother.40

In pulling Kate into this space of semiotic underdevelopment imputed to the

deaf and blind child, the film also pulls its listeners into this world. Spectators are
given a glimpse of the imagined nightmarish qualities of sensory impairment. The
Miracle Worker in this way sets up its narrative objective: to deliver the child, and

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with her the caregiver and the viewer, from a nightmare of nonmeaning and to
enter (with) her into the intersubjective public space of maternal playback and
social signification. In both Miracle and Mandy, it is the mothers responsibility to
thus deliver the child. For the remainder of these two films, the mothers struggle
to save their daughters from their silent worlds, belatedly bringing them up with
the help of professional doubles, maternal surrogates.
Focusing on sound, thus far Ive suggested that The Miracle Worker invites the
listener to identify empathically with the shame of the grief-stricken mother. Her
narrative voice pulls the listener into the space of a uterine nightmare in which
deafness and blindness are the conditions of a fundamental tragedy in which the
child cannot develop a normative self. But I have overlooked vision and the
image, the question of Kellers blindness, and a reading of affect that might
bring us somewhere other than into the uterine nightmare the film seems to
want listeners to experience. Jumping tracks in The Miracle Worker from sound to
image, we see that throughout the opening scene, the baby Helen is never
shown on screen. Her off-screen presence is indicated by the direction of Kate
Kellers gaze. Kates face, bathed in light, gazes into the off-screen space and at
the implied subject of the reverse shot that never comes. The baby for whom
Kates look is intended is incapable of receiving this expressively powerful look,
an affirmative affective projection that is so crucial to the emergence of the
childs ego, according to child psychoanalysis. What can we do with those cornerstones of psychoanalytic feminist film theory, including the mirror stage and
the visually and aurally based theorization of subsequent phases of entry into
language and subjectivity,41 when a deaf and blind infant subject is constituted
as absence, and as a subject without the ability to normatively constitute herself
in the world? If we follow the lead of Chion, the screen childs failure to hear
and to see leads the viewer to imagine a tragic failure of subject emergence.
The very basis of subject formation and of filmic identification, spectatorial
unity with the maternal body and the subsequent formation of the ego through
a process of separating from that oneness of infant and maternal bodies, is suspended in this splitting of onscreen mother and off-screen, invisible child.
Helen needs to be part of an intersubjective unit through which she may come
to life before she can gain voice and agency in the film. The agenda of these
films, to give voice to mother and child, becomes focused in this process of splitting of sound and image, mother and child. Narrative tension in these films centers on the listeners anticipation that Mandy and Helen will, to use a term
introduced by Helens brother Jimmie, be opened to dialogic speech.
Mandy and Miracle Worker each pick up their stories about six years later with
girls now of school age who, the films imply, have remained locked in the
shadow worlds of their domestic spaces and infant egos. They are unprepared to
enter the public sphere insofar as they have not achieved the ability properly to
listen, to speak and, in Kellers case, to see. Keller is particularly noncompliant,
performing like the proverbial wild child who communicates her desires

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through gesture, physical force, and tantrum.42 Christines story resumes with
her bitter statement that Mandy spent the next five years being sheltered, and
we see that the family has indeed gone back in time to a version of the uterine
nightmare, moving from their bright modern flat to the dark and drab Victorian
home of Harrys parents. The latter home fully captures the stereotype of
between-the-wars England as a smothering and defensive domestic space.
Christine and Harry face a crucial decision: Should Mandy be kept in this dreary
home under the tutelage of an elderly, finger-spelling nurse-governess and doting paternal grandparents, as her father wishes, or should she be sent away to a
modern residential school for the deaf where she would be taught to lip-read
and possibly to speak in order to prepare her for life in the hearing world, as her
mother desires? The mothers desires win out, casting her for the remainder of
the film as the champion and representative of all that is moral and good about
Britains modern welfare state and its humanitarian reforms.
Debates about Deaf residential schools were very much in the air in postwar
Britain. Discussions following the Education Act of 1944 proposed some integration of Deaf students into nonresidential schools.43 That institutionalization
is the films moral response to Mandys circumstance is made clear for viewers
through a series of short vignettes set in the Victorian paternal home. Through
these quick segments we witness Mandy dangerously compromised by her inability to listen and to communicate in this space. Viewers are expediently aligned
with Christine and residential education as the modern, humane choice in a
series of scenes that posit life at home as endangering Mandys social welfare
and life.
In one of these segments we see Mandy in a medium close-up looking longingly through a wired-over gap in the wall framing the Garland yard where she
plays protected and alone. We cut to a shot, filmed from Mandys point of view,
of children noisily at play across a rubble-strewn lot, presumably the previous site
of a home destroyed in an air raid during the war. The camera then returns, in
a forlorn reverse shot, to Mandy. In a 1992 reading of Mandy, Annette Kuhn has
written that the domestic chasm where the children play in this scene symbolizes
the gap between Mandy and other children caused by her inability to speak.
Mandys longing gaze across the chasm wont be returned because she cannot
hail those children with her voice. When Mandy later in the film utters her first
word, Christine comments that it is like seeing the door of a cage open, and
we are meant to visualize Mandys escape from this fenced yard into the social
world of play with hearing children.44 The backyard chasm scene is recalled at
the end of the film, Kuhn reminds us, in a climactic scene where we see Mandy
gazing across the same breach again, having returned home after a year at a residential school for the Deaf. But this time she enters the postwar playing field as
a listener and a speaker, reading the lips of the child who asks her name and,
using her voice to hail her peers, to name herself, affirming her own identity and
thus bridging the gap symbolized by the bomb chasm.

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Kuhn reads these scenes within the terms of this metaphor of voice as emergent
agency. I will give her reading closer consideration, but I first wish to consider
what was at stake regarding listening in England during the war. In a vignette coupled with the chasm scene, the family dog runs into the street. Mandy leaps from
the doorway into the path of the car to pull the dog from the path of the vehicle.
Point-of-view shots from Mandys perspective establish clearly that Mandy has seen
the danger and makes the choice to risk her own life to rescue her pet. But the
scene nonetheless is folded into a series of cases demonstrating the dangers posed
to children who cannot hear the warning sounds of modern urban culture, such
as the car horn, where technology increasingly encroaches upon private domestic space. The driver blares his horn, screeches his brakes, and hollers at Mandy
in a tirade that fades to a faint hum on the soundtrack, putting listeners in
Mandys supposed auditory point of view as we see her shamed face in close up.
The scene is clearly set up to suggest that Mandy requires special training and protection to survive in postwar climate of technological advancement.
During World War II listening for air-raid sirens, planes, and air strikes was a
critical means of survival for hearing citizens. Deaf workers relied on visual and
physical cues set up in advance with hearing coworkers. Accounts of experiences among Deaf citizens help to put the meanings of Mandys chasm and car
scenes into perspective. Accounts like the one quoted below suggest that the
chasm in Mandy would have had a meaning for deaf British viewers of the film
very different from those of film listeners. This is the account of one informant,
a Bristol woman who paradoxically worked manufacturing munitions:
I worked in Yate, just outside Bristol, in an ammunition factory, making shells. One
night I was working when suddenly I noticed the power was failing on my machine. . . .
I looked up and the woman opposite me pointed above her head and said Jerries
above. . . . Suddenly the lights went out. . . . We were told to go and wait in a field away
from the factory. . . . I looked over toward Bristol and saw nothing but a sea of flames.
I . . . watched the fire and cried. I was only 19.
When I finally got home I couldnt get into the house because the front door was
locked. I . . . climbed over the garden wall where the bomb shelter was because I
thought maybe my parents didnt know it was safe to come out. They were not in the
shelter and I began to get very worried. In the end I broke a window to get into the
house. They had slept the whole night through and had not known there was a raid.
We all looked at the piece of string tied to my mothers toe. It had snapped.
There was a hearing foreman who got on very well with Deaf people, and he could
communicate with me, using a special set of gestures that we had worked out between
us. The foreman always worked on the same shift as I did so he could keep an eye on
me. The foreman ran up to me and said (in our special gestures) run for your life!
There was a wall along my route to the shelter that should have protected me, but
I was in a panic and ran along the wrong side of the wall where I could be seen. An
aeroplane followed me, shooting me with its machine gun. . . . as I came to a gap in the
wall, he [the foreman] grabbed me and pulled me to the shelter on the other side. We
saw a bomb land directly on the factory.45

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Education toward the goal of survival in and service to a hearing world that
was increasingly utilizing sound not only for communication but for workplace,
home, and public safety helped to justify ongoing curricula in lip-reading and
speech. This controversy surrounding sign (represented in Mandy by the signed
English of the elderly nanny, not British Sign Language) versus oralism is precisely the broader tension driving the films plot forward, lifting the text from
sentimental melodrama and metaphor and placing it squarely into the realworld domain that is the stuff of the social problem film. The controversy is cast
in postwar terms, foregrounding listening as a means of public safety and civic
participation.46 For the postwar milieu of Mandy, to become a listener is fully to
become subject as citizen.

Acoustics in Mandy: The Deaf Child as Speaker

To become a speaker in the social sense of that term is to perform with the
independence required of the public citizen. A speaker in the technological
sense is an instrument that converts electrical energy into sound energy. It is
also an amplifier, a public address system. In an essay about Helen Keller and
the symbolic and literal meanings of her hand, Diana Fuss writes that the telephone was the first technology Keller was associated with. She was introduced
to it by Alexander Graham Bell at the 1893 Worlds Fair, where at the same time
she was introduced to the phonograph. Keller, Fuss observes, most often
appears in photographs as the passive receiver of the manual alphabet pressed
into her hand by her interlocutor.47 Fantasies of Keller as a receptive medium
extend to representations of her interest in the technology of radio. I mean to
suggest here that Mandy, in her transition from the uterine space of the
Victorian home to the residential school, performs this public function. She
becomes a facilitative technology of voice, and not simply of reception.
Through Mandy the nation may recognize itself as having the ability to confer
agency, to extend to its citizens the ability to speak and to listen. Like the psychoanalytic projector, the figure whose emanations enter the recipient with
force, the speaker is a figure whose emanations amplify affect from screen to
audience.
Mandy is set, as previously noted, in the fictional Bishop David School for the
Deaf, a location probably meant to suggest a private Church of England mission
school. The bulk of the film was shot at the real-life public Royal Manchester
School for the Deaf. At this institution are set scenes that feature Mandys emotionally grueling acquisition of lip-reading and oral speech performance in her
sixth year of life, a process witnessed by viewers through the perspectives of
Christine and the female teachers who help Mandy achieve oral speech. The
children with whom Mandy interacts on screen were actual residents of the

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Manchester school, untrained actors whom director Alexander Mackendrick

coached to perform in the film.48 They themselves would have been undergoing
the oral training we see Mandy undergo on screen. Press coverage and the films
credits established the documentary status of these scenes for the films
audiences, ensuring that the public understood the real and present social
importance of the melodramas message regarding speech acquisition among
the Deaf.
Published in 1992, Annette Kuhns essay Mandy and Possibility recalls the
film theorists own experience viewing the movie as a girl in a British cinema theater shortly after its release. Kuhns mother had taken her to see this picture
everyone is talking about, a film about a girl, Kuhn explains, who could so easily be myself.49 It is not surprising that Mandy had a child audience, for in postwar Britain youth film culture thrived through the vast Odeon and
Gaumont-Britain Childrens Cinema Clubs, which had a collective membership
of over four hundred thousand children, aged seven to fourteen (one in ten
British children in this age group) at the phenomenons height, all sworn to an
oath of good and honourable young citizenship.50 Ealing Studios would have
been aware of this civic-minded young audience, suggesting the possibility that
Mandy was indeed a film for girls. Kuhn explains to her readers that Mandy left
its mark on the child Annette in the form of intense, emotionally charged memories of identification with the character Mandy during moments when the girl
struggles to perform oral speech. Kuhns identification with Mandy is interesting in a film that is so overtly designed to establish Christine, not Mandy, as
narrative authority. After recounting her experience, Kuhn fast-forwards to a
memory from 1980 when, as a film professor, she seized the opportunity to
reconsider this film that had drawn from her such a strongly affective response
years before. She recounts having an incongruous tearful outburst as an adult
during a discussion about the film with a colleague. For Kuhn, this revisiting of
Mandy is the catalyst not only for remembering, but also for taking seriously such
affective responses to film. Mandy, Kuhn explains, speaks to the child in both
the child and the adult.51
My concern is, first, with the term in. Might not the child-figure Mandy also
speak to or call forth an adult female subject waiting in the girl who is the spectator of Mandy? In other words, might the film not also speak to the woman who
the girl will someday become? And by what mechanism does Mandy call forth
the child inside the adult spectator? My hypothesis is, first, that this process
occurs in the complex we form of identification, the sort that involves reciprocity and an interconstitutive process in subject formation. I also posit that
that uniquely self-reflective and feminine affect, shame, is a major factor is the
intersubjective processes of projective and incorporative identification. Kuhns
choice of terms hereMandy speaksis of course deliberate in discussing a film
where speech acquisition drives the plot. But the focus on Mandy as speaker is
deeply perplexing, for throughout the film the child Mandy does not acquire

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the framework and use of oral language but rather acquires the initial ability to
speak orally, articulating exactly two words: her own name, and mommy. These
words are uttered with intense difficulty. In Kuhns reading, Mandys agency
crystallizes in the moment in which the deaf girl speaks her own name out loud,
announcing herself with this single word as a subject in a social world of oral
speakers as she joins hearing children to play in a field of domestic remains. The
child Annette, Kuhn tells her readers,
desperately wants Mandy to triumph. At the end of the film, showing the world she can
now listen, can understand (Lend us your ball, shouts a boy among a group of children at play. Mandy offers it to him with a smile. Whats your name? he asks). Mandy
makes the supreme effort to utter her name. With an equal intensity of concentration,
the girl in the audience wills the sound to come from those silently mouthing lips;
inwardly, urgently, speaks the name for her; feels such release when Mandy at last, in
flat uninflected tones, manages to achieve the two syllables.52

In psychoanalysis and in much of feminism, to speak the word is to enter the

social space of language and paternal law, a space that one always enters, in
Lacans account, as a gendered subject.53 Kuhn writes as the everygirl of postwar
British listeners who gained voice and agency with an equal intensity along
with the screen child, naming herself as a properly listening postwar subject, a
girl preparing to enter the public playing field of adulthood through the second-wave womens movement. But the matter of liberation is a complex one.
Kuhns essay was published well into the reform of Deaf education toward inclusion of sign language and during a period of wider recognition of the oppressive
aspects of oralist education.
I wish to shift the focus of analysis from the utterance of the word by the
autonomous Mandy as signifier of her emergence as agent in language and the
law, to the significance of the intersubjective production of vocalized sound, not
word-sound but a simple phoneme, as signifier of a different sort of developmental moment. This utterance is achieved intersubjectively, between Mandy,
her teacher, and her mother. The scene I have in mind is noted by the films
contemporary reviewers to describe their cathartic experience via Mandys entry
into speech and the hearing social order. This is a classroom scene during which
Mandy first utters a letter sound. This scene was singled out in the eras journalism for its documentary fidelity. I turn to this scene so highly regarded as
faithful to reality as a means of moving away from the privileging of the word
and language as mediators of the subjects place in the law. I suggest two deviations from Kuhns focus. First, I wish to shift the emphasis from word to
phonetic sound. Second, in this scene, Mandys coming to linguistically meaningful phonetic sound is a profoundly moving and even traumatic process that
secures her place not as an independent agent, but as a participant with a maternal other in the pleasures of dialogically produced embodied sound. I wish to

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highlight this moment of phonetic vocal expression as the one the film seems to
indicate as the climactic passage into subjecthood for Mandy and her mother
together, as a necessarily interdependent pair.
In her dissertation on phonosemantics, Finnish scholar Margaret Mannus
proposes that the phoneme carries meaning; the morpheme is not the smallest
unit of meaning.54 In the case of oral speech this would mean that sound, prior
to its place in a word, may hold meaning. I wish to go with this claim for the purpose of this analysis. This scene includes a highly analytic montage shot in close
up in one of the schools classrooms. Comprised of about thirty close shots of
Mandy and her teacher, Miss Stockton (played by the teenaged Australian
actress Dorothy Allison), this sequence performs something akin to a serial
motion study of the two figures as they negotiate Mandys phonetic utterance.
Its analytic intensity reveals in harsh detail the trauma Mandy experiences in
achieving voice. Sound and image are fractured just as Mandy herself is torn by
the struggle, violently thrust into the role of phonetic speaker, a role that I will
propose allows her to transcend her state of silence, encoded as shameful, and
enter symbolically into a position of access to public agency and hence pride. It
is through uttering a phoneme that Mandy is born as a British subject and as
her mothers pride and joy.
Affect figures importantly in the process of coming to voice in this scene. The
scene features an experiment in which Mandy comes to understand her own
body as an instrument that transfers feeling and allows her feelings to be publicly channeled and communicated through acoustics into her female teacher
and, importantly, her mother. Instrumental to this process is the teacher as
maternal surrogate, and a transitional object55in this case, a container that
substitutes for that primary form of the container that is the maternal body.
The transitional objects featured in this scene are first a doll, a hollow of the
human form tailor-made for the child to fill with projection; and then a balloon, a supple, responsive body pared down to porous skin and hollow container, waiting to be touched and filled with the resonance of intersubjective
voice.
The scene begins in a classroom where a little girl plays with Mandy, modeling to her the word baby with her lips as she holds a baby surrogate, a doll.
Mandy presses her lips together, silently copying the b-b-b sound, keeping the
sound, as it were, inside her mouth. Viewers look in on this scene along with a
nervous female teacher positioned as voyeur at the classroom door. This teacher
is not a lovely young woman like Dorothy Allison, but an older, cynical instructor who could be described as homely. She happens to pause to look in at this
scene as she passes by the doorway during her preparations to leave the school
and the profession. Importantly, this teacher with whom we watch this scene is a
skeptical viewer caught in the act of turning away: in a previous scene we
watched and listened to her outburst as she revealed to the schools headmaster
her intense shame and bitter resentment over her own inability to help these

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children speak. Her outburst, fraught with bitter cynicism and defensive negativity about her internalized defeat, was the classic response of turning away in
impotent shame: she stated her wish to leave the school and the thankless job
because she had failed to teach these children to speak. The classroom scene
catches her in the act of turning away. She is positioned inside the film as the
moral witness, the distant, critical, external gaze before which the shame that is
a child who cannot listen, cannot speak, may be played out and worked through
for the films spectators, an audience caught during this crucial historical turn
in the act of turning away from the social problem of deaf education. Like the
teacher, the audience is positioned as distant invisible witness to the scene. This
invisibility and distance, requisites of pity, allows the audience to sustain its look
in the face of Mandys pain, and thereby to work through that moment when the
spectators eyes lower from anothers pain to afford them privacy and to spare
the spectator from the moral injunction to respond with compassionate immediacy. Importantly, by positioning the spectator outside the door with the skeptical teacher double, this scene at first asks nothing of the spectator except to act
as distant witness of suffering.
When Mandy silently mouths the labial sound b-b-b, Miss Stockton notices
immediately. She rushes over to Mandys side. In a move that will be replicated
with a difference in The Miracle Worker ten years later, the teacher takes the place
of the playmate, making the scene into a playground of repetitiona kind of
object-relations play therapy. Miss Stockton thrusts into Mandys hands a b-b-bballoon, a phonetic substitute for b-b-b-baby. Like the baby doll, the balloon is a
hollow body, a transitional, scooped out object waiting to be filled with the resonant exchanges that will pass between female teacher and girl child in a crucial
transitional passage of Mandy from listener to speaker. With these quick transitions in player and object, the scene shifts gears formally into a pattern of serial
close-ups and extreme close-ups, shot-reverse shots of the teacher-child pair
physically linked through their manual and labial contact with the resonant
transitional object positioned between them, the balloon (see figure 5.1).
Stockton presses her hands and lips to the balloon, uttering a staccato series of
b sounds on its surface. As if performing an externalized display of the transitional zone described in Spitzs work on the primal cavity, Miss Stockton transfers her voice from her mouth out onto the surface of the balloon, where it is
mediated into the balloons interior space, and then on to Mandys own lips and
hands.56 Feel the vibration, Miss Stockton instructs Mandy as the sound passes
into her body. The camera cuts in to an extreme close-up of Mandys hands and
lips pressed against the balloons surface as Stocktons b-b-b utterance is looped
on the soundtrack, first louder, then distorted in the wowing sound of stretched
magnetic tape. The looped playback is then slowed to a gradual stop. The b-b-b
sound drops out and a high-pitched string-instrument whine cuts in. This single,
high-pitched tone is sustained and matched to Mandys face, suggesting that it
is meant to signify Mandys interior auditory and tactile experience of the

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Disclaimer:
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are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 5.1. Mandy and Stockton connected by the acoustic field of the balloon.
Still from Mandy (1952).

sound. The abstract string-instrument vibration gets louder then drops out as
the camera cuts between Stockton and Mandy negotiating the balloon that is
now firmly established as a connective acoustic field between them. The spectatorlistener witnesses a negotiation in which Mandy at first resists and then succumbs to the transference and incorporation of the teachers letter-sound
physically into her own body. Mandy literally takes in that sound.
Ren Spitz, the Austrian psychiatrist who pioneered the use of Freudian psychoanalysis to empirically chart ego development in the first year of life, developed the concept of the mouth as a primal cavity in directions that will be
useful here. Spitz identified certain transitional oral zones that mediate between
inside and outside, between peripheral sensory organs (such as the skin) and visceral ones. These transitional organs and zones include the tongue, the laryngopharynx, the soft palate, the inside of the cheek, where they intersect with the
peripheral zones: the lips, the chin, the nose, and the outside of the cheek surface. In my discussion of Mandys passage into acoustic space, these transitional
zones are both replicated in, and are extended and facilitated by, the transitional objects of doll and balloon (and later, in Johnny Belinda, by another hollow
instrument, the fiddle). For Spitz, the transitional zones that mediate between
inside and outside also play an anaclitic function: they form a bridge between
co-enesthetic (autonomic, visceral, unconscious) and diacritic (conscious,

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cognitive) functions in the experience of the subject. In my discussion below,

the balloon is a mediating, transitional object that anaclitically props upwe
may go so far as to say prosthetically extendsthe transitional zones of the body
described by Spitz. Mandys incorporation of Miss Stocktons labial phonemic
utterance depends on this facilitative skin, the balloon that forms a bridge
between their bodies, but that also, for Mandy, forms a bridge between the visceral and the unconscious, on the one hand, and the conscious, on the other.
The balloons mediation allows her experience to move from feeling to meaning, from affect to representation, and from incorporation to introjection.
I have used the term incorporation, not introjection, thus far for particular reasons. Distinction between the terms requires clarification here. Laplanche and
Pontalis remind us that orality is the prototype of incorporation, making incorporation the matrix of introjection and identification. Freud first used the term
incorporation in his earliest discussion of the oral stage (1915), during which he
began to emphasize the importance of the object (the breast). Previously, in his
1905 Three Essays on the Theory of Sexuality, he had emphasized the activity of sucking. According to Freuds 1915 writings on the oral stage of the organization of
the libido, Laplanche and Pontalis remind us, the subjects act of obtaining erotic
mastery over the object entails the destruction of the object.57 The destructive
tendency of projection features strongly in Melanie Kleins discussions of projective identification. Maria Torok makes a strong distinction between the terms
incorporation and introjection.58 Her distinction helps us to better understand
the significance of introjection for this scene in Mandy and the moment in subject formation it models. Torok proposes that incorporation tends toward compensation for loss, and involves the taking in whole of a traumatically lost entity.
Introjection is a very different process, tending toward development and growth
rather than compensation. Introjection is a gradual process in which instinctual
promptings are transformed by naming into desires and fantasies of desires, and
are thus given the right to exist in the world. Incorporation is much more immediate and internally organized, operating by means of representations, affects,
and bodily states. Incorporation occurs relative to a loss that constitutes an insurmountable obstacle. The naming that transforms instinctual promptings into fantasies in introjection is absent in incorporation. While the introjection of desires
puts an end to objectal dependency, incorporation of the object creates or reinforces imaginal ties and hence dependency. Finally, like myth, incorporation
may state the desire to introject even as it does not achieve the naming of the
unborn desire it disguises.59
Toroks point that incorporation proceeds by way of representations, affects,
and bodily states but not by ways of naming (the word) or articulation of fantasy
(narrativization) is a crucial one for our purposes. Her distinction opens up a
space for analysis of what comes before naming, before the word, but still within
the realm of representation and bodily states. These can be observed and
described, even if they do not engage in practices of naming and narrativization

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themselves. Incorporation is a process that proceeds as if magically and instantaneously, presupposing a lost object and taking it in without giving it the means
to exist in the world. But this process, modeled in screen characters, can
nonetheless be describednamed and narrativized. The lost object that I am
proposing in my reading of Mandy is not her hearing but her voice or, more precisely, the child with a voice who Mandys mother imagined Mandy might have
become, but for her deafness. By taking in Miss Stocktons projected voice, by
swallowing it whole and spitting it back out with expulsive force, Mandy puts herself on the path to the incorporation of the word (the ability to name, to narrativize, to speak the word). But she is not yet there.
In incorporating Miss Stocktons vocalization, Mandy identifies her body as
potential space for the movement of sound that is the basis for dialogic speech.
We might consider the process of identification to be one in which the subject
recognizes herself not only as one who is (or, who is mirrored in) the other in
potential space, but as part of the potential space itself through which communication moves. She is an extension of the mediating balloon which is at once
both transitional object and potential space. For Winnicott, a transitional object
may be an entity such as a blanket or toy conferred upon the child by the
mother. The transitional object is a container for what passes between mother
and child, substituting for the direct physical contact of body to body, mouth to
breast. The balloon allows the child to invest her feelings away from the body of
the mother and into the field inhabited also by an intermediate other. The skin
of the balloon makes it, like the doll she had been playing with earlier in this
scene, a contained entity that abstractly duplicates the body of an other, allowing
it to enter into the field of play. The balloons hollow interior offers the openness and containment of an acoustic field through which communication, moving sound, may resonate. This is a potential space waiting to be inhabited. It is a
space waiting to take in and hold a projection.
The soundtrack is, in a metaphoric sense, also an empty space of interconnection that waits to be filled. Silence fills a few key moments of this portion of
the scene in which Stockton and Mandy struggle over what passes between them
in the acoustic space contained by the balloon. A rarity in sound-era cinema,
absolute silence makes these moments stand out to listeners, who would have
been acutely aware of the pregnant pauses intended significance as Mandys
acoustic viewpoint, her supposedly blank aural experience, waiting to be broken and filled. Abruptly, sound floods the acoustic field of the theater. Listeners
are jolted out of Mandys aural perspective with a piercing shriek that, confusingly, is Mandys own voice. This shriek is accompanied by a deafening shatter
that is synched with a shot of a china cup and saucer crashing to the floor, shot
from Mandys optical point of view. This abrupt transition in sound casts the
listener from a deep involvement with Mandys silent inner distress, her
metaphorical absence, into the surprise shock of breakthrough to powerful
sound emanating from her previously silent body. An extreme close-up on

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Mandys face reveals that she is crying. These are not tears of shame or anguish,
but of confusion, relief, and pride. The careful sequencing of events leads the
spectator-listener to read this flood of sound and tears as dam-breaking relief,
signaling transition to that positive affect that is shames mirror image: joy.
What is staged in this moment of breakthrough is Mandys belated achievement of a mirror-stage developmental equivalent. Mandy feels sound pass
through her and, in taking it in, (mis)recognizes it as her own. Sound fills her
to bursting, causing a tension that forces its deafening expulsive projection: the
scream. But at this moment of sonic excorporation, Mandys signifying orifice,
her mouth, is ironically hidden from view by the balloon pressed to her lips. Her
mouth is out of sight, but listeners can hear her utterance, her loud and frantic
B-B-B-B, resonating through the potential space of the balloon that had linked
her to her teacher. The physical transference of agency from caregiver to child
is complete as the child gives back sound, completing the passionately affective
feedback loop that is empathic identification. Mandy has not become like Miss
Stockton, nor does she learn to speak words like her; rather, she has taken in
and spit out a part-objectthe phonemic sound Miss Stockton has quite literally
projected into her.
Here is the lesson in affect regulation and modulation modeled in this scene:
Mandy, feeling the sonic impact of the cup and saucer as they crashed to the
floor, stands frozen, startled and overwhelmed by her loss of control over excitations. Surely someone will disapprove of this destructive behavior toward the
object. Miss Stockton defies the logic of the normative six-year-old superego and
lets Mandy have the babyish tantrum. She drags Mandy over to another cup and
saucer set and gestures to her to repeat her forceful expulsion that produced
such damaging effects. Mandys transition out of shame through the emergency
affect of rage is thus effected in the medium of sound and the destroyed object
as she crashes a second cup to the floor. This scene echoes a scene in the earlier
Mandy, in which the father, Harry Garland, in an emergency state of fear and
denial regarding his discovery of his daughters deafness, crashes a metal tray to
the floor. At that moment the fathers aggressive act of aural significationthe
crash of the tray a command to his toddler daughter to listen, an act that would
be signaled by her looking his wayis utterly lost on the daughters deaf ears.
She does not respond to the command to listen (look). This confirms in him
and in the films spectator-listeners the shattering reality of Mandys deafness,
her tragic inability to become a listener in a world defined by hearing.
Through the passage of letter-sound from Miss Stockton and into Mandy via
the balloon, and in the projection of sound into Stockton that Mandy performs,
Mandys shameful, devastating silence is transformed into an intersubjective
achievement of becoming the potential space through which sound passes and
is shared. This is the social space of intersubjective communication. Filled to
bursting with sound, Mandy is also filled to bursting with anger, fear, and, finally,
pride in her imagined sense of self-control over production, containment, and

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expulsion of sound. Just as the toddler apprehends itself in the mirror and imagines itself in command of the figure it spies, proudly reflected in the gleam in its
mothers eye, so the child Mandy belatedly achieves a sense of mastery over her
body as the bounded space through which communication may pass, regulated
by her movements.
Given the sense of self-mastery conveyed in this scene, it is striking that in the
remainder of this scene Mandys mouth is never visible on screen as she repeats
the labial phoneme whose incorporation and excorporation she has mastered.
What matters is not Mandys speech performance, but her embodiment of
soundand, as we shall now see, her engagement with its responsive echo in the
body of another. Psychoanalyst and theorist of affect Andr Green notes that
the most primitive expression of subjectivity needs to find an echo in another
in order to receive its meaning.60 Mandy, upon recognizing herself in sound,
immediately seeks out her affirming echo. Not surprisingly, she finds this in the
body of her mother. Following the performance described above, Mandy
urgently signs to her teacher to take her to her motherand it is here, in the
act of signing, that we first see Mandy as speaker. Stockton answers by rushing
Mandy from the room to a vast hall where her mother stands waiting to receive
her. In the triumphant shot that concludes the scene, the performance of
sound-incorporation and excorporation between teacher and child is
repeatedbut with two crucial differences. In the place of the teacher stands
the mother. And in the place of the transitional object, the balloon, stands
Mandys own body as transitional space. Mandy grabs her mothers hand and
places it upon her own chest, inviting her mother not to hear but to feel the
B-B-B sound resonating inside her. The sound that passes directly from the
daughters hollow chest cavity through the mothers hand and into her body
echoes with improbable loudness against the hard, reflective walls of the entry
hall, as if that space were the interior of Mandy herself. This expansive hall is the
ideal theater for Mandys grand entrance into sound. Mandy, the projector
(amplifier) of sound, is born as listening subject in this moment of the film. We
feel her feeling sound emanate from within herself. We feel her projecting it
into the body of her mother through that medium of direct transmission of feeling that is the hands. As Mandy recognizes sound as an object produced within
her, she expels and projects it into her mother, who lovingly takes it into herself.
The intersubjective, affective feedback loop of sound-feeling is complete.
Or is it? Mandy has become a speaker, an acoustic playback medium that performs and amplifies her own voice, asserting her agency and control over the
body in a kind of late-breaking mirror-stage performance. But for Mandy fully to
experience pride of self in her performance, she must be able to hear herself
speak. Recall Doanes observation that whereas we appear to others without
appearing to ourselves, we at once emit and hear the vocal sounds we produce.
Sound is routed as if immediate, as if without medium. But Mandy, like Robeson
in the cavernous music venues in which he could not hear himself sing, has no

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capacity to hear herself speak. Mandy requires an acoustic envelope, a playback

mechanism. Recall Kohuts description of a scene in a film of the 1940s by
Burlingham and Robinson in which a girl who is blind lights up with joy at the
experience of being a listener to her own voice on a tape recorder, a machine
whose playback function Kohut likens to the mirroring function of the mother.61
It is the mothers face, in this final shot of this pivotal scene in Mandy, I propose,
which functions as Mandys playback device. The mothers face is a machine that
produces delight, delivering in and to Mandy the ego-constitutive thrill of seeing the sound of her own voice received. Christines face, fully visible to spectators while Mandys mouth remains out of sight, her back to the camera, reflects
Mandys performance back to the girl and to the films spectators. The maternal
face, along with the conductive hand that connects her body with her daughters, forms a sensory loop in which Mandy both sees and feels the pleasure her
sound performance confers to her mother, and thus potentially to others, even
as she cannot hear it herself. For the film listener-spectator, the mother and her
surrogate, the teacher, are empathic pathways to Mandy, insofar as they are
moved by her performance of sound (not language) and mirror it back to her,
constituting her in the social space of affective communication. Ironically,
Mandys performance of sign, her urgent request to be taken to her mother, is
entirely overlooked in this film that equates oral speech with agency.

Notes
This essay is an adapted excerpt from Moral Spectatorship, a forthcoming book on psychoanalysis and child agency, voice, and affect, in press with Duke University Press.
In the section of the book from which this essay is drawn, Mandy is considered alongside Johnny Belinda (Warner Bros./First National/Jean Negulesco, USA, 1948); the
documentary film Thursdays Children (Lindsay Anderson and Guy Benton, England,
1954); the Helen Keller biopic The Miracle Worker (United Artists/Arthur Penn, US,
1962); and, finally, Children of a Lesser God (Paramount/Randa Haines, US, 1986).
1. A deliberate choice has been made to capitalize the term Deaf where it refers
to a person who belongs to the culture and community that has formed around the
use of American Sign Language as the preferred means of communication.
2. Sarah Kozloff, Overhearing Film Dialogue (Berkeley: University of California Press,
2000), 7.
3. Kaja Silverman, The Acoustic Mirror: The Female Voice in Psychoanalysis and Cinema
(Bloomington: Indiana University Press, 1988), 6771.
4. Mary Ann Doane, The Desire to Desire: The Womans Film of the 1940s
(Bloomington: Indiana University Press, 1987), 85.
5. Kozloff, Overhearing Film Dialogue, 77. On the function of muteness in stage
melodrama, see Peter Brooks, The Melodramatic Imagination: Balzac, Henry James,
Melodrama, and the Role of Excess (New York: Columbia University Press, 1985).
6. W. A. Mueller, Audience Noise as a Limitation to the Permissible Volume Range
of Dialog in Sound Motion Pictures, Journal of the Society of Motion Picture Engineers 35
(July 1940), 48.

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7. Steven Cohan, Case Study: Interpreting Singin in the Rain, in Christine

Gledhill and Linda Williams, eds., Reinventing Film Studies (New York and London:
Oxford University Press, 2000), 5375, quotation from 56.
8. Tania Modleski, Time and Desire in the Womans Film, in Christine Gledhill,
ed., Home Is Where the Heart Is: Studies in Melodrama and the Womans Film (London:
BFI, 1987), 32638.
9. Marcia Landy, British Genres: 19301960 (Princeton, NJ: Princeton University
Press, 1991), 459.
10. Landy, British Genres, 458.
11. Douglas C. Baynton, Forbidden Signs: American Culture and the Campaign Against
Sign Language (Chicago: University of Chicago Press, 1996), 5.
12. Margaret Deuchar, British Sign Language (London: Routledge, 1984), 3335.
Although the name of Mandys fictional Bishop David School for the Deaf would suggest it is meant to be one of these religious establishments, the film provides scant
demonstration of BSL in use.
13. Ruth Lister, Citizenship: Feminist Perspectives (New York: New York University Press,
1998), 177.
14. Alison Light, Forever England: Femininity, Literature and Conservatism Between the
Wars (New York and London: Routledge, 1991), 160.
15. Light, Forever England, 11315.
16. Silverman, Acoustic Mirror, 76.
17. Mary Ann Doane, The Voice in the Cinema: The Articulation of Body and
Space, Narrative, Apparatus, Ideology: A Film Theory Reader, ed. Philip Rosen (New
York: Columbia University Press, 1986), 34243. Originally published in Yale French
Studies 60 (1980): 3360. The text she references is Pascal Bonitzer, Les Silences de
la voix, Cahiers du cinema 256 (FebruaryMarch 1975), 2233.
18. Doane, Voice in the Cinema, 33840.
19. Didier Anzieu, Lenveloppe sonore du soi, Nouvelle revue de psychoanalyse 13
(1941), 16179.
20. Guy Rosalato, La Voix: entre corps et langage, Revue franaise de psychoanalyse
38 (January 1974), 33.
21. Doane, Voice in the Cinema, 33.
22. Heinz Kohut, The Analysis of the Self: A Systematic Approach to the Treatment of
Narcissistic Personality Disorders (New York: International Universities Press, 1971),
118.
23. The concept of the mirror phase as an element in the childs entry into the symbolic order is a cornerstone of Lacans writing and references to it are many. The
concept can be traced back to a non-psychoanalytic essay of philosopher Henri
Wallon (Comment se dveloppe chez lenfant la notion de corps proper, Journal de
Psychologie, 1931) and was described in the psychoanalytic context by Lacan in a 1936
lecture before the fourteenth congress of the International Psychoanalytical
Association (Le Stade du miroir. Thorie dun moment structurant et gntique de
la constitution de la ralit, conu en relation avec lexprience et la doctrine psychanalytique). A later version of the concept was delivered at the sixteenth
International Congress of Psychoanalysis, in Zrich, July 17, 1949, and it is this essay
which is the basis for Jacques Lacan, The mirror stage as formative of the function
of the I as revealed in psychoanalytic experience, crits: A Selection, trans. Alan
Sheridan (New York: W. W. Norton, 1977), 17.

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24. Dorothy Burlingham, Some Problems of Ego Development in Blind Children,

Psychoanalytic Studies of the Sighted and the Blind (New York: International Universities
Press, 1972 [1965]), 327.
25. Burlingham, Some Problems of Ego Development in Blind Children, 327.
26. Vann Spruiell, MD, Thinking Blind. Unpublished research paper based on
observations at the Hampstead Nursery in 1974. http://www.analysis.com/vs/
vs84b.html.
27. Kohut, The Analysis of the Self, 11517.
28. Harold Burris-Meyer, Development and Current Uses of the Acoustic
Envelope, Journal of the Society of Motion Picture Engineers 37:1 (1941), 10914.
29. See Doanes full discussion of sound-body relationships in The Voice in the
Cinema.
30. Doane, The Voice in the Cinema, 347.
31. Landy, British Genres, 45859.
32. Pascal Bonitzer, Le Regard et la voix. (Paris: Union Gnrale dditions, 1976), 32.
Passage translated and quoted in Kaja Silverman, The Acoustic Mirror: The Female Voice
in Psychoanalysis and Cinema (Bloomington: Indiana University Press, 1988), 163.
33. In the words of Andersons biographer, Allison Graham, Lindsay Anderson
(Boston: Twayne, 1981), 49.
34. This technique of using celebrities to invoke paternal or maternal authority is
widely replicated in later decades across texts such as the television documentary
spin-offs of the popular television series An American Family (PBS, 1973), titled Who
Are The DeBolts and Where Did They Get 19 Kids? (John Korty, 1977) and its sequel,
Stepping Out-The DeBolts Grow Up (Pyramid Films, 1981), narrated by Henry Winkler
and Kris Kristofferson, respectively (20 kids, different races, different nationalities,
some handicapped, some not. Some adopted, some not); and the appointment of
Susan Sarandon, following her starring role in Stepmom (Tristar/Chris Columbus,
1988), as Special Representative to the United Nations Childrens Fund for the year
2000.
35. Silvan Tompkins, Shame-Humiliation and Contempt-Disgust in Eve Kosofsky
Sedgwick and Adam Frank, eds., Shame and its Sisters: A Silvan Tompkins Reader
(Durham, NC: Duke University Press, 1995), 146.
36. Ren Spitz and Katherine M. Wolf, The Smiling Response: A Contribution to
the Ontogenesis of Social Relations, in Ruth Washburn, Ren Spitz, and Florence
Goodenough, Facial Expression in Children: Three Studies (New York: Arno Press, 1976).
(Originally published as Genetic Psychology Monographs 34 [1946]: 57125.)
37. Ren Spitz, The Primal Cavity: A Contribution to the Study of the Genesis of
Perception and Its Role for Psychoanalytic Theory, The Psychoanalytic Study of the
Child 10 (1955).
38. Michel Chion, La voix au cinma. (Paris: ditions de LEtoile, 1982), 57, quoted
in Silverman, Acoustic Mirror, 74.
39. Robert Fliess, Symbol, Dream, and Psychosis (New York: International Universities
Press, 1973), 203, quoting Freud.
40. Silverman, Acoustic Mirror, 75.
41. For readers unfamiliar with psychoanalytic feminist film theory see the excellent
review of the field by Anneke Smelik, available in book form and online: Feminist
Film Theory, in The Cinema Book, Second Edition (London: British Film Institute,
1999), 35365. Also posted at http://www.let.uu.nl/womens_studies/anneke/
filmtheory.html (accessed 6/05).

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42. On the figure of the wild child, see J. M. G. Itard, The Wild Boy of Aveyron. Trans.
G. Humphrey and M. Humphrey (New York: Appleton-Century-Crofts, 1962 [1801
and 1806]); Susan Curtiss, Genie: A Psycholinguistic Study of a Modern-Day Wild Child
(New York: Academic Press, 1977); and the film Lenfant sauvage, Franois Truffaut,
1970 (British release title The Wild Boy, U.S. release title The Wild Child).
43. Sources are sparse but it seems this goal went largely unrealized.
44. Annette Kuhn, Mandy and Possibility, Screen 33:3 (Autumn 1992), 23343.
45. Account of an unidentified informant interview quoted by Gloria Pullen and
Rachel Sutton-Spend, The British Deaf Community during the 19391945 War, in
Renate Fischer and Harlan Lane, eds., Looking Back: A Reader on the History of Deaf
Communities and their Sign Languages (Hamburg: Signum Press, 1993), 17176, quotation from 17576.
46. On the history of Deaf culture and American and European sign languages see
Jack R. Gannon, Deaf Heritage: A Narrative History of Deaf America (Silver Spring, MD:
National Association of the Deaf, 1981); Carol Padden and Tom Humphries, Deaf in
America: Voices from a Culture (Cambridge, MA: Harvard University Press, 1988); Carol
Padden and Tom Humphries, Inside Deaf Culture (Cambridge, MA: Harvard, 2005);
Baynton, Forbidden Signs; and Harlan L. Lane, Robert Hoffmeister, and Benjamin J.
Bahan, A Journey into the Deaf-World (San Diego, CA: Dawnsign Press, 1996). From the
eighteenth century, when the first schools for the deaf were founded in Europe, until
the 1860s, hearing educators of the deaf often used some form of manual sign to
teach their deaf students, and various sign languages functioned as the indigenous
and spontaneous forms of communication within deaf communities. But by the 1860s
and 1870s, a campaign against signing and manualist methods of Deaf education
gained momentum among those oralists favoring education in speech for the deaf in
Europe and the United States. In 1880 at an international conference in Milan it was
mandated that sign language be banned from deaf education. This was a watershed
moment in a complex and heated debate. Methods of communication and education
all along the spectrum between sign and speech never disappeared, but the overall
scene of Deaf education shifted dramatically in favor of mainstreaming deaf children
into hearing culture by sending them to institutions where they would be trained to
speak. Speech education for the Deaf was by and large the norm in schools for the
deaf throughout Britain, the United States, and much of Europe at the time of these
films production; this would remain the case until late in the twentieth century.
While the arguments against signing varied, some of them were based on theories of
evolution and the rise of eugenic thinking. Alexander Graham Bell was a vehement
oralist in the eugenic tradition. Prohibitions against sign language were sometimes
linked to arguments against intermarriage among the Deaf, and campaigns arose in
favor of the sterilization of Deaf people during the early twentieth century. One
charge against sign was that it damaged the minds of Deaf people and interfered with
their ability to develop higher levels of thinking; manual speech was a primitive form
of communication. Sign languages were nonetheless passed down within Deaf cultures. Deaf parents taught their Deaf children to sign in communities bypassed by the
push toward institutionalization due to geographic isolation or poverty; residents of
Deaf institutions continued to communicate in sign among themselves; and some
teachers persisted in using finger-speech despite opposition to it.
47. Diana Fuss, The Sense of an Interior, (New York: Routledge, 2004), 12223.
48. The New York Times described child actress Mandy Miller as remarkably fluent
in her performance of deafness, and Sight and Sound singled out the performances

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of the Deaf children at the school for their unnaturally alert faces, their quick trust
and extraordinary patience.
49. Kuhn, Mandy and Possibility, 233.
50. See John Trumpbour, Selling Hollywood to the World: US and European Struggles for
Mastery of the Global Film Industry, 19201950 (Cambridge: Cambridge University
Press, 2001), 11920 and 17980. On the issue of British film culture and child audiences, Trumpbour reports that Mary Field, the director of Gaumont-British
Childrens Education Films and the future director of UNESCOs International
Centre of Films for Young People, speculated as to whether Britain, which leads the
world in documentary, will be the pioneer and acknowledged leader in the field of
childrens films (quoted in Trumpbour, 180).
51. Kuhn, Mandy and Possibility, 23637.
52. Kuhn, Mandy and Possibility, 234.
53. Jacques Lacan, The Agency of the Letter in the Unconscious; or Reason Since
Freud, in Ecrits, 14678.
54. Margaret Mannus, Whats in a Word: Studies in Phonosemantics. PhD dissertation
(November 16, 2001), University of Trondheim, Norway.
55. On this concept see Donald Winnicott, Transitional Objects and Transitional
Phenomena: A Study of the First Not-Me Possession, in Winnicott, Through
Paediatrics to Psycho-analysis: Collected Papers (New York: Basic Books, 1975), 22942.
56. Spitz, The Primal Cavity, and Ren Spitz, The First Year of Life: A Psychoanalytic
Study of Normal and Deviant Development of Object Relations (New York: International
Universities Press, 1965), 4445.
57. J. Laplanche and J. B. Pontalis, The Language of Psychoanalysis, trans. Donald
Nicholson-Smith (New York: W. W. Norton, 1973), 212.
58. The concept of introjection was introduced by Sandor Ferenczi in his 1909
paper Introjection and Transference (published in Ferenczi, Sex in Psychoanalysis,
New York: Robert Bruner, 1950). The term is described in shorthand by Nicholas
Abraham and Maria Torok as an explicative synonym for transference in Nicholas
T. Rand, ed. and trans., The Shell and the Kernel: Renewals of Psychoanalysis, Volume 1
(Chicago: University of Chicago Press, 1994 [1968]), 111. Ferenczi describes introjection as the egos extension and as the growing onto, or including of the loved
object in, the ego (cited in Abraham and Torok, The Shell and the Kernel, 112).
59. Abraham and Torok, The Shell and the Kernel, 11315.
60. Andr Green, The Fabric of Affect in the Psychoanalytic Discourse, trans. Alan
Sheridan (London and New York: Routledge, 1999), 297. (Orig. Le Discours vivant,
Presses Universitaires de France, Paris, 1973).
61. Kohut, The Analysis of the Self, 118.

Chapter Six

Projecting Breast Cancer

Self-Examination Films and the Making
of a New Cultural Practice
Leslie J. Reagan
The making, showing, and viewing of health education movies is a mass social
practice, a public health practice, and a cultural practice deserving critical
attention, yet by and large film scholars have neglected educational movies.1
In the 1950s, the American Cancer Society (ACS) vigorously focused the
attention of American women and doctors on breast cancer and breast selfexamination through a pair of path breaking educational films: Breast Cancer,
the Problem of Early Diagnosis (1949), made for physicians, and Breast SelfExamination (1950), for women only.2 The ACS produced and distributed
these two movies as part of a massive educational campaign for two different
audiences: the female public and the male medical profession. As such, they
afford a particularly rich opportunity for analysis of the social practice of
health education films as well as of sexuality, gender, and power in midtwentiethcentury America.
Showing the naked breast was prohibited in Hollywood movies and censored
by state authorities, yet ACS health educational films openly did so. The legitimacy of showing the bare breast in a health film was by no means automatically
granted by authorities or critics, however. Instead, it was a carefully constructed
achievement. As the movies uncontroversial success indicates, the ACS and its
filmmakers astutely negotiated the lines between decency and obscenity, sexual
desire and clinical medicine. This chapter analyzes the ACSs work to desexualize and medicalize the breast through a close analysis of the distribution, content, and reception of these films. It also shows how the breast self-examination
campaign relied upon women as health educators for the general public.
Through voluntary civic work, middle-class women taught other women to see
themselves as patientseven when well and in their own homesand to subordinate themselves to physician knowledge and power.

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Breast Self-Examination was a new kind of womens health film that did not conform to either the womens film or sex hygiene film genres of the post-war
period, for it spotlighted an average woman as an individual with health needs
of her ownas a woman and an adult, rather than as a mother or wife. This
unique film neither used the mother-daughter dyad typical of maternal melodrama to drive its narrative, nor focused on heterosexual couples and the making of the nuclear family as found in sex hygiene films of the 1940s and 1950s.3
Instead of the mother-daughter or husband-wife relationship, the primary relationship in the movie was that of the (male) doctor and (female) patient. The
film addressed adult women who were part of a community of women and urged
them to think about and speak of their breasts and of dread disease. To say the
words breast cancer was treated as a brave and beneficial act. In this, Breast SelfExamination followed public health tradition in working to eliminate the shame
associated with diseases like syphilis, tuberculosis, and cancer, and also paralleled the womens films about deaf girls analyzed by Lisa Cartwright in this volume. To speak was equated with womens empowerment.
The companion to Breast Self-Examination was an educational film produced
for physicians. Although a handful of scholars have analyzed health education
films produced for the public,4 films produced to teach medical professionals
have yet to receive attention. Using Breast Cancer: the Problem of Early Diagnosis,
I outline and analyze the genre of medical education films. Clinical and laboratory information was presented within a historical and scientific narrative and in
a mode that helped build medical authority. Different types of footageincluding diagrams, specimens, and live patientsmade the film medical, as did the
voice of the male expert narrator. Like documentaries and news shows, the medical movie used an authoritative male narrator to convey its messages. It also
used silence to convey medical authority and patient subordination.
The coordinated, nationwide campaign to teach women to perform breast selfexamination by showing movies may be one of the most successful and longestrunning public health education campaigns of the twentieth century. As I show
below, millions of American women saw Breast Self-Examination in the 1950s and
a remake of the movie played through the 1960s. Furthermore, this campaign
provided the model for future ACS work and created new ties between ACS and
the medical profession. As such, it deserves our attention to both the effort
involved in achieving success on a mass scale and the multiple teachings embedded within these movies. Movies were a significant component of ACS work and
played a primary role in producing knowledge and changing medical and patient
attitudes and practices. Barron Lerner has shown why the Halsted mastectomy
operation persisted for nearly a century despite the critiques of physicians, scientists, and patients.5 This essay suggests that the ACS breast self-examination
movies may also have contributed to the persistence of the radical mastectomy by
encouraging female action at the stage of detection and female passivity at the
stage of treatment. Yet at the same time, in its emphasis on the independent,

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165

individual woman and the representation of respectful medical treatment, this

film anticipated the womens health movements of the 1970s.
Breast self-examination has become normative, yet it is a complex and ritualized cultural practice, and one that has to be learned. These movies taught their
viewers how to perform a specific medical examinationalone at home and
together in the doctors officeand succeeded in making this examination normal. Health educational materials always did more than teach the public about
a specific disease. Films, and the pamphlets, radio shows, and lectures associated
with them,6 all participated in producing a picture of the ideal patient, the ideal
doctor, and the ideal physician-patient interaction. In this pair of films we can
see not only what women and physicians were learning about disease, but also
what they were learning about each other in the 1950s.7 Health education films
influenced what physicians and patients brought in the door with them when
they met during office visits where they either succeeded or stumbled in their
communications about disease, diagnosis, and treatment. These two particular
movies, produced as part of a project to make one examination an acceptable
and standard practice, invite analysis of the culture of physical examination and
the gendered power dynamics of the physician-patient encounter. These movies
and the practice of breast examination provide a case study of the Foucauldian
insight that medical examination of the body is part of a larger social project
that produces subjects, knowledge, and normative behaviors.8
Comparing the movies made for women with those made for doctors illuminates what is seen and heard in each movie, and what is not. The movie for
women-only taught them how to perform the new habit of examining their own
breasts. The movie sent contradictory messages to its female viewers: they were
to be actively involved in their own health care and, at the same time, were told
to be submissive patients who relied on their doctors judgment. The film for
doctors taught them to examine, diagnose, biopsy, and prepare for immediate
mastectomy. As physicians learned clinical efficiency, they also learned clinical
distance and medical authority. Both movies emphasized that time was of the
essence; delay spelled danger.
These are not silent movies, yet there are silences in them. The movie for the
public tells almost nothing about illness and death; the movie for MDs says little
about how to talk with their female patients about examination, disease, or
death. Examination of the breasts raised the specter of sexuality, and these educational films were intended to help overcome anxieties felt by physicians and
patients alike when the bodys private parts were touched in order to find and
treat disease. Both movies, however, are silent about sex and silent about the
emotional meanings attached to the breasts. Indeed, silence is a metaphor that
runs through cancer educational materials in general. In the womens movie,
for example, the doctor encourages the public to talk rather than keep quiet
about the disease in order to have a better chance . . . of living healthy lives,
and in the same breath names breast cancer a silent disease. The silence of

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the disease, its lack of symptoms, required that women themselves and their doctors regularly look for subtle signs of sickness.
Finally, analysis of this historical moment when the American Cancer Society
put breast cancer at the forefront of the minds of women and their physicians
highlights the trend in public health and medicine toward constant examination and monitoring of bodies. This campaigns push for self-surveillance of the
healthy body for signs of ill-health was new. Earlier public health efforts had
encouraged pre- and post-natal check-ups by physicians of women and annual
physical examinations of children in order to reduce maternal and infant mortality,9 physical examination of incoming immigrants by government authorities,10 and mass screening for syphilis and tuberculosis.11 Since its inception, the
ACS had advised the public to monitor their own bodies for signs of possible
cancer and to see a doctor for regular check-ups. The breast self-examination
campaign, however, took this advice a step further by encouraging systematic
physical examination of ones own body for hidden signs of cancer. Although
the ACS soon began to urge men to submit to examination in the 1950s, the
mandate for examination and self-scrutiny was most focused on women. Cancer
education was part of a twentieth-century drive toward constant examination of
the seemingly healthy body, first by medical experts, and, increasingly, since mid
century, by the individual herself.
Although the ACS had long focused on women and alerted the public to the
breast as one important site of cancer since its founding in 1913, the intensity
of this mid-century campaign was unprecedented. The campaigns centerpiece
was the fifteen-minute movie titled Breast Self-Examination, which the American
Cancer Society aimed to show to every woman in the country over the age of
thirty-five. The ACS had been making educational films since the 1920s,12 but
had never before attempted to reach an entire targeted population. Although
there was some concern about resentment by the prudish, given that the film
used partially nude models, the ACS believed that the possibility of saving thousands of lives justified its production.13 These persistent worries about prudery
appeared to be a projection on to women. There is no evidence of women
protesting, complaining, or staying away from showings of this film; instead they
came in droves to see it. Before analyzing the crowds who came to watch the
movie, I begin with the film itself.
The movie opens with a bulletin board announcing that the Central Womens
Club was sponsoring a Health Lecture.14 The viewers hear applause and see
the clapping hands of white women. We then see the audience: respectable
women dressed in suits and hats fill the auditorium. An older woman speaks to
the audience in the movie and to us: she thanks Dr. Williams for this highly
informative talk on breast cancer. As viewers of the film, we join the audience,
but we join after the lecture for the question-and-answer session. The scene
would be quite familiar to the club women who had for decades organized and

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167

attended cancer and other health educational events. The film recognizes and
imitates its own audience. After several questions about the twenty thousand
women who died annually due to breast cancer, the doctor advises, the next
time you visit your doctor for a general physical checkup . . . be sure to ask him
about breast self-examination. We then see Mrs. Wright in her doctors office
where she brings up the lecture she heard at our womens club last week.
Dr. Johnson approves of the idea of breast self-examination, examines Mrs. Wrights
breasts himself, and then shows her how to do the exam with her own hands.
After this demonstration, we see Mrs. Wright taking her lesson and performing
a self-exam at home in her bedroom sitting before her mirror and then lying
down on her bed to physically examine her breasts with her own hands (see
figure 6.1). The film repeats for the audience three times, both visually and verbally, how to perform a breast examination. When Mrs. Wright is done, fortunately having found no lumps or irregularities, we see her in the final frames
buttoning up her dress. The last frame is the conventional female use of the mirror: she checks her face and smiles with satisfaction. We know that she smiles not
only at her reflection, but also with the internal knowledge that she has performed the exam and found no signs of breast cancer. Indeed, Mrs. Wrights
attractive face, hair, and figure call upon a convention of sickness and health in
Hollywood movies to tell the audience that she is, in fact, well. If she had cancer
or its signs, Hollywood would represent the illness through smeared lipstick,
messed hair, and rumpled clothing.15 Her image, like her smile, reassures.
The movie concludes, Here truly is a habit for health with an immediate
reward: peace of mind. . . . Make it a habit for life. Mrs. Wright smiled: for at least
a month she need not be concerned about cancer. Breast exams and monthly
worry were mapped on to the pre-existing monthly practice of tracking and worrying about periods and pregnancy. The films ending attempts to reassure women
who may be worried about breast cancer. Yet the film and the entire campaign
required teaching women to think regularly about the possibility of breast cancer
once a month (but not in between, the doctor warns). This is an inherent contradiction in twentieth-century health education: the desire to reduce disease and
death through changing personal behaviors requires making people conscious of
threats to their lives if they fail to act. The focus on individual habits rather than
environmental or social causes of ill-health inevitably leads to increasing anxiety
(among those who heed the warnings) and blame for their troubles among those
who either failed to listen, or failed to avoid disease. Mrs. Right modeled the
right way to perform the self-exam, the right way to be a patient, the right way to
live a healthy life: the right way to be a good, healthy citizen.
The ACS worried that producing a film that focused on breasts would raise
objections (or desires). How would this health education film be differentiated
from obscenity? The decency of the movie was produced in the way that ACS
introduced and advertised the movie, in the spaces in which it was presented, and
in the movies style and tone. First, the film was labeled a health education movie.

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educational entertainment

Disclaimer:
Some images in the printed
version of this book
are not available for inclusion
in the eBook.
To view the image on this
page please refer to
the printed version of this
book.

Figure 6.1. Mrs. Wright practicing

breast self-examination in her bedroom
at home. The audience sees her visually
examining her breasts in her mirror. For
the movie audience, this is the third
demonstration of breast self-examination. The importance of the movie
medium for the ACS is emphasized by
their presentation of these images as if
they were a series of frames on a strip of
film. The Missing Member of the
Breast-Cancer Team, CA: A Bulletin of
Cancer Progress 1:1 (November 1950):
31. Reprinted by the permission of the
American Cancer Society, Inc. All rights
reserved.

projecting breast cancer

169

It was made in cooperation with the federal governments National Cancer

Institute; the American Medical Association previewed and approved the film; and
physicians often attended screenings and answered audience questions.16
Embedding the film within medicine ensured that the public understood the
movie as a healthy, not prurient, film. Promotional materials declared that this
film was one of the finest . . . ever produced by the American Cancer Society.
Nude models were necessary, but, ACS leaders were assured, this portion of the
film is handled in an aesthetic and acceptable manner.17 Volunteers surely told
their audiences the same before and after presenting the film, thus working to
quiet any qualms that might arise. The film was shown in churches, civic auditoriums,
and other places where womens and other civic clubs met.18 Audiences were sexsegregated; this movie that showed bare breasts was for adult womens groups
only. The segregation of the audience by sex was a movie-going convention from
the 1910s designed by social reformers to protect girls and women while they
received venereal disease and sex education at the movies19 and it persisted in the
schoolroom when girls and boys were divided on the day girls saw menstruation
films.20 Sex-segregation of the audience was also a tactic that sexploitation films
of the period used to attract curious audiences,21 however, and the double meanings of women-only may have helped the ACS attract audiences.
The American Cancer Society produced a solemn and serious film and avoided
the conventions of pornography or sexualized Hollywood photography.
Mrs. Wright does not undress for viewers; there is no surreptitious peeking or glimpses
of cleavage; no lace, no shadows, no sighs; the view of Mrs. Wrights bare breasts
are through full-frontal, brightly lit shots. Although the lighting was similar to forties pin-ups or fifties (pornographic) art photos, Mrs. Wrights body was not
oddly posed to accentuate nudity or nipples nor was she a platinum-blonde like
Marilyn Monroe.22 The film depicts educated, married, middle-class white
women and serious male doctors discussing and practicing breast examination in
an asexual manner. Clearly a practice of decent people, neither the examination
nor the film could be viewed as indecent. A clinical view, not a pornographic one,
is constructed for the films audiences. Neither this movie nor the one for doctors portrayed or acknowledged nervousness on the part of male physicians or
female patients about the viewing and touching of breasts during a medical
examination. The mechanism for handling any sexual discomfort was repression:
maintain silence, treat the medical encounter soberly, and have a female nurse
present at all times as the quiet guard against male impropriety (see figure 6.2).
Finally, all of the characters in this film were white. How racial and cultural prejudices might change the dynamics of medical interactions is unaddressed. The
respectability and social authority of the women and medical personnel in this
film, the venues in which the film was shown, its presentation by upstanding medical men and civic leaders in the community, the mode of photographing bare
breasts, and the non-discussion of sexuality all told viewers (including potential
censors) that this was a morally acceptable movie.

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educational entertainment

Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 6.2. Dr. Johnson examining and teaching Mrs. Wright in the doctors
office. Note how the patient and nurse both listen carefully to the doctors words.
It Takes Two to Find Cancer, Cancer News 7:4 (October 1953): 8. Reprinted by
the permission of the American Cancer Society, Inc. All rights reserved.

The movie projected contradictory messages about the doctor-patient relationship: it taught female viewers to take their health care into their own hands
while simultaneously limiting the power of female patients and telling them to
trust their doctors. The goal was to create educated and compliant patients; a good

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171

patient examined her own body with physician-trained hands and attended to
her own health care by bringing suspicious signs to the doctor. Once she walked
through the doctors door however, she placed herself in his hands. Although
his examination was prompted by her concernswhich he either confirmed or
dismissedhe determined diagnosis and course of treatment. The patients
power did not extend into the realm of decision-making about surgery or other
therapies. From a doctors perspective, perhaps, her hands merely replaced his
on a monthly basis. (In the same way that nurses served as the physicians
hand.23) In the process, the woman learned a clinical attitude towards herself
and adopted a medicalized touch toward her breasts.24
Nonetheless, the film was an empowering one for female viewers, for it taught
women to take their own health care and lives into their own hands. It showed
by example that one need not fear or be ashamed of this examination. Mrs. Wright
treats the exam matter-of-factly; the women viewing the film should do the same.
In striking contrast to health education for women since the late nineteenth
century, this film did not tell women to do this on behalf of their children, their
husbands, or their families. Instead, performing breast self-examination is for
her own health and no one elses benefit. The focus on the woman herself was a
major change. If women discovered breast cancer as a result, the movie promised that their lives would be extended. Early diagnosis promised cure. Women
learned the same techniques that physicians used and, through regular practice,
they would become familiar with their own bodies and know when something
unusual appeared. Teaching women these examination techniques, the warning
signs, and the necessity of immediate follow-up put female patients and their
doctors on the same level. The patient would know what to expect and would
realize if the doctor seemed unskillful or uncertain about performing a breast
examination or slow to respond to any irregularities found by the woman herself. The sense of gaining knowledge of oneself and control over ones own
health contributed to the popularity of this film.
The movies storyline points to the importance of womens club networks in
health education. Without the dedicated work of club women in every state to
organize and offer showings of Breast Self-Examination, the campaign could not
have succeeded. Distribution of this and other ACS films was highly organized
and complex. The film was first shown to health-care professionals at the Nurses
Biennial Convention, the International Cancer Congress, held in Paris, and the
AMA annual meeting, and then distributed and shown to the general public
throughout the United States by ACS volunteers.25 In Illinois, in the first month
that the film was available, in October 1950, a premier showing was held in the
auditorium of the American College of Surgeons for presidents and program
chairmen of all womens societies in Chicago. This premier alerted busy local
leaders of the availability of a new health film specifically for women and,
because the premier was seen in the space of a prestigious national medical
society, viewers also learned that the film and this new health habit had medical

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support. Six years later, the film had been shown to over ten thousand groups,
in club meetings, at work, and in high schools.26 The Iowa division had seventyseven copies of the film, which any adult womens organization could borrow.
Two months into the campaign, the chapter had shown the movie to more than
one hundred female-only audiences. Halfway through 1951, over 125,000 Iowa
women saw the film.27 In addition, like the Hollywood movie industry, the NCI
and ACS distributed the movie internationally.28 One thousand prints of Breast
Self-Examination were sold, far more than any previous public health film.29
Before the end of the first year, over a million American women, approximately
three percent of the targeted population, had seen it nationally.30
Breast Self-Examination was part of a multi-media campaign in which every
piece reinforced the other. The film was tied to radio, written texts, advertising,
and newspaper and magazine news and advice columns.31 At the time of this
campaign, radio was the movies greatest competitor and a leading source of
health information for many Americans.32 Radio programs both advertised the
film and educated their audiences. In Minneapolis, for example, radio station
WMIN ran a fifteen-minute program during the 1951 annual meeting of the
Minnesota Division of the ACS. Listeners heard what sounded like a conversation (but which was entirely scripted), among the radio host, Dr. Clare Gates, a
department of health physician, and Mrs. Rose Spencer and Miss Shair, two ACS
activists. After listening to the doctor discuss scientific research and the possibility of curing cancer, Mrs. Spencer remarked, It seems to me . . . that lately
Ive been hearing and reading about breast cancer. Not only is this remark
quite disingenuous coming from the Minneapolis-St. Paul area commander of
the ACS, but it downplayed her skills (and those of other ACS women) in
orchestrating publicity and organizing this very effort. Miss Shair explained that
breast cancer was an urgent problem, but if we can encourage every woman
. . . to examine her own breasts once a month for signs which might mean cancer, we could lower the death rate from breast cancer substantially. Dr. Gates is
the first to mention the motion picture, which, she observed, has been
received with such enthusiasm by doctors everywhere. After this medical
endorsement, the two ACS women describe the film and explain how a listener
could arrange for a showing at her club. The working woman, with her
employers cooperation, Shair also pointed out, might use the facilities of her
business. Since the film only runs fifteen minutes, lunch hour might be a good
time. And a union meeting might also provide a good setting. The radio show
ended with Dr. Gates reiterating the importance of annual examination by a
physician, monthly self-examination of the breasts, and, of course, [a woman
should] consult her doctor if anything abnormal is found.33
The radio program encapsulated, in the same amount of time as the movie, the
main messages to women: see your doctor and examine your breasts for signs of
cancer. Given the size and diversity of radio audiences, the radio shows may well
have been heard by more people than ever saw the movie, and may have been

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the most effective tool for reaching lower-income, rural, minority, and foreignborn audiences. Unlike the movie, though, which visually and verbally demonstrated self-examination, or printed materials and magazine articles that taught
examination techniques through text and drawings, ACS did not attempt verbally
to teach its radio listeners how to perform a self exam. Thus, though the words
cancer and breast might be usedand this was regarded as an advance in itself
the value of the radio show as a form of health education was more limited. (An
effective verbal description alone of the exam would not only be difficult to write,
but also beyond the bounds of acceptability in radio broadcasting.) For illiterate
audiences who might hear only a radio show, the message was vague.
Pamphlets or other written materials and group discussion almost always
accompanied the viewing of health and other educational films. The genre of
educational films required doing more than simply showing them to a passive
audience. Educational films are made to be used, not merely shown, argued
one commentator, and the way that a film is used is a most important determinant of the educational effectiveness of that film. A 16mm educational film was,
emphatically, not a 35mm Hollywood film on a smaller scale.34 Local organizers as well as the national ACS office produced leaflets for the audiences of Breast
Self-Examination35 and provided expert speakers.
Although cancer education films could not be classified as pure entertainment, educational movies drew on the social practice of going to the movies for
entertainment. Indeed, ACS leaders and organizers were well aware of the
importance of producing films that entertained, rather than bored, their audiences, and that were professional, not amateurish.36 The society bragged
about films that struck a chord with audiences, and advertised the popularity,
color, and drama, as well as the educational value of the ACS films to potential
audiences. The lure of Hollywood was not far from the thoughts of health
activists; advice to volunteers on how to plan ACS film showings was accompanied by a sketch depicting a theater audience of men and women looking at a
screen that showed a man and woman in a romantic close-up.37 Audiences
wanted to see medically oriented movies; since Hollywood and non-Hollywood
exploitation films on medical topics, including syphilis, surgery, and childbirth,
were already popular in the 1930s and 1940s, ACS could build on this preexisting popularity.38
Breast Self-Examination, in fact, took on some of the attributes of a popular
Hollywood movie as it moved into regular movie theaters and marquees advertised its showing. Innovative organizers diversified and expanded the films audience by bringing it into theaters. Newspapers and radio advertised free matinees
of Breast Self-Examination and invited all women to attend. These open showings
attracted huge audiences who went to the same movie theaters to see Hollywood
movies featuring curvaceous women, but this time the entertainment and breasts
were produced on behalf of womens health rather than for male pleasure.39
In Illinois, four hundred women went to a matinee of Breast Self-Examination

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educational entertainment

Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 6.3. Here a San Diego, California theater advertised the free showing of
a Lifesaving Cancer Film for Women Only and women lined up to see it.
Note that though breast cancer was said in the film and breasts appeared on the
screen, the word breast was not on the marquee. Learning to Live, Cancer News
9:4 (Fall 1955): 5. Reprinted by the permission of the American Cancer Society,
Inc. All rights reserved.

at the Frisina Theater in Taylorville and two hundred and fifty women in a town
of two thousand went to Amboys local theater. By 1956, Illinois alone had one
hundred and seventy-nine open showings at which thousands of women had seen
the film40 (see figures 6.3 and 6.4).
In another move that demonstrated ACS volunteers gendered awareness of
their audiences as well as the classic link between women and consumption, innovative organizers turned to the one urban space that had always been considered
womens own: department stores. Department stores catering to women became
one of the unexpected locations for successful showings to employees and women
patrons alike, a national leader reported.41 As surprising as the availability of this
space may have been to (male) ACS leaders, it recalled an earlier tradition when
organized women transformed department stores into a political and educational
space in which they promoted votes for women and painless childbearing.42 No
doubt this was an attractive space in which to receive health education for both
shoppers and working women. Department stores surely appreciated the positive

projecting breast cancer

175

Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 6.4. One example of the enormous audiences that attended public showings of Breast Self-Examination. These women saw the film at the Sacramento Civic
Auditorium, a highly respectable public space and indicative as well of the way
that attention to breast cancer and self-examination was becoming a civic dutyof
women. Learning to Live, Cancer News 9:4 (Fall 1955): 5. Reprinted by the permission of the American Cancer Society, Inc. All rights reserved.

publicity they received for this social service as well as the chance to sell the cosmetics and clothing to which the film alluded in its final frames.
Although the womens club network served the ACSs educational efforts well,
the societys national leadership wanted to reach beyond womens clubs and the
middle class to working-class Americans.43 The ACS made connections to the trade
union movement and worked to bring Breast Self-Examination to working-class audiences. Energetic volunteers (still primarily club women), took the show on the
road to workplaces across the country. With the endorsement of the United
Packinghouse Workers and the company, the society showed Breast Self-Examination
at meatpacking plants. Nearly every single woman at one meatpacking plant (275
of 300, or 92 percent) saw the film in the womens lounge.44 Over five hundred
employees watched three cancer films, including Breast Self-Examination, at the
Micro Switch Company in Freeport, Illinois. Bell Telephone, Western Electric,
Armco Steel, Standard Oil, Dupont, and Union Central Life Insurance (Ohio) all
sponsored showings of the film for their female employees. The educational effort
at Bell Telephone matched the ideal: a doctor answered questions and each
woman received a take-home pamphlet to remind her of the message.45

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By the 1960s, it was not only the location of screenings that had changed from
middle-class clubs to workplaces, but the film itself had changed in order to
speak to working-class audiences. A 1962 version of Breast Self-Examination represented working women as cancer survivors. It included new footage of three
women who survived their breast cancer: a beautician, a homemaker, and a
teacher, each of whom discovered lumps during self-examination and had a life
saving operation. They all appear to be white.46 Cancer educational materials
of the late 1940s and 1950s depicted a cross-class portrait of white ethnic
America. Until the 1970s, the representations of cancer victims and survivors
were rarely racially mixed.47
The movies audience, however, included both white women and women of
color. Health activists widely distributed materials to women of all ethnic, racial,
and religious groups and to both urban and rural women through womens
clubs. The organizations that helped distribute and present the film indicate
greater audience breadth than the term club women might suggest. They
included, for example, the Young Womens Christian Association, . . . the
National Council of Negro Women, the National Organization of Public Health
Nursing, the General Federation of Womens Clubs, the Home Bureau Extension
Service (U.S. Department of Agriculture), the American Association of University
Women, [and] . . . the Daughters of the American Revolution.48 Furthermore,
in response to awareness of the limitations of ACSs educational reach, a Spanishlanguage edition of Breast Self-Examination was produced and shown to large
audiences by 1958. In Chicago, over eight hundred Spanish-speaking women saw
the movie at their neighborhood Spanish movie theater and had a chance to
ask questions of a physician. The Woodlawn Puerto Rican Cancer Committee
organized another showing of two Spanish-language movies, including Breast SelfExamination with Dr. S. L. Mora as a speaker for Chicagos Puerto Rican women.49
The efforts to reach Spanish-speaking women may have been prompted by an
internal critique of the racial and class makeup of the ACSs educational program. A 1956 ACS self-evaluation concluded that the organization largely failed
to reach immigrant, non-English speaking, and African American populations
who constituted twenty percent of the American population. The review committee sharply criticized the whiteness of the organization and the ACSs concentration on the most highly educated and affluent groups who least needed to
learn about cancer or be convinced to see a doctor. Negroes, the report
pointed out, comprise almost one-tenth of the American people, but until
recently no Society activity of consequence has been directed to their needs or
included them in their work. The evidence shouts the fact that Negroesindeed,
most minoritiesare almost uniformly ignorant concerning cancer control and
prevention. The reviewers sounded outraged at the organizations apparent
reluctance to approach African Americans. The report noted that only three
African Americans held leadership positions and named Black medical, news,
and civil rights organizations that should be cultivated for more than fundraising.

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The racial problem admittedly is complex and delicate, the reviewers agreed,
but they did not let the societys leaders and volunteers off the hook. It is not the
Societys function to solve the problem of civil rights, they concluded, but it is
the Societys acknowledged responsibility to advance health rightsthe health
rights of all Americans, including the Negro. The report urged courage and
imagination. Otherwise, the society risked being seen as elitist.50
The movies successmillions of women saw Breast Self-Examination, up to
10% of the adult female population by 195551points to not only the societys
organizational skills, but also the films popularity with women. Translating viewing into doing was no simple project, however. Although determining audience
reception to cultural materials is a difficult historical project (since historians
cannot create focus groups or controlled studies of audience reception),
archival sources and published reports occasionally remark on audience reception. The evidence indicates that the multimedia campaign made impressive
progress in the cultural work to create the new practice of breast self-examination. Reports came in from around the country of women who performed breast
self-examination, found suspicious lumps, and went to their doctors after seeing
this movie. One Iowa newspaper reported that Nine . . . women save[d their]
own lives through help of educational film. Each woman went to her doctor
with her suspicions and had immediate surgery for cancer.52 A survey of New
York audiences of textile workers, nurses, and PTA members found that threequarters had performed the self-exam at least once and some more frequently
after seeing the film. The New York survey also found that the movie helped to
increase discussion of breast cancer; sixty-six percent reported talking with
friends about breast cancer, but only twenty percent had done so with a doctor.
Other surveys showed that eighty to ninety percent of female viewers performed
a self-examination after seeing the movie compared to under ten percent before
seeing the movie. A third or more reported continuing the practice. The film
succeeded with women of color and white women both.53 Whether a new, permanent, monthly habit could indeed be created among all women was, of
course, still a question mark. Nevertheless, it is clear that many female viewers
took the film seriously and tried to live by its message.
The film produced for women not only brought growing numbers of women
into doctors offices, it also helped bring growing numbers of doctors into the
American Cancer Societys orbit. This was an important achievement for the
ACS, since in previous years some physicians had been suspicious of the organization.54 Because the society urged volunteers to combine a showing of Breast
Self-Examination with a question-and-answer period by a doctor, many doctors
were asked to join in the effort to teach women about cancer. The ACSs organizational capacity, and its medical legitimacy, increased as a result of the
intense campaign around Breast Self-Examination.55 Interestingly, despite questions about the efficacy of monthly breast self-exams, there was great medical
enthusiasm for the film.56 Some physicians may have been unaware of doubts

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about the value of breast examination. The majority of cancer surgeons, however, believed in early detection, radical (and super radical) mastectomy, and
angrily dismissed physicians and scientists who questioned that conviction.57
The message to see a doctor annually may also have helped override any doubts
about the methods being taught.
A parallel campaign educated doctors about their role in detecting cancer
through the thirty-four-minute movie Breast Cancer: The Problem of Early Diagnosis
(1949). Like the female public, physicians needed to be made aware of the dangers of breast cancer. As the medical movie put it, their index of suspicion had
to be raised to a high level. Fifty thousand women developed the disease every
year. This means, the movie narrator explained, that breast cancer is one of
the grave health problems of our time.58 The movie, which received high praise
from medical reviewers, was the second in a series of six produced for physicians
by the American Cancer Society and the National Cancer Institute. The first had
received an international award for medical motion pictures.59 Breast Cancer: The
Problem of Early Diagnosis was produced for medical audiences, including medical
and nursing students, medical social workers, public health doctors and nurses,
and health educators, and was likely to be shown in either the classroom or at
local and national professional meetings. The film could be bought or borrowed
from the American Cancer Society or state departments of public health, and
came with a program guide. An ideal presentation, according to one medical
review panel, would be to build a panel discussion with several specialists around
the films showing at a county medical society educational meeting. ACS pamphlets on breast cancer could be given to the audience as well. Although the
reviewers had a few ideas about how to make this a better movie, including giving it a better title, they felt that few professional audiences will see this film
without enthusiasm, expanded learning, and improved methods.60
The movie opens with History, represented through sculpture and the naming of a Roman physician, which served to aggrandize the practitioner and legitimate the suggested medical practices. It then quickly moves into Science; the
first section of the film summarizes knowledge of anatomy and human development, tracing the development, shape, and purpose of the breast from the
embryo through puberty, lactation, and menopause, through diagrams and film
of partially undressed girls and women. The movie then shifts from the normal
to the abnormal with footage of a series of women with advanced signs of breast
cancer. The medical audience sees physicians examining, squeezing, and probing breasts and sees women with retracted nipples, women demonstrating (by
squeezing their hands together or putting their hands on their waists) dimpling
of the breasts, lesions, and, finally, a woman with the classic sign of orange peeling, which, the narrator intones, is usually indicative of advanced disease.
These images of women bared to the waist who exhibit the signs of breast cancer are interspersed with slices of the female body: cross-section diagrams and
gross medical specimens. The interspersing of specimens along with photos of

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live patients underscores the point: clinical examination of the bodys exterior
and microscopic examination of the bodys interior cells obtained via surgery
are both required. The film declared, Only by a microscopic examination of tissue specimens can a diagnosis of breast cancer be made with scientific accuracy.
The physician who puts off microscopic examination would regret it; cancer
would follow its own law, the narrator warned, and metastasize. The films next
frame makes the warning vivid: metastasized cancer is represented in the form
of the doomed woman: here is a woman showing all of the inevitable consequence of unchecked cancer: retraction, ulceration, axillary spread . . . enlarged
hard lymph nodes. To avoid this ominous picture of inevitable death, the doctor had to perform regular breast examinations, learn to recognize the signs of
possible cancer, and, if found, act quickly to biopsy the breast so that surgery
could be performed immediately.
The representations of the breast and breast cancer through diagrams, biopsies, and partly-nude patients indicate the scientific and educational nature of
the film. Yet these conventions of the science movie do more: they simultaneously teach viewers to see female patients as medical specimens. It is not that
such images should not have appeared in the medical movie; learning how to
look for signs and see them through clinical examination was necessary in order
to educate doctors in diagnosis. The modern medical understanding of diseasewhich assumes that diseases are specific and work in the same way in all
people, regardless of their character, class, race, or the climate in which they
livemade it imperative that practitioners think in generalizations and see their
patient as one of many. Yet we can also see how the conventions of medical education contributed to a greater distance between physician and patient.
For all the concern over ensuring that the women-only movie with its footage
of an undressed woman be socially acceptable, it was the movie for medical personnel, not the movie for women, that raised questions about bare breasts.
A medical review panel declared Breast Cancer: The Problem of Early Diagnosis to be
a very excellent film. Yet, as a matter of taste, the reviewers remarked, the
long shots of women nude to the waist were longer in duration than fitted the
niceties of the film. Furthermore, they observed the feelings of the women presented as specimens: too many looked abashed at the camera scrutiny.61
Although these women and girls served as specimens, their discomfort came
through on film. They were unable to present themselves with clinical detachment. Indeed, they disrupted Science and suggested, without voicing words
and without attention from the filmmaker or narrator, the human angle of
being subjected to medical and photographic viewing. These women are different from Mrs. Wright in the womens movie. They are real patients with signs
of cancer. Mrs. Wright is played by an actress who is comfortable in her role
and in displaying her naked breasts to the eyes of the doctor, the camera, and
the films audience. The movie for the public used a model to produce a model
interaction between physician and patient. The film for medical professionals

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used clinical patients to represent the actual marks of cancer. In so doing, it may
have sketched an image of the type of woman who had cancer into the minds of
doctors, as well as who would not. The women who have cancer in the medical
movie all appear much older than Mrs. Wright, in their sixties and seventies,
and look as though they have lived hard lives, not privileged ones. Despite the
mixture of gross specimens and clinical material in the medical movie, doctors
and other health professionals glimpsed real life and real patients, while the
public watched a sanitized movie version.
Careful viewing of the medical movie reveals what was omitted from the films
produced for popular consumption at mid-century: images of advanced signs of
cancer and mastectomy. The viewers of cancer films for the public only saw
healthy people. Cancer itself, its signs, its ravages, its damage, are unrepresented. ACS speakers, publications, and films all deliberately emphasized cure
and avoided reference to or pictures of late cancerous lesions or other allusions
depressing to those not directly associated with the health professions.62 Instead,
cancer was depicted by the healthy, the smart, the smiling, and the cured; viewers who persisted in wondering what cancer might look like (or feel like) or what
the cure consisted of, were left to their imaginations. Although the film for the
public alerted viewers to the twenty thousand women who died annually due to
breast cancer, its overall message is that with breast self-examination, women can
be cured and avoid death. The mastectomy operation is unseen and the word
unspoken. Medical movies taught doctors that the treatment permitting the
greatest chance for survival is the radical mastectomy, but medical viewers also
learned that three-quarters of patients will succumb in five years.63 This dismal
accounting is missing from the movie for women. Instead, all cancer educational
materials urgently taught the public that cancer could be cured. What was not
said was what cured meant. If the diagnosis was breast cancer in 1950s
America, a radical mastectomy was the only cure offered.64 In cancer discourse
cured meant surviving five years past diagnosis, but this measure did not say
anything about ones life-span, or whether a cancer might recur or another
type of cancer be found at a later date, or whether one might, ultimately, die of
cancer.
The doctors movie addressed the problem of early diagnosis; it did not
address the problem of physician-patient communication. In contrast to the
movie for women, the scene demonstrating the examination of the breast presents the female patient as a silent object who is observed and touched by the
doctor. Although the film mentions the responsibility of the doctor or the
nurse to teach women how to perform breast self-examination, it fails to model
or discuss an appropriate method of teaching or speaking with patients. During
the scene in which the physician examines the breasts of his female patient,
their words are silenced. A similar scene appeared in the womens movie, but
the conversation, the questions, the answers and the training of the patient is
missing in the medical movie. The silence implies that the style of communication

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during a breast-examination or, for that matter, any check-up is not as important
as learning anatomy and professional distance. The medical movie silenced the
words of the female patient, but required its medical audiences to listen to
the male narrator. The words of the expert narrator must be heard and remembered, the film subtly taught its medical viewers, while the words of the
patient might be ignored in favor of attending to clinical signs and laboratory
information.
Although convincing physicians to teach women breast self-examination was
one of the primary goals of the ACS educational campaign, it was secondary at
best in the medical film in placement, time allotted, and emphasis to the scientific education which predominated. Scientific knowledge and proof of the need
for early diagnosis were needed first to legitimate the subject of patient education. Ultimately, the film was more about getting general practitioners to take
examination of the breast for cancer seriously and intended to frighten them
into making immediate referrals for biopsy and surgery, if needed. Effective
physician-to-patient communication, unlike diagnosis, was assumed rather than
taught in the film. This is a contrast to the contemporaneous handbooks on
effective communication produced by the ACS for its leaders, volunteers, and
public speakers.65
Perhaps some physicians learned of their duty to teach women to examine
their breasts for early signs of cancer and how to communicate that lesson through
a special issue of the ACS medical publication, Cancer Progress. While the society
worked to educate physicians, however, it simultaneously participated in using
and perpetuating demeaning stereotypes of women. A shadow of a female
patient represented The Missing Member of the Breast Cancer Team among
seven other key players, mostly male physicians, including the general practitioner, the radiologist, and the surgeon, and one female nurse.66 The article
uses a roundabout gambit to encourage physicians to teach their patients about
breast self-examination. It is not doctors, the article declares, who need to realize the importance of teamwork, but the laity that needs educating and alerting. Female patients are represented to doctors as ignorant and in need of a
serious talking to by their physicians. That phrase played to physicians
authority and promoted the self-image of the fatherly, friendly, and wise doctor
who advises his (child-like) patient. The ACS advised the doctor on his duties,
but disguised the advice by playing up the doctors paternalistic role. The dutiful doctor, ACS suggested, will dispense health sermons about the need for
every woman [to] assum[e] her responsibility for early detection of breast
lumps. Teaching the patient is easy, the journal assured. Finally, the doctor
is given additional ammunition to help him convince his patients to perform
this examination; reminding the lady of the hours she spends on her cosmetic
ritual would make the minutes devoted to this self health examination seem
minor. Not only did the reference to womens commitment to feminine fashion serve as a talking point, it also offered doctors a chance to smirk at women

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and their mistaken priorities.67 One should not conclude that all doctors
regarded women with such disdain, but we can see here how laughing at the
(female) patient provided a socially acceptable avenue for discussing the
potentially difficult subjects of examination of a sexualized part of the body,
cancer diagnosis, treatment, and physician-patient communication. This
insider conversation about how to talk to the female patient, like the conventions of the scientific medical movie, contributed to the distant and patronizing treatment that many patients complained of when they saw their doctors.
The Cancer Progress article stands in marked contrast to the message of respect
for doctors and their judgments that patients received in the ACS educational
materials produced for them.
Physicians may have learned more about how to communicate with their
patients by watching the movie for women than they did from movies designed
for medical education. There is no evidence of the movies being used for this
purpose, however.68 My own audiences laughter at the idea that physicians
might have watched and learned from a film produced for non-medical female
audiences indicates our own assumption that health education is highly targeted
and audiences segmented. We watch movies made for us. To do otherwise might
be silly for physicians; dangerous, voyeuristic, or sickening for a lay audience
seeing medical movies.69 Yet watching medical movies made for someone else
for those who care for us, or for whom we provide carecan be highly
enlightening.

Conclusion
At a time when breasts were in the public eye as highly sexualized objects and
when their maternal function for nourishing infants was denigrated and
denied,70 the pair of breast self-examination films desexualized the breast by clinicalizing it. Most ironic in light of later feminist analyses of medicine as maledominated and controlling, this clinicalization of the breast was embraced by
women as empowering. Making the breast an object of the clinical gaze (albeit
male) rather than the male sexual gaze enabled women to claim their breasts as
their own. Their breasts, their bodies, their health were theirs. This feature of
Breast Self-Examination, its focus on the individual adult woman and her health
and knowledge rather than on the woman as mother or wife and her duties to
others, is what made the movie unique among health films and womens films,
and made it powerful with its female audiences.
The breast self-examination movies were extraordinarily successful and longrunning. Their success was built on several factors, from the films messages to
its advertising to its distribution in a wide range of public and social spaces.
Success grew out of the ACSs creation of a new type of womens health film that
spoke to womens interest in their own health. Adult women were represented

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as rational, unafraid of dread disease, and responsiblefor both the community

of women and for their own individual health. The ACS womens film deftly differentiated itself from sexploitation films by presenting itself as a serious health
movie in its filming, lighting, and tone as well as through its association with the
people and spaces of medicine and middle-class womanhood. At the same time,
the ACS and the womens clubs that made the widespread distribution of the
film possible, drew upon some of the exploitation film industrys tactics for
attracting audiences, by advertising the film as women-only and using radio,
pamphlets, and news media to generate excitement and audiences. The films
success was due to its careful production as medical, decent, and civic-minded,
and its distribution through womens networks and interests. Womens organizations, womens places such as department stores and churches, womens
workplaces, womens columns in newspapers and magazines, and women
physicians were all tapped in order to reach as many women as possible across
the social spectrum.
It is perhaps ironic that these two movies, projected and viewed collectively by
groups of women and medical personnel, emphasized individualized and private examinations. One of the fundamental assumptions in both movies, and in
all ACS educational materials, is that every woman (and every man and child) in
America had a personal relationship with a private physician. Breast SelfExamination and other ACS movies for the public helped promote Americans
allegiance to the system of private medicine. Medicine is portrayed as a private,
one-on-one, individualized relationship where money never changes hands and
concern about fees or insurance never crosses the minds of either doctors or
patients. Although local ACS activists put energy into providing services, including free transportation, dressings, and free or inexpensive examinations and
treatment, care for the indigent was not a priority of the societys national leadership.71 The problem of a lack of health services, whether because of a lack of
income, insurance, or discrimination, was invisible in its movies. That the ACS
identified false modesty72 as the problem that kept men and women from
going to doctors to be examined for signs of cancer rather than the lack of
health insurance or other barriers surely contributed to the universally positive
endorsements ACS movies received from organized medicine. The AMA and
other medical societies had only recently stopped President Trumans attempt
to secure a national health insurance system.73 The problem of diagnosis and
treatment in ACS movies was never a problem of poverty, but was represented
instead as a problem of knowledge and habits.
As Breast Self-Examination began showing nationwide in 1950, the ACS realized
that men neglected cancer exams and had been neglected by the societys educational programs. In response, in the early 1950s the ACS produced a parallel
campaign for men, which focused on lung cancer and urged all men over age
forty-five to have two chest x-rays annually. This campaign, too, centered on
movies, this time made for men.74 It also spoke to women in order to get men to

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follow ACS advice and seek regular cancer examinations. The use of womens
magazines to alert women of mens need for examinations and the urging of
men to listen to the health advice dispensed by their wives, underlines the gendered nature of health education and the persistent expectation that women
would teach the lessons of public health and ensure family health.75
The campaign for breast self-examination continues today and the message
has changed little. Movies, along with new educational devices like showerhead
hangers that remind women to examine their breasts, still play an important
role. At the end of the twentieth century, health maintenance organizations
offered their patients free instructional videos on how to perform breast selfexam for early signs of cancer. The ten-minute Breast Self-Exam Techniques
(1994),76 a video produced in cooperation with the ACS, is a direct descendent
of the film made for women only in 1950. Women may now watch the video
alone at home rather than within a community of women in a public space;
breast self-examination has become thoroughly individualized and privatized in
its training and its practice. Viewers of the video are no longer promised a
cure, but are told instead that early detection gives the best chance of a complete cure. The video promotes the exam as part of a smart fitness and finances
program through its use of a jogger and by calling the exam an important
investment in your health. Like its predecessor, it shows a woman viewing her
breasts in a bedroom mirror and examining herself while lying on her bed. Like
Mrs. Wright, this younger woman is white. Although she is a jogger instead of a
club woman, both representations mark the women as middle class. The movie
has been updated by diversifying its portrait of women in its opening scene,
which includes one (and one only) black woman and a casual group of young
white women with children; by using a female rather than male narrator; by representing the physician to whom a woman with suspicious signs might go as a
(white) female; and by advocating mammography. In the HMO video, the teaching of the technique by a doctor has been deleted.
Almost fifty years after the start of the breast self-examination campaign, its success was apparent in the widespread fear of breast cancer and belief among
American women that they were at a greater risk of dying from breast cancer than
heart disease. The practice of going to health movies had real effects. In the
1990s, commentators speculated that these mistaken beliefs might be attributed
to womens misunderstanding of statistics or their hyper-concern about their
breasts.77 These observerslike so much health educationfound the fault to be
in women. They failed to realize that women had learned their health lessons well.
For decades, women had been taught through a massive health education effort
and the screening of Breast Self-Examination and other movies like it that breast cancer posed a special danger. Furthermore, it was a danger to which women as intelligent and responsible citizens needed to be attuned at the prime of life.
The campaign to teach breast self-examination through the movies contributed to the incorporation of masses of women into the prevailing medical

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model of surveillance and surgery. As women learned about the disease of breast
cancer and their duty to search for its signs, they learned to see themselves as
patients when they felt well and to accept their subordination to physicians. In
later years, new movements of women challenged ACS teachings to trust their
doctors decisions without question. In the 1950s, the founder and volunteers
for Reach for Recovery challenged the silence surrounding women in the
process of recovering from mastectomy and emphasized that women with breast
cancer could still be sexually attractive and socially active. In the 1970s, women
with breast cancer drew on feminist critiques to challenge the persistence of the
radical mastectomy and the one-step procedure in which the surgeon, without
consulting the woman, automatically performed the radical mastectomy on his
anesthetized patient whenever a biopsy showed cancer.78 The practice of breast
self-examination was not questioned. The contemporary breast cancer movement, like its predecessors, tends to support self-examination and early detection even when the value of early detection is unclear.
Cancer education was part of a twentieth-century drive toward constant monitoring of the body by both the individual and the medical system. Through
Breast Self-Examination and Breast Cancer: The Problem of Early Diagnosis and the
accompanying materials, radio shows, and lectures, women and doctors both
learned the duty to examine manually and visually the breasts of healthy women.
Women were taught both self-knowledge and subordination to the physician.
The contemporary womens health movements relationship to the medical profession is different because it is less deferential. Nonetheless, its emphasis on
knowledge of ones own body and health information and responsibility for ones
own health has roots both in the traditional female responsibility for health
and in health education efforts such as the mid-twentieth-century breast selfexamination campaign. The medical film and related materials demonstrated
and reinforced medical authority and patient subordination. Physicians were
taught how to look at and touch the female body, but with clinical distance.
Patient emotions and anxieties related to cancer or the potential loss of the
breast were not dealt with in the medical movie. The emotional responses to
cancer and the long-term consequences of the disease were left for others to
manage, for ACS volunteers, social workers, and nurses, not doctors.
Cancer films taught women, most particularly healthy, well-off, white women,
self-surveillance as self-protection. This campaign was part of a long-term transformation in the relationship between medicine and the population: over the
course of the twentieth century, physicians and patients increasingly meet not
only during times of sickness or emergency, but when patients are well. Both
physicians and patients were learning to look at the healthy body for hidden
signs of illness. The public health campaign for breast self-examination begun
in the 1950s, like the New Public Health in general, focused on individual
responsibility rather than environmental causes of disease.79 Perhaps even more
significant, these campaigns focused on protecting the individual rather than

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promoting larger social measures to prevent disease or provide medical

attention to the entire population. The promotion of regular self- and medical
examination of the body that is the hallmark of twentieth-century cancer campaigns was both a redefinition of public health and a culmination of a trend that
focused on the individual. While public health charged every individual with
responsibility for their own health, the individual addressed in the breast selfexamination campaign was pictured as healthy, white, and presumably insured.
Finally, the ongoing promotion of breast self-examination, even with doubts
about its value in lowering mortality,80 suggests that doctors and female cancer
activists shared an ideological belief in self-examination. The practice of
self-inspection had become a virtue. And a marker of the responsible female
citizen-patient.

Notes
I am grateful to Diane Gottheil, Barron Lerner, Mary Odem, Sarah Projansky, Daniel
Schneider, Susan Smith, Eric Smoodin, Nancy Tomes, Paula A. Treichler, and my
audiences at York University; University of California, Berkeley; University of
Wisconsin, Madison; Indiana University; and University of Illinois for their comments on earlier versions of this essay. I thank Dawn Flood, Matt Gambino, and Rose
Holz for their research assistance, and the Beatrice Bain Research Group at the
University of California, Berkeley and the Research Board at the University of
Illinois, Urbana-Champaign for supporting this project.
1. For a concise overview of film studies, I found Graeme Turner, Film as Social
Practice, 3rd ed. (London and New York: Routledge, 1999) most helpful. For general
histories of American movies, see Robert Sklar, Movie-Made America: A Social History of
American Movies (New York: Random House, 1975); Larry May, Screening Out the Past:
The Birth of Mass Culture and the Motion Picture Industry (New York: Oxford University
Press, 1980); Steven J. Ross, Working-Class Hollywood: Silent Film and the Shaping of Class
in America (Princeton, NJ: Princeton University Press, 1998). For the handful of studies on educational film, see Ken Smith, Mental Hygiene: Better Living through Classroom
Films, 19451970 (New York: Blast Books, 1999); Lea Jacobs, Reformers and
Spectators: The Film Education Movement in the 1930s, Camera Obscura 22 (1990):
2949; Eric Smoodin, The Moral Part of the Story was Great: Frank Capra and
Film Education in the 1930s, Velvet Light Trap 42 (Fall 1998): 2035; Martin
S. Pernick, Thomas Edisons Tuberculosis Films: Mass Media and Health
Propaganda, Hastings Center Report 8:3 (June 1978): 2127; Annette Kuhn, The
Power of the Image: Essays on Representation and Sexuality (London: Routledge and
Kegan Paul, 1985), chapter 5 (on early twentieth-century VD films); Stacie
A. Colwell, The End of the Road: Gender, the Dissemination of Knowledge, and
the American Campaign against Venereal Disease during World War I, in The Visible
Woman: Imaging Technologies, Gender, and Science, ed. by Paula A. Treichler, Lisa
Cartwright, and Constance Penley (New York and London: New York University
Press, 1998), 4482; Gregg Mitman, Reel Nature: Americas Romance with Wildlife on
Film (Cambridge, MA: Harvard University Press, 1999).

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2. Breast Cancer: The Problem of Early Diagnosis (1949) and Breast Self-Examination
(1950) were both produced by the American Cancer Society and the National
Cancer Institute. Copies of both films are held by the Library of Congress,
Washington, D.C. I thank Librarian Madeline F. Matz for her assistance.
3. Mary Ann Doane, The Desire to Desire: The Womans Film of the 1940s
(Bloomington: Indiana University Press, 1987); Christine Gledhill, ed., Home is Where
the Heart Is: Studies in Womens Melodrama and the Womans Film (London: British Film
Institute, 1990); Linda Williams, Melodrama Revised, in Refiguring American Film
Genres: History and Theory, ed. by Nick Browne (Berkeley: University of California
Press, 1998), 4288; Eric Schaefer, Bold! Daring! Shocking! True!: A History of
Exploitations Films, 19191959 (Durham, NC: Duke University Press, 1999),
197203; Suzanne White, Mom and Dad (1944): Venereal Disease Exploitation,
Bulletin of the History of Medicine 62:2 (Summer 1988): 25270.
4. See Martin S. Pernick, The Black Stork: Eugenics and the Death of Defective Babies
in American Medicine and Motion Pictures Since 1915 (New York: Oxford University
Press, 1996); Pernick, Thomas Edisons Tuberculosis Films: Kuhn, The Power of the
Image; Colwell, The End of the Road; and Joanne Trautmann Banks, ed., Moving
Pictures, special issue, Literature and Medicine 17:1 (Spring 1998).
5. On breast cancer in particular, see Barron H. Lerner, The Breast Cancer Wars:
Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America (New York: Oxford
University Press, 2001); Kirsten E. Gardner, Early Detection: Women, Cancer, and
Awareness Campaigns in the Twentieth-Century United States (Chapel Hill: University of
North Carolina Press, 2006); Pamela Sanders-Goebel, Crisis and Controversy:
Historical Patterns in Breast Cancer Surgery, Canadian Bulletin of Medical History 8:1
(1991): 7790; Susan Garfinkel, This Trial Was Sent in Love and Mercy for My
Refinement: A Quaker Womans Experience of Breast Cancer Surgery in 1814,
New Jersey Folklife 15 (1990): 1831. On the cancer experience, research, health education, and the ACS in general, see Barbara Natalie Clow, Negotiating Disease: Power
and Cancer Care, 19001950 (Montreal: McGill-Queens University Press, 2001);
Leslie J. Reagan, Engendering the Dread Disease: Women, Men, and Cancer,
American Journal of Public Health 87:11 (November 1997): 177987; Robert N.
Proctor, Cancer Wars: How Politics Shapes What We Know and Dont Know About Cancer
(New York: Basic Books, 1995); James T. Patterson, The Dread Disease: Cancer and
Modern American Culture (Cambridge, MA: Harvard University Press, 1987); Lester
Breslow, Principal Investigator, A History of Cancer Control in the United States,
19461971, 4 volumes (Washington, D.C., 1978) and esp. chapter 10 of Book Two
by Devra M. Breslow on the American Cancer Society; Stephen P. Strickland, Politics,
Science, and Dread Disease: A Short History of United States Medical Research Policy
(Cambridge, MA: Harvard University Press, 1972); Richard Carter, The Gentle Legions
(Garden City, NY: Doubleday, 1961), chapter 5; Donald F. Shaughnessy, A History
of the American Society for the Control of Cancer, 19131943 (PhD dissertation,
Columbia University, 1955), box 1815, American Cancer Society Archives, Atlanta,
Georgia (hereafter ACSA).
6. On public health education, see Nancy Tomes, The Gospel of Germs: Men, Women,
and the Microbe in American Life (Cambridge, MA: Harvard University Press, 1998);
Georgina D. Feldberg, Disease and Class: Tuberculosis and the Shaping of Modern North
American Society (New Brunswick, NJ: Rutgers University Press, 1995), 81100;
Richard Harrison Shryock, National Tuberculosis Association, 19041954: A Study of the
Voluntary Health Movement in the United States (New York: National Tuberculosis

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Association, 1957); John C. Burnham, Change in the Popularization of Health in

the United States, Bulletin of the History of Medicine 58:2 (Summer 1984): 18397;
Lynne Curry, Modern Mothers in the Heartland: Gender, Health, and Progress in Illinois,
19001930 (Columbus, OH: Ohio University Press, 1999), chap. 4; Molly LaddTaylor, Mother-Work: Women, Child Welfare, and the State, 18901930 (Urbana:
University of Illinois Press, 1994). Much of the literature on the twentieth-century
history of public health discusses health education to some extent; these are just a
few examples.
7. Irving Schneider finds that the movies do influence patient expectations in The
Theory and Practice of Movie Psychiatry, American Journal of Psychiatry 144 (1987):
9961002.
8. Michel Foucault, Discipline and Punish: The Birth of the Prison (New York: Random
House, Vintage Books, 1979), 18494. For other histories of medical examination,
see Roy Porter, The Rise of the Physical Examination, in Medicine and the Five Senses,
ed. by W. F. Bynum and Roy Porter (Cambridge: Cambridge University Press, 1993),
17997; Barbara Duden, The Woman Beneath the Skin: A Doctors Patients in EighteenthCentury Germany trans. by Thomas Dunlap (Cambridge, MA: Harvard University
Press, 1991); and Alexandra Minna Stern, Buildings, Boundaries, and Blood:
Medicalization and Nation-Building on the U.S.-Mexico Border, 19101930,
Hispanic American Historical Review 79 (February 1999): 4181.
9. Curry, Modern Mothers in the Heartland; Ladd-Taylor, Mother-Work; Susan L. Smith,
Sick and Tired of Being Sick and Tired: Black Womens Health Activism in America,
18901950 (Philadelphia: University of Pennsylvania Press, 1995); Alan M. Kraut,
Silent Travelers: Germs, Genes, and the Immigrant Menace (New York: Basic Books,
1994), chap. 4; Richard Meckel, Save the Babies: American Public Health Reform and the
Prevention of Infant Mortality in Late Nineteenth-Century America (Princeton, NJ:
Princeton University Press, 1991).
10. Kraut, Silent Travelers, chap. 3; Stern, Buildings, Boundaries, and Blood.
11. Allan M. Brandt, No Magic Bullet: A Social History of Venereal Disease in the United
States (Oxford: Oxford University Press, 1986); Suzanne Poirier, Chicagos War on
Syphilis, 19371940: The Times, The Trib, and the Clap Doctor (Urbana: University of
Illinois Press, 1995); Barron H. Lerner, Contagion and Confinement: Controlling
Tuberculosis Along the Skid Road (Baltimore, MD: Johns Hopkins University Press,
1998), 3455; Shryock, National Tuberculosis Association, 26063.
12. Devra M. Breslow, Book Two of A History of Cancer Control in the United States, 780.
Earlier movies used breast cancer as their primary example, and thus contributed to
womens growing awareness of the danger of this specific type of cancer, but they
were produced for general audiences and to recruit volunteers. See Choose to Live
(1940) and Time is Life (1946), both available at the National Archives, College Park,
MD. The Idaho division of the ACS also produced a film, Life-Saving Fingers (1948),
which demonstrated breast self-examination. A copy of Life-Saving Fingers is available
in the Library of Congress. See Gardner, Early Detection, chap. 2 for further discussion
of these films.
13. Breast Self-ExaminationA New A.C.S. Film for Women, New Horizons (hereafter cited as NH) 3:4 (September 1950): 3.
14. All quotations and descriptions of the film are based on my viewing of the print
available at the Library of Congress.
15. This is an example of moviemakers use of and reliance upon audience understanding of what film scholars call intertextuality. Movie audiences bring knowledge

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of other movies, which enables them to understand metaphors and logical shortcuts
in the film. On the conventions of womens makeup in Hollywood medical movies
in the 1940s, see Doane, The Desire to Desire, 40, 42.
16. Breast Self-ExaminationA New A.C.S. Film for Women; Film Teaches
Women to Examine Selves for Cancer, Science News Letter 58:2 (8 July 1950): 18.
17. ACS, Film Catalogue, [1953], p. 4, ACS undated folder, box 1, Rose Carolyn
Spencer Papers (hereafter RCSP), Minnesota Historical Society, St. Paul, Minnesota.
Another handbook reassured that the films pictorial demonstration is conducted
with restraint and good taste. ACS, Pennsylvania Division, Cancer Education
Program Manual for Education Chairmen, community commanders and other volunteers of the American Cancer Society, [1952], box 1896, ACSA. I thank Connie
Dowd and Jeff Clements for their assistance at the American Cancer Society.
18. See the photo of a meeting of four Grand Junction womens clubs that met
jointly at the Methodist church in NH 4:3 (July 1951): 5.
19. Coleman, The End of the Road, 68.
20. Many still would like to see the mysterious films that the other sex saw.
21. White, Mom and Dad (1944), 256 and n. 19, 256.
22. On nude art photos and Marilyn Monroe, see Richard Dyer, Heavenly Bodies:
Film Stars and Society (New York: St. Martins Press, 1986), 2831. The Motion Picture
Code forbade complete nudity . . . This includes nudity in fact or in silhouette, or
any lecherous or licentious notice thereof by other characters in the picture.
A Code To Maintain Social and Community Values in the Production of Silent,
Synchronized and Talking Motion Pictures, ratified by the Board of Directors of
Motion Picture Producers and Distributors of America, Inc., March 31, 1930, folder 11,
box 5, Poole Program Records, General Federation of Womens Clubs Archives,
Washington, D.C. (Hereafter GFCWA.) The Outlaw [1941] was censored because it
showed a womans bare breasts, Edward de Grazia and Roger K. Newman, Banned
Films: Movies, Censors, and the First Amendment (New York and London: R. R. Bowker
Company, 1982), 6567. On the social importance of (large) breasts in the 1950s,
see Elizabeth Haiken, Venus Envy: A History of Cosmetic Surgery (Baltimore, MD: Johns
Hopkins University Press, 1997), chap. 6; and on the expansion of sexual images of
women in the mass media, see Joanne Meyerowitz, Women, Cheesecake, and
Borderline Material: Responses to Girlie Pictures in the Mid-Twentieth-Century
U.S., Journal of Womens History 8:3 (Fall 1996): 935.
23. Barbara Melosh, The Physicians Hand: Work, Culture, and Conflict in American
Nursing (Philadelphia, PA: Temple University Press, 1982).
24. Mary Ann Doane reaches a similar conclusion about Hollywood medical movies
in which, she argues, women viewers see the bodies and diseases of women through
a male medical gaze. Doane, The Desire to Desire, 67.
25. Raymond F. Kaiser, A Special Purpose Health Education Program: Breast SelfExamination, Public Health Reports 70:4 (April 1955): 429; Devra M. Breslow,
Federal Cancer Control Program, 194657, chap. 4 in Book Two of A History of
Cancer Control in the United States, 555; Devra M. Breslow, Organized Voluntary
Cancer Control Programs, chapter 10 in Book Two of A History of Cancer Control in
the United States, 79093.
26. Summary of Executive Directors Annual Report, Illinois Cancer News (hereafter
ICN) 11:3 (December 1956): 7. On the Womens Field Army, see Gardner, Early Detection,
chap. 2; Patterson, Dread Disease, 12123; Shaughnessy, History of the American Society
for the Control of Cancer, chap. 10; Reagan, Engendering the Dread Disease.

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27. We liked this, NH 4:3 (July 1951): 5.

28. NCI and ACS worked to bring Breast Self-Examination to foreign audiences by
showing it at international film festivals, sending copies to thirty United States
embassies, and distributing it through the United Nations and the World Health
Organization as well. Kaiser, A Special Purpose Health Education Program. The
impact of the international distribution of this medical-cultural product deserves further research. On American health movies produced for export, see Lisa Cartwright
and Brian Goldfarb, Cultural Contagion: On Disneys Health Education Films for
Latin America, in Disney Discourse: Producing the Magic Kingdom, ed. by Eric Smoodin
(New York: Routledge, 1994), 16980.
29. Annual Report of the Public Health Service, 1951, as cited in Devra M. Breslow,
Federal Cancer Control Program, 194657, 555.
30. Report of Mifford R. Runyon, Executive Vice President of ACS, Annual meeting
of Members, 25 October 1951, 11, folder JuneDecember 1951, box 1, RCSP.
31. For drawings of how to self-examine the breast, see Self-Inspection Against
Cancer, Todays Health 30 (January 1952): 2223; Self-Examination for Cancer of
the Breast, Ladies Home Journal (August 1952): 84; J. D. Ratcliff, You can Fight
Cancer in Your Home, Womans Home Companion (May 1952): 84. See also the Tell
Me Doctor column in Ladies Home Journal 70 (November 1953): 37.
32. A 1949 study of black and white patients in North Carolina found that radio was
the leading (media) source of health information. See Rosemary May Kent, An
Evaluation of the Health Education Program of the American Cancer Society, North
Carolina Division, Inc., In Terms of Case Studies of Educational Backgrounds and
Influences of Patients Seeking Medical Service for Tumors or Other Cancer Danger
Signals (PhD dissertation, University of North Carolina, 1949), 127, 128, 48, 53, 71,
box 1896, ACSA.
33. Radio Continuity, September 27, 1951, 2:15 p.m., quotations of Spencer on 5,
Shair on 5, 6, 9, Gates on 8, 10, Folder ACS JuneDecember 1951, box 1, RCSP.
34. The Best Films, editorial, Educational Screen 29 (March 1950): 104. The order
of quoted phrases is reversed in original; emphasis in original.
35. For example, Dr. William DeHollander and Mrs. Alton G. Hall of the Sangamon
County, Illinois chapter of ACS designed and produced A Reminder leaflet [for]
each woman who saw the film. Quote in Illinois Highlights, ICN 5:5 (January
1951): 4. The national office of ACS produced Personal Memo as a reminder for
women who saw the film, ACS, Annual Report, 1951, 25, box 1813, ACSA.
36. J. Louis Neff remarked, Doctor Gephard paid tribute to the ingenuity of the
amateur in the preparations of homemade exhibits. That is all right for exhibits but
certainly there is no place for the homemade motion picture in an education program. Films, to be effective, must be right. They must be prepared from an outline
created with the help of someone who thoroughly knows the subject, must be developed from a script written from that outline by a professional script writer, they must
be enacted by a professional cast under professional direction and with professional
photography. Anything else is immediately branded as amateurish and has its effectiveness materially reduced. Quotation in J. Louis Neff, Films, in Tenth Anniversary
of the Field Army of the American Cancer Society, National Assembly held in Mississippi,
November 1823, 1946, 42, box 1836, ACSA.
37. ACS, Field Army Leaders Guide [1940s], box 1836, ACSA.
38. White, Mom and Dad (1944), 25253; Susan E. Lederer and John Parascandola,
Screening Syphilis: Dr. Ehrlichs Magic Bullet Meets the Public Health Service, Journal

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of the History of Medicine and Allied Sciences 53:4 (October 1998), 345, 348; Susan E.
Lederer, Repellent Subjects: Hollywood Censorship and Surgical Images in the
1930s, Literature and Medicine 17 (1998): 91113.
39. Looking at womens bodies and cleavage no doubt interested some women as
well even if the movies were made by and for men. See Meyerowitz, Women,
Cheesecake, and Borderline Material, on the divisions among women over the
depiction of women as sex objects in this period.
40. Illinois Highlights, ICN 7:4 (January 1953): 4; Illinois Highlights, ICN 5:7
(March 1951): 4; Summary of Executive Directors Annual Report, ICN 11:3
(December 1956): 7.
41. ACS, Annual Report, 1951, 21, box 1813, ACSA.
42. Judith Walzer Leavitt, Brought to Bed: Childbearing in America, 17501950 (New
York: Oxford University Press, 1986), 131; Susan Porter Benson, Counter Cultures:
Saleswomen, Managers, and Customers in American Department Stores, 18901940
(Urbana and Chicago: University of Illinois Press, 1986); Jeanne Allen, Palaces of
Consumption as Womens Club: En-Countering Womens Labor History and
Feminist Film Criticism, Camera Obscura 22 (January 1990): 15058. Turn-of-the-century
department stores also promoted the movies and theaters imitated the service and
style of department stores in order to attract middle-class women to the movies. See
Shelley Stamp, Movie Struck Girls: Women and Motion Picture Culture after the Nickelodeon
(Princeton, NJ: Princeton University Press, 2000), 1720.
43. Report of Mifford R. Runyon, Executive Vice President of ACS, Annual Meeting
of Members, 25 October 1951, JuneDecember 1951, 13, folder, box 1, RCSP.
44. NH 4:1 (January 1951): photo on 13.
45. See photo and caption, ICN 8:10 (June 1954): 3. On Bell Telephone see ACS,
Annual Report, 1951, 21. In Illinois, the company showed the film throughout the
state in 1954, and again in 1956 to 2000 new female employees. Illinois
Highlights, ICN 10:6 (March 1956): 4.
46. ACS, Annual Report, 1962, 14, box 1813, ACSA. The American Cancer Society
provided me with a video copy of this film.
47. Choose to Live (1940) began by declaring, In the city, on the farm, rich or poor,
everyone is a possible cancer victim and included the stereotypical public health service image of a black male farmer leading a mule along with photos of white female telephone operators and white male lawyers and miners. The film then focused on a white
middle-class woman, her husband, and two children. Examples of more recent films
with women of various races include How to Examine Your Breasts, which included a
demonstration of three women representing major ethnic groups: Anglo-Saxon,
Spanish-speaking, and Black and I Raise My Hand, which showed black, Puerto Rican,
and white women doing breast self-examination. Spanish-language films included Como
Examinarse Los Senos and La Mujer Merece Lo Mejor about breast and uterine cancer respectively. Films listed in ACS, Films and Spot Announcements (1985), box 1833, ACSA.
48. ACS, Annual Report, 1951.
49. Illinois Highlights, ICN 12:6 (March 1958): 4; Illinois Highlights, ICN, 13:2
(November 1958): 4.
50. Indeed, some already believed that cancer is a snob diseasethe people on the
other side of the tracks are not supposed to have it! (Quotation on p. 154.) ACS
Public Education Review Committee, Public Education for Cancer Control: A Review of
The American Cancer Societys Public Education Program (AprilOctober 1956), quotations on 152, 153, 154, box 1896, ACSA.

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51. ACS, Annual Report, 1955, 34 reported the high figure of five million female
viewers. The ACS Public Education Review Committee questioned this estimate,
however, and suggested that the audience size was more likely half that number and,
furthermore, that the campaign was off-target and failing to reach the low-income,
less-educated, working, and childless women who were either unlikely to know much
about cancer or more likely to get breast cancer Public Education for Cancer Control,
15051.
52. We liked that, NH 4:3 (July 1951): 5. For similar reports from Illinois,
Minnesota, and Colorado, see Physicians Praise Education Program, ICN 5:8 (April
1951): 3; ACS, Annual Report, 1950, p. 13; ACS, Annual Report, 1951, p. 22.
53. Ninety-two percent of the Iowa women and 80 percent of the New Haven women
reported doing the self-exam after the movie; 47 percent of the Iowa women and
33 percent of the Baltimore women reported that they were continuing the practice.
While the Yale (New Haven) group consisted of primarily of women of higher economic and cultural levels, the Baltimore group matched the city in color and age.
Furthermore, the Baltimore study found that Married women, nonwhite women,
and women with the highest educational attainments responded best to this educational technique. Preliminary Report, 14 June 1951, folder 21, box 2, Savel
Zimand Papers, Social Welfare History Archives, University of Minnesota,
Minneapolis, Minnesota; Kaiser, Special Purposes Health Education Program, 431.
54. Report of Dr. Burton T. Simpson of Buffalo, NY, 11 February 1932, 7, box 1837,
ACSA. The AMA opposed the 1937 Act to create the National Cancer Institute,
Devra M. Breslow, Book Two of A History of Cancer Control in the United States, 504.
55. ACS, Annual Report, 1951, 25.
56. On doubts about the value of breast self-examination and mass screening see
I. G. MacDonald, Biological predeterminism in human cancer, Surgery, Gynecology,
and Obstetrics 92 (April 1951): 44352 as cited in Devra M. Breslow, Book Two,
A History of Cancer Control in the United States, 630, and Sharon Batt who reports that,
according to Cornelia Baines and Susan Love, no well-designed study has ever evaluated breast self-exam, and its potential for reducing mortality is still not clear, in
Patient No More: The Politics of Breast Cancer (Charlottetown, P.E.I., Canada: Gynergy
books, 1994), 36, 394. On medical enthusiasm, see ACS Public Education Review
Committee, Public Education for Cancer Control, 13334.
57. Lerner, The Breast Cancer Wars, chap. 5.
58. Breast Cancer: The Problem of Early Diagnosis. All quotations and descriptions of this
film are based on my viewing of the print available at the Library of Congress.
59. Cancer: The Problem of Early Diagnosis (1949) was the co-winner of the first prize
for motion pictures on medicine and natural science at the 10th International
Exhibition of Cinematographic Arts in Venice, Italy. ACS, Annual Report, 1949, 21,
box 1813, ACSA. See also the letters and reviews in the scrapbook on the film, box
1839, ACSA. The film covered five cancer sites: stomach, breast, rectal, cervix, and
lung. It emphasized pathology and showed actual surgeries, in full color. The film is
available at the National Library of Medicine.
60. Review of Breast Cancer: The Problem of Early Diagnosis, 10 February 1950, Cancer
Films Reviews Folder, box 5, Adolf Nichtenhauser Collection (hereafter ANC),
Medical Film Materials, MS C 277, History of Medicine Division, National Library of
Medicine, Bethesda, Maryland. This ACS film received high praise from medical
reviewers who in other cases did not hesitate to criticize harshly. For example, one
film was described as greatly defective, inaccurate, and crudely amateurish, and

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others as too bloody. See Review of Cervical Smear Instead of Vaginal Smear for
Diagnosis of Cancer of the Cervix and Uterus, June 1950 and Review of Radical
Operation for Cancer of the Cervix (Wertheims Operation), 20 January 1950, both
in Cancer Films Reviews Folder, box 5, ANC. I have not found any count of the number of prints distributed or the size of audiences, but the excellent reviews and the
success of the first movie in this series, Cancer: The Problem of Early Diagnosis, makes it
likely that the second movie was widely bought, borrowed, and shown as well. The
ACS reported that over 220 copies of the first movie were sold in the first seven
months that it was available, ACS, Annual Report, 1949, 21.
61. Review of Breast Cancer: The Problem of Early Diagnosis by Medical Film Institute,
Panel no. 903, 10 February 1950, Cancer Film Reviews folder, box 5, ANC.
62. G. E. Wakerlin, Forums as an educational medium, in Tenth Anniversary of the
Field Army of the American Cancer Society, 52. This is not to say that the materials
avoided fear as a motivator; ACS educational materials always raised fears and then
denied them. On the U.S. Public Health Services avoidance of the use of medical
photography, see White, Mom and Dad (1944), 26465.
63. Quotation from Cancer: The Problem of Early Diagnosis. In Breast Cancer: The Problem
of Early Diagnosis, viewers learned that nearly 50,000 women develop breast cancer
annually and that over half died within five years.
64. Lerner, Breast Cancer Wars, chaps. 2, 4; Sanders-Goebel, Crisis and Controversy,
8185. ACS films Choose to Live (1940) and Time is Life (1946), however, both showed
women undergoing biopsies and Choose to Live showed an operation without naming
or explaining the mastectomy.
65. See ACS, Field Army Leaders Guide [circa 1945], box 1836, ACSA; and the annual
ACS, Speakers Handbook, 194953, box 1817, ACSA, which included a page of
reminders to speakers and canned 3, 5, and 15 minute speeches for womens, mens,
and general groups.
66. The Missing Member of the Breast Cancer Team, Cancer Progress, Bulletin of the
American Cancer Society 1:4 (July 1950), no page numbers, box 1833, ACSA.
67. The Missing Member of the Breast Cancer Team. The patronizing method of
pointing to womens interest in their appearance to suggest that they pay attention
to their health and get exams persisted. See, for example, the inside back cover of
Cancer News 23:1 (Spring/Summer 1969), which had photos of four women (three
white, one black) putting on makeup, earrings, facial cream, and curling their hair.
The poster asked, When was the last time you thought enough of yourself to have a
Pap Test for uterine cancer? Other medical journal articles used sexual jokes and
borderline pornographic images to discuss breast cancer and examination of the
breast. See illustrations and discussion in Lerner, Breast Cancer Wars, 5758.
68. Of course, the physicians who assisted ACS in its educational efforts and spoke
at showings of Breast Self-Examination saw the film.
69. Cancer: The Problem of Early Diagnosis included, for example, in excellent color . . .
considerable dramatic blood-letting and organ removal. For this reason,
I assume, the medical review panel warned that, This film should not be shown to
lay audiences. Review of Cancer: The Problem of Early Diagnosis, 29 December 1949,
Cancer Films Reviews Folder, box 5, ANC. The Motion Picture Code declared medical subjects to be inappropriate for Hollywood movies produced for the public and
movies were cut and/or banned for certain types of medical content. The Code
specifically forbade Sex hygiene and venereal diseases, Scenes of actual child birth,
and Surgical Operations (listed as one of six repellent subjects.) Emphasis in original.

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educational entertainment

A Code To Maintain Social and Community Values in the Production of Silent,

Synchronized and Talking Motion Pictures. On the censorship of surgery, see
Lederer, Repellent Subjects.
70. Jule DeJager Ward, La Leche League: At the Crossroads of Medicine, Feminism, and
Religion (Chapel Hill: University of North Carolina Press, 2000); Rima D. Apple,
Mothers and Medicine: A Social History of Infant Feeding, 18901950 (Madison:
University of Wisconsin Press, 1987).
71. Club women in Maryland donated the money they raised for the purchase of
radium for the use of indigent cancer patients at the University of Maryland
Hospital, Statement of Cancer Control, [1939], folder 18, box 3, Dunbar Program
Records, GFWCA. On providing transportation for hardship cases who were not
eligible for public assistance, see Minutes of the Service Committee, Minnesota
Division, ACS, 22 September 1949, p. 2, folder 194549, box 1, RCSP. On dressings,
see Are Cancer Dressings Really Needed? Cancergram 23, November 1951, folder
ACS JuneDecember 1951, box 1, RCSP; ACS, Cancer Dressings: The Role of the
Volunteer in Lay Service (NY: ACS, 1947), folder ACS undated, box 1, RCSP. On free
clinics, Patterson, Dread Disease, 122. Indeed, in the 1930s, the WFA had originally
been forbidden from raising money for radium or directly funding clinics or hospitals. See Shaughnessy, History of the American Society for the Control of Cancer,
179. Devra M. Breslow shows that the ACS was increasingly devoted to research in
the postwar period, but the Womens Field Army provided services for the indigent
in the 1930s and 1940s and even though it was disbanded and renamed by 1951,
local volunteers still provided some services. See Devra M. Breslow, Organized
Voluntary Cancer Control Programs, chapter 10 of A History of Cancer Control in the
United States, 786, 83031.
72. Reagan, Engendering the Dread Disease, 178184.
73. Paul Starr, The Social Transformation of American Medicine (New York: Basic Books,
1982), 28089; Ronald L. Numbers, The Third Party: Health Insurance in America,
in Sickness and Health in America: Readings in the History of Medicine and Public Health,
ed. by Judith Walzer Leavitt and Ronald L. Numbers, 3rd rev. ed. (Madison:
University of Wisconsin Press, 1997), 269283.
74. The centerpiece of the mens campaign was The Warning Shadow (1953), Public
Education, ACS, Annual Report, 1954, 21. See also Reagan, Engendering the Dread
Disease, 178284.
75. As an embroidered ACS advertisement declared, A Nagging Wife May Save
Your Life, and advised men to have bi-annual chest x-rays and to see The Warning
Shadow, in Cancer News 8:4 (October 1954): inside back cover. See also Lawrence
Galton, Lung Cancer among Men, Better Homes and Gardens (October 1953): 64,
305; Evan McLeod Wylie, 24 Hours in a Cancer Hospital, McCalls (February 5,
1956): 45.
76. Thank you to Phoebe Southwood for giving me the copy she received free from
her HMO of the ten-minute Breast Self-Exam Techniques: A Patient-Education Service from
Wyeth-Ayerst Laboratories, prepared with the assistance and advice of the American
Cancer Society, 1994. The video advises women to adopt the habit of self-examination
starting at age twenty.
77. David Plotkin, Good News and Bad News about Breast Cancer, Atlantic Monthly
277 (June 1996): 5355; William C. Black, Robert F. Nease, Jr., and Anna N. A.
Tosteson, Perceptions of Breast Cancer Risk and Screening Effectiveness in Women
Younger than 50 Years of Age, Journal of the National Cancer Institute 87 (May 17,

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195

1995): 72026; Jane E. Brody, The Leading Killer of Women: Heart Disease, New
York Times, 10 November 1993; Susan C. Sanderson, Womens Health in the
Curriculum: Coming of Age, Academic Physician and Scientist (June/July 1996): 4.
78. Lerner, Breast Cancer Wars, chaps. 2, 3, 10.
79. Tomes, The Gospel of Germs; Barbara Guttmann Rosenkrantz, Public Health and the
State: Changing Views in Massachusetts, 18421936 (Cambridge, MA: Harvard
University Press, 1972), chap. 5.
80. Sanders-Goebel, Crisis and Controversy, 85. Similarly, even though there were
doubts about the usefulness of examinations and treatment for lung cancer in the
1950s and prostate cancer in 2000, the belief in early detection and treatment is now
strongly held among Americans: most will opt for treatment regardless of negative
side-effects (assuming they have insurance). ACS Public Education Review
Committee, Public Education for Cancer Control, v, 133; Kenneth Chang, Findings Fuel
Debate on Prostate Test, New York Times, 2 May 2000, section D1, 1, 5; Gina Kolata,
Study Doubts Breast Self-Exams Cut Deaths, NYT, 3 October 2002. As Dr. Meg
Durbin remarks, Weve known for a long time that theres no data to suggest that
self breast-exam helps people live longer. But its heresy to say that out loud. I said it
at a conference of women, and I nearly got thrown out of the room. Quotation in
Mary Duenwald, Putting Cancer Screening to the Test, NYT 15 October 2002, D5.

Part 3

Defining Authenticity,
Exercising Authority

Chapter Seven

American Medicine and the

Politics of Filmmaking
Sister Kenny (RKO, 1946)
Naomi Rogers
In December 1941, Hollywood screenwriter Mary E. McCarthy read a story in the
latest issue of the Readers Digest. In Sister Kenny vs. Infantile Paralysis an
Australian nurse, based in Minneapolis, amazed skeptical doctors as she treated
patients paralyzed by polio. A few months later, McCarthy took the train from Los
Angeles to Minneapolis, and found an imposing white-haired woman teaching
nurses and doctors at the University of Minnesotas medical school, caring for
patients at the university hospital, and writing her autobiography. The two
women delighted in their shared Irish background and sardonic sense of humor.
But it was the possibility that Elizabeth Kennys story could rival those of other
Hollywood scientist-heroes seen in such films as The Story of Louis Pasteur (1936)
and Dr. Ehrlichs Magic Bullet (1940) that excited the screenwriter. One can say,
without fear of contradiction, McCarthy declared in the screen proposal she
sent to studio executives in 1942, that the persecution [Kenny] endured makes
the lives of Pasteur and Dr. E[h]rlich sound like Sunday School picnics.1
The movie Sister Kenny, produced in 1946 by RKO Studios and starring Rosalind
Russell, was more than just another Hollywood biopic, as biographical films were
known in the 1930s and 1940s. Stories of doctors, scientists and inventors had
done well at the box office, and the success of Madame Curie (1943) had shown
that a woman scientist could win over audiences as much as stories of British or
Egyptian queens.2 But unlike these Hollywood protagonists, Elizabeth Kenny was
alive and an active participant in both the making and promotion of the film.
Kenny had come to the United States from Australia in 1940 to convince
American physicians to reject the use of splints and braces in treating polio
patients and to adopt instead her methods of hot packs and muscle retraining.3 In
the 1940s polio was a high profile, much feared disease, and Kenny promised not

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only a new treatment but, more controversially, a new concept of the disease.
Doctors and nurses rapidly adopted her methods of polio care, but were more
wary of her claim that only she understood why they worked. As Kenny continued
to fight for professional respect, RKOs Sister Kenny became part of her challenge
to medical orthodoxy. Set within the standard biopic genre of a discoverers struggle for acceptance, the film raised the hopes of the American public as it dealt
with a frightening, persistent public health problem. Its populist message, reinforced by the portrayal of the protagonist as a flawless hero fighting narrowminded, elitist professionals, asked lay viewers (over the heads of doctors) to judge
for themselves, and appealed to a public dissatisfied with standard polio therapies
and, more broadly, with the policies and practices of organized medicine.
The RKO film was constructed through a process of negotiation between the
screenwriters, the studio executives, and Kenny herself. Featuring crippled children, a nurse who talked back to doctors, and scenes of clinics and hospital
amphitheaters, the final version of the film did challenge Hollywoods typical
depiction of doctors as heroes. In it, doctors were bad guys, and disease was
fought by a brave nurse and her wise lay followers. Reflecting the growing
domestic conservatism of the early cold war, Kennys story was not, however, constructed as a distinctively gendered challenge to medical authority. In her many
interviews in popular magazines she had rejected cultural norms of the helpful,
humble nurse, and had fiercely warned physicians that their old ideas were
harming American children, although, as the Readers Digest had made clear, the
nurse practicing the Kenny method does not replace the doctor, but works with
him.4 The screenwriters dealt with these unsettling topics by making sure that
the final film featured at least one good doctor; that the specialist who
opposed Kenny was condescending but not evil; and that Kennys crusade for
acceptance as a medical discoverer was balanced by a love story that forced her
character to choose between personal happiness and career.
This study of the making of Sister Kenny from its earliest screen proposal to its
premiere in September 1946 points to the close relationship between Hollywood
and the medical profession, a relationship Kennys promotion of the RKO film
threatened to breach. During the 1930s and 1940s, American medical leaders
worked with the commercial movie industry to monitor and suppress inappropriate language and scenes.5 Hollywood producers sent early drafts of scripts
dealing with doctors and medical procedures to Morris Fishbein, the American
Medical Associations powerful general secretary and editor of the Journal of the
American Medical Association (JAMA), and usually took his advice.6 Since the 1910s
medical professionals and health educators, especially in public health departments and in groups like the National Tuberculosis Association and the
American Social Hygiene Association, had used films as educational and
fundraising tools.7 But it was the National Foundation for Infantile Paralysis
(NFIP), known popularly as the March of Dimes, that brought both the techniques and personnel of Hollywood to promotional filmmaking and made them

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an integral part of modern philanthropy. The NFIPs sophisticated publicity

department, relying on the donated skills of Hollywood directors and actors as
well as its own professional staff, produced dramatic and sentimental short films
shown as previews in commercial cinemas. These films featured such Hollywood
stars as Judy Garland and Mickey Rooney, urging audiences to support the NFIPs
March of Dimes campaigns, as, with the cooperation of Hollywood executives
and cinema owners, ushers with NFIP collection boxes walked down the aisles.8
The making of Sister Kenny complicates our view of relations between Hollywood
and the American medical establishment. Hollywoods portrayal of medical science and scientists in the 1930s and 1940s has been frequently taken as a marker
of the medical professions prestige and the cultural esteem of science, and as compelling evidence of what has been called the Golden Age of American medicine.9
Yet, as films become more common as sources in the writing of history, filmmaking is being newly interrogated. We need close attention to cinematic genre, technique, and iconography, and alsoas this case study suggeststo the complicated
process of filmmaking. While this 1946 film drew on Hollywood biopic conventions, it also dramatized a critical view of medical professionals and the workings
of scientific change. Here men in white are confronted by a woman in white,
flanked by a pathetic child victim whose tragedy is not solely paralysis from the disease but, unsettlingly, the paralyzing effect of orthodox therapy. Because Kenny
was a living medical celebrity, many of the movies viewers wrote to her, and their
letters enable us to hear what the film meant in their own lives and how it informed
their understandings of polio, health care, and medical authority. Clearly this is a
distinctive case and an unusual story. Yet it must also be considered part of the
shaping of mid-century American medicine, a process that involved patients who
saw themselves as medical consumers, who sometimes challenged the policies and
practices of organized medicinein this case, the professions cultural authority
and its qualification to define expertise and to judge evidence of scientific truth.
Talking about polio in the 1940s was to talk about money. The RKO film was
not just another Hollywood production, but was, like March of Dimes previews,
a weapon in the battle for the publics dimes. It became part of a debate over
what a film could and should do, what stories it should tell and how to tell them.
Kenny saw both Hollywood movies and technical documentaries as legitimate
means to amaze, persuade, convince, and convert. For her the boundaries
between a technical medical film and the drama of Hollywood were fluid; for
many doctors, however, such fluidity was the sign of an unscientific charlatan.
And in the film Sister Kenny, Hollywood, medicine, philanthropy, and unorthodox healing all came together. The films star, Rosalind Russell, raised money for
Kennys work; Kenny was feted at Hollywood cocktail parties; and screenwriters
constructed a saleable story about crippled children, muscle therapy, and a
middle-aged nurse through an awkward balance between sex and science. Thus,
Sister Kenny allows us a closer look at the overlapping worlds of the culture of
Hollywood, the power of American medicine, and the politics of filmmaking.

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Hollywood, Philanthropy, and Elizabeth Kenny

In the period spanning the Great Depression and World War II, a Hollywood
star was expected to boast not of beauty or talent but of a demonstrated commitment to some kind of good cause. Disease worked well, especially if the victims, such as crippled children, were both photogenic and pathetic. By the
1930s the care and rehabilitation of crippled children had become part of the
larger problem of polio, with epidemics growing more frequent and serious,
threatening large and small communities. Once seen as a disease of immigrants
and the poor, by the early 1940s (with even the U.S. president a survivor), polio
had become, as the NFIPs publicity proclaimed, everyones disease.10 Unlike
the many Societies for Crippled Children, which tended to be oriented to local
patient care and individual institutions, the NFIP, led by Franklin Roosevelts
former law partner Basil OConnor, developed a well-coordinated national program that paid for medical and rehabilitative care, braces, crutches, and iron
lungs, professional training in the latest polio techniques, and clinical and laboratory research on polio. With chapters around the country headed by prominent professionals and business leaders, and with Womens Divisions headed,
frequently, by their wives, the NFIP became a popular Hollywood charity.11
The NFIP depended on Hollywood, and Hollywood relied on the philanthropys reputation for helping crippled children receive the best care. It was a
balance that Elizabeth Kenny threatened. In 1940 Kenny had gone to the NFIPs
headquarters to seek support, and when she began teaching under the auspices
of the University of Minnesotas medical school, the NFIP had funded her work.
But in December 1942, Kenny left the medical school to establish her own organization: the Kenny Institute in Minneapolis. Resisting any effort to be categorized
as simply a nurse with technical skills, Kenny claimed that the efficacy of her
method provided the basis for a new concept of polio, in which deformities were
the result of not recognizing and treating muscle spasm, and in which the
poliovirus only temporarily disrupted pathways between nerve and muscles, not
destroyed them.12 She needed a place where she could not only teach and heal
but also, she hoped, attract scientific researchers to prove that her ideas were correct13 (see figure 7.1). The NFIP continued its policy of paying for any kind of
polio treatment if recommended by a physician, but refused to fund research at
the Kenny Institute, claiming that it was not equipped for proper scientific investigation.14 Relations between the NFIP and Kenny deteriorated. With the conflict
amplified by the sympathetic Hearst newspapers, Kenny threatened to leave the
country and began to claim that the NFIPs lack of support was harming children
everywhere by denying them the only effective polio treatment.15
In 1944, former silent picture star Mary Pickford, now a Hollywood producer,
heard these complaints. She wrote to Basil OConnor warning that, as national
chair of the NFIPs Womens Division, I am frankly deeply concerned and, personally, believe it is doing the Foundation irreparable injury. While on a hospital

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Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 7.1. Elizabeth Kenny examining a child in the acute stage of polio,
Minneapolis, (ca. 1943). Note that, unlike the physical therapists, Kenny is not
wearing a mask. Minnesota Historical Society.

tour, Pickford had noticed the Kenny method in use everywhere. Yet according to the local papers and letters from other members of the Womens Division,
the NFIP refused to fund the Kenny Institute, and although Sister Kenny has
been here [a] considerable time she has not been permitted to train even one
nurse in the Kenny treatment. A friend of Pickford had been told that she
would have to have two doctors present in order to have her twenty-month-old
nephew assessed by Kenny, evidence that seemed to Pickford to show that Kenny
was no quack but a sensitive professional who valued and trusted orthodox medical authority. Nonetheless, at a cocktail party they had both attended at the
Waldorf, Pickford reminded OConnor, Dr. Fishbein was very outspoken in his
criticism of her which surprised me greatly.16 Indeed, Fishbein had privately
told OConnor, she is, of course, an impossible person as far as concerns any
sensible conversation. I propose to have nothing further to do with her.17 As
Kennys attack on the NFIP gained public attention, Pickford recognized that it

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d e f i n i n g au t h e n t i c i t y, e x e r c i s i n g au t h o r i t y

was tainting the reputation of the charity she and her Hollywood friends publicly represented. Even if I were not connected with the Foundation I would be
profoundly upset by all this but, being Chairman of the Womens Division, you
can well understand my consternation. Do let me hear from you, Basil, as I do
not wish to answer these letters without knowing what to say or what you have in
mind concerning the Kenny situation.18 Pickfords letter was just one of many
warnings from the Hollywood community articulating the dangers of tangling
with a popular figure like Elizabeth Kenny whose accusations of discrimination
and medical elitism were gaining public credence.
By this time Kenny had become an active player in polio fundraising. She traveled around the country from one epidemic to another, spoke frequently to
the popular press, attracted celebrity patients like Australian-born Metropolitan
Opera singer Marjorie Lawrence, and had begun to organize her own Kenny
Foundation to raise money for her institute and her work. Through Mary
McCarthy, Kenny had already made her own Hollywood friends, and managed
to attract mostly Irish Catholic celebrities, including Bing Crosby, Kate Smith,
and Rosalind Russell, as patrons in her fundraising drives.19
Book-length versions of her life and work also gave Kenny publicity that combined entertainment and education. In 1943 Kenny published her autobiography And They Shall Walk (the story of her discovery of her method in the
isolated Australian bush), and in 1944 a version was serialized in the Hearst
Sunday supplement, the America Weekly, as God Is My Doctor.20 She also published The Kenny Concept of Infantile Paralysis and Its Treatment, a textbook full of
photographs and detailed instructions written with John Pohl, an orthopedic
surgeon in charge of the Infantile Paralysis Clinic at the Minneapolis General
Hospital.21 To the many people who wrote asking for help, Kenny replied that
she could not give advice by post but advised them to get a copy of her textbook and use it in consultation with their personal physician. Sometimes she
urged them to send a nurse, physical therapist, or physician from their local hospital to her Institute for training in the Kenny method.22
More than her books and press interviews, Kenny relied on film to promote
her work. Filmmaking had become an integral part of the practice of mid-twentieth
century medicine. Public health departments, hospitals, medical societies, and
charities all used films to educate and entertain students, patients, and staff, and
film companies discovered a small profitable market in medical films.23 In the
1930s, with the coming of sound and the expansion of the Hollywood studio system, film assumed a new standing in American culture. As commercial films
became big business, the public flocked to Hollywood extravaganzas presented
in plush theaters with chandeliers, padded seats, and attentive ushers.24
For Kenny, film was a powerful scientific medium. Not only could it demonstrate the achievements of her method, but, in her eyes, a technical film was a
form of scientific proof, a kind of virtual witnessing equivalent to the experiential persuasion conveyed by personal demonstrations.25 In Queensland, in the

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1930s, she had made a silent documentary of her Australian patients. In 1944,
with financial help from the Kenny Foundation and from Rosalind Russell, she
produced two sound films using patients from the Kenny Institute: an hour-anda-half film, The Kenny Concept of Infantile Paralysis, intended for medical audiences, and a twelve-minute film, The Value of a Life, which was, she told one
teacher, really more for the lay person.26 In The Kenny Concept, which showed,
she claimed, the results of my research, Kenny and her technicians demonstrate, in a mixture of drama and technical display, first, the disabling effects of
orthodox treatment, and then the disappearance of those disabling effects following Kenneys treatment.27 Here is Patty several months after attack of disease, began one story. She had not received treatment for the disturbance in
the peripheral structures. Some pathological changes have occurred. Stiffness is
marked and the shortening of the peripheral structure in the posterior limbs is
very evident. Spasm has done its deadly work. Kennys voice reiterates how her
methods can transform crippled young people into productive and useful citizens, an especially powerful argument during the Depression and the war. A girl
grows up and is able to walk down the aisle as a bride; a boy succeeds in business
and gains a promotion.28 This mixture of drama, tragedy, hope, and technical
skill impressed even her critics. In 1944, in an otherwise critical report, one
medical committee acknowledged that the educational film for physicians illustrating the Kenny Concept and Method, while spectacular and definitely of a
propaganda nature, was nevertheless persuasive and interesting, especially
with regard to . . . results accomplished by muscle reeducation.29
On occasion, sympathetic doctors tried to explain to Kenny how a technical
film should work, and how to present evidence to convince a scientific audience.
In May 1945, James E. Perkins asked for a copy of Kennys film so that he and
other New York State health officials could watch it in the departments private
viewing room to determine whether or not this Department should take an
active interest in promoting the showing of this film to various professional
groups in the future.30 In Perkinss subsequent assessment, the use of dramatic
cinematic conventions made The Kenny Concept of Infantile Paralysis untrustworthy as a medical film.31
After watching the film, Perkins wrote to Kenny and first praised those portions showing you at work at the bedside [which] make clear, as no amount of
printed matter can, your mastery of muscle anatomy and physiology, as well as
your understanding of the mental factors involved. But, he continued, there
are certain aspects of the film which I think are unfortunate and which I am sure
will hinder your cause rather than help it so far as the medical profession is concerned. He compared the personal testimonials the films narrator read to what
was missing: a clinical trial or other controlled study. Doctors, he warned, have
been burned so many times in the past through excess enthusiasm based on
insufficient and unscientific data . . . [and can be convinced] not through testimonials, but through critical study of carefully conducted and carefully

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controlled scientific study.32 At a hearing on the licensing of chiropractors in

the New York state legislature, for example, the most glowing and yet worthless
testimonials were presented . . . not by individuals of no reputation, but by such
individuals as a retired brigadier general, an Army nurse, a Rabbi, a Catholic
priest, and a Metropolitan opera star who were absolutely sincere, but their
conclusions completely erroneous. Eliminate those scenes when you compare
a group of your cases with a group of deformed patients treated some time ago
by orthodox methods, Perkins urged, because the comparison is open to the
very valid criticism that each group represents selected cases. Although I know
some of the above remarks will not be to your liking, he concluded, they have
been written in a friendly and constructive manner.33
Constructive, or even destructive criticism, is always helpful, Kennys
response began, rather disingenuously, noting that Perkinss criticisms of the
film were the only ones recorded up to date. The idea that testimonials were
not scientifically valid evidence was something Kenny never accepted; to her, a
witnesss qualifications made a medical claim more valid. The films did not use
testimonials from lay people, she explained to Perkins, but instead quoted
extracts from scientific papers and showed Kenny examining groups of patients
only in the presence of medical men. That a film should show the results of
any kind of clinical trial involving other methods of polio therapy appalled her;
she would reject any controlled study of a method of treatment that would condemn children to suffer pain.34 I started to answer the letter paragraph by
paragraph, but thought better of the idea, Perkins replied somewhat sadly; I
thought I probably would get about the sort of answer which I did. He continued to hope that Kenney would heed [his] advice, for, he believed, it will definitely help your cause and personally, I think your cause is worth helping,
adding in frustration, your difficulties arise principally from your complete lack
of conception of what is known as the scientific method, but that is simply that,
and I doubt there is anything anybody can do about it.35 As this public health
official sought to convey, making a medical film was not a matter of dramatically
comparing the good and bad; relying on popular cinematic styles could alienate
rather than convince a medical audience. By this time Kenny had begun to recognize that her technical films were not providing the kind of unambiguous evidence she sought, and such criticism made the Hollywood film more crucial
than ever.

Selling Sister Kenny

Sister Kenny took four years to make, from Mary McCarthys first screen proposal
to its premiere in Times Square. During this time, as her crusade gained broad
appeal, Kenny became a celebrity, featured in newsreels and honored by groups
ranging from Parents Magazine to the American Congress of Physical Therapy.36

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As a result, her Hollywood supporters were able to convince studio executives to

produce the film despite its controversial subject, and Kenny came to believe
that, with the proper guidance, the Hollywood production would simultaneously entertain and educate the public about the Kenny method.
In 1942, Kenny began staying in Los Angeles as the guest first of Mary
McCarthy and then Rosalind Russell (see figure 7.2). Her new friends drew
her into the Hollywood cycle of cocktail parties, dances, and luncheons; by
December 1942, at the dedication of her new institute, Kenny was already boasting to NFIP officials of the possibility of a Hollywood film of her life as she
accepted flowers from McCarthy and Russell and a very beautiful garland of red
roses from RKO Studios.37 All her life, Kenny loved Hollywood movies. While
running a clinic in Brisbane in the 1930s she had regularly popped out for an
afternoon show at the local Regents Theater, which later premiered the RKO
version of her life.38 Reveling in the cinemas fantasy and anonymity, Kenny did
the same in Minneapolis, and she and Mary Kenny McCracken, Kennys ward

Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 7.2. Mary McCarthy, Elizabeth Kenny, and Rosalind Russell, 1943.
Minnesota Historical Society.

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Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 7.3. Film-struck Aussies Mary Kenny and Elizabeth Kenny meet Cary
Grant, 1943. Minnesota Historical Society.

and assistant, were fascinated by the stars, the gossip, the fashion; they were, in
McCrackens words, two film-struck Aussies.39 (see figure 7.3) In 1992, when I
interviewed Mary McCracken, then in her seventies, she still glowed with the
memories of dancing with Cary Grant while Kenny was partnered by Basil
Rathbone, and the wonderful moment when Veronica Lake asked McCracken if
Kenny would give her an autograph.40
Kenny saw herself on a quest to ensure that the movie reflected her vision of
herself and her work. McCarthy had introduced her to Rosalind Russell, and
later, in a slightly joking way, Kenny told reporters that she approved of Russell
because she hasnt been divorced, for one thing. Their shared Irish Catholic
background may have been another reason Kenney approved of the casting
decision.41 Russell also shared Kennys view that the film should be very accurate.42 Studio publicity claimed that Russell did an intensive course in the
Kenny method, and had the nurses magic hand motions down pat.43 By the
end of 1943, Kenny had a contract that gave her control of the films technical
aspects, and in 1945, during the filming, she sent her trusted Kenny technician
Valerie Harvey to Hollywood as a consultant.44

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Rosalind Russell had many reasons for wanting to play Sister Kenny. In 1941,
Russell had finished a contract with MGM Studios and was working as a freelance
agent. Respected for her roles as a comic career woman in The Women (1939) and
His Girl Friday (1940), she also had received an Academy Award nomination for
My Sister Eileen (1942), but was looking for a serious winning role.45 By 1944
she had embraced Kennys cause and had become a member of the Kenny
Foundations board of directors; when Kenny identified and then healed a leg
deformity in Russells son, her faith in Kennys healing powers solidified.46
Russell saw her struggle to get the movie made as her own altruistic crusade.
Her experiences, I realized, were medical historyin our time, she later told
reporters. I was determined to put her story on the screen, even though a film
about crippled children didnt sound like box office to the movie magnates.47
Russell supposedly hounded RKO executive Charles Koerner, who would say
Oh, please, Rosalind, not that story about the nurse, but finally agreed to take
a chance if you star, and if she would do two other films for RKO.48 But one danger of turning the movie into a crusade was that others could use any delay
against her. In 1944, when shooting was delayed by Russells other film commitments and by her nervous breakdown after the birth of her son, powerful gossip
columnist Hedda Hopper began to speculate in print whether Russell was committed to the project which may save thousands of little children from being
crippled for life.49 Kennys telegram retorting that Hopper was very much misinformed with regard to Rosalind Russells attitude toward the picture, and that
Russell has promoted my work ten times more than other individual in
America, was reported in Hollywood gossip columns by both Hopper and
Louella Parsons.50 But in private Kenny hated the delay in production, and
asked McCarthy in rhetorical frustration, Is there not a studio in Hollywood
that understands the pleadings of the heart of the nation? And is there not a star
with sufficient pity in her heart who will attempt to help to take this message to
the medical men who are anxiously awaiting it and to the mothers and fathers
who are praying for it?51
Russell introduced Kenny to Dudley Nichols, a screenwriter who was interested in directing. Nichols had worked with John Ford on Stagecoach (1939) and
The Informer (1935)for which he had won an Academy Awardand had also
written comedies like Bringing up Baby (1938) and The Bells of St Marys (1945).
In public, at least, his involvement in the project became another story of conversion: a skeptical Hollywood professional who committed only after visiting
Kennys institute and seeing her work.52 In a more pragmatic bargain, Nichols
told Russell he would direct and produce Sister Kenny if Russell would star in his
next big project, a screen version of Eugene ONeills Mourning Becomes Electra.
Both Nichols films won Russell Academy Award nominations but not statuettes,
and both were commercial failures.53
Crippled children and a middle-aged nurse did not sound like the stuff of
a Hollywood hit. Although polio was not a socially unacceptable disease like

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syphilis, putting the disabled on screen could make a film seem too close to
RKOs horror film department or to medical teaching films.54 RKO executives
told McCarthy there were entirely too many scenes . . . dealing with the Kenny
method, and advisors at the Selznick Agency thought it would be nothing but
a dull and rather clinical portrayal of hospitals, etc.55 Further, Kennys medical
claims drew the film into the kind of controversy that Hollywood tended to
avoid. But Kenny was confident that the transcendent appeal of healing had
commercial value as well. You should not worry so much about the script,
Kenny reassured McCarthy, I think if you just keep in mind that this picture is
intended to give a message to the mothers of mankind throughout the world
and is advertised as such, the box [office] possibilities shall be taken care of
before it starts . . . You may remember that is what I told the RKO people at the
luncheon, and they seemed pleased. You know men always preen themselves
when they think they are acting big toward the world.56
As the head of her institute and fundraising foundation, Elizabeth Kenny
could not appear too eager to embrace Hollywood, for a true scientific discoverer, it was assumed, would be suspicious of its glamorous, scandal-ridden culture.57 Thus, Kenny and her allies were careful to have her appear initially
unenthusiastic about the idea of a Hollywood film of her life. As McCarthy told
the story in her first film proposal, the eager screenwriter had contacted Kenny
by telegram, but Kenny had wired back and told her to stay where she was, that
she had no time for the movies. And even after Kenny had reluctantly agreed to
be interviewed, McCarthy claimed, I spent five days with her . . . trying to pry the
dramatic story of her life out of her.58 In fact, Kenny had boasted to McCarthy a
few months after they met that, when her autobiography was published, there
wont [sic] be too many studios who would not desire to film the story.59
A scientific hero also had to appear to be unworldly in matters of money.
Kenny frequently told reporters she received no salary, and devoted her life to
patient care, and her autobiography, one commentator noted, offered a highly
romantic and dramatic picture of a lowly life of sacrifice.60 Similarly, according
to McCarthys initial proposal, Kenny had not received a single cent for all the
magnificent work she was doing. Moreover, she had beggared herself through
the years by donating her own money for the care of countless children . . . In
fact, on many occasions, Elizabeth had had to fight a very touching and very feminine battle with her own conscience. She dearly loved those big black hats, you
know . . . and manys the time she had to choose between buying a new hat with
a grand feather on it and buying something sorely needed by her young
charges.61 Thus, there was no hint in any of the scripts of the benefits Kenny
had gained from grateful, wealthy patients: her regular suite at New Yorks
Waldorf Astoria, or the lovely house in Minneapolis that local businessmen provided for her. While reporters commented on the large payment Kenny had
received from RKO for the rights to her autobiography ($50,000 according to
some sources), they usually added that it had been all donated to her institute,

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or, in one account, put in trust for her seventeen nephews who were all in the
Australian air force.62

Sex, Science and Sacrifice

From the outset, then, the film was intended to convey a story of struggle and
sacrifice, with its central character devoted and altruistic. There was little of
Elizabeth Kennys temper, her sharp tongue, or her antagonism to the medical
establishment. Instead, the film was to be a teaching instrument, converting as
it entertained. This picture will have the rare combination of wit and pathos,
Kenny explained to McCarthy, and also a message of healing which has not yet
been combined in anything in the film world that I know of.63
Studio executives, however, were not convinced that McCarthy had written a
commercial enough script, and in 1943, RKO hired Milton L. Gunzberg, a more
experienced screenwriter. He and McCarthy began to try to construct a different kind of woman in white, whose life, while focused around healing crippled
children, also included love and romance.
McCarthys original proposal had framed the story as a stirring saga of a
fighter who battled against odds . . . [with] complete unselfishness. Gunzberg
disagreed, telling her, Baby, this is a love story! Rich, full and warm!64 In each
version of the script a romance between Kenny and a local rancher (Dan, later
Larry, and then Kevin) became more central. Personally, I think there is too
much Dan Cunningham and, I may also say, rapturous kissing which is not
Elizabeth Kenny, Kenny told McCarthy after reading one draft.65 But the sex
stayed. When Kenny visited the set during the filming of the scene where the
rancher surprises her character in the pantry and then a plate drops from
behind the pantry door, Kenny, supposedly shocked, said I wasnt that kind of
a girl.66
In typical Hollywood fashion, Kenny is forced to choose between professional
success and personal happiness. She finally chooses helping the worlds children
over having her own, or as McCarthy put it at a fundraising luncheon in Los
Angeles in 1943: Many times Elizabeth Kenny decided to give upto run away
from persecution and ridiculeand go back to the life which, as a young girl,
she had dreamed would be hers. She had wanted nothing more of life than to
marry and have children and own a string of fine horses.67 The tragic tone of
the films ending reinforced the idea of Kennys sacrifice. Kenny stands at the
front gates of her institute, lonely and unhappy, having faced the death of her
oldest medical supporter and a rejection by yet another medical committee.
Suddenly a flock of happy children (former patients) come running to greet her
singing Happy Birthday. It is a poignant scene, but hardly a sign of uplifting
success, and when Kenny first learned about the ending she sent an angry
telegram to RKO Studios stating that the object of the picture to convey to all

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mankind the message of healing has failed, for the end conveys a message of
defeat. She demanded that RKO not release the picture without a more positive ending, otherwise it would not be my life. After speaking to Russell and
Valerie Harvey, however, she wired again to say, I am willing to take their verdict that the ending of the film was satisfactory.68
Kennys character drew on both the feisty independent professional woman
typical of 1930s Hollywood films (including Rosalind Russells), and the harsher
(often tragic) stories of such women in post-war films, like Joan Crawford in
Mildred Pierce (1945). The writers carefully tempered Kennys fierce devotion to
her cause with a sympathetic femininity.69 In McCarthys 1943 script, Kenny first
appears as a sixteen-year-old tall, thin, gangling girl with black hair, eyes
always alive with merriment, a tempestuous mouth and a chin that wont back
down for anything.70 When she is forced by a medical emergency to break a
date with her fianc, still wearing her evening gown with its beautiful long white
satin train, she mounted her horse and rode off to the sick children.71
The gender relations in the film are stark: all the nurses and technicians are
women, all the doctors are men, and all the patients are children.72 Never straying far from the path of the good nurse, Kenny is soft-spoken with patients and
defiant but not disrespectful with doctors. A Hollywood nurse was usually a
clever, supportive assistant whose innocent insight aids the more brilliant male
scientist or doctor, but a few films had gone beyond the nurse-handmaiden
approach: Kay Francis as Florence Nightingale in Warner Bros. The White Angel
(1936) and Anna Neagle in RKOs Nurse Edith Cavell (1939); and the military
nurse dramas MGMs Cry Havoc (1943) and Paramounts So Proudly We Hail
(1943).73 Perhaps the success of MGMs Madame Curie (1943) also explained
RKOs willingness to stretch the conventions of commercial film storytelling,
and allow Kenny to be portrayed not only as a healing nurse but also as a scientific innovator, challenging physicians to accept her concept of the disease in
ways similar to the cantankerous scientific heroes featured in Paul de Kruifs
popular science books.74 When a Kenny opponent claims near the end of the
film that because instead of aiding physicians you have the arrogance to try to
teach [them] . . . in the opinion of many doctors you are no longer a nurse,
audiences have already been assured that Kennys dedication and self-sacrifice
refute any such accusation, as Kennys character responds, not too bitterly,
I have given up too much to wear this nurses uniform.
McCarthy and Gunzberg had planned to dramatize one of the few class conflicts alluded to in Kennys autobiography through the figure of Lady Latham,
seen by McCarthy as a parody of a female British aristocrat with three chins, a
lorgnette and a nose perpetually pointed upward in disapproval.75 In one script
version McCarthy made Latham a trustee of the Toowomba Nurses Home,
where Kenny is just finishing her training. Elizabeth Kenny may be a good
nurse, but she must be taught to keep her place, Latham announces; her offduty clothes are too frivolous and beyond her station in life. No good

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Australian has any patience with that station in life nonsense, young Kenny
retorts. We nurses resent people who give money to hospitals just for their own
personal glory and amusement. Laymen should consider it a privilege to give
such checks, but, after giving them, they should go away quickly and permit
experts to run the affairs of the sick.76 Gunzberg at first liked this character,
adding this was not to be the first nor the last society woman to become peeved
when Kenny refused to permit them to bask in the sunshine of her career at
[the] expense of her treatment.77 But because wealthy women like Latham
loomed larger in Elizabeth Kennys real-life fundraising efforts, the character
was dropped, as was any depiction of Kenny as an Australian naf, despite
Gunzbergs earlier sense that the mere thought of Kenny in Manhattan offers
comedy situations.78
The final film offered a safely domesticated story of scientific discovery.79 Playing
on the public perception that scientific progress (like Alexander Flemings penicillin) occurs by accident, Kennys new understanding of polio is portrayed as
coming from her heart and from her clinical experience. Kennys character succeeds in healing a child paralyzed by polio because she does not understand the
disease and is thus free from the constraints of any orthodox medical knowledge. Her hands, her knowledge of sick bodies, and her ability to use tools of
the domestic environment such as strips of blanket and hot water, augment her
natural understanding of healing. In McCarthys words, she succeeds using
nothing but her shrewd eyes and her common sense, plus her great knowledge
of the muscular system.80 Her skills, empathy, and intelligence allow her to go
beyond medical orthodoxy without ever faltering or changing her mind; or, as a
reviewer in Brisbanes Courier Mail asked after the films Australian premiere,
couldnt she be wrong, once?81
The screenwriters struggled with ways to show how Kenny convinced her medical opponents. In her autobiography, Kenny had distinguished between doctors
with the heart of a true physician and those who have eyes but see not.82
McCarthy tried dramatizing professional conversion by combining it with the
emotional trauma of confronting a childs illness. In the first script, a European
specialist initially dismisses Kennys work, but, after his daughter becomes sick,
recants and begs for her help. When he sees his daughter walking again, he is,
McCarthy explained, no longer an eminent scientist . . . just a father who was
unashamed to weep.83 McCarthy also suggested making Kennys fianc a medical student who did not want his wife to work as a nurse, and who, as a doctor,
rejected her ideas. But, after he moves to America, marries another, and has a
little girl with polio, this time they are no longer opponents. A helpless Larry is
begging his Liz to use her derided system to cure his child. The possibilities,
McCarthy pointed out to Gunzberg, of this sort of set-up are obvious.84 In both
examples it is only when male doctors are weakened and helpless, forced to
resort to such feminized means as weeping and begging, that they are able to
appreciate Kennys skills.

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Gunzbergs first script had tried to dramatize a mass professional conversion,

with Kenny received by President Roosevelt at a March of Dimes ball or appearing at an AMA convention where she is acclaimed the greatest living medical figure of this generation.85 But by the mid-1940s, while Kenny had met
Rooseveltalthough at a White House lunch, not a ball, and with Basil
OConnor as a prominent third guestand leaders of the AMA had adopted
her work but without her theory, it was clear the battle between Kenny and the
medical profession was too intense and well known for such a scene to be believable. Indeed, believability was a key aim for the film, which maintained a sense
of cinematic documentation, reinforced by old-fashioned clothes and other cinematic tricks that set off the film in a special time as well as place. Reviewers
were largely convinced that the story was true; one called it a straightforward
dramatization. And the movie was promoted by signs flashing BIG! TRUE!
THRILLING!86
In the final film the dichotomy between right and wrong is exemplified by
the two central male physicians.87 Aeneas McDonnell, played by Canadian character actor Alexander Knox, is the rural general practitioner, a man of the people who, in the words of one reviewer, speaks with a fine, thick Scotch burr and
looks on Miss Russell as the greatest thing in medicine since Pasteur.88 The
contemptuous Brisbane orthopedic specialist Dr. Brack was played by Philip
Merivale, a British actor speaking in a cultured accent, and is carefully presented as neither irrational nor evil.89 Gunzberg had at first wanted to dramatize an episode from Kennys autobiography where a medical antagonist steals
her manuscript and tries to publish it under his own name. To balance this
picture of a bad doctor, Gunzberg was willing to make Kenny more angry,
explaining to McCarthy: in justice to the medical profession, as well as to the
humanization of Kenny, we have established that her temper was responsible
for some of the misunderstandings and prejudices against her.90 But in the
final film, Brack is no thief and Kenny shows exasperation and despair, but not
anger.
From the outset, Brack doubts Kennys claims and her evidence that her
methods work. He dismisses her first healed patient, saying, that girl didnt
have polio. Meanwhile, the film lingers on one of Kennys patients (child actor
Doreen McCann) turning cartwheels, while Bracks own patient, a small boy in
braces and crutches, watches morosely. Like Kennys technical films, this juxtaposition of healed and crippled children was used to dramatize the dangers of
orthodox care. Indeed, in October 1945 the RKO producers had borrowed The
Kenny Concept of Infantile Paralysis to use shots of some of her patients.91
Simultaneously the Kenny Foundation requested extracts from the Hollywood
film in process for a fundraising trailer, and announced proudly that all the
child actors except for McCann were cured patients from the Kenny Institute.92
In response, the NFIP made sure its chapters knew that David Martinson, the
boy in the cartwheel scene, had spina bifida, not polio.93

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In the final films most dramatic scene, based on an episode in Kennys autobiography, Kenny confronts Brack while he is lecturing in a Brisbane hospital
amphitheater to a group of nurses and doctors on the virtues of splinting.94 A
polite middle-aged Kenny, simmering with frustration, interrupts Brack, asking
him why he refuses to meet with her, and why he has colluded with the city
health authorities to close her clinic. Although Brack tells Kenny that, as openminded men of science we do not reject ideas without examination, he dismisses her, saying her words are not scientific terms. Kenny replies, the words
I use describe the things I see. When Brack asks her why doctors do not see
them, she says, because youve got a book in front of your eyes, and turns to
Bracks audience to remind them that medical ideas change: your fathers bled
their patients.95 Throughout the scene a patient lies at the center, fully encased
in splints, and when Brack warns Kenny, not in front of the patient, Kenny
retorts, its his life, not yours or mine.96
In 1947, just before the films premiere in Australia, Queenslands state censor threatened to cut this scene, claiming it was not authentic, but Charles
Chuter, a state civil servant and long-time Kenny supporter, prevented this,
arguing: This scene is, in my opinion, the great scene in the picture. It focuses
and crystallizes the issue fought over many years and in many countries. The
brave nurse forces her way into the teaching citadel and fights out the issue.
Dr. Brack portrays the concept [and] attitude of traditional medicine admirably
and accurately.97 Members of Brisbanes medical elite, who had long disliked
Kenny, promised that when the Hollywood film was shown, pamphlets attacking Sister Kennys treatment of infantile paralysis will be sold to theatre
audiences.98
Up to the last minute, RKO was uncertain about the balance between the film
as love story and as a biopic featuring a controversial conqueror of a dread disease. During the summer of 1946, RKO previewed the almost completed film
five times: to bobbysoxers in San Francisco, shipyard workers in Oakland,
high types in Burlingame, Mexicans in Indio, and a mixed group in downtown
Los Angeles. According to a letter by Russell to Kenny supporter Jim Henry, published in the Minneapolis Star-Journal, the people love the picture. They pull for
Kenny like mad . . . [and are] ONLY interested in the polio part of the story.
That amazed us so that the love story will be cut quite a bit. It still runs through
the picture, but the polio part of the story predominates and you can hear a pin
drop during the medical portion of the film.99 Nonetheless it was the love story
that appeared in RKO posters and magazine advertisements. Russell stood in a
bridal gown (never shown in the film) under the heading The wedding gown
that waited with the caption Tucked away in a cedar chest for half a lifetime by
a courageous nurse who wanted desperately to wear it . . . but wanted even more
to help children walk again.100 In another poster Russell faced Brack with the
words She won FAME . . . but lost LOVE!101 For a Hollywood woman to succeed in the world of medical science she had to sacrifice everything else.

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Raising Hope, Making Heroes

The NFIP had always paid close attention to any movies about polio. In 1944,
the B-studio Monogram produced They Shall Have Faith (later renamed Forever
Yours), the story of a doctors daughter (played by Gale Storm) paralyzed by
polio, who defies her fathers old-fashioned splinting methods and is healed by
the experimental treatment of army surgeon Tex OConnor (played by Johnny
Mack Brown). Should his Minneapolis chapter sponsor this film, Frank Higgins
asked the New York headquarters, or Would we be getting into something that
would lead us into a controversy with doctors or the Kenny people?102 The
films producers had already asked the NFIPs Los Angeles chapter to give
them our blessing and, in order not to offend the producing company, the
chapter had arranged to have a preview of the picture.103 Even before the movie
was distributed, the NFIPs public relations staff had read a copy of the films
script, reporting that it was a fair picture, a bit on the lean side, and that
lines like How these doctors hate to discard their old textbooks for new ones
might be picked up by certain people and magnified out of all proportion.
The staff concluded that polio was hardly central to the plot: the film uses
infantile paralysis as simply a peg on which to hang the usual Hollywood
romance (spoiled heiress and stalwart medico) and for all the difference it
makes the girl victim could have been suffering from any other dread disease,
or even a broken leg.104 Still, Higgins was advised not to sponsor the film, for
the picture will do no damage but is the type of thing which we should have
no part of.105
RKOs Sister Kenny was different. Not only was polio central to the plot, but
there was an explicit discussion of medical orthodoxy, and the doctors who disagreed with Kennys ideas were leaving children deformed. Elizabeth Kenny
made the film her personal triumph, flew to New York to attend its premiere,
and spoke at a gathering of New Yorks social elite at the Waldorf Astoria, where
she was presented with a large book of photographs commemorating the
movie106 (see figure 7.4). To balance Kennys embrace of the glamorous movie
world, Russell told reporters a few weeks later that she had called Kenny to tell
her the film was a hit, and found the tireless humanitarian . . . [at] a busy polio
clinic in the same little bush town where the film began.107
Although the film did not do well at the box office, audiences and many film
critics liked it. In November 1946, the National Screen Council, comprised of
local motion picture committees, gave the film that months Blue Ribbon Award
for family entertainment, even though its average gross was lower than usual
award choices.108 Howard Barnes of the New York Tribune called it a fascinating
documentation of a ceaseless and stirring medical struggle, and Archer
Winston of the New York Post, while commenting that it should not be taken as
scientific gospel, found it a fine example of the semi-documentary film which
is both entertaining and significant.109

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Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 7.4. Elizabeth Kenny reading the special promotional book prepared by
RKO for the New York City premier of Sister Kenny, 1946. (Private McCracken
Collection, Caloundra, Queensland, Australia).

From the outset the film became part of the battle for the American publics
faith in medical authority and polio expertise. James E. Hullett, Jr., a young sociologist at the University of Illinois, decided that the movie provided the perfect
research subject to follow the conflict between scientific medicine and the
Kenny group as it affects the attitudes of the public.110 Questions about whether

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the NFIP had an unjust and harmful polio monopoly were debated by Elizabeth
Kenny, NFIP officials, film critics, medical journal editors, and gossip columnists. When Ed Sullivan in his syndicated column Little Old New York came
out on Kennys side in October 1946, the editor of New York Medicine called
Sullivan a romantic partisan and Kenny tragically egotistical. Sullivan responded
that she has the method; the National Foundation has the money! Basil
OConnor wont give her the money, wont even sit down with her although he
is only the custodian of public funds. That is the tragic issue, gentlemen!111 In
the Los Angeles Examiner, Louella Parsons praised Russell, who gives the greatest
performance of her life, which was, she explained, gratifying because I personally know all about the long and bitter fight she waged to win the chance to
make this picture. Just how the orthopedic men will feel, I dont know. Some
of them accept Sister Kennys treatment; others are diametrically opposed to any
but the old way of treating the disease. I have no intention of getting into the
argument only to say that this is a good picture and you must see it.112
Finally in January 1947 the NFIP issued counter-publicity in the form of a
thirteen-page statement on The Kenny Question. The recent film depicting the
life of the Australian nurse, Elizabeth Kenny, has raised a number of questions
with respect to the relationship of the National Foundation . . . and Miss Kenny.
The questions indicate . . . a slight confusion in the public mind as to the present status of the Kenny method of treatment. Thus we welcome an opportunity
to clarify the situation. Doctors had accepted her method and most now practiced a modified version, the pamphlet explained; moreover, March of Dimes
money was available for any polio treatment prescribed by a doctor, including at
the Kenny Institute. It was Kennys concept of the disease that doctors rejected.
True scientists, the pamphlet told its readers, are willing to follow any clue,
any lead that seems to promise new discoveries. They merely are unwilling to disbelieve the evidence of many competent investigations and reports already
made, though less publicized than the Kenny concept among laymen.113 The
film thus became a sign of Kennys inappropriate use of publicity to try to persuade patients and doctors, a technique only a quack would resort to. Reflecting
the successful use of publicity around the film by its competitor, the Kenny
Foundation, the head of NFIP public relations sent a memo to all chapters
explaining that our policy will continue to be based on the fact that this is a free
country and anyone who wants to run a campaign is entitled to do so. Our job
is not to complain about others but rather to sell our services, and if well all
buckle down to organizing a good campaign in 1947 there will be nothing to
worry about.114
Theater managers, uneasy about the films anti-doctor tone, were advised by
their trade journals to draw attention to the performance of Rosalind Russell
and to the name of Sister Kenny . . . [and] to avoid the controversial aspect of the
Sister Kenny vs. the medical profession fight.115 But many medical societies
delighted in the controversy and reprinted the films most critical lay reviews as

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a way of attacking both Kenny and also journalists who preferred fantastical
drama to the less exciting, scientifically proven truth. We would suggest a few
movies, books, and magazine articles portraying the heartaches, the emotional
catastrophes which every reputable physician encounters as counsellor in the
ultimate facing of the bitter truth by those whose hopes have been falsely
aroused, suggested the editor of the Westchester Medical Bulletin. Referring implicitly to the Hearst papers support of both Kenny and anti-vivisectionists, the editor continued, Let those who have in their control the tremendously powerful
media for moulding the thinking of the masses through press, radio and motion
picture screen realize and live up to their great educational responsibility!116 Too
many journalists prefer the drama usually associated with medical discoveries
made by those other than physicians, Morris Fishbein similarly reflected in the
section of his 1969 autobiography that dealt with Kenny. Here was apparently,
as most of the press liked to portray, another unprofessional investigator and discoverer being denied and overwhelmed by medical authority.117
Fishbein, and most of the films critics, tended to portray the lay public as a
passive audience, easily swayed by this populist attack on not just polio orthodoxy but medical orthodoxy.118 Such fears explained the decision by the hospital
staff of the Poliomyelitis Hospital of Caracas to refuse to allow the film to be
used as a fundraiser, for its attacks on orthopedists and standard polio care
might create in [the] Venezuelan public, confusion and a false view of the treatment of polio.119 Eileen Creelman of the New York Sun warned that the film
might keep people from accepting the standard methods, for whether Sister
Kenny will do harm or good is not for the layman to decide. Time magazine
made a list of the films most outstanding distortions.120
The sanctification of Elizabeth Kenny also disturbed critics. Making a medical
figure more heroic than life was, of course, a standard part of the Hollywood
biopic.121 However, the idea of producing a film about a living person whose
noble accomplishmentsunlike the work of Emile Zola, Marie Curie, and
Louis Pasteurhad not yet been established in history . . . had social and moral
perils, warned Bosley Crowther, the leading film reviewer for the New York
Times.122 When Florence Fisher Perry attacked the film in the Pittsburgh Press as
misrepresenting the medical profession in a manner shocking to those who
hold it in high regard, she received a sharp rebuke from many, many readers.
Perry dismissed this populist outburst as a result of the Kenny Foundations
propaganda, which had created millions of disciples who sincerely believe that
she has been a martyr to persecution.123
Both the films sanctification of Kenny and its harsh dichotomy between medical right and wrong were at the heart of film critic John McCartens review,
Experiment Perilous, in the New Yorker. The business of treating Miss Kennys
clinics with the kind of reverence that suggests the miracles of Lourdes is obviously dangerous, he argued. There is in this picture no hint that Miss Kenny is
fallible. Her patients, one and all, are represented as being completely cured,

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whereas the patients of physicians unwilling to subscribe in toto to her ideas are
uniformly revealed to be hopelessly warped and twisted. Its
enthusiastic attack on the medical profession . . . [ends up in] the peculiar position of
arguing that too much knowledge is a dangerous thing for a physician . . . [with] such
lines as The people are more important than the system, a clich which, when translated to make it apply in this case, means that the people know more about infantile
paralysis than the men attempting to cure it.124

Kenny herself was aware of the danger of claiming miracle cures, and in the
script for one of her own promotional films, the narrator emphasized that the
Kenny Institute was a serious scientific place. These are not miracles . . . They
are the results of a scientific method of polio treatment, proven over the years,
and applied under the supervision of competent physicians, by Kenny technicians and Kenny students. Tireless workers with no thought for themselves.125

The Public Responds

After the RKO movie was distributed, letters poured into the Kenny Institute.
The film, seen as the dramatized true story of a great figure who could heal the
crippled and who understood polio better than doctors, convinced many
Americans that Kenny was a polio expert and probably a miracle worker as well.
Writers variously interpreted her work as Hollywood legend, as medical
resource, and sometimes as generalizable to other disabling diseases like multiple sclerosis or osteomyelitis.126 She was a preferable alternative to a doctor,
partly for her skills and partly for her empathy for the suffering, as shown by her
personal sacrifices on the silver screen (see figure 7.5).
A few viewers wrote as movie buffs. S. M. Bollinger of Thibedaux, Louisiana,
asked Kenny for the name of the book, the play or story, and the name of the
publisher so we may be able to get the story in printed form.127 Virginia Hall of
Jackson, Mississippi, knew Rosalind Russell played the part of when you were
young but wondered if Kenny had played the last part of where you were older
. . . any[-]way loved you from the time you got older right to the end.128
Paralyzed forty-nine years earlier, Ray Pospisil of Miami, Florida, saw Kennys
work as a medical resource, explaining, I saw the moving picture of you treating the infintile [sic] paralysis with hot packs that gave me a new idea how to
treat my paralysis. He asked please send me the book so I can get well.129
Some felt the film confirmed their doubts, not just about an individual doctor
but also about the whole orthodox profession. With a daughter always in pain,
Mrs. H. P. Schoening of Allegan, Michigan, was so happy that you have told the
truth about so many doctors and how many people have been cripple[d] for life
from Polio, through so many doctors. It had taken nine doctors to make a

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Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 7.5. The Story of The Wedding Gown that waited RKO billboard,
Times Square, 1946. (Private McCracken Collection, Caloundra, Queensland,
Australia).

diagnosis of osteomyelitis and the doctors even went so far as to tell us it was a
mental condition.130 Leon A. Colton of Milwaukee admitted, I do not go to
shows very often, and do not care much for them but this one I stayed awake.
He had no doubt that he and Kenny agreed on the flaws of organized medicine.
I have know[n] for some time that Doctors of today could not live under the

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present system, if everybody were well. So it is the duty of a Dr. not to make you
well, and not to kill you, but to prolong your life as long as possible so as to give
the Dr. a meal ticket . . . I am for you and with you in this work 100% & wish you
much luck & success.131
Just as NFIP officials had feared, writers appealed to Kenny as healer and medical consultant. Responding to the films unsympathetic portrayal of surgeon
Brack, many saw Kennys method as a promising alternative to orthopedic surgery. Alda Cononna of River Edge, New Jersey, paralyzed by polio since 1939,
had become interested in the Kenny method since seeing the movie. Her doctor had urged her to have an operation, but she first wanted to try the Kenny
treatment and have your personal advice about it.132 Others like Helen E.
Sente of Hastings-on-Hudson, New York, had had a number of operations, and
would still go throu[gh] more if there was ever the slightest hope of getting rid
of one brace. Paralyzed by polio during the 1916 epidemic, Sente thought the
picture of your life . . . was to[o] wonderful for words . . . You certainly have
given a lot to humanity. She was also willing to be part of any scientific research.
I know it is asking a lot after all these years, but I do believe in mericals [sic]
and am will[ing] to be a human guinea pig if I may use that expression . . . Ive
had a lot of disappointments in my life, so please dont hesitate to give me your
honest opinion.133
Kenny became a diagnostician and, to many, a last hope. Mrs. Gerald Howard
of Ladysmith, Wisconsin, whose sixteen-year-old daughters leg had been paralyzed since she was seven, told Kenny, I recently saw your motion picture (I feel
its yours cause it seems so like you . . .). Ive never seen a picture that moved me
as much as it did . . . People realize more about your work & the wonderful things
youve doing by seeing it. Ill never forget it. Howard wondered if her daughter
might regain the use of her leg a little . . . if you could just tell me whether there
was hope for her or not. I would be satisfied with your diagnosis.134 A woman
whose eleven-year-old granddaughter had polio explained that last evening
Georgia Lee asked me please to write to Sister Kenny. The grandmother had
read Kennys autobiography twice and seen the movie production. She
enclosed a snapshot, adding, Your will and courage are very great, beyond words
to express them. Unusually, Kennys secretary suggested that Georgia Lees personal physician contact Kenny, giving some history of the case.135
Kennys experiences depicted in the movie made many writers sure that she
would have special empathy as well as knowledge, as this heart-wrenching yet
unsentimental single letter suggests. Arthur, the son of Mrs. Mary Cavallaro of
Brooklyn, had been paralyzed by polio in 1944. He spent four months in the
St. Charles Hospital and then was sent home and told to use therapy daily to
stretch his foot. His mother took him to another doctor who suggested a stretching with instruments and his leg in a cast for 6 weeks but our doctor disagreed,
warning that his foot might deform and then require an operation. Last night I
saw your picture, Cavallaro told Kenny, and after seeing what you gave up to

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help the children, I knew I had to write to you. She had thought her son
accepted his brace, but last week I heard him cry for the first time because he
cant go skating. I hear that cry in my head day and night and it[]s almost driving me crazy. She believed Kenny could advise her on what medical option to
follow: if you tell me its all right to do that, Ill do it because I have a lot of faith
in you. Because to me, you are like a God. Cavallaros friends told her she was
crazy, and that you wouldnt help me or see my son, but I feel different . . .
after seeing your picture and reading about your work youve done with children
with braces and corsets, I think you can make my son well. In a combination of
a bargain and a plea, she promised, Sister Kenny, if you do this, so help me God,
Ill do anything in my power to help you in any way. Ill even help your fight
against those Doctors who still dont believe in you . . . Hes the only child I have and
everytime I watch him walk a nail go[es] through my heart deeper and deeper.136
Kennys own reaction to the film was intense, positive, and defensive. In
September 1946, Life magazine presented a typically fulsome story on the film
as its movie of the week, but added a brief commentary from New York pediatrician Philip Stimson. Stimson, a strong Kenny supporter since the early 1940s,
praised the Kenny method, but noted the similarities between Kenny and many
orthopedists, and reminded readers that the best treatment of polio involves
the services of many experts.137 Kenny was furious. In the angry tone she often
used when those she considered converts recanted, she told reporters that Dr.
Stimson knew nothing about the early treatment except what I taught him, and
theres still quite a bit he doesnt know. You are entirely in the wrong if you
think that any presentation in the entertainment picture can do harm, Kenny
told him privately. Showing a mother what to do for a child in agony was of
world wide importance.138 Stimson, deeply distressed, wrote asking for a public
apology for this belittling of my professional qualifications.139 But Kenny
ignored his plea and instead grandly reiterated the reasons she felt so embattled: May I be pardoned if I say that the National Foundation for Infantile
Paralysis and certain members of the American Medical Association have shown
a very poor spirit of gratitude for these priceless gifts and have remained cruelly
silent [when] inaccurate and untruthful statements have been published in
medical journals.140 The Hollywood film had become part of her work to be
defended as strongly as her clinics, textbooks, or technicians.

Conclusion: A Message to the Mothers of Mankind

When Elizabeth Kenny came to Washington in May 1948 to testify before a congressional committee debating the establishment of the National Science
Foundation, she brought her film The Kenny Concept of Infantile Paralysis. She
showed it to the committee and included its transcript in her testimony. In all
my experience on this committee, chairman Charles Wolverton told Kenny on

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the second day of the hearings, you have had more photographers interested
in taking your picture than any witness we have ever had before the committee.141 She had become a celebrity witness, and even her opponents acknowledged her polio contributions. It would be difficult today to find any institution
in the United States taking care of acute poliomyelitis, the NFIPs medical
director remarked during the hearings, that is not using some form of heat,
physical therapy, and most of the concepts of treatment that were advocated and
are advocated by Miss Kenny.142
It was RKOs Sister Kenny that had enabled Kenny to claim both celebrity status
and medical respect. In a familiar mix of propaganda, pedagogy, and sentimentality, the 1946 Hollywood film had provided dramatized evidence to demonstrate the veracity of Kennys claims. In its carefully constructed portrayal of
Kenny as heroic nursealtruistic, skilled, almost saintly, and never mistaken
the film was designed to establish her authority, or at least remind audiences
who the polio expert was, and who was in error. Kenny had wanted the movie to
provide enough technical information about her method to aid the mothers of
mankind, but even more to impress doctors with the dramatic transformation
of patients from crippled to healed, and to convert medical figures from skeptics to believers.
The films critical message about the medical establishment (pitting generalists with good hearts against narrow-minded elitist specialists) was a provocative
move away from the standard Hollywood portrayal of the doctor as hero and
good guy. In this stark picture of medical right and wrong, a boy in braces is
compared to a girl turning cartwheels; a doctor dressed in white lecturing in an
amphitheater, his patient encased in white splints and bandages, is challenged
by a woman in a black hat and severe black dress who removes the patients
splints and exposes the skin to air and light. The source of medical authority was
challenged as well by Hollywoods portrayal of Kenny as a woman whose innate
knowledge of healing trumped mainstream medical ideas based on tradition
and book-learning. Set firmly into the Hollywood genre of scientist-as-hero,
Kennys story has a transgressive twist: a nurse becomes a scientific discoverer,
debates theory, and is even shown being a little cantankerous as she battles medical elitism, all within the familiar Hollywood storyline of the woman protagonist
forced to choose between love and professional success.
Despite the films populist, anti-intellectual claim that Kenny gained her
knowledge through her ignorance of orthodoxy, through the experiential evidence of her own eyes and hands, and through her feminine empathy with the
suffering, Sister Kenny is not an anti-science film, and its protagonist, however
beloved by the people, continues to seek medical respect. No quack, this
healer avoids the easy path to success, and her sacrifices bring her no personal
gain. Elizabeth Kennys own propaganda (as well as the movie) argued that her
ability to heal was the result of science, a special kind of ascetics science gained
from rejecting sex and love, the distracting, carnal side of a womans life.

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The films image of scientific discoverythe outsider versus the conservative

professional establishmentwas, leaders of organized medicine realized, one
that fit all too well with the lay publics distrust of the overblown claims of
Americas medical elite. This theme was echoed by Chairman Wolverton at the
1948 hearings when he warned that too often the medical profession is too
orthodox, and unwilling to recognize the individual who is traveling along a
path that is different . . . so many of our great inventions have come about in a
most unexpected way, through the vision or the thought of some individual who
was thinking differently.143 In the history of medicine, Kenny reflected a few
months before her death, it is not always the great scientist or the learned doctor who goes forward to discover new fields, new avenues, new ideas.144 The
films populist tone was further reinforced by a direct appeal to the lay public,
as viewers were asked to judge for themselves the value of Kennys techniques.
Members of the audience would leave the cinema able to choose between
experts to care for a child paralyzed with polio, an option they had always had
but that was now recognized with the power of Hollywoods silver screen. Critics
feared the movie would sway a lay public already eager to embrace a miracle
worker. But the letters sent to Elizabeth Kenny at her Institute in Minneapolis
show instead that those most eager to understand her method were already dissatisfied with their doctors or with medical science more broadly.
The charisma that made Kenny a good news story also made her a dangerous
Hollywood subject. Making a film of this controversial medical figure meant
entering into the contemporary debate about the worth of her work. The close
relationship between Hollywood and the medical establishment was not something the films writers and producers were eager to breach. Unlike the 1943
autobiography, which dwelt for some chapters on her struggles to convert
American physicians, the filmmakers therefore omitted almost all of Kennys
experiences in the United States, creating the idea, as one commentator
pointed out, that it was just another of Hollywoods portrayals of settled phases
of medical history.145 This enabled the film to leave out Basil OConnor and the
NFIP, an omission that audiences must have found glaring.
The movie was a hard sell: a middle-aged woman and deformed children in
hospitals were not the usual Hollywood fare. But this, like all Hollywood films,
did not spring full-grown from the head of a single screenwriter, producer,
or studio executive. Its construction was a process of negotiation, in this case
between the influence of a populist nurse, a Hollywood star, and the drama of a
specific, uncontrolled disease. The final script of Sister Kenny presented a romanticized depiction of Kennys life and work, and a message of hope at a time when
Americans lived under the specter of epidemic polio. Advertised as one of the
worlds great stories of love, sacrifice, and conflict, the film was clearly made to
capitalize on public curiosity about a controversial and popular figure, and on
the box office draw of Rosalind Russell.146 As sentimental as any March of Dimes
preview, Sister Kenny drew its appeal from dramatizing the fear, the hope, and the

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tragedy of ignoring the value of the Kenny method. It also relied on the audiences familiarity with health films, including Kennys own, as a way of reinforcing the idea that this was not just a true story, but also a contribution to the
public welfare. Kennys active participation in the filming of her life demonstrated her sophisticated understanding of the commercial films power, and
also the idealism of her belief that she could use a Hollywood film as a teaching
tool in the same way that she had used films and lectures in her own work.
Filmmaking had become a significant tool in American medical practice and
professional propaganda; this case study suggests, however, that Hollywood did
not always reproduce an AMA-sanctioned depiction of the men in white. On
occasion it offered the American public a heroic woman in white who provided alternative, perhaps even anti-orthodox, solutions to puzzles the American
medical establishment could not solve.

Notes
1. Mary McCarthy, Sister Kenny Outline, [1942], Paul Kohner Inc., Hollywood,
in Sister Kenny Collection, Margaret Herrick Library, Academy of Motion Picture
Arts and Sciences, Beverley Hills, 13. The most prominent early media accounts
were: Lois Maddox Miller, Sister Kenny vs. Infantile Paralysis, Readers Digest
(December 1941) 39: 16; Robert D. Potter, Sister Kennys Treatment for Infantile
Paralysis, American Weekly (August 1941) 413; R. M. Yoder, Healer from the
Outback, Saturday Evening Post (January 17, 1942) 214: 1819, 68, 70; Anonymous,
Sister Kenny: Australian Nurse Demonstrates Her Treatment for Infantile Paralysis,
Life (September 28, 1942) 13: 7375, 77; and Lois Maddox Miller, Sister Kenny
Wins Her Fight, Readers Digest (October 1942) 41: 2730. Mary E. McCarthy was no
relation to the novelist and critic Mary Therese McCarthy.
2. See George F. Custen, Bio/Pics: How Hollywood Constructed Public History (New
Brunswick, NJ: Rutgers University Press, 1992); Bruce Babbington To Catch a Star
on Your Fingertips: Diagnosing the Medical Biopic from The Story of Louis Pasteur to
Freud in Graeme Harper and Andrew Moor, eds., Signs of Life: Medicine and Cinema
(London: Wallflower Press, 2005) 12031; T. Hugh Crawford, Glowing Dishes:
Radium, Marie Curie, and Hollywood, Biography (2000) 23: 7189; and Naomi
Rogers, Sister Kenny, Isis (1993) 84: 77274.
3. On Kenny, see Naomi Rogers, Sister Kenny Goes to Washington: Polio,
Populism, and Medical Politics in Postwar America, in Robert D. Johnston, ed., The
Politics of Healing: Histories of Alternative Medicine in Twentieth-Century North America
(New York: Routledge, 2004), 97116; Victor Cohn, Sister Kenny: The Woman Who
Challenged the Doctors (Minneapolis: University of Minnesota Press, 1975); Tony
Gould, A Summer Plague: Polio and its Survivors (New Haven, CT: Yale University Press,
1995), 85110; and John R. Paul, A History of Poliomyelitis (New Haven, CT: Yale
University Press, 1971), 33038. On Kenny in Australia, see John R. Wilson, Through
Kennys Eyes: An Exploration of Sister Elizabeth Kennys Views about Nursing (Townsville:
Royal College of Nursing, Australia, 1995); Philippa Martyr, A Small Price to Pay
for Peace: The Elizabeth Kenny Controversy Re-examined, Australian Historical

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Studies 28 (April 1997) 4765; and Wade Alexander, Sister Elizabeth Kenny: Maverick
Heroine of the Polio Treatment Controversy (Rockhampton: Central Queensland
University Press, 2002).
4. Miller, Sister Kenny vs. Infantile Paralysis, 2.
5. On medical politics in the 1930s and 1940s, see, for example, Jonathan Engel,
Doctors and Reformers: Discussion and Debate over Health Policy 19251950 (Charleston:
University of South Carolina Press, 2002); Elizabeth Fee and Theodore Brown, eds.,
Making Medical History: The Life and Times of Henry E. Sigerist (Baltimore, MD: Johns
Hopkins University Press, 1997); and Rosemary Stevens, American Medicine and the
Public Interest (Berkeley: University of California Press, [1971] 1998).
6. See Susan E. Lederer, Repellent Subjects: Hollywood Censorship and Surgical
Images in the 1930s, Literature and Medicine (1998) 17: 91113; and Lederer and
John Parascandola, Screening Syphilis: Dr Ehrlichs Magic Bullet Meets the Public
Health Service, Journal of the History of Medicine and Allied Sciences (1998) 53: 34570.
On Fishbein, see Engel, Doctors and Reformers.
7. See Martin S. Pernick, The Ethics of Preventive Medicine: Thomas Edisons
Tuberculosis Films: Mass Media and Health Propaganda, Hastings Center Report
(June 1978) 8: 2127; Pernick, The Black Stork: Eugenics and the Death of Defective
Babies in American Medicine and Motion Pictures since 1915 (New York: Oxford
University Press, 1996); Allan M. Brandt, No Magic Bullet: A Social History of Venereal
Disease in the United States since 1880 (New York: Oxford University Press, 1987,
1995); Eric Schaefer, Bold! Daring! Shocking! True!: A History of Exploitation Films,
19191959 (Durham, NC: Duke University Press, 1999); Ken Smith, Mental Hygiene:
Classroom Films, 19451970 (New York: Blast Books, 1999); Rogers, Vegetables on
Parade: American Medicine and the Child Health Movement in the Jazz Age, in
Childrens Health Issues in Historical Perspective, eds. Cheryl Krasnick Warsh and
Veronica Strong-Boag (Waterloo, ON: Wilfred Laurier University Press, 2005),
2371; Susan E. Lederer and Naomi Rogers, Media, in Medicine in the Twentieth
Century, eds. Roger Cooter and John Pickstone (London: Harwood, 2000) 487502;
Kay Sloan, The Loud Silents: Origins of the Social Problem Film (Urbana: University of
Illinois Press, 1988); and Suzanne White, Mom and Dad (1944): Venereal Disease
Exploitation, Bulletin of the History of Medicine (1988) 62: 25270.
8. There is no complete history of the National Foundation but see Paul, A History
of Poliomyelitis, 35794; Gould, Summer Plague, 41126; David Oshinsky, Polio: An
American Story (New York: Oxford University Press, 2005), 4391; David Rose, March
of Dimes (Charleston, SC: Arcadia Publishing, 2003); Jane S. Smith, Patenting the Sun:
Polio and the Salk Vaccine (New York: William Morrow, 1990); Richard Carter, The
Gentle Legions: National Voluntary Health Organizations in America (New Brunswick, NJ:
Transaction Publishers, [1961] 1992); and Angela N. H. Creager, The Life of a Virus:
Tobacco Mosaic Virus as an Experimental Model, 19301965 (Chicago: University of
Chicago, 2001). For promotional histories, see Roland H. Berg, Polio and Its Problems
(Philadelphia; J. B. Lippincott, 1948) and Victor Cohn, Four Billion Dimes
(Minneapolis: Minneapolis Star and Tribune, 1955).
9. John C. Burnham, American Medicines Golden Age: Whats Happened To
It? [1982] in Judith Walzer Leavitt and Ronald L. Numbers, eds., Sickness and
Health in America: Readings in the History of Medicine and Public Health, 3rd ed.
(Madison: University of Wisconsin Press, 1997), 28494; and for a more critical
view, see Allan M. Brandt and Martha Gardner, The Golden Age of Medicine? in
Cooter and Pickstone, eds., Medicine in the Twentieth Century, 2137. In a survey of

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d e f i n i n g au t h e n t i c i t y, e x e r c i s i n g au t h o r i t y

four hundred Hollywood films with a physician character produced in 1949 and
1950, in only 25 instances was the doctor portrayed as a bad person, and when he
was bad there were often extenuating circumstances; cited by Burnham, Golden
Age, 28586.
10. See Naomi Rogers, Dirt and Disease: Polio before FDR (New Brunswick, NJ: Rutgers
University Press, 1992).
11. Smith, Patenting the Sun, 6487.
12. Kenny claimed that polio paralysis was caused not by the poliovirus destroying
the pathways between nerve and muscle, but by the lack of recognition and treatment of a new symptom she identified: muscle spasm (involuntary contractions of
muscles) signified by pain, tenderness, and hyperirritability. If the muscle in spasm
was left untreated, and if the opposing muscles that were in a state of pseudoparalysis (in which nerve pathways were temporarily non-functioning) were not given
careful physical therapy, then muscle shortening and other deformities would occur.
Her use of hot packs, her rejection of immobilization and splinting, and her introduction of physical therapy (or muscle re-education) in the early stages of the disease were quickly accepted by most medical professionals. But her physiological
explanation of the causes and significance of spasm were contested; see Wilson,
Through Kennys Eyes, 4048. Today, with renewed attention to muscle functioning
after the appearance of Post Polio Syndrome in the 1980s, some physiologists have
argued that the poliovirus destroys only some of the muscle fibers, and patients have
been able to improve their function through recovery in the excitability of functional, but not degenerated, motor neurons, through collateral sprouting of neurons, and through an increase in size of the muscle fibers. Kennys argument that
polio was a disease of muscles rather than nerves, and that the virus created a systemic infection was even more controversial. The idea that polio virus spread
through the bloodstream and was deposited primarily into the gastro-intestinal tract
rather than in the brain and spinal cord was not accepted until the work of virologists David Bodian and Isabel Morgan in the late 1940s; see Paul, A History of
Poliomyelitis, 38294.
13. For examples of the National Foundations positive presentation of Kenny in the
early 1940s, see Don W. Gudakunst, The Importance of Research (New York: National
Foundation for Infantile Paralysis, 1942), 1824; Anonymous, The Story of the Kenny
Method (New York: National Foundation for Infantile Paralysis, 1944).
14. Cohn, Sister Kenny, 18185.
15. See, for example, Help Me, or I Quit U.S. Sister Kenny, Chicago HeraldAmerican, February 4, 1944; Editorial, After 10 Years of Giving America Begins to
Wonder, Seattle Times, February 13, 1944; and Keep Sister Kenny Here, New York
Journal-American, February 17, 1944.
16. Mary [Pickford] to Dear Basil [OConnor], March 11, 1944, Public Relations,
Kenny Files, January 1944, March of Dimes Foundations Archives, White Plains,
New York.
17. Fishbein to Basil OConnor, October 9, 1941, Public Relations, Kenny Files,
January 1940, March of Dimes; and see Morris Fishbein, Morris Fishbein, MD:
An Autobiography (Garden City, NY: Doubleday & Co., 1969), 22934.
18. Mary to Dear Basil, March 11, 1944.
19. In 1941, Marjorie Lawrence developed paralysis and came to Minneapolis for
Kennys help. She returned to her singing career, but not to her position as a member of New Yorks Metropolitan Opera staff. See Marjorie Lawrence, Interrupted

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Melody: The Story of My Life (New York: Appleton-Century-Crofts, Inc, 1949),

193205. In 1955, MGM made the book into a film starring Eleanor Parker, who
won an Academy Award nomination; the film won the Academy Award for best story
and screenplay.
20. Elizabeth Kenny and Martha Ostenso, And They Shall Walk: The Life Story of Sister
Elizabeth Kenny (New York: Dodd, Mead and Company, 1943); Elizabeth Kenny, God
Is My Doctor: The Real Story of Her Battle against Infantile Paralysis, American
Weekly, March 26, April 2, 9, 16, 23, 1944.
21. John R. Pohl and Elizabeth Kenny, The Kenny Concept of Infantile Paralysis and Its
Treatment (Minneapolis: Bruce Publishing Company, 1943). See also John F. Pohl,
The Kenny Treatment of Anterior Poliomyelitis (Infantile Paralysis): Report of First
Cases Treated in America, Journal of the American Medical Association 118 (April 23,
1942): 142833; Wallace H. Cole, John F. Pohl, and Miland E. Knapp, The Kenny
Method of Treatment for Infantile Paralysis, Archives of Physical Therapy 23 (1942):
399418, published as a separate pamphlet by the National Foundation for Infantile
Paralysis (Publication No. 40, 1942).
22. See, for example, Assistant Secretary to Sister Elizabeth Kenny to Miss Coleman,
February 10, 1947, General Correspondence, February 110, 1947, Box 5, Elizabeth
Kenny Collection, Minnesota Historical Society (hereafter Kenny-MHS).
23. On medicine and film in this period, see Brian Glasser Magic Bullets, Dark
Victories and Cold Comforts: Some Preliminary Observations about Stories of
Sickness in the Cinema in Science of Life, 718; Pernick, Black Stork; and Lederer and
Rogers, Media in Medicine in the Twentieth Century, 487502. On public health films
see, for example, Susan L. Smith, Sick and Tired of Being Sick and Tired: Black Womens
Health Activism in America, 18901950 (Philadelphia: University of Pennsylvania
Press, 1995); and Timothy M. Boon, Health Education Films in Britain, 191939:
Production, Genres and Audiences in Signs of Life, 4557.
24. See Lederer and Rogers, Media; see also Thomas Doherty, Projections of War:
Hollywood, American Culture, and World War II (New York: Columbia University Press,
1993).
25. As she explained in a pamphlet distributed with her film, The Kenny Concept,
in the different groups and individuals presented, you will see convincing proof
of the value of [the Kenny concept]; Kenny, A Brief Description of the Film
Presenting the Kenny Concept, [n.p., 1944]; pamphlet in possession of author.
26. Kenny to Dennis Rigan, February 27, 1948, Michigan-Misc, 19421951, KennyMHS. On Russells contribution of forty thousand dollars to help make this film, see
Warren Hall, American Weekly, September 26, 1946; and Cohn, Sister Kenny, 193. The
NFIP had quietly collected reports on these films, noting the dominance of Kennys
narrating voice; Kent H. Powers to Mr. Stone, October 13, 1944, Public Relations,
Kenny Files, 1944, March of Dimes.
27. Kenny to Dear Mr. Smith, August 14, 1944, Smith, Howard R., 1944, Kenny-MHS.
28. Film transcript in Kennys testimony, Kenny, May 19, 1948, Hearings, U.S. 80th
Congress. 2d session. House. Hearings. Committee on Interstate and Foreign Commerce. [bills
on] Cancer and polio research. H.R. 977, 3257, 3464. May 13, 14, and 19, 1948
(Washington: United States Government Printing Office, 1948), 197. A copy of the
film is in nurse-historian John Wilsons private collection, the Australian Nursing
Archives, Quioba, Tasmania.
29. National Research Council Division of Medical Sciences, Report of Special
Committee to review Request submitted by Elizabeth Kenny Institute, Inc. to

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National Foundation for Infantile Paralysis, November 8, 1944, Public Relations,

Kenny Files, September 1944, March of Dimes, 78, 21. Compare the much
harsher response to her work: Ralph K. Ghormley, et al, Evaluation of the Kenny
Treatment of Infantile Paralysis, JAMA 125 (June 17, 1944): 46669.
30. James E. Perkins to Miss Kenny, January 3, 1945, Perkins, Dr. James E., 194445,
Box 5, Kenny-MHS.
31. On believability in medical and scientific films, see Gregg Mitman, Cinematic
Nature: Hollywood Technology, Popular Culture, and the American Museum of Natural
History, Isis 84 (1993): 63761; Lederer and Rogers, Media; Pernick, Black Stork; and
see R. Fawn Mitchell Making Medical Movies, Hygeia 9 (June 1931): 55153.
32. Perkins to Kenny, May 15, 1945, Perkins, Dr. James E., 194445, Box 5, KennyMHS. On the clinical trial ideal in this period, see Harry M. Marks, The Progress of
Experiment: Science and Therapeutic Reform in the United States, 19001990 (Cambridge:
Cambridge University Press, 1997).
33. Perkins to Kenny, May 15, 1945, Perkins, Dr. James E., 194445, Box 5, KennyMHS. On the continuing appeal and power of critics of medical orthodoxy, see
Ronald L. Numbers, The Fall and Rise of the American Medical Profession, in
Judith Walzer Leavitt and Ronald L. Numbers, eds., Sickness and Health in America:
Readings in the History of Medicine and Public Health, 2nd rev ed. (Madison: University
of Wisconsin Press, 1985), 18596; Susan E. Lederer, Subjected to Science: Human
Experimentation in American before the Second World War (Baltimore, MD: Johns Hopkins
University Press, 1995); Norman Gevitz, The D.O.s: Osteopathic Medicine in America
(Baltimore, MD: Johns Hopkins University Press, 1982); and Naomi Rogers, The
Public Face of Homeopathy: Politics, the Public and Alternative Medicine in the
United States 19001940, in Martin Dinges, ed., Patients in the History of Homeopathy
(Sheffield: European Association for the History of Medicine and Health
Publications, 2002), 35171.
34. Kenny to Perkins, May 23, 1945, Perkins, Dr. James E., 194445, Box 5, Kenny-MHS.
35. Perkins to Kenny, June 4, 1945, Perkins, Dr. James E., 194445, Box 5, KennyMHS.
36. Among other honors, in 1942 Kenny was awarded a Gold Key by the American
Congress of Physical Therapy, and a Parents Magazine Medal for Outstanding Service
to Children; in 1943 she received an honorary Doctor of Science from the University
of Rochester and an honorary Doctor of Humane Letters from New York University;
see Wilson, Through Kennys Eyes, 13435.
37. Kenny to McCarthy, August 26, 1942, McCarthy, Mary, 194244, Kenny-MHS;
PJAC [Peter Cusack] to BOC [Basil OConnor], December 8, 1942, Public Relations,
Kenny Files, September 1942, March of Dimes; Kenny to McCarthy, December 21,
1942, McCarthy, Mary, 194244, Kenny-MHS, and see Rosalind Russell in Mike
Steen, Hollywood Speaks: An Oral History (New York: G. P. Putnams Sons, 1974), 82;
Cohn, Sister Kenny, 16769.
38. Mary Kenny McCracken, interview with Naomi Rogers, November 21, 1993,
Caloundra, Queensland, Australia; see also Harry Evans, Coast to Coast Diary, The
Family Circle (January 14, 1944) 24. After showing Sister Kenny the sights in New
York] Roz said, Ive never enjoyed New York more. Because she is so enthusiastic.
Last night we saw Oklahoma! and Sister Kenny got such a bang out of it that the
audience watched her. Shes a grand person.
39. McCracken, interview with Rogers, November 21, 1993, Caloundra, Queensland,
Australia.

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40. McCracken, interview with Rogers, May 10, 1992, Caloundra, Queensland,
Australia.
41. McCarthy to My beloved Elizabeth, October 21, 1943, McCarthy Mary
194244, Kenny-MHS; and Kenny to McCarthy, August 26, 1942; Cohn, Sister Kenny,
16769; Rosalind Russell and Chris Chase, Life is a Banquet (New York: Random
House, 1977), 12. For Kennys divorce comment, see E. B. Radcliffe, Show Mirror,
Enquirer [n.d.] Public Relations, Kenny File, Clippings 1941, March of Dimes.
42. Kenny to McCarthy, August 26, 1942.
43. Liberty, October 12, 1946
44. Assistant Secretary to Sister Elizabeth Kenny to Mrs Mickelsen, October 9, 1945,
RKO-Misc, 194248, Kenny-MHS.
45. I felt I had to get away from executive women parts. So I deliberately did Sister
Kenny. I knew her, and Id always been interested in orthopedic work and worked at
the Orthopedic Hospital here [in Los Angeles] with the League for Crippled
Children. Thats how the script came to me; then I met Sister, was fascinated, and just
had to do it; Russell in Roy Newquist, Showcase: A Candid Cross Section of the Show
World by the People Who Make it Show Business (New York: William Morrow & Company,
1966), 396.
46. On Lance story, see McCracken, interview, November 21, 1993; and Cohn Sister
Kenny, 19293; he grew up to play baseball and to ski, and his mother never looked
at his leg without thinking of Sister, 193. The story is not mentioned in Russells
autobiography, Life is a Banquet.
47. Lowell E. Redelings, The Hollywood Scene, Citizen News, September 26, 1946;
Russell, Banquet, 14546, 154.
48. Redelings, The Hollywood Scene; and see Russell, Banquet, 14347. On the
RKO studio reaction, What, a story about cripples and a nurse? No! see Nicholas
Yanni, Rosalind Russell (New York: Pyramid, 1975), 86.
49. Hedda Hopper, Looking at Hollywood, Los Angeles Times, September 22, 1944;
Louella O. Parsons, Roz Russell Seriously Ill; Los Angeles Examiner, September 24,
1944; and see Russell, Banquet, 14647.
50. Kenny to Hedda Hopper, telegram, September 23, 1944, RKO-Misc, 194248,
Kenny-MHS; and see Louella O. Parsons, In Hollywood: Sister Kenny Protests
Blaming of Rosalind Russell for Polio Film Delay, Los Angeles Examiner, September
27, 1944; and McCarthy to Sister Dear, February 25, 1944, McCarthy, Mary,
194244, Kenny-MHS.
51. Kenny to Dear Mary, February 17, 1944, McCarthy, Mary, 194244, Kenny-MHS.
52. Redelings, The Hollywood Scene; Erskine Johnson, Los Angeles Daily
News, September 12, 1946; Russell in Steen, Hollywood Speaks, 83; Russell, Banquet,
145.
53. See, for example, Russell in Steen, Hollywood Speaks, 8283. Russell played a
newspaper reporter, writer, advertising executive, aviator, and psychiatrist; Yanni,
Russell, 6798. Her role in Sister Kenny won her a Golden Globe award for best dramatic actress, but the Oscar for Best Actress went to Olivia de Haviland for her role
in To Each His Own.
54. On medicine and horror movies, see Susan E. Lederer, Frankenstein: Penetrating
the Secrets of Nature (New Brunswick, NJ: Rutgers University Press, 2002). On
Hollywood and disabled people on screen, see Martin F. Norden, The Cinema of
Isolation: A History of Physical Disability in the Movies (New Brunswick, NJ: Rutgers
University Press, 1994); and Anthony Enns, Christopher R. Smit, eds., Screening Disability:

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Essays on Cinema and Disability (Lanham, MD: University Press of America, 2001); and
Rosemarie Garland Thomson, ed., Freakery: Cultural Spectacles of the Extraordinary Body
(New York: New York University Press, 1996). RKO had, for example, produced The
Hunchback of Notre Dame (1939), and I Walked With a Zombie (1943).
55. McCarthy to Sister Dear, February 25, 1944, McCarthy, Mary, 194244, KennyMHS.
56. Kenny to McCarthy, May 26, 1943, McCarthy, Mary, 194244, Kenny-MHS.
57. On the tensions between objective scientific work and the gendered ideal of the
scientific hero, see Naomi Oreskes, Objectivity or Heroism? On the Invisibility of
Women in Science, Osiris 11 (1996): 87113; and on the scientist-hero in public
culture, see Geoffrey Cantor, The Scientist as Hero: Public Images of Michael
Faraday, in Michael Shortland and Richard Yeo, eds., Telling Lives in Science: Essays
on Scientific Biography (Cambridge: Cambridge University Press, 1996), 17193; and
Martha Vicious, Tactful Organizing and Executive Power: Biographies of Florence
Nightingale for Girls, in Telling Lives in Science, 195213.
58. McCarthy Outline.
59. Kenny to McCarthy, August 26, 1942, McCarthy, Mary, 194244, Kenny-MHS.
60. J. E. Hulett, Jr., The Kenny Healing Cult: Preliminary Analysis of Leadership
and Patterns of Interaction, American Sociological Review 10 (1945): 365.
61. McCarthy, Outline, 16.
62. Cohn, Sister Kenny, 2034; Angel of Mercy New York Times, November 21, 1946.
In this account the amount was one hundred thousand dollars.
63. Kenny to McCarthy, August 26, 1942.
64. McCarthy, Outline, 3; Milton Gunzberg to McCarthy, [1943] in Kenny
Collection, Margaret Herrick Library.
65. Kenny to McCarthy, September 1, 1943, McCarthy Mary, 194244, Kenny-MHS.
66. McCracken interview, November 1993; see also Cohn, Sister Kenny, 195.
67. Mary McCarthy, speech honoring Kenny at fundraising luncheon [1943],
reprinted in Kenny and Ostenso, And They Shall Walk, 266.
68. Kenny to RKO Studios, August 2, 1946, RKO-Misc, 194248, Kenny-MHS;
Elizabeth Kenny to Manager, RKO Studio, August 3, 1946, RKO-Misc, 194248,
Kenny-MHS.
69. Only three of twenty advance proofs sent to newspapers in the
UrbanaChampaign area referred to some opposition; J. E. Hulett, Jr., Estimating
the Net Effect of a Commercial Motion Picture Upon the Trend of Local Public
Opinion, American Sociological Review 14 (April 1949) n9, p 267.
70. McCarthy, Kenny, [1943] Milton Gunzberg Collection, Margaret Herrick
Library, Special Collections, 5.
71. McCarthy, Outline, 7.
72. On the five feature films in the 1930s with a main woman doctor character, see
Lederer and Rogers, Media, 493; see also Peter E. Dans, Doctors in the Movies: Boil
the Water and Just Aay Ahh (Bloomington, IL: Medi-Ed Press, 2000).
73. See Julia Hallam, Angels, Battleaxes and Good-Time Girls: Cinemas Images of
Nurses, in Signs of Life, 10519; Anne Karpf, Doctoring the Media: The Reporting of
Health and Medicine (London: Routledge, 1988); and Doherty, Projections of War,
15962.
74. See Paul de Kruif, Microbe Hunters (New York: Harcourt, Brace and Company,
1926); de Kruif, Hunger Fighters (New York: Harcourt, Brace and Company, 1928);
and de Kruif, Men Against Death (New York: Harcourt, Brace and Company, 1932).

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For further discussion of such gender stereotyping, see Lederer, Porto Ricochet:
Joking about Germs, Cancer, and Race Extermination in the 1930s, American
Literary History 14 (2002): 72046.
75. McCarthy, Kenny, 24. This battle would have only made sense if Kennys background had been portrayed as working-class or lower middle-class. In the final film
her background is left ambiguous, but in other script versions McCarthy had tried to
distance Kenny from nurses typical class origins by making her family middle class.
When Elizabeth announced to her startled family that she wished to become a
nurse, they objected heatedly. They were in quite comfortable financial circumstances, and were horrified that their daughter should set out to take a job of any
kind, McCarthy, Outline, 5; on the Kenny family home as large and comfortable
with many verandas and a beautiful garden, see McCarthy, Kenny, 2.
76. McCarthy, Kenny, 2429. On Latham, see Kenny and Ostenso, And They Shall
Walk, 12729. Kenny supposedly said that what she hated most was to go to teas
with a lot of fat, overdressed, overbejewelled [sic] women whove never done one
honest days work in their lives; Cohn, Sister Kenny, 168. Eleanor Mary (Ella) Latham
(18781964) was the president of Melbournes Royal Childrens Hospital management committee from 1933 until 1954, and founding president of the Victorian
Society for Crippled Children in 1936; see Howard E. Williams, From Charity to
Teaching hospital: Ella Lathams Presidency 19331954 (Melbourne: Royal Childrens
Hospital, 1989).
77. Milton Gunzberg, Sister Kenny: Rough Outline of Fictionized Fact [1943],
Milton Gunzberg Collection, Margaret Herrick Library, 51.
78. Gunzberg, Rough Outline, 82. See also Gunzbergs suggestions that the
appearance of paralyzed children be done for laughs so that the audience is not
wincing with the tragedy of children becoming ill, Rough Outline, 12.
79. On science popularization, see Nancy Tomes, Merchants of Health: Medicine
and Consumer Culture in the United States, 19001940, Journal of American History
88 (2001): 51948; and John C. Burnham, How Superstition Won and Science Lost:
Popularizing Science and Health in the United States (New Brunswick, NJ: Rutgers
University Press).
80. McCarthy, Outline, 7. One reviewer called this the application of common
sense; see Edwin Schallent, Sister Kenny Experiments Nobly with Propaganda,
Los Angeles Times, October 11, 1946.
81. Te Pana [sic], Couldnt she be wrong, once? [Brisbane] Courier Mail, October
18, 1947; for the same point, see also Bosley Crowther, Sizing Sister Kenny, New
York Times, October 6, 1946.
82. This was the title of chapter six of Kennys 1943 autobiography.
83. McCarthy, Outline, 17.
84. McCarthy, Outline, 2021, 22. Gunzberg also considered having Kenny meet
an American doctor who may be the typical small American who represents the
open scientific mind of that profession in America. He may even have her book in
his library; Rough Outline, 85.
85. Gunzberg, Rough Outline, 8990.
86. Look, October 15, 1946.
87. See Dudley Nichols to Victor Cohn [n.d.], cited in Cohn, Sister Kenny, 203: I
tried to get at the basic truth of Kennys life through a dramatic organization of
actual or symbolic happenings . . . The highest aim of fiction, as I see it, is to get at
the real truth . . . I had to condense, put the attitudes and actions of many doctors

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into one doctor, and thus the result to the literal mind seems to be fiction whereas it
is the deeper truth.
88. John McCarten, Experiment Perilous, New Yorker, September 28, 1946. See
also RKO Studios, Call Bureau Cast Service, June 10, 1946, Clipping File, Kenny
Collection, Margaret Herrick Library. The rest of the featured cast were good studio actors without Russells star reputation. Alexander Knox, a Canadian character
actor, played Anneas McDonnell, and had been nominated for an Oscar for best
actor for his role as Woodrow Wilson in Wilson (1944). Kevin Connors was played
by Dean Jagger, whose previous roles in the 1930s were in Woman Trap (1936) and
Revolt of the Zombies (1936); he had made his reputation with the central role in
Brigham Young (1940). Kennys mother was played by Beulah Bondi, a well-known
character actor who had played Arrowsmiths mother-in-law in Arrowsmith (1931),
another mother in Mr. Smith Goes to Washington (1939), and Jimmy Stewarts
mother in Its a Wonderful Life (1946), and had been nominated for two best supping actress Oscars in the 1930s for The Gorgeous Hussy (1936) and Of Human Hearts
(1939).
89. Philip Merivale, an English stage and screen actor, had worked with a Nichols
script in This Land is Mine (1943).
90. Gunzberg, Rough Outline, 36. Gunzberg also proposed that an angry father
or grandfather threaten Brack with a gun and that Kenny save his life, Rough
Outline, 57.
91. Edward Donahoe to Sister Kenny, November 9, 1945, RKO-Misc, 194248,
Kenny-MHS.
92. On the movie jam-packed with crippled kids, with all but six-year-old Doreen
McCann actual Institute patients, see Anonymous, Liberty, October 12, 1946; and
see Kenny to Edward Donahoe, October 4, 1945; Eddie Donahoe to Sister Kenny,
October 12, 1945, RKO-Misc, 194248, Kenny-MHS. Donohoe told Kenny that in
most of the scenes, the little boy, David Martinson, appears. His affliction is spinal
abifida [sic], and I dont know whether you would want to use him or not.
93. See Florence Kendall, interview with Naomi Rogers, April 26, 1999, Silver
Springs, Maryland; and see letter by Ellen [Kendalls sister in Minneapolis] to
Florence, [February] 1947, Kendall Collection.
94. For various examples of specialists who rejected Kennys work, see Kenny and
Ostenso, And They Shall Walk, 9293, 12228. A group of informants in a 1946 survey on the film mentioned this scene as the most memorable; Hulett, Estimating the
Net Effect of a Commercial Motion Picture, n81, 271.
95. For a discussion of this scene as an example of the medical biopics dramatization of innovation versus conservatism, and the difficulties filmmakers faced in
portraying the medical profession as embodying harmful tradition, yet also as the
source of healing and scientific ideals, see Babbington, To Catch a Star on Your
Fingertips, 12526.
96. For a brief discussion of this scene, where Kenny articulates the biopic credo of
the person who has personal visions where others merely wear blinkers, see Custen,
Bio/Pics, 191. In an earlier script, Kenny spoke a version of this to Lady Latham: This
isnt a question of your rights or mine. Neither you nor I have any in this matter, not
have doctors or nurses or anyone else. In a hospital, the only rights are those of the
sickand Ill fight for those rights as long as I live; McCarthy, Kenny, 29.
97. Charles Chuter to D. Scheider [RKO Radio Pictures Australia, Ltd, Brisbane],
October 15 [1947]; Chuter to George Bayer [manager of Brisbanes Regent

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Theatre], October 30 [1947]; Chuter to Elizabeth Kenny, October 15 [1947].

Copies of these letters are in the Chuter Collection, John Oxley Library, State Library
of Queensland, Brisbane, Queensland, Australia. Kenny attended the films premiere in Brisbane, and also showed her technical films; on the deep silence and
intense interest with which the films were followed, will speak for itself insomuch as
all present were keenly interest throughout, see Miss I. Martin to Dear Madam
[Sister Kenny], November 6, 1947, John Wilsons Australian Nursing Archives,
Quioba, Tasmania.
98. Will Attack Kenny Film, [newspaper unnamed, 1947] in Scrapbook Section,
Oxley Library; and Sister Kenny Prepares For Her Hardest Battle, The Brisbane
Telegraph, September 25, 1947. According to one historian, in perpetuating myths
and presenting credibility gaps to an already polarized Australian community, the
film adversely affected the moves to re-reestablish an Australian base for Kennys
work; John Wilson, The Sister Kenny Clinics: What Endures? Australian Journal of
Advanced Nursing 3 (1986): 17.
99. Cedric Adams, In This Corner, Minneapolis Star-Journal, July 8, 1944.
100. The Wedding Gown that Waited, [advertisement], Womans Home Companion
[1946] 81.
101. Bride poster in authors possession; for other posters, see Victor Cohn, Sister
Kennys Fierce Fight for Better Polio Care, Smithsonian Magazine (November 1981),
196. See also Hulett, Estimating the Net Effect of a Commercial Motion Picture,
267.
102. Frank H. Higgins [president, Hennepin County NFIP] to Peter J. A. Cusack,
January 9, 1944 [1945], Public Relations, Kenny, September 1944, March of
Dimes. The local movie people . . . would give us a split of the proceeds, or allow us
to pass collection boxes at the completion of the film.
103. Roy E. Naftzger to Peter J. A. Cusack, November 20, 1944, Public Relations,
Kenny, 1944, March of Dimes; Cusack to Naftzger, November 22, 1944, Public
Relations, Kenny, 1944, March of Dimes.
104. Cusack to Naftzger, November 22, 1944.
105. Peter J. A. Cusack to Frank H. Higgins, [telegram], January 10, 1945, Public
Relations, Kenny, September 1944, March of Dimes; and see Phillip K. Scheuer,
New Picture Poignant Los Angeles Times, December 12, 1944.
106. She told Mary: Wish you were here to go with me. I have a new green evening
frock to wear as I am not quite sure what these bally Americans will do to me at such
a premiere; Kenny to My dear Mary and Stewart September 24, 1946, in Mary
Kenny McCracken Collection, Caloundra, Queensland, Australia.
107. See Cohn, Sister Kenny, 201; Anonymous, Liberty, October 12, 1946.
108. Velam West Sykes, Sister Kenny Is Voted the Winner of November Blue
Ribbon Award, Boxoffice (December 14, 1946).
109. See Howard Barnes, New York Tribune [1946] and Archer Winston, New York Post
[November 1, 1946], in Clipping File, Kenny Collection, Margaret Herrick Library.
110. Hulett to National Foundation, August 22, 1946, Public Relations, Kenny Files,
1946, March of Dimes; see also Hulett, Jr., Estimating the Net Effect of a
Commercial Motion Picture.
111. Editorial, Sister Kenny: Problem Child of Medicine, New York Medicine 2
(November 20, 1946): 41314; Ed Sullivan, Little Old New York: I Have News for
You, [1946], Public Relations, Kenny, Clippings 1941, March of Dimes; see also
Cohn, Sister Kenny, 207. On the film as providing guidance for what to do for a child

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with polio before getting aid from a physician or a Kenny technician, see Virginia
Wright, Los Angeles Daily News, November 30, 1943.
112. Louella O. Parsons, In Hollywood: Sister Kenny Triumph for Rosalind
Russell, Los Angeles Examiner, October 11, 1946.
113. The National Foundation for Infantile Paralysis Discusses the Kenny
Question [January 1947], Public Relations, Kenny, September 1946, March of
Dimes. On fears that Rosalyn [sic] Russells motion picture might injure us, see
John B. Middleton [Regional Director], Memorandum: Re Statement on Kenny
Drive Activities 1946 to George LaPorte, June 26, 1946, Public Relations, Kenny
Files, January 1946, March of Dimes.
114. George La Porte, Memorandum: Re: 1946 Kenny Campaign to Regional
Directors and State Representatives, June 19, 1946, Public Relations, Kenny Files,
January 1946, March of Dimes.
115. Sister Kenny, [New York] Motion Picture Daily, July 16, 1946 What
reaction medical societies and doctors may have to the film will be only be known in
time.
116. Editorial, Experiment Perilous, Westchester Medical Bulletin (November 1946),
2526, quotes 26, [copy in] Public Relations, Kenny Files, October 1946, March of
Dimes.
117. Fishbein, Autobiography, 23132.
118. A great many uninformed people will be badly confused by this film, which is
presumably intended to spread confidence and light; Crowther, Sizing Sister
Kenny. See also vitally interested families may take its one-sided message too
deeply to heart. They should be warned that the pictures natural enthusiasm of the
biography renders it somewhat misleading as present-day scientific gospel; Arthur
Winston, New York Post, November 1, 1946.
119. Trino Castro [Director of Venezuelan Foundation Against Infantile Paralysis,
and director of Poliomyelitis Hospital of Caracas] to Don Gudakunst, November 27,
1946, Public Relations, Kenny Files, Clippings 1941, March of Dimes.
120. Eileen Creelman, New York Sun [1946], in Clipping File, Kenny Collection,
Margaret Herrick Library; Time magazine review, reprinted in Minneapolis Morning
Tribune, October 3, 1946.
121. At the end of a 1943 review of Madame Curie, the New Yorker film critic did
ask plaintively whether someday a film would be made about a scientist who was
not scoffed at by the authorities . . . who did not have to surmount insurmountable
obstacles to reach his goal . . . who lolled in luxury, [and] knocked off an invention
or two when he felt like it; David Lardner, Popular Science, New Yorker, December
18, 1943, 54.
122. Crowther, Sizing Sister Kenny ; Crowthers review was quoted extensively in
Editorial, Sister Kenny: Problem Child of Medicine, New York Medicine 2 (November
20, 1946): 41314.
123. Florence Fisher Perry, I Dare Say: Difference Between Therapy and Cure,
Pittsburgh Press, November 13, 1946; for a different Pittsburgh view, see Sister
Kenny Good, Pittsburgh Sunday Telegraph, November 1946, Public Relations, Kenny
Files, Clippings 1941, March of Dimes.
124. McCarten, Experiment Perilous. The title of the review was a reference to the
1944 RKO thriller of the same name.
125. Boyd Correll, Lady in Blue [script] (Hudson Production, Ltd, Hollywood),
folder 16, Nick Grinde Collection, Special Collections, Margaret Herrick Library, 14.

KENNY

(rko, 1946)

SISTER

237

Lady in Blue referred to the blue nurses uniforms Kenny had designed for her
technicians.
126. On multiple sclerosis see, for example, Mrs. Lewis Potratz [Prairie du Chien
Wisconsin] to Kenny Institute, February 16, 1947, General Corresp, February 1128,
1947, Box 5, Kenny-MHS. For an important analysis of the historical experiences of
American polio survivors see Daniel J. Wilson, Living with Polio: The Epidemic and Its
Survivors (Chicago: University of Chicago, 2005).
127. S. M. Bollinger [Thibedaux, Louisiana] to Sister Kenney [sic], January 24,
1947, General Corresp, February 110, 1947, Box 5, Kenny-MHS.
128. Virginia Hall [Jackson Mississippi] to Sister Kenny, April 21, 1947, General
Corresp, April 1630, 1947, Box 5, Kenny-MHS.
129. Ray Pospisil [Miami Florida] to Sister Kenny, February 14, 1947, General
Corresp, February 1128, 1947, Box 5, Kenny-MHS.
130. Mrs. H. P. Schoening [Allegan, Michigan] to Sister Kenny, December 26, 1946,
General Corresp, February 110, 1947, Box 5, Kenny-MHS. In one operation a doctor had scraped bone from knife to knee and gave the sulfa drug and put her in [a]
cast until her nerves where [sic] shot. If you could just give me any kind of advice
to what we could do, or are we seeing the right Dr. for the exrays [sic] show black
streaks in bone; Assistant Secretary to Sister Elizabeth Kenny to Mrs Scheoning,
February 7, 1947, unless the case is specially diagnosed as infantile paralysis it would
not come within her scope.
131. Leon A. Colton [Milwaukee] to Sister Kenny, January 19, 1947, General
Corresp, February 110, 1947, Box 5, Kenny-MHS, Your picture is the first real educational, and constructive [one] that I have ever seen on a screen.
132. Alda Erma Cononna [River Edge, New Jersey] to Sister Kenny, December 29,
1946, General Corresp, February 110, 1947, Box 5, Kenny-MHS.
133. Helen E. Sente [Hastings on Hudson, New York] to Sister Kenny, January 30,
1947, General Corresp, February 110, 1947, Box 5, Kenny-MHS.
134. Mrs. Gerald W. Howard [Ladysmith, Wisconsin] to Sister Kenny, March 5,
1947, General Corresp, March 1531, 1947, Box 5, Kenny-MHS.
135. Mrs. W. A. Sites [Colby Kansas] to Sister Kenny, March 5, 1947, General
Corresp, March 1531, 1947, Box 5, Kenny-MHS.
136. Mrs. Mary Cavallaro [Brooklyn] to Sister Kenny, January 16, 1947, General
Corresp, March 1531, 1947, Box 5, Kenny-MHS, I know you are very busy and you
must receive lots of letters of this kind.
137. Movie of the Week: Sister Kenny, and A Doctor Comments on Sister
Kenny Life, September 16, 1946, 7782; see also Judith Klein, Sister Kenny Film
Seen Raising False Hopes, [New York] Herald Tribune, October 6, 1946.
138. Kenny to Philip M. Stimson, October 2, 1946, in [Scrapbook] Sister Elizabeth
Kenny and Her Treatment of Acute Poliomyelitis in The United States as
Experienced and Taught by Philip M. Stimson, M.D. [1969], Rare Books Room,
New York Academy of Medicine, New York City; New Controversy Forecast as Result
of Kenny Movie, Minneapolis Morning Tribune, September 13, 1946.
139. Stimson to Kenny, September 19, 1946 in Stimson, Scrapbook.
140. Kenny to Stimson, October 2, 1946, in Stimson, Scrapbook.
141. Wolverton, Hearings, May 14, 1948, 101; see also Sister Kenny Takes the
Stand, [Washington, DC] Times Herald, May 15, 1948; Rogers, Sister Kenny Goes to
Washington, 97116. For a list of European countries Kenny had visited in 1947
taking her technical films, see Kenny, May 14, 1948, Hearings, 133.

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d e f i n i n g au t h e n t i c i t y, e x e r c i s i n g au t h o r i t y

142. Hart Van Riper, Hearings, May 13, 1948, 81.

143. Wolverton during testimony by C. W. Jungeblut, May 1948, Hearings, 97.
144. Kenny, My Battle and Victory: History of the Discovery of Poliomyelitis as a Systemic
Disease (London: Robert Hale, 1955), 10.
145. Hulett, Estimating the Net Effect of a Commercial Motion Picture, n26,
p 275.
146. The Wedding Gown that Waited.

Chapter Eight

Passing or Passive
Postwar Hollywood Images of Black Physicians
Vanessa Northington Gamble
1949 is definitely lining up as the year of the Negro problem pic [sic]; result has
been . . . a race to be first on the screen with the subject, declared a March 2,
1948, article in Variety, the motion picture trade paper. Indeed, by 1950, on the
heels of a series of films that had attacked anti-Semitism, movie studios released
five films that examined the race problem in America and the dilemmas faced
by black Americans. Four of the filmsHome of the Brave, Lost Boundaries, Pinky,
and Intruder in the Dusthit the screen in 1949. The final film, No Way Out,
appeared in 1950.1
Several factors prompted Hollywoods interest, albeit brief, in the Negro problem. World War II had put a new emphasis on race relations in the United States
and had drawn links between the international struggle against Nazism and fascism and the domestic battle against racism. According to cultural theorist Gayle
Wald, by 1949 the major Hollywood studios had largely abandoned their view of
film as mere entertainment and had forged an emerging consensus about the
potential efficacy of cinematic representation to shape public discourse about
race and national identity. As early as 1942, Walter White, the executive director
of the National Association for the Advancement of Colored People (NAACP),
had lobbied Hollywood to broaden the screen images of African Americans
beyond the stereotypes and caricatures that then dominated the screen. Film historian Thomas Cripps has noted that a liberal-Hollywood-black-alliance had
formed during the war, and the production of these race problem films
resulted from that alliance. Another factor influenced the development of these
movies: after World War II, films with such adult themes as anti-Semitism, juvenile delinquency, and mental illness had found an audience and had made profits for the studios. In this climate, the race problem seemed a topic ideal for
raising profitable controversy. As noted by Thomas M. Pryor, the New York Times
film reviewer, the goal of these films was not to solve racial problems, but to hold
. . . the important issues of life up to the mirror of public opinion.2

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Film historians Daniel J. Leab, Thomas Cripps, and Donald Bogle have comprehensively analyzed the history of race problem films. In their analyses, they
have discussed these films primarily within the contexts of film history and
African-American history. None of these scholars has examined the medical
themes that play major roles in the narrative of four of the five films: Home of the
Brave, Lost Boundaries, Pinky, and No Way Out.3
Home of the Brave launched the cycle of race problem films, and focused on the
psychiatric problems of a young black soldier, Peter Moss. During World War II,
Moss had been admitted to a military hospital for treatment of hysterical paralysis and amnesia. The film follows his successful therapy with a sympathetic
white psychiatrist. The film reveals that a precipitating factor in his emotional
breakdown had been the racist treatment he received from fellow soldiers during a military mission to a Japanese-occupied island.
Pinky told the story of a light-skinned black nurse who returns to her hometown in the South after passing for white and falling in love with a white physician
while attending nursing school in New England. Upon her return she is immediately subjected to the indignities suffered by black women in the South, and
decides to leave. Before she can do so, however, Pinkyat the request of her
beloved grandmotherprovides nursing care to a strong-willed, rich white
widow with whom she initially clashes. Upon her death, the widow wills her house
and land to Pinky, who successfully survives a legal challenge from the widows
relatives when they contest the will. After discovering her true racial identity, the
white physician still wants to marry her and implores her to leave town with him.
She rejects his pleas, and instead decides to stay and use her bequest to establish
a clinic and nurse training school for the towns black population.
Two of the race problem films, Lost Boundaries and No Way Out, portrayed the
lives of black physicians. Lost Boundaries presented a fictionalized account of the
true life and career of a physician who passed as white in a rural New England
town; No Way Out portrayed the experiences of a fictional physician in a large
county hospital. This essay will concentrate on these two films by presenting synopses, discussing production, and examining their reception by both black and
white audiences. In contrast to other studies of postwar race movies, this essay
will analyze the depiction of black physicians and place the two films within the
context of African-American medical history. I argue that postwar Hollywood
presented two cinematic images of black physicians: as either passing or passive.4
Lost Boundaries, loosely based on a 1948 book of the same title by William L.
White (no relation to the NAACPs Walter White), examines the life of Dr. Albert
Johnston, a black physician, and his family, who passed as white for a dozen years
in small-town New Hampshire (see figure 8.1). Johnston, a 1929 graduate of
Chicagos Rush Medical School, was born in Chicago on August 17, 1900.
Although his birth certificate identified him as black, his family had a tradition of
passing. His father had passed as white in order to obtain a job as a real estate
agent, and went so far as to discourage darker-skinned blacks from visiting his

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241

Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 8.1. Dr. Albert Johnston, Sr., and his family, left to right: Thyra, Albert,
Sr., Albert, Jr., Anne, Donald, and Paul in an undated photograph. Image
Courtesy of the Historical Society of Cheshire County, Keene, New Hampshire.

home. When people began to ask the young Albert about his racial heritage, he
responded that he was one-eighth Cherokee because he was embarrassed to say
that he was black.5
During his undergraduate years at the University of Chicago, Johnston began
to associate with black people, and even joined the black fraternity Kappa Alpha
Psi. His decision may have been prompted by the racial discrimination he experienced on campus, where black students were barred from social events.
Johnston later said of the situation, No one seemed to mind this social exclusion. We had our own fraternity house, our own life, and there was considerable
talent in this small group.6
In 1923, Johnston met twenty-year-old Thyra Baumann, a fair-skinned black
woman from Boston whose family also adopted the practice of passing.
Originally from New Orleans, Thyra moved with her family to Boston after the
1912 election of President Woodrow Wilson. Her father, a post office clerk,
feared that the election of a Democrat would lead to increased segregation in
the South. In Boston, the Baumanns socialized with black professionals, but kept

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these friendships separate from their white ones. After her graduation from
high school, Thyra Baumann applied for a job as a stenographer. In order to get
the job she wrote on the employment application that she was white. Thyras
passing was not limited to race; raised Roman Catholic, she wrote on another
job application that she was Protestant.7
Albert Johnston and Thyra Baumann married after a yearlong whirlwind
romance. The wedding occurred around the time that Albert was beginning his
medical studies at Rush. In 1924, most black medical students went to one of
the two black medical schools that then existedNashvilles Meharry Medical
College or Washingtons Howard University Medical Department. A few predominantly white medical schools did admit a few black students, and Rush was
one of them. At the time, Rush admitted a quota of two black students each
year. Johnston alleged that he and the other black student, Ralph Scull, were
treated well during their medical school years, a view he maintained despite the
fact that the two of them could not serve as junior interns at a local hospital (as
the rest of the class did) because of their race. It was common practice in medical education at the time that African-American medical students were often
prohibited from working with white patients, for fear that the patients would
object. Ironically, within a few years, all of Johnstons patients would be white.8
Upon graduation, Johnston encountered a roadblock that hindered the professional advancement of most African-American medical school graduates at the
time: difficulty obtaining an internship. In 1929, the year that Johnston received
his medical degree, approximately 125 black medical students graduated, and
competed for only seventy internship slots. Most of the opportunities for black
graduates were at one of the fourteen black hospitals that had approved internships. Postgraduate training at a black hospital was not an option for Johnston;
the completion of an internship at a hospital approved by Rush was a prerequisite for obtaining his medical degree, and none of the black hospitals were on the
list. He then attempted to obtain an internship at what he considered the most
liberal hospitals in the country, but soon found his professional dreams dashed.
Initially, a hospital in Toledo, Ohio, wanted to offer him a position, until the faceto-face interview revealed that he was black, and hospital officials said that its policy prohibited them from hiring black physicians. He was also turned down for a
position at Worcester City Hospital in Massachusetts, and contended that, once
again, his race played a role in his rejection.9
Dr. Johnstons journey across the color line began in 1929 when he was
accepted for an internship at Maine General Hospital in Portland. Hospital officials there never asked him his race and he never volunteered it, but he did
acknowledge that he started out in great fear that here again they might recognize and reject him. According to William L. White, Johnston explained his decision to pass by stating that he had to do it, not because I was ashamed of being
colored, but only to make a living. Years later, Thyra Johnston also echoed this
sentiment, We werent trying to pass for white; we just never said anything one

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way or the other. We were getting along so well, and we worried about what would
happen if people knew we were partly colored. In those days, you know, it was
hard for a man of color to make a decent living. In other words, Albert
Johnstons need to survive professionally prompted his actions, and thus he followed in the footsteps of his father. He understood that whiteness bestowed both
privilege and cash value. Johnstons medical degree from Rush gave him not only
an opportunity to practice medicine, but also a license to pass. A degree from one
of the black medical colleges would have most certainly identified him as black
and would have derailed any dreams of crossing the color line.10
The internship in New England also proved beneficial for personal reasons.
After their marriage, Thyra Johnston moved back to Boston to live with her parents because the young couples strained financial situation had grown worse
after the birth of their first child, Albert, Jr., in 1925. The cost of Johnstons
room and board in Portland made moving his family there impossible, but his
proximity to Boston meant that he could see them more frequently.
After completing his internship in 1930, Johnston bought a general practice
in Gorham, New Hampshire, a small town of twenty-five hundred people, all
white, near the foot of Mount Washington, where his identity as a white physician became even more cemented. Only on occasion did a black employee of a
summer vacationer come to town. Ethnic tensions did exist in Gorham
between the longstanding Yankee residents and the newly immigrated French
Canadians. Johnstons practice thrived, enabling him to bring his family to
Gorham. The Johnstons soon became civic and social leaders of the community.
Albert was elected to the school board, the Rotary Club, and the Masonic Lodge.
He also served as chairman of the local Republican Party. Thyra was elected
president of the Gorham Womens Club and the White Mountain Junior League
of the Congregational Church.
As Dr. Johnston acknowledged, passing allowed him to circumvent the professional obstacles that African-American physicians usually faced. For example,
he was able to join his state medical society and the American Medical
Association without difficulty. He even assumed leadership positions in medical
circles, serving as secretary-treasurer of both the New Hampshire Roentgen-Ray
Society and the Cheshire County Medical Society. Johnston was also able to
attend medical conventions that were closed to black physicians. At some of
these meetings, his racial camouflage enabled him to witness racism in medicine
first-hand. He reported that, at one convention, southern physicians told him,
Johnston, you just dont know the problem. Negroes dont have the brains, or
any sense of moral values like you and I have. You have to treat em like that.
Upon hearing this remark, he remained silent. He worried that if he come out
as black, he would not have been able to accomplish as much as he did in medicineprofessional advancement was his reward for passing. Yet, he later
lamented, Whatever, I do, my race gets no credit. At a time when there were
few black specialists, Johnston in 1937 began a years training in radiology at

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Harvard Medical School, where he continued his racial masquerade. (Ironically,

he later claimed to be the first black physician to train in radiology at the
school.) Johnstons Harvard credentials enabled him to continue his ascent in
medicine from general practitioner to distinguished specialist.11
After practicing in Gorham for almost ten years, Johnston accepted a radiology position in 1939 at a hospital in Keene, New Hampshire, where once again
he and Thyra became pillars of the community, but continued to keep their
racial identity secreteven from their four children. But they constantly feared
exposure. In 1940, as the United States geared up for a possible war, the navy
faced a shortage of radiologiststhere were only 2,200 nationwideand
recruited Dr. Johnston. The navy offered him a commission as lieutenant commander in the Naval Reserve, but soon withdrew it. His professional qualifications were clearly not at issue (he was a diplomate of the American Board of
Radiology), but his race was. The navy discovered that although Johnston was
registered as white, he had colored blood in [his] veins and rejected his
application as a naval officer because of his inability to meet physical requirements.12 The navy did accept African Americans in low level positions such as
cooks, steward mates, or mess attendants.
After living as white persons for over ten years, the Johnstons were forced back
over the color line as a result of Johnstons outing by the navy. Their return journey to blackness was hard. First, they had to tell their children the truth about
their racial identity. The revelation initially led to severe emotional anguish for
their eldest son, Albert, Jr. He dropped out of college and successfully joined the
navy by continuing to pass for white, but was discharged because of psychiatric
disease. At one point, the family consulted Dr. Solomon Fuller, one of the countrys first black psychiatrists, because they thought that they could tell Fuller the
truth about the familys life. As part of his recovery, Albert, Jr., hitchhiked across
the country and stayed in several middle-class, African-Americans enclaves
where he met black people, including members of his extended family, who
were accomplished, successful, and well adjusted. After this trip, he returned to
New Hampshire ready to embrace his blackness.
The navy incident and the forced revelation left scars on Dr. Johnston. He
stopped going to Rotary and to the Masonic Lodge. Describing his mental state,
he said, I guess I have become morose. He also suspected that his appointment
at a local hospital had not been renewed after his true racial identity became
known. The hospital denied this accusation and instead pointed to a contractual
dispute about compensation and the terms of the appointment. But for the most
part, the Johnstons encountered no prejudice from the towns citizens. It turned
out that the familys true racial identity had been unspoken but common knowledge in the town for several years. Johnston continued to practice in Keene
until 1966 when the family moved to Kauai where he worked as a radiologist
until his retirement in the mid-1970s. He died on June 23, 1988, at the age of
87. Thyra Johnston died on November 22, 1995.13

passing or passive

245

Dr. Johnstons story came to the page and subsequently to the screen through
the efforts of Louis de Rochemont, a New Hampshire-based producer. De
Rochemont was co-creator and executive producer of The March of Time, an
innovative and Academy Award-winning documentary newsreel series. De
Rochemont learned of the story of the Johnston family from Albert, Jr., who was
then a student at the University of New Hampshire. Intrigued by the story, he
commissioned author William L. White to write an article about the Johnstons
that Readers Digest published in December 1947. The next year Lost Boundaries
appeared in book form and became a bestseller.
In spring 1948, Metro-Goldwyn-Mayer (MGM) bought the screen rights for
the book and entered into a partnership with de Rochemont to produce the
film. The road to the film version of Lost Boundaries was rocky, and writing an
acceptable script proved particularly difficult. The script, in fact, went
through at least three writers. As film historian Thomas Cripps has cogently
contended, the dramatic enigma at the heart of the book . . . mitigated
against good cinema. Passing, after all, he continued, was a passive, even
covert, act rather than a heroic gesture. The scriptwriters were also not
accustomed to writing portrayals of black professionals. The films racial focus
provoked anxieties in MGM executives, who even hired a company to test
public opinion about the proposed film. By November 1948, the partnership
between MGM and de Rochemont had unraveled because of budgetary
reasons and for what, Ebony alleged, were differences between the two parties over handling of the Negro theme. The studio ultimately released
the rights to de Rochemont, who decided to produce the film independently.
De Rochemont hired Alfred L. Werker to direct the film, which was shot on
location in Portsmouth, New Hampshire, and cast mostly with little-known
actors and local residents. Filming took about two months at a cost of
$650,000.14
Lost Boundaries, a ninety-nine-minute, black-and-white feature, opened in June
1949, and the transition from the book to the screen yielded several changes.
Some of these changes were relatively minor: for unknown reasons, the names
of the main characters, the medical school, and the town were changed. Albert
and Thyra Johnston were now Scott and Marcia Carter; the action took place in
the fictitious town of Keenham, New Hampshire; and the main character had
graduated from Chase Medical School. Several other changes, however, were
significant. First of all, white actors had been cast as the light-skinned black family members; Mel Ferrer, in his screen debut, was cast as Scott Carter, and
Beatrice Pearson as Marcia Carter (see figure 8.2). This casting was a bitter disappointment for black actors who had hoped that the film would supply them
with much needed jobs. The casting change may have been engineered in order
to placate southern theatre owners and to draw empathy from white audiences
who could see white people being discriminated againstin other words, seeing
their own people treated as if they were black.

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d e f i n i n g au t h e n t i c i t y, e x e r c i s i n g au t h o r i t y

Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 8.2. Dr. Scott Carter (Mel Ferrer) and his wife Marcia (Beatrice Pearson)
on their wedding day in the film version of Lost Boundaries. Lost Boundaries
1949 Warner Brothers. All rights reserved.

The book made clear that Johnston had decided to pass in order to advance
in medicine at a time when racism severely limited the options available to black
physicians. The movie, however, most forthrightly places discrimination in the
hands of dark-skinned African Americans against fair-skinned African
Americans. According to the movie, this discrimination provided the initial
impetus for the physicians decision to pass. The day after graduating from
Chase Medical School and getting married, Dr. Carter is scheduled to begin his
internship at Garrison Memorial Hospital, a fictitious black hospital in
Meridian, Georgia. The internship had been secured for him by Dr. Charles
Frederick Howard, a black physician from Boston. Dr. Howard had received an
honorary degree from Chase at Carters commencement for his contributions to
medicine and research. The citation noted that Dr. Howard had triumphed
over obstacles that would have discouraged a lesser man, to bring honor to his
college, to his profession, and to his race. At the time of his graduation, Dr. Carters
prospects were much brighter than those of the other black graduate, Dr. Jesse

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247

Pridham, who despite his excellent record had not received any internship
offers. Pridham stated that he was not worried, Until something comes along,
why, there is always good old George Pullman. Ive been a porter before and I
can be one again. In real life, Albert Johnston also had worked as a Pullman
porter to help pay his medical school expenses.15
When the fictionalized Dr. JohnstonDr. Carterarrives at the hospital,
which is filled with black patients needing care, he receives an unexpectedly
unwelcome reception. Upon seeing Dr. Carter, the hospital superintendent, Dr.
Cashman, immediately rescinds the internship offer. He claims that just the previous week the hospital board of trustees had decided to restrict the hospitals
internships to southern physicians. Carter, obviously taken aback, asks whether
being a northern Negro meant that he was not welcome at the hospital. Still dismayed by the turn of events, he tries to make his case to Cashman, noting that
the hospital had accepted him, that he had moved his wife to Meridian, and that
he had already rented a place to live. Cashman remains adamant and tells the
young doctor that he is sorry, reassuring him that he should not have any
trouble finding a position at a northern hospital. Cashman does not mention Carters skin color, but the scene makes clear that northern meant
fair-skinned.
This scene did not appear in the book version of Lost Boundaries, and the only
parallel to this bait and switch in Johnstons real life was he was turned down
for an internship by white hospitals in Ohio and Massachusetts. Given the
paucity of qualified black doctors, the pressing need to provide health care to
black patients, and the color hierarchy that then existed in the black community
at that time (fair skin and straight hair were especially prized), it is extremely
doubtful that a black hospital would discriminate in this way. Nonetheless, the
film gave the impression that the physician chose to pass in order to avoid discrimination by black people. This is particularly significant because the film was
presented as a documentary, and therefore, as cultural theorist Gayle Wald contends, there is an implied contract of realism with the white viewer. The film
thus distorted the realities of black physicians status by showing the only personally mediated act of discrimination in the movie as that of a black person
against another black person. The film, however, did include a scene that very
clearly showed the U.S. Navys discrimination against the physician.16
Dr. Carter could not find another internship because he identified himself as
black. Family members and friends urged him to pass until he could establish
himself as a physician. His father-in-law, who was passing, commented that his
rejection by the black hospital was the best thing that ever happened to him.
The film portrayed the physician as reluctantly deciding to pass, but only out of
financial necessity, because of the impending birth of his first child. He then
applies for an internship in Portsmouth, New Hampshire, without revealing his
race. The book, on the other hand, did not give the impression that Dr.
Johnston crossed over the color line so hesitantly.

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Two additional changes between the book and screen versions of Lost
Boundaries were also noteworthy. In the book, the son visited middle-class black
communities to discover his cultural roots. In the film, he went to Harlem,
which, in the words of the NAACPs Walter White, is presented as being a place
of filth, frustration, crime, and abject poverty. Before the film was released,
White had unsuccessfully urged the filmmakers to add portrayals of professional, law-abiding, and middle-class residents of Harlem. The film also did not
portray the psychic cost to Dr. Johnston of revealing his race. The final scenes
include a sermon by a minister calling for tolerance: For we are all Gods children and bear his heavenly image. The family, after having been shunned by
some of the towns residents, is welcomed back into the community. In the final
scene, the films narrator reassures viewers that the doctor is still our doctor.17
Lost Boundaries received widespread acclaim. Written by Eugene Ling and
Virginia Shaler, it won the best screenplay award at the 1949 Cannes Film
Festival. It was also nominated for the Writers Guild of Americas Robert Meltzer
Award for a Screenplay Dealing Most Ably with Problems of the American
Scene. Its director, Alfred L. Werker, received a nomination for the Directors
Guild of America Award for outstanding directorial achievement. Bosley
Crowther, the New York Times movie critic, honored it as one of the best films of
1949, and praised the film for its intelligence, restraint, and good screen techniques in handling a new and difficult theme. The July 4, 1950, issue of Life
named it the movie of the week, calling it honest and affecting, stating that the
story had been related without melodrama and acted with conviction.
Newsweek hailed it as a superior documentary, and praised de Rochemont for
bucking the cautious-minded Hollywood studios and tackling such a controversial topic. Although the review in the Saturday Review of Literature criticized
the filmmaking as unimaginative and the ending as too pat, it found the film
honest and courageous. Time also found that dramatically Lost Boundaries
dragged because of the writing and direction but found it not only a first-class
social document, but also a profoundly moving film. Many of these reviews
praised the films documentary style, yet failed to comment on or criticize the
decision to use white actors in the film.18
Other reviews were less charitable. The progressive magazine The Nation contended that Lost Boundaries was mildly poignant, has a simple, direct honesty . . .
and tells a good story dedicated to the idea that silence about being a Negro is
golden if you can get away with it. It went on, The light-skinned Negro couple
. . . are passive, innocuous, duty-happy creatures totally unscarred by discrimination. The review also criticized the Harlem scenes as Goya-like view[s] of
Lenox Avenue highlighting grotesque faces, ambling Dead End Kids, [and] clusters of suspicious Negroes. Some of the harshest criticism of the film came from
V. J. Jerome, chairman of the Communist Partys Cultural Commission, in his
1950 book, The Negro in Hollywood Films. He charged that the film distorted
racism in medicine, inappropriately used white actors for the principal roles,

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and undermined black solidarity by holding outto certain Negroesthe

prize of acceptability at the hands of whites. He pointed out that the only personified act of bigotry in the film came from the African-American superintendent when he denied Dr. Carter the appointment in a black hospital.
Furthermore, he argued, the film failed to show the systemic racism from whites
that adversely affected the careers of black physicians. Describing the use of
white actors in Lost Boundaries, he retorted, the insult is direct: Negro actors
may be used for stereotypes or for subordinate parts; but heroic roles belong
to white players. To him the message of the film was clearby offering middleclass Negroes, particularly those of a lighter skin, in return for denying their
people, the reward of acceptability by good whites it aims to undermine the
solidarity of the Negro people.19
African Americans, for the most part, responded positively to Lost
Boundaries. The NAACPs Walter White played a very active role in publicizing
the film and called it one of the first films to feature African Americans in nonstereotyped roles. White, a fair-skinned, blond-haired, and blue-eyed African
American, whose biographer called him a voluntary Negro, had himself
passed to investigate lynching for the NAACP. White criticized the use of white
actors in the film, but conceded: That is a contest yet to be fought and won.
He had lobbied for the expansion of dignified roles for black actors in
Hollywood films, and would have preferred the casting of black actors to play
the family members in the film. He believed, however, that the importance of
this film far outweighed the race of the actors cast, and pledged his support
for future efforts to broaden opportunities for black actors. Actor and political
activist Canada Lee, who had a small role in the film as a detective who helped
young Ralph Carter during his foray into Harlem, praised the film: It is
through films like Lost Boundaries . . . that all peoples will see us as we are
and not as buffoons and the yas-sah boss type as some people believe us to
be. B. M. Phillips, an assistant managing editor at the Baltimore Afro-American,
wrote that the film had moved her to tears, and called it one of the best treatments of a racial story that I have seen out of Hollywood. She also supported
the physicians use of passing as a means to advance professionally. You see,
she wrote, Im realistic enough to know that a trained white person can go a
little further than a trained colored person. Im rooting for anybody who can
put one over on the folks and get away with it. Ebony characterized the film
as exciting entertainment on a provocative theme. The Norfolk Journal &
Guide called it a realistic, highly effective drama. A July 9, 1949, Chicago
Defender article called Lost Boundaries a beautifully produced film, and said
that the filmmakers deserve credit for courage and imagination. The paper
did note, however, that the film did not attempt to do any large amount of
problem solving. A month later, a decidedly more mixed review appeared in
the Defender, which, while calling the film entertaining, interesting, and
soul stirring, criticized the filmmakers for distorting and twisting the facts of

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the original story, perhaps in an effort to gain southern recognition and

approval.20
Black praise for Lost Boundaries was not unanimous. Writing in the Baltimore
Afro-American, journalist Al Andersen criticized the filmmakers for using white
actors to portray the Johnston family. In addition, he contended that the film
sang loud and long of tolerance and clammed up on the matter of equality.
Let us be tolerant, it whined. . . . This naturally distorts the entire point. There
is nothing to be tolerant of. All people should be equally treated not because its
the . . . nice thing to do, but because they are equal. Actress Fredi Washington,
who had played Peola, the light-skinned black woman who passed in Imitation of
Life (1934), had auditioned and been rejected for a role in Lost Boundaries. An
ardent civil rights activist, Washington called the claims that the film was a documentary disingenuous, and criticized the scenes that occurred in Harlem and
at the black hospital. Writer Ralph Ellison also lambasted the films fiction
that is, its portrayal of discrimination by darker-skinned African Americans as
Carters motivation for passing. Ellison wrote,
The only functional purpose served by this fiction is to gain sympathy for Carter by
placing part of the blame for his predicament upon black Negroes. Nor should the
irony be missed that part of the sentiment evoked when the Carters are welcomed back
into the community is gained by painting Negro life as horrible, a fate worse then a living death. It would seem that in the eyes of Hollywood, it is only white Negroes who
ever suffer.

He also noted that Lost Boundaries evaded the question of whether a mulatto
Negro has the right to practice the old American pragmatic philosophy of
capitalizing upon ones assets. Whiteness, he argued, has been given an
economic and social value in our culture. Thus, he pointed out, passing
was the quickest and most certain means for Dr. Johnston to succeed in
medicine.21
Lost Boundaries was an immense commercial success. It fared well not only in
the North, but in various locations in the South, including Norfolk, Richmond,
Louisville, and Raleigh. It was banned, however, in Memphis and Atlanta. Lloyd
T. Binford, the controversial chair of the Memphis Board of Censors banned the
film; indeed, he would not even allow private showings. The Atlanta censor
Christine Smith banned it on the grounds that it might adversely affect the
peace, health, morals, and good order of the city. The controversy surrounding
the bans did translate into increased ticket sales, however. The movie grossed
about $1.8 million, an especially remarkable financial achievement given that it
was distributed by a small independent company and produced for only $650,000.
The first three of the race problem filmsHome of the Brave, Lost Boundaries, and
Pinkydid so well at the box office that Variety declared, the films leading [box
office] star for 1949 wasnt a personality, but . . . a subjectracial prejudice.

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The article noted that the films had grossed over $20 million at the box office.
With their eyes toward profits, Hollywood continued to release films about the
Negro problem.22
On August 16, 1950, 20th Century Fox released the pessimistically titled No
Way Out, the last film in the cycle of race problem movies. It was produced personally by the powerful head of Fox, Darryl F. Zanuck, who had previously produced the controversial Gentlemans Agreement (about anti-Semitism) and Pinky,
and was directed by Joseph L. Mankiewicz, who had recently won an Academy
Award for A Letter to Three Wives. Zanuck proclaimed that the movie would be as
real as sweat . . . deal[ing] with the absolute blood and guts . . . of Negro hating. Lesser Samuels wrote the original story on which the film was based, and
shared the screenwriting credit with Mankiewicz. He stated that the storys inspiration came from discussions he had had with physician friends of his daughter
about the indignities suffered by their black colleagues. Describing the film,
Samuels contended, We deal with the predicament of upper-level Negroes . . .
people who because of their talent or learning have proved their value to society, only to be ostracized and frustrated simply because they are black. No Way
Out focused on the professional dilemmas of a fictional character, Dr. Luther
Brooks, played by twenty-two-year-old Sidney Poitier in his screen debut. (Poitier
had lied about his age to get the role, stating that he was twenty-seven). As film
historian Donald Bogle has noted, the film launched Poitiers career as the
model integrationist heroeducated, intelligent, tame, and a paragon of
black middle-class values and virtues. In stark visual contrast to the image of a
white actor playing a black doctor in Lost Boundaries, the dark-skinned Sidney
Poitier glistened in his hospital whites in No Way Out.23
In the film, Dr. Luther Brooks is the only, and it appears first, black intern at
a county hospital in an unnamed northern city. Brooks was well qualified for the
position. He had passed his state licensing boards and had excelled in medical
school, receiving all As in his courses. Critics at the time assumed that the hospitals locale was Chicago, because the unnamed city resembled the Windy City.
Placing a black intern at a county hospital in 1950s Chicago was historically
accurate. By that time, a few black physicians had gained admission to internships at county and municipal hospitals, due in large part to black activists
efforts dating back to the 1930s to break down the racial barriers at taxsupported facilities. One of the first of these hospitals to admit black physicians
and patients was Chicagos Cook County Hospital.
No Way Out portrayed the events surrounding and subsequent to the death of
a white patient while under Luther Brookss care in the hospitals prison ward.
In the film, small-time hoodlums Ray and Johnny Biddle are both shot in the leg
by police during the course of a robbery. As the intern covering the prison ward,
Brooks is called to treat the injured men. As he tries to take care of the prisoners injuries, he is subjected to a torrent of racial epithets by Ray Biddle (played
by Richard Widmark). Although Johnny Biddle had been admitted for the

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treatment of his leg wound, Brooks observes what he takes to be signs of

increased intracranial pressure and suspects that the patient has a brain tumor.
To make the diagnosis, Brooks conducts a spinal tap; during the course of this
procedure, Johnny dies. (Ironically, the scene is medically inaccurate. At the
time, most physicians thought that a spinal tap was contraindicated in cases of
increased intracranial pressure.) Ray Biddle believes that Brooks intentionally
killed his brother and pledges revenge. Brooks consults chief resident Dr. Dan
Wharton (played by Stephen McNally) and requests an autopsy to confirm his
diagnosis and to dispel any suspicions about Johnny Biddles death (see figure
8.3). He is not entirely sure himself that Rays Negro-baiting had not gotten to
him. Ray Biddle refuses to consent to an autopsy and urges Edie (played by
Linda Darnell), his brothers ex-wife and his own former lover (while she was
still married to his brother), to do the same. To exact his revenge, Biddle conspires with another brother to have a mob from Beaver Canal wipe out Nigger
Town. The black residents of the city get wind of the impending attack, however, and organize their own mob, striking first and beating the white mob.
Black and white victims of the race riot are brought to the hospitals emergency
room, where Brooks is on duty. When the mother of one of the white victims
sees that Brooks is taking care of her son, she demands that he keep his hands
off the boy, and then spits in his face. Recognizing the tragic consequences of
Johnny Biddles death and his own role in it, a stunned Luther Brooks leaves the
hospital and turns himself in to the police for Johnny Biddles murder. But his
confession is in fact a ruse to force an autopsy, which ultimately shows that
Johnny Biddle had indeed died from a brain tumor, and that the spinal tap was
indeed warranted. This finding does not satisfy the revenge-hungry Ray Biddle,
however, who escapes from custody and sets a trap to kill Brooks. But Edie, who
Ray had beaten to force her to assist with the ambush, foils the plan. In the struggle, Biddle shoots Brooks in the shoulder and re-injures his own leg. Edie urges
Brooks to let Biddle die, but perhaps remembering the Hippocratic Oath,
Brooks takes care of the man who tried to kill him, telling Edie, I cant kill a
man because he hates me.24
The film depicted both subtle and virulent racism, as well as personally mediated and institutional racism. And in contrast to Lost Boundaries, acts of racism
directed at blacks in this film are perpetrated by whites. A police officer concerned about Brooks medical judgment consults a white orderly, who of course
lacks the expertise and training to comment. The orderlys expertise lay in his
whiteness, not in his credentials. In a later scene, the hospital administrator
expresses fears that if the press were to discover that Johnny Biddle died while
in the care of the hospitals first black doctor, the hospitals governmental funding would be jeopardized. In other words, the hospital might be punished for
hiring a black physician who appeared to be inept; and although incorrect, the
publicity and appearance of incompetence would hurt both the hospital and the
reputations of black physicians in general.

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Disclaimer:
Some images in the printed version of this book
are not available for inclusion in the eBook.
To view the image on this page please refer to
the printed version of this book.

Figure 8.3. Dr. Luther Brooks (Sidney Poitier) with his chief resident Dr. Dan
Wharton (Stephen McNally) No Way Out 1950 Twentieth-Century-Fox. All
rights reserved.

Bigotry in this film takes the form of virulent racism embodied by Ray Biddle
and the white, lower class residents of Beaver Canal. When told that Brooks is a
physician and not a janitor, Biddle retorts, I dont want him. I want a white doctor. A policeman at Biddles bedside responds, Well turn the lights out, so you
wont know the difference. After Johnny Biddle dies, his brother screams, That
dirty nigger killed him! In a later scene, Ray tries to convince Edie to deny the
autopsy request, saying, Im suppose to forget that my brother couldnt have a
white doctor, that hed be alive if he did. That nigger doctor killed Johnny. If you
had a kid, would you send him to a nigger doctor? Would you like him putting
his dirty black hands on your body? In his last statement, he tried to appeal to
white fears that black men posed a threat to the purported sanctity of white
womens bodies. Indeed, at the time, some medical schools that admitted black
male students prohibited them from attending pregnant white womens labor
and deliveries.
Although Luther Brooks is obviously conscientious, smart, and well educated,
he is presented on the screen primarily as a passive individualsubmissive,

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uncertain, hesitant, and apprehensive. In one of the films first scenes, Brooks
tells Wharton, the chief resident, that he needs to extend his postgraduate training, not because he wants the additional training to specialize, but because he is
not confident in his skills. Im not sure of myself in many ways, he tells
Wharton. I think that I need a little more time than the others. Apparently he
believes himself to be inferior to his white peers because of his race. After
Johnny Biddles death, Brooks confides to Wharton, Theres a possibility that
I killed him, isnt there? Wharton reassures him, Dont be a fool . . . I dont
want to ever hear you say any thing like that again. You were the doctor in
charge. You did what you thought was right and theres an end to it. At first
glance, this could simply be an interaction between an intern and a resident, in
which the intern consults his superior about a case. Through the prism of race
and the films storyline, however, another message emergesthat black physicians are not competent, especially since there are no scenes in the movie in
which a white physician needs to ask for assistance. To be sure, No Way Out contains a few scenes in which Brooks expressed subdued anger. Most notably, in
the films final scene, while taking care of Ray Biddles injury, Brooks seethingly
spits out, Dont cry white boy, youre going to live.25
The passivity of Luther Brooks was not lost on contemporary viewers. A Time
magazine reviewer noted that the movie does an effective job of conveying the
helplessness of its hero against unreasoning hatred. Social scientists Martha
Wolfenstein and Nathan Leites contended that what the audience saw in the
prison hospital scenes was an inexperienced, insecure Negro doctor, whose
procedure looks dubious to everyone present, [who] treats a man with a seemingly minor injury in such a way that he immediately dies. They argued that the
autopsy findings do not completely obliterate the impact of the audiences initial impression of Luther Brooks, and by extension, I would add, of black physicians in general. They also pointed out that Brooks epitomized a stock
character in Hollywood melodramas, namely, the falsely accused hero.
Wolfenstein and Leites also noted, however, that there was a significant difference between Brooks and the typical white hero. The typical white hero, they
contended, meets his difficulties self-reliantly and fights alone for safety; the
Negro is here dependent on others to fight his battles. They note, for example,
that in the final scene it is Edie Biddle, a white woman, who saves Brooks.26
The release of No Way Out proved far more controversial than that of Lost
Boundaries, primarily because it contained racial epithets and depicted a race
riot. According to director Joseph L. Mankiewicz, the film showed racial violence on the screen for the first time since the 1915 release of the virulently
racist Birth of a Nation. No Way Out found itself briefly banned in Chicago,
threatened with a ban in Boston and Philadelphia, potentially censured in
Baltimore, and not released at all in the South. On August 8, 1950, the Chicago
Board of Censors recommended that the film be banned in the Windy City.
Police Commissioner John C. Prendergast and Police Censor Harry Fulmer

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supported the recommendation and sought to ban the film under a city ordinance that prohibited events that produced a breach of the peace, riots, or
unrest. Captain Fulmer charged that the picture was something that might
even cause more racial unrest than we have now. We already have a problem
without adding to it. We have numbers of policemen detailed on housing projects just to prevent trouble. He noted that he had seen no problems with Pinky
and Lost Boundaries because the endings of these films indicated acceptance or
reconciliation between the races. He alleged that at the end of No Way Out,
the colored and white characters appeared to hate each other as much as at
the beginning.27
NAACP Executive Secretary Walter White quickly sped into action and orchestrated a campaign to protest the ban. He received support from a broad array of
progressive and civil rights organizations, such as the Anti-Defamation League,
the Public Education Fund, and the Common Council for American Unity, in
addition to support from local Chicago sources such as businessman Marshall
Field and the Chicago Sun Times. In a telegram to Chicago Mayor Martin
D. Kennelly, White explained why he thought that the ban should be rescinded:
This picture, he wrote, is the most forthright and courageous picturization of
the evil of race prejudice which has yet been made. . . . No Way Out exposes
the evil nature of this practice and instead of inciting to riot as police censor
claims will do enormous good in the exactly opposite direction. Whites actions
were not surprising. He had worked behind the scenes with Fox executives to
build black support for the movie, and at their urging wrote articles praising the
film. White viewed the films success as crucial for the achievement of the
NAACPs Hollywood campaign, and feared that a ban would stop Hollywood
from making such films. Fulmer appointed a citizens committee composed of
three blacks and three whites to review the film; the committee unanimously recommended that it not be banned. Fulmer followed the committees recommendation, and the film opened without cuts and without incident on
September 23, 1950.28
The film was not banned in Boston, but it was released with edits. Attempts by
the Maryland censor to edit the film sparked controversy in Baltimore, however,
and led to a split in black opinion over the movie. At issue was the decision by
Sidney R. Traub, chairman of the Maryland Board of Motion Picture Censors to
delete the scenes in which the black mob attacks the white mob and in which
epithets are used. Traub, as well as the Maryland State Police and the Baltimore
City Police, regarded those scenes and the accompanying dialog as highly
provocative and crime inciting. Lillie M. Jackson, president of the Baltimore
branch of the NAACP, said the deleted scenes were vital to the film, for they provided context for the use of the racial epithets. In a letter to Traub, she acknowledged that representatives of her organization had not objected to the use of
the epithets when they viewed the uncut version of the film. She wrote, We did
not oppose the racial epithets because as the picture unfolds, they are shown to

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be the stimulating cause of the victorious battle . . . and justify the intense
defense [the black mob] put up. She concluded that if the scenes remained
deleted and the epithets intact, the local branch of the NAACP would oppose
the showing of the film in Baltimore.29
Carl Murphy, the powerful publisher of the Afro-American newspapers entered
the fray and argued that the movie should not be shown, even with the mob
scenes restored, because of the epithets. He ran stories such as No Way Out
Film Filthy With Epithets, and Movie Epithets Indict Our Leadership, which
not only condemned the film but also criticized black leaders for not opposing
the use of foul language. One article read, We believe that the release of a film
such as No Way Out tends to debase and corrupt the morals of the people by
permitting language that is not decent for women and children to hear.
Murphy telegrammed Maryland governor W. Preston Lane not only to declare
his opposition to the film, but also to warn the governor that its release might
harm his reelection campaign. Murphy used his clout to get the Negro
Newspaper Publishers Association to pass a resolution condemning the number
of epithets in the film. Walter White, caught between the demands of Hollywood
executives and black critics, tried to play both sides of the fence. Publicly, he
urged Traub to restore the cuts, and privately, he suggested that 20th Century
Foxif technically possible and artistically feasibledelete the epithets from
future showings. Traub stood firm, and the film, with the cuts he had initially
made, was released in Baltimore.30
Despite the controversy, No Way Out did receive some strong and, at times,
hyperbolic support from the African-American community. The Pittsburgh
Courier heralded it as a great film. The California Eagle dubbed the movie a
must to see that presented a new, startling approach to [the] racial problem.
Channing Tobias, the first black director of the Phelps-Stokes Fund, a philanthropic organization dedicated to improving educational opportunities for
African Americans, called No Way Out a very strong picture and one that will
serve a useful educational purpose. The Negro Actors Guild honored Darryl F.
Zanuck for his work on a film it called, the greatest step forward in the fight
against racial prejudice since the start of movie-making, and, the most dramatic and most effective expose of prejudice and discrimination yet filmed.31
African-American physicians identified with the fictional Luther Brooks and
praised the film for its depiction of the obstacles they faced. An editorial in The
Journal of the National Medical Association, a publication of the black medical society, the National Medical Association, called No Way Out, a preeminently medical film, and urged its members to see it. Referring to the insults that Dr.
Brooks had to endure, it stated, There is nothing in the picture which the
informed observer of medical developments among the Negro could not identify with parallels from his own experience. The editorial also contended that
the film struck a blow at the tendency for the Negro sometimes to regard himself as requiring special attention. As evidence, it pointed to a scene in which

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Dr. Brooks thanks Dr. Wharton, the chief resident, for showing special interest
in him. Wharton, however, challenges Brooks assessment of their professional
relationship, and makes clear that he is receiving the same attention as any other
good doctor on the staff.32
Critics responses to No Way Out were also mixed, although the performances
were universally praised. An examination of the films reviews clearly show that
the 106-minute black and white feature provoked strong, passionate, and
intense reactions. Life, as it had with Lost Boundaries, named the film a movie of
the week, describing it a bold, crude, outspoken film which makes all the previous [films about race relations] look like pussyfooting. The review continued,
Earnest and vigorous and very well acted, No Way Out is one of the top shows of
the year for that portion of the movie audience that likes its meat raw. Newsweek
hailed the film as following in the courageous footsteps of the other race problem movies, and noted, Darryl Zanucks contribution to the screens way on Jim
Crowism packs as much emotional dynamite as any of its predecessors. Philip
Hamburger, writing in the New Yorker, noted that the film had many compelling
things to say about the plight of a Negro doctor in an unnamed county hospital,
but regretted the filmmakers tendency to smother the vigor and truth of their
message with heightened melodrama and excessive emotion. He recommended the film because of its strong performances. Time stated that the overly
melodramatic No Way Out was not the best of the Negro-problem pictures, but
that it was undoubtedly the most outspoken and pertinent . . . and comes
directly to grips with racial prejudice in what is presumably an enlightened area
of the U.S. It found that, like most films of its kind, the picture stacks its cards
too obviously in the Negros favor, and that most of the characters were oversimplified blacks and whites. Hollis Alpert, reviewing the film for the Saturday
Review of Literature, also criticized the film as overly melodramatic, and described
it as a stark, almost nightmarish tale of a young Negro attempting to take a dignified place in society as a doctor. Howard Clurman in the New Republic found
the movie unremittingly sadistic, and said that when it was over he was in the
mood to killblacks, whites, the producers, and practically everyone else. The
New York Times reviewer Thomas M. Pryor called the movie a blunt exposition
of anti-Negro feelings, and described an audience reaction to the film as alternating between stunned silence and inspired frequent applause. He concluded that No Way Out was an important picture because it was a harsh,
outspoken picture with implications that will keep you thinking about it long
after leaving the theater. In a later article, Pryor contended that of all the race
problem movies, No Way Out came closer to reflecting the animosities which
most Negroes experience sooner or later.33
Several reviews criticized the films portrayal of racism as the exclusive realm
of lower class or psychotic whites. The Saturday Reviews Alpert disapproved of
the films depiction of bigotry as primarily being the result of a sick mind For my
experiences tell me, he contended, that there are fairly normal, reasonably

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well-adjusted housewives who will not live on the same street as a Negro, who
wont share a housing project with Negro families. Newsweek contended that
the film featured a character who has a psychotic hatred towards blacks, but
noted that a less psychotic character would have served better as an indication
of how race prejudice can grow to the dimensions of sicknesseven in the
North.34
Controversy and mixed reviews did not stop No Way Out from receiving honors. Screenwriters Joseph L. Mankiewicz and Lesser Samuels were nominated
both for an Academy Award and for the Writers Guild of Americas Robert
Meltzer Award. The Foreign Language Press Film Critics Circle gave the film an
unprecedented special award because of its contributions to the improvement
of American race relations. Despite such honors, the viewing public voted
against No Way Out, and it failed at the box office, as did Intruder in the Dust, the
movie in the cycle of race problem films that immediately preceded it. These
failures contributed to the end of Hollywoods postwar interest in the plight of
African Americans. The investigations of Hollywood by the House on UnAmerican Activities Committee also played a significant role. Myron C. Fagan,
head of the Cinema Education Guild, which he had established to unmask communists in Hollywood, had painted No Way Out red, declaring it communist in
orientation.35
Either passing or passivethese were the images of black physicians that
Hollywood presented in the postwar era. In The Shadow and the Act, his essay
on the postwar race movies, Ralph Ellison contended, Obviously these films are
not about Negroes, at all; they are about what whites think and feel about
Negroes. Indeed, off the screen, a different image of postwar black physicians
emerges. After World War II, black medical organizations launched an activist
civil rights agenda and fought for their equality in medicine. They worked to
desegregate hospitals, training programs, and medical schools, and pushed to
have their credentials accepted by national medical organizations. For example,
in 1945, the board of trustees of the National Medical Association outlined a
program to desegregate the medical profession. Two years later, the NMA joined
forces with the National Association for the Advancement of Colored People
(NAACP) to push a medical civil rights agenda. Thus the imagery of black physicians that Hollywood presented in Lost Boundaries and No Way Outas either
passing or passivebelied the social and professional realities of black physicians in the years following World War II. But, despite their flaws, these films are
significant not only in film history but in black medical history. They provided
many white Americans with their first and only encounteralbeit cinematic
with black physicians, and thus made plain to a broad audience that black physicians could and did practice medicine. In 1950, approximately 3,750 black
physicians practiced in the United States, and Lost Boundaries and No Way Out
brought to light the obstacles these physicians faced as they made their way in
the medical world.36

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Notes
I wish to thank Gaynell Simpson and Michelle Yeboah for their research assistance
in the preparation of this essay. This work was supported in part by a Robert Wood
Johnson Foundation Investigator Award in Health Policy. The views expressed imply
no endorsement by the Robert Wood Johnson Foundation.
1. Quoted in Daniel J. Leab, From Sambo to Superspade: The Black Experience in Motion
Pictures (Boston: Houghton Mifflin, 1975), 146. The two films that examined antiSemitism were Crossfire (1947) and Gentlemans Agreement (1947).
2. Leab, From Sambo to Superspade, 146; Gayle Wald, Crossing the Line: Racial Passing
in Twentieth-Century U.S. Literature and Culture (Durham: Duke University Press,
2000), 89; Thomas M. Pryor, Racial Issue Film, New York Times, August 20, 1950, 81.
3. For an extended discussion of the history of the race problem films, see
Daniel J. Leab, From Sambo to Superspade, 14571; Donald Bogle, Toms, Coons,
Mulattoes, Mammies, & Bucks: An Interpretive History of Blacks in American Films, New
Expanded Edition (New York: Continuum, 1989), 14358 and 17579; and
Thomas Cripps, Making Movies Black: The Hollywood Message Movies from World War
II to the Civil Rights Era (New York: Oxford University Press, 1993), 21549. A useful, but dated, description of using film to teach African-American history can be
found in Marshall Hyatt and Cheryl Sanders, Film as a Medium to Study the
Twentieth-Century Afro-American Experience, Journal of Negro Education 53
(1984): 16172. For an excellent essay review and bibliography of AfricanAmerican film history, see Thomas Cripps, Film and Television, in Evelyn Brooks
Higginbotham, ed., The Harvard Guide to African-American History (Cambridge:
Harvard University Press, 2001), 177208. Home of the Brave and Lost Boundaries
are available in VHS format. Pinky and No Way Out are available in both VHS and
DVD formats.
4. For a cursory discussion of the image of black physicians in films, including the
films analyzed here, see Peter E. Dans, Doctors in the Movies: Boil the Water and Just Say
Aah (Bloomington, IL: Medi-Ed Press, 2000), 14971.
5. William L. White, Lost Boundaries (New York: Harcourt, Brace and Company,
1948). The story first appeared in condensed form in W. L. White, Lost Boundaries,
Readers Digest, 51 (December 1947), 13554; White, Lost Boundaries, 1516.
6. Ibid., 16.
7. Ibid., 1113.
8. Ibid., 1617, and Vanessa Northington Gamble, Making a Place for Ourselves: The
Black Hospital Movement, 19201945 (New York: Oxford University Press, 1997). For
an account of the status of black medical students in the 1920s, see Committee
Investigating the Admittance of Colored Interns and Nurses to the Staff of Cleveland
City Hospital, December 12, 1927, unpublished report, Western Reserve Historical
Society Library, Cleveland, Ohio.
9. White, Lost Boundaries, 18.
10. White, Lost Boundaries, 18 and 9; Judith Gaines, N.H. Town Fetes Family, Film,
That Broke Barriers, Boston Globe, July 30, 1989, 33. For an excellent analysis of how
whiteness bestows power, privilege, and wealth, see George Lipsitz, The Possessive
Investment in Whiteness: How White People Profit from Identity Politics, revised and
expanded edition (Philadelphia: Temple University Press, 2006).
11. White, Lost Boundaries, 85; Albert Chandler Johnston, Sr. Mamiya Medical
Heritage Center web page: http://hml.org/mmhc/mdindex/johnstona.html.

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[Accessed May 7, 2006]; Robert McG. Thomas, Jr., Thyra Johnston, 91, Symbol of
Racial Distinction, Dies, New York Times, November 29, 1995, B11.
12. White, Lost Boundaries, 3033. The navy accepted the first black naval officers in
1943. For more information on these pioneers, see Paul Stillwell, ed., The Golden Thirteen:
Recollections of the First Black Naval Officers (Annapolis, MD: Naval Institute Press, 1993).
13. Ibid., 3842; 4874; 8384; Dorothy Dunbar Bromley, Dr. Johnstons Case,
New York Herald Tribune, October 16, 1949; II7. The Johnston family returned to
Keene to celebrate the fortieth anniversary of the films release, held on July 24,
1989. For information on this event, see Gaines, N.H. Town, and Howard
Mansfield, Amid Prejudice, A Fraction of Success, Washington Post, July 25, 1989,
C1 and C8. New Hampshire Public Television also produced a 1989 documentary,
Home to Keene: The Lost Boundaries Reunion, about the anniversary.
14. Lillian Scott, Lost Boundaries is Purchased by Metro, Chicago Defender, June 5,
1948, 8; Walter White to William L. White, November 18, 1948, Lost Boundaries
Folder, NAACP Group II, Box A277, NAACP Papers, Library of Congress,
Washington, D.C. (Hereafter, Lost BoundariesNAACP Papers); Cripps, Making Movies
Black, 227; Lost Boundaries, Ebony 5 (June 1949), 51.
15. For an extended analysis of passing in Lost Boundaries and Pinky, see Wald,
Crossing the Line, 82115.
16. Ibid., 92.
17. Walter White to Louis de Rochemont, May 23, 1949, Lost BoundariesNAACP
Papers.
18. Bosley Crowther, Best Films of 1949, The New York Times Film Reviews, vol. 4
(New York: Times Books and Garland Publishing, 1990), 2388 (originally published
December 25, 1949); Movie of the Week: Lost Boundaries, Life 27 (July 4, 1949), 64;
John Mason Brown, Eyes That Blind, The Saturday Review of Literature 32
(September 10, 1948), 3233; Lost Boundaries, Time, July 4, 1949, 65.
19. Manny Farber, Lost Boundaries, July 30, 1949, 114; V. J. Jerome, The Negro in
Hollywood Films (New York: Masses & Mainstream, 1950), 3031, 34, and 49.
20. For information about the NAACPs efforts to advertise and support the film, see
Lost BoundariesNAACP Papers; Walter White, Do Race Pictures Denote New
Hollywood Attitude, Chicago Defender, June 25, 1949, 7; Kenneth Robert Janken,
White: The Biography of Walter White, Mr. NAACP (New York: The New Press, 2003),
xiii; Lee Predicts More Films Like Boundaries, Afro-American (Baltimore),
September 24, 1949, 8; B. M. Phillips, AFRO Writer Previews Dramatic Film, Lost
Boundaries, Story of Passing, Afro-American (Baltimore), August 13, 1949, 8. The
publishing headquarters for the Afro-American were located in Baltimore. The reach
of the newspaper, however, was national; at one time as many as thirteen editions of
the paper existed across the country, in cities such as Baltimore, Washington, D.C.,
Philadelphia, Richmond, and Newark. Unless otherwise noted, the Baltimore edition was used in writing this chapter. Lost Boundaries, Ebony, 51; Rose Pelswick,
Lost Boundaries is a Highly Effective Drama, Norfolk Journal & Guide, August 8,
1949, 14; Meredith Johns, A New Dawn Is Slowly Breaking Over Hollywood,
Chicago Defender, July 9, 1949, 12; Al Monroe, Lost Boundaries An Entertaining
film of Distorted Story, Chicago Defender, August 27, 1949, 25.
21. Al Andersen, Hollywoods Conscience Shown in 1949, Afro-American (National
Edition), 31 December 1949, 9; Cripps, 23031; Ralph Ellison, The Shadow and
the Act, in his Shadow and Act (New York: Random House, 1964), 27879
(Originally published in The Reporter December 6, 1949).

passing or passive

261

22. Leab, From Sambo to Superspade, 147 and 156; May Censor Movies, Says Atlanta
Jurist, New York Times, March 3, 1950, 23; $20,000,000 Box-Office Payoff for
Hwood Negro-Tolerance Pix, Variety, November 30, 1949, 1.
23. For an extended discussion of Zanucks social consciousness films, see Russell
Campbell, The Ideology of the Social Consciousness Movie: Three Films of Darryl
F. Zanuck. Quarterly Review of Film Studies 3 (Winter 1978), 4971; Kenneth L. Geist,
Pictures Will Talk: The Life and Films of Joseph L. Mankiewicz (New York: Charles
Scribners Sons, 1978), 153; Lesser Samuels, No Place For Anger, New York Times,
July 30, 1950, II5; Sidney Poitier, This Life (New York: Alfred A. Knopf, 1980), 131;
Bogle, Toms, Coons, Mulattoes, Mammies, & Bucks, 17576.
24. Excerpts from No Way Out 1950. Courtesy of Twentieth Century Fox. Written
by Joseph L. Mankiewicz and Lesser Samuels. All rights reserved.
25. Ibid.
26. No Way Out, Time, 84; Martha Wolfenstein and Nathan Leites, Two Social
Scientists View No Way Out, Commentary 9 (1950): 38990.
27. Mel Gussow, Darryl F. Zanuck: Dont Say Yes Until I Finish Talking (New York: Da
Capo Press, 1971), 158; No Way Out Is Out in Chicago, New York Daily News, August
24, 1950, 27; Chicago Ban on Film No Way Out Draws Protest, Norfolk Journal and
Guide, September 2, 1950, 15.
28. Nelson M. Willis to Walter White, August 29, 1950, No Way Out Folder, NAACP
Group II, Box A278, NAACP Papers. (Hereafter, No Way OutNAACP Papers); Malcolm
Ross to Walter White, July 31, 1950, No Way OutNAACP Papers; At Last, No Way
Out Makes Its Chicago Debut, The Chicago Defender, September 23, 1950, 21.
29. John B. Hynes to Walter White, September 21, 1950, No Way OutNAACP
Papers; Lillie M. Jackson to Sidney Traub, October 13, 1950, No Way OutNAACP
Papers.
30. No Way Out Film Filthy With Epithets, Afro-American (Baltimore), n.d., and
Movie Epithets Indict Our Leadership, Afro-American (Baltimore), n.d., newspaper
clippings in No Way OutNAACP Papers; Sidney R. Traub to Walter White, October
30, 1950, No Way OutNAACP Papers; Walter White to Edward Harrison, October
23, 1950, No Way OutNAACP Papers Walter White to Sidney R. Traub, October 20,
1950, No Way OutNAACP Papers.
31. No Way Out Is Great Film, Pittsburgh Courier, September 23, 1950, 14;
Gertrude Gipson, No Way Out Presents New Startling Approach To Racial
Problem, California Eagle 25 August 1950, 14 and 16; Quotes From Opinions on No
Way Out, The Afro-American (Baltimore), August 13, 1950, 8; No Way Out Cited as
Most Effective Expose of Hatred, The Afro-American (Baltimore), August 26, 1950, 8.
32. Problem Movies, editorial, Journal of the National Medical Association, 42 (1950):
39596.
33. No Way Out, Life 29 (September 4, 1950), 44; No Way Out, Newsweek, August
21, 1950, 83; Philip Hamburger, No Way Out, New Yorker, August 26, 1950, 68; No
Way Out, Time, August 21, 1950, 84; Hollis Alpert The Fall and Rise of Richard
Widmark, The Saturday Review, 33 (September 2, 1950), 28; Harold Clurman, No
Way Out, New Republic, 4 September 1950, 23; Thomas M. Pryor, No Way Out, New
York Times, August 17, 1950, 23; Thomas M. Pryor, Racial Issue Film, 81.
34. Alpert The Fall and Rise of Richard Widmark, 84; No Way Out, Newsweek, 83.
35. Critics Award Goes to Pix No Way Out, Chicago Defender, August 26, 1950,
21; Michael Shortland, Medicine and Film: A Checklist, Survey, and Research Resource
(Oxford: Wellcome Unit for the History of Medicine, 1989), 35.

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36. Ellison, The Shadow and Act, 275; Jessie Parkhurst Guzman, ed., 1952 Negro
Year Book (New York: Wm. H. Wise, 1952), 16364. For information on the civil
rights activities of black physicians, see Gamble, Making a Place for Ourselves, 18296;
David Barton Smith, Health Care Divided: Race and Healing a Nation (Ann Arbor:
University of Michigan Press, 1999), 3295; P. Preston Reynolds, Hospitals and Civil
Rights, 19451963: The Case of Simkins v. Moses H. Cone Memorial Hospital,
Annals of Internal Medicine 126 (1997): 898906; P. Preston Reynolds, Dr. Louis T.
Wright and the NAACP: Pioneers in Hospital Racial Integration, American Journal of
Public Health 90 (2000): 88392; W. Michael Byrd and Linda A. Clayton, Race,
Medicine, and Health Care in the United States, 19002000 (New York: Routledge,
2002), 193280.

Chapter Nine

From Expert in Action to

Existential Angst
A Half Century of Television Doctors
Joseph Turow and Rachel Gans-Boriskin
Prime time series about the medical profession, its settings, and its practitioners
have been staples of U.S. television since the 1950s. Over the decades, series
with medical practitioners as main characters have often provided an opportunity for viewers to learn specifically what goes on in parts of the profession that
they cant see. Such series fictional presentations have opened curtains on relationships between doctors and nurses, specialists and generalists. In ways that
news reports cannot, they have played out various assumptions about how health
care should be delivered, about conflicts that affect health care, and about how
those conflicts should be resolved and why. Accurate or not, these depictions
have provided both intellectual and emotional colorations to audience understandings that can reinforce, extend, or contradict ideas about the institutions
they encounter in news and in person.
The shaping of those stories has been guided by the television industrys desire
to work with successful formulasthat is, with systematic approaches to characters, setting, and patterns of actionthat draw large audiences. The word formula may imply a static set of features. Actually, as John Cawelti and other analysts
of the popular arts have pointed out, storytelling formulas are dynamic aspects of
culture.1 They are marked by changes and continuities that reflect the time in
which they emerged as well as the contemporary period of their production. From
an historical perspective, changes to a popular culture formula about an institution can yield more subtle insight into the ideas held by a broad population about
institutional power than analyzing only the non-fictional materials presented to
that population. In addition, understanding the reasons behind continuities and
changes in setting, characterizations, and plot patterns of a storytelling formula
can illuminate the forces guiding broadly-shared views of the institution.

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Continuity and change is of particular interest when it comes to prime time

televisions medical show formula. Assumptions about medicine that guide
government and corporate policymakers today are drastically unlike those that
motivated their predecessors fifty years ago, when popular TV medical series
were emerging. In the middle of the twentieth century, U.S. policymakers
viewed medical care largely as an unlimited resource to be governed by hightech, hospital-based physicians specializing in acute problems. By contrast, present-day policymakers see medical care as a scarce commodity that must be
parceled out not primarily by physicians, but by corporate or political entities
that might profitably encourage more non-specialists and non-physicians in nonhospital environments. Moreover, policymakers see chronic disease of an aging
population, rather than acute illness, as the major challenge facing the medical
system.
This chapter examines the ways in which American televisions longstanding
formula for prime time medical series responded to these systemic changes. Our
conclusions about the nature and trajectory of the formula over more than five
decades are based on several methods: interviews with producers, directors, writers, and actors of many of the series; our own formal content analyses of such
programs during the early 1980s and early 2000s; the examination of writings
about medical programs by other analysts; and regular viewing of the great number of fictional medical shows that have aired in prime time on U.S. broadcast
and cable networks.
Based on these disparate sources we argue that a kind of tyranny of the formula shaped American televisions changing depictions of the medical system.
The health care ideals of an earlier era were built into the formula through collaboration between organized medicine and the creators of the early TV programs. Fundamental elements of the medical show formula from televisions
early daysits focus on doctors facing acute-care challenges in high-tech hospital settingsremained the organizing principles for medical series long after
government and corporate policymakers discredited the assumptions the model
reflected. Rather than venture into stories that deal with the challenges of contemporary medical economics in a wide range of settings and through a broad
gamut of health care practitioners, TVs medical show creators tended to follow
the formula and found ways to explore new takes on the familiar hospital setting
and patterns of action. The template has been flexible enough to survive both
the evolving demands of the television industry, and creators ideas about realistic portrayals in the face of change in the medical institution. Over the
decades, producers and writers have learned how to maintain the basic structure
of the essential formula while selectively incorporating elements to update it.
For creators of recent medical series, portraying the times realistically has
meant rethinking characterization by using traditional plots and settings in new
ways. Most prominently, this has resulted in questions about the viability of the
strong bond between patients and physicians historically central to the system.

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265

In the 2000s, creators regularly subverted plotlines that in previous decades

were used to underscore the centrality of physicians to hospital decision-making.
Many plots are now touchstones for ethical dilemmas that appear to challenge
the very ability of doctors in hospitals to treat people. One result is that while the
characters and action generated from the early version of the doctor show formula celebrated the hospital as a free-flowing temple of healing, TV programs
using contemporary versions now regularly depict the hospital as an existentially
scary place for physicians and patients alike.

The Early Formula

Televisions doctor show formula evolved from a combination of storytelling
approaches that had existed previously in popular films, radio, and literature, as
well as the general optimism about the medical institution in the years following
World War II. Modern medicine was making great advances. Penicillin, better
vaccines, and improved hygiene had all but conquered yellow fever, dysentery,
typhus, tetanus, pneumonia, and meningitis. The science and technology of
modern medicine seemed to be the new frontier, and the doctor was its hero as
surely as the cowboy had once dominated the West. Film, book, and radio series
such as Dr. Kildare and Dr. Christian attracted large audiences. The creators of
these materials took great care to portray medical doctors as members of a modern elect with great authority over their patients. In their worlds, hospitals were
citadels for the elects scientific practice and duties. Their approach reflected
government policymakers view of medicine as an unlimited resource with hospital-based, specialist-oriented medicine at its high-tech core.2
Medic, a show that aired with acceptablethough not greatratings from
1954 to 1956, helped to instantiate this approach into TV, with a high-tech twist.
The programs architect, James Moser, had helped to create Dragnet (195159),
a cop show that prided itself on a realistic approach to police detective work.
Starting with the premise that the Kildare and Christian radio shows did not focus
sufficiently on the wonders of acute medical care, Moser became obsessed with
the idea of medical realism. His idea was to concentrate on the life-and-death
problems of patients that doctors confronted in the most modern medical setting: the hospital. To prepare for writing the pilot, Moser shadowed interns at a
local hospital, keeping the same hours they did, and taking elaborate notes on
their experiences.
NBC bought the idea, and Dow Chemical agreed to sponsor it. When Dow
allotted only $25,000 to produce each show, however, Moser recognized that to
achieve the realism of a hospital, he had to go to the medical system for help.
He struck a deal with the Los Angeles County Medical Association (LACMA) to
allow him to film the program on location in L.A. County Hospital. In return for
access and the appearance of the LACMA seal on the program, Moser and the

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producers of Medic had to submit every script to LACMA for review of its medical accuracy. In practice, LACMA received leverage over the entire range of
Medics portrayal of medicine.
The LACMA originally had a committee of twenty-one people review every
script. After much protest from the shows writers and producers, however, the
committee was reduced to five. The resulting group of reviewers was nevertheless obsessive about even small details; members vetoed certain language,
for instance, not wanting doctors to use grammatical contractions in their
speech. In one episode, the script dictated that two doctors drink coffee while
discussing an accident victim admitted to intensive care. One of the physicians
on the review team, however, objected that showing doctors drinking coffee in
that circumstance would give viewers the impression that they did not have
serious concern for the patient. The coffee, as a result, was dropped from the
scene.
The LACMA deal meant that the images of doctors on television were being
crafted, if not to support organized medicine, then at the very least to avoid
offending it. To Moser, his sponsor, and the network, this was not a problem.
They shared the basic premises of setting (hospital-based, high-tech), characterization (doctor-centered), and plot (successful care of acute medical problems) with the leaders of medicine. Social controversies did arise around the
realism of a few episodesnotably about the showing of a caesarian birth and
depiction of discrimination against an African-American doctor. In general,
though, none of the parties involved in the shows production had particular
interest in offending the medical establishment or in investigating the politics of
medicine, such as the growing arguments about nationally funded health insurance. Production and network executives believed, moreover, that being able to
display the seal of the medical association among the shows credits gave them
credibility with the audience.

Solidification of the Formula in the Early 1960s

The perspective that Moser developed in Medic reverberated in the doctor shows
that followed during the early 1960s. Producers picked up the idea of a series
built around acute, hospital-based realism, vetted by a society of medical professionals to whom realism meant clinical accuracy about the nature of disease
and the handling of equipment. They allowed a script to drip with high melodrama, unlikely solicitousness of the physician for his patient, and even doctorpatient romance. But producers insisted that all this had to be buttressed by
verisimilitude in the hospital setting, in dialogue about diseases and medicines,
and in the handling of equipment. They especially urged consultants to take
care that the TV surgeons hold scalpels and other equipment as their real-life
counterparts would.

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The hit series that solidified the formula and its notions of realism were Ben
Casey (196166) and Doctor Kildare (196166). Ben Caseys originator was James
Moser, and Dr. Kildares executive producer was Norman Felton, who headed
MGMs television division. Both men were optimistic about the direction of
medical science, and they believed that Medic had pointed out the potential for
creating a realistic prime time television series on medicine. But Felton and even
Moser had come to believe that Medic had not hit it big in the ratings because
its patterns of action were too realistic in stressing health care techniques and
technology.
Felton believed that a way to make a medical series compelling was to blend
the realism of Medic with the standard characters of melodrama. He specifically
wanted to employ the themes from MGMs highly popular movie and radio
series from the 1940s about an intern named Dr. Kildare. Felton did not want to
duplicate the radio and film series, which he felt was too soap operatic, but
rather use the Kildare name to attract new audiences. Felton, understanding the
rules of television, also thought that viewers would like to watch the exploits of
a young and attractive doctor. NBC programmers agreed, especially after seeing
the enthusiastic test audiences reaction to the star, Richard Chamberlain.
James Moser had also decided that he had to get closer to a more melodramatic approach to medicine if he were successfully to pitch his next idea for a
medical drama to a network. Visiting a friend at L.A. County Hospital to search
for story ideas, he decided that the medical area he should focus on was neurosurgery, which, he believed, pulsated with the human drama and emergency situations that television required. Another selling point, he decided, was a central
male character with the gruff style he saw in the surgical interns. This character,
he believed, could be the perfect medical counterpart to the popular antihero
of the later 1950s. He would be James Deanthe rebel without a causein a
surgical gown. It struck me, Moser recalled, that it was a pretty good hook. It
was believable, argumentativeyou know, challenges his superiors, the whole
bit.3 It fit within the established formula but was just different enough to hold
appeal for the networks.
Moser and Felton worked to balance the needs of the ratings-driven networks
and the image conscious medical establishment. Both were concerned with
ensuring the authentic medical look of their hospital-based series, as well as
the accuracy of the specific information mentioned in them. They hired technical advisors, usually MDs, to check scripts and guide verisimilitude on the set.
Beyond the technical advice, the two shows had to pass the scrutiny of the
advisory committee at the AMA, which had succeeded LACMA as the oversight
body. They had received the AMAs seal on the condition that the advisory committee had the right to pass on every script. The AMA was also interested in guiding depictions of medicine in an era in which they saw challenges to the
traditional fee-for-service model of medicine emerging in governmental programs like Medicare and Medicaid. The committee members saw themselves as

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both safeguarding their professions public image during a stressful period, and
reinforcing medicines role as a teacher of responsible health care behavior. Yet,
when they talked publicly about their work, they emphasized the latter role.
Studio personnel recalled that AMA demands centered on preserving the traditional godlike image of physicians as the unquestioned rulers of the health
care setting. Moser, Felton, their writers, and their producers said that they had
to be pragmatic about their dealing with the medical establishment if they
wanted its support. All admitted that such pragmatism resulted in self-censorship. Moser noted specifically that there were storiesabout doctors shielding
one another from legitimate complaints, and about turf fights between medical
specialtiesthat he and others working on Ben Casey felt were too sensitive for
television. At the same time, the producers were able to get committee members
to compromise now and then. So, for example, the physicians moderated their
stance on accuracy to allow for the dramatic telescoping of time and the use of
inappropriately large syringes that would look good on camera.4
The central characters in Kildare and Casey fit a mold that transcended the
medical drama. Both shows featured a handsome young man and an older man
who acted as his mentor, confidante, and sometime antagonist. These were
the roles and rules of television. As for the plots, there was a definite pattern
to follow. Mostly, as James Moser noted, it was doctor/patient/hospital.5 The
unblemished doctor in the unblemished hospital would establish a relationship
with a physically distressed patient. Throughout the action, the physicians were
clearly positioned as the leaders of the medical ship who were sworn to see
health care as an unlimited resource. Patients would get all the attention and
technologies they needed, with no concern for cost.
Ideas that fit this form could come from many sources in the realm of popular culture. A successful episode had to include guest stars, as the primary focus
was rarely the physician characters. Indeed, the viewer really learned very little
about these regulars, who were, instead, catalysts that sparked an exploration of
the visitors (typically patients) and their concerns.
The exploration often tied into a contemporary social issuechild abuse,
greedy funeral directors, drug abuse, fear of epilepticsthat the visitor represented, even while the visitor was there for a physical problem. The patterns of
action reflected the interests of both the medical and television industries. Since
a hospital stay was needed, the medical problems tended to be complex, and
they were almost always physical rather than psychological. Because each
episode was generally expected to tell a story that stood alone, the patients difficulties were typically acute or in their acute stages, allowing them to move
towards a cure (or, much less often, death) that created a natural end to the
episode.
The extraordinary popularity of both Kildare and Casey encouraged other
attempts to hit gold with medical shows in prime time during the 1960s. The
Eleventh Hour (196264) and The Breaking Point (196364) tried to find acute

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269

dramatic moments in the work of psychiatrists. The Nurses (196265) attempted

to graft the doctor formula onto other professions. All faltered in the ratings, in
addition to provoking anger from elite physician groups such as the AMA. Postmortems in the TV trade press and in casual executive conversations evolved
three dicta. Shows focusing on the mind would not work as well as shows about
acute life-and-death problems of the body. Shows about the politics of medicine
(tried now and then by The Nurses) would not turn viewers on. Finally, only programs centering on (male) doctorsnot nurses and not psychologists (as in The
Eleventh Hour)could realistically deal with the range of life-and-death concerns
that would grip viewers on a weekly basis.

Continuity and Change

The creators of Medical Center (196875) and Marcus Welby (196875), both of
which premiered in 1968, picked up these dicta and crafted their series around
them and the Casey-Kildare formula. Don Brinkley and Frank Glicksman, who
had worked on Ben Casey, followed the pattern to a T with Medical Center. The
show revolved around a young physician and an older physician treating mostly
acute patients in a hospital complex. A new setting allowed the creators to
update the formula to fit the times; the hospital was located at a university, so
that watered-down versions of the youth protests of the day could sometimes
infiltrate the plots. In addition to adding an air of realism to the melodrama, the
emphasis on youthful rebellion aimed to attract young-adult viewers who were at
that time becoming the most important groups for advertisers to lure.
Marcus Welby pushed the formulas setting and plots in a different direction.
Unlike earlier (and later) TV series, and more like Doctor Christian of pre-World
War II radio and movie fame, Marcus Welby valorized the general practitioner
rather than the specialist. The show also dealt consistently with long-term medical problems that were tied directly to the patients psyche and interpersonal
behavior. Still, the basic pattern remained. The patients that Marcus Welby and
his young colleague, Steven Kiley, treated almost always appeared for only one
episode, no matter the course of the disease. In fact, whether the illness was
chronic or acute, the focus was invariably an acutely dangerous problem that
forced the patient into the hospital in the episodes climax. Welby even moved
his practice to a hospital toward the end of the programs run.
By the early 1970s, then, the doctor show formula was a familiar and accepted
part of television production. It was also quite clear that the formulas very
approach to characters and patterns of action had respect for the profession
built into it. To physician Michael Halberstam, writing in the New York Times
Magazine, that was for the good. Commenting on the most popular show of the
day, Marcus Welby, M.D., he suggested that in an era when medicine and other
professions were being denigrated, it was important to have a widely popular

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program that romanticized physicians. The need for scientific knowledge, for
compassion, and for relentless dedication is not a trick bag decked out by the
AMA, but the deepest want of any human in trouble.6 He said that Welby continually reminded the public that the best of Americas physicians abided by that
credo.
Many physicians disagreed strongly. At professional conferences and in letters
to journals, they argued that the credo the show enacted was totally unrealistic
for the modern physician. Focusing on one patient and his (or her) family per
episode, Welby and his partner seemed to be running a two-person intensivecare service. The doctors even found time to take patients to ballgames, stop by
their workplaces, and attend their weddings. Beyond that, physicians complained, diagnosis of major problems on the Welby series was typically quick,
even in the case of chronic problems. This gave viewers the impression, said critics, that good physicians can untangle serious illnesses rather quickly. Illnesses
began to clear up during the course of the episode, giving the impression of
quick cures for even long-term illnesses. Further, the anti-Welby faction railed,
money never seemed to be a concern, either between Welby and patients or
Welby and his partner. Organized medicine was beginning to question, in fact,
whether all of the carefully crafted images of doctors over the past decades had
actually harmed physicians. Leading physicians carped publicly that TV doctors
were too solicitous of their patients, and that viewers, as a result, unrealistically
expected their own physicians to act the same way. The view by some was that
the increased readiness to sue physicians came at least partly from a feeling of
betrayal that physicians were not acting the way viewers had been led to believe
they ought to act.
These arguments surrounding Welby marked the first time that the medical
establishment got involved in large-scale debates about whether positive fictional representations actually had negative effects on its status. At a time of
strong public antipathy to institutional power, organized medicine saw that it
was time to back away from direct image control, although it is questionable
whether the medical establishment had enough clout in the 1970s to exert the
same sort of pressure on television producers that it did in the 1950s and early
1960s. The American Medical Association discontinued its TV advisory panel
and stopped offering its imprimatur to television series. For Welby, David Victor
did seek the help of the American Academy of Family Physicians, which allowed
him to post their approval at the end of the program in return for monthly
review of scripts. Victor also, however, hired an L.A. physician as his script consultant, and a nurse to help with the in-studio details. That kind of independent expertise became the norm for doctor shows in the 1970s and beyond.
Though nominally independent from organized medicine, the experts nevertheless represented their professions viewpoints to the writers and producers.
There was plenty of work to go around; twenty-seven doctor series aired during the 1970s. For creators, the trick was to find a variation on the tried-and-true

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formula. One way was to appear urgently relevant (a buzzword meaning

engaged realism in the 1970s television industry) without being truly controversial. The Bold Ones: The New Doctors (196973) were among the shows that
attempted to focus on state-of-the-art medical technology. A few programs introduced women and African Americans as medical professionals. Producers also
tried to gain audiences by confronting hot-button issues such as abortion, homosexuality, drug addiction, venereal disease, and rape. During the 1960s, network
executives would never have allowed such issues on TV. Now, in the heat of ratings competition, and with their social antennae attuned to changing mores,
they did. Arguments between producers and networks shifted from deciding
whether a topic was acceptable to making sure that a relevant but potentially
volatile topic would not offend the viewing audience.
A few producers went off the formulas beaten track and tried to merge what
they considered the life-and-death aura of medicine with elements from other
areas of popular culture. The creators of two such series, Emergency! (197276)
and Quincy, ME (197683), succeeded. Emergency!, which followed a team of
paramedics on their rescue missions, started out as an attempt to develop a TV
series based on a Universal Studio movie about a fire and rescue team. Quincy,
about a medical examiner, mixed the doctor and the detective.
Rather than encouraging a stream of imitations, though, the programs
approaches were considered dead-ends by the late 1970s. In Emergencys case, it
was because the two series that attempted to copy the medical rescue format
turned out quickly to be unsuccessful. Quincys success, TV insiders believed, was
due less to the concept than to the appeal and energy of its star, Jack Klugman.
Most producers and network executives believed that greater chances for ratings
success could be found working with the traditional hospital-based model.

Challenges to the Formula

That did not mean that all was well with the doctor show, however. In fact, at the
height of its presence on TV, its viability was in question from two very different
constituencies. In corporate and government circles, policymakers were rethinking the medical system, the result being that assumptions at the core of the doctor series were seriously outmoded. At the same time, but quite separately, TV
industry executives were voicing a serious lack of faith in the doctor shows continued ability to tell compelling stories.
Reconsideration of the medical system had drawn a lot of interest by the mid1970s.7 Many health care experts had begun to worry that the cost of medical
care was rising out of proportion to inflation. Private employers became concerned that the cost of insuring their workers was forcing up the price of their
goods, which would make them less competitive with products manufactured
outside the United States. During the late 70s and throughout the 80s, as the

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cost of medical care continued to rise, it became clear to policymakers and

bureaucrats that U.S. society could no longer consider medicine an unlimited
resource available to all those who needed it in the amount that they desired or
even required. Managing medical care became a focus of government and private-sector economists as health maintenance organizations (HMOs) and other
managed care facilities began to spring up. The cost of high-tech care was questioned, as was the alleged over-abundance of physician specialists.
At the same time, economists and ethicists became concerned about the
problems that such a rethinking of health care might cause. Should only certain hospitals be allowed to buy certain kinds of expensive equipment?
Should specialization be discouraged in favor of an increase in the number of
primary care physicians? Would managed care inevitably mean rationing? If
so, on what basis might care be rationed? Age? Socioeconomic status? Who
should make rationing decisions? Legislators? Insurance executives?
Physicians? Some combination of these? What might the implications be for
medicine and society when physicians no longer saw themselves in full control of medical care?
These questions, along with the general policy transformation, might have suggested an entirely new approach to realism in medical settings, characters, and
plotsone in which struggles over resources and the impact on patients and
health care workers would take center stage. One 70s show, Medical Story (1975),
did try consistently to dramatize some of the changes afoot. It died in the ratings
and became a justification by some TV producers to steer clear of the political
forces behind medicine. Still, experimenting with politically charged series that
took place in an unusual (for TV) part of the medical systemsay, an insurance
company, a center for disease control, or a pharmaceutical firmneed not have
seemed so far fetched. To many in Hollywood, the traditional formula seemed
not to be working well. Of the twenty-seven doctor programs that aired during
the 1970s, eighteen did not last more than a year. Some TV creators, like producer Jerry Thorpe (Rafferty, 1976), tended to believe that the doctor show had
shown it didnt have the resiliency other TV formulas exhibited to express realistically the mood of changing times. The law and detective forms allowed broad
license in the attitude toward human life, he suggested. Its possible on those
shows to take life less than seriously, he said, but on doctor shows you cant do
that. So you reach a dead end, a limit beyond which you cant go.8
But not all producers were ready to write off the traditional medical show formula, in part because programs that strayed too far from the formulas basics
seemed to fail. Further, network programmers believed that the life-and-death,
physician-centered hospital series was still a solid, female-oriented vehicle that
could be useful if aired sparingly in the later hours of prime time. The trick, they
thought, was to find an element that would refresh the form, but not avoid the
traps of the 70s shows that pandered to contemporary controversy, the female
or ethnic lead doctor, the attempts at action outside the hospital.

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The M*A*S*H Difference

Advocates of the traditional doctor show formula believed that M*A*S*H
(197283) pointed toward a solution. The iconoclastic half-hour series about
surgeons during the Korean War had become wildly popular during the 1970s.
It had also become a tempting target for imitation. Producers believed that
redoing characterization of doctor shows along M*A*S*H lines would allow
them to respond successfully to the times while keeping the essential elements
of the hospital-based, acute, physician-centered formula.
Based on the popular 1971 Robert Altman feature film, M*A*S*H combined
the horror and desperation of war and the operating room with the manic antics
of the surgeons outside of surgery. At the core of the show was the realization
that the only way for medical personnel to keep their sanity amid the chaos of
war was to view their situation as hopeless and crazy, and act accordingly.
From the beginning, neither head writer Larry Gelbart, nor producer Gene
Reynolds, conceived of M*A*S*H as a medical show, per se. Nevertheless,
Reynolds hired Dr. Walter Dishell, an ear, nose, and throat surgeon who had
consulted on CBSs Medical Center, for medical accuracy. Gelbart and Reynolds
were quite respectful in their depiction of medical activities. For instance, they
did not use a laugh track in operating room scenes. Furthermore, they shied
away from showing medical incompetence. With soldiers of the day injured on
the battlefields of Vietnam, they did not feel American audiences were ready to
see depictions of physician errors on their televisions screens. Gelbart and
Reynolds also argued that it made sense that surgeons in the M*A*S*H unit were
excellent; otherwise, their outrageous behavior outside of the O.R. would never
have been tolerated.9
Despite this traditional respect for physicians and the medical system, when
considered in the context of doctor shows, M*A*S*H had subversive implications for the formula. Previous programs from Medic through Marcus Welby had
focused on the impact (usually positive) of the doctor on their patients and
social environment. M*A*S*H, by contrast, centered on the impact (usually negative) of the patients and the environment on the physicians. The writers tried
to show the ways in which the war and the constant flood of injured soldiers took
their toll on the doctors and nurses who treated them.
To Gelbart, the difference came down to a shift in control. The war set up a
situation where doctors were not the ultimate order-givers. This was a dramatic
change from the hospitals of Ben Casey and Dr. Kildare, where doctors ruled
unquestioningly. By removing the sense of control from the doctors and by
focusing on the physicians lives instead of the patients, M*A*S*H altered the
medical formula. It was a model that was to be reflected even in shows that
depicted non-military doctors. The program itself did not fundamentally question the abilities of physicians, their desire to heal, or their confidence that they
knew what to do medically. At the same time, its producers pointed to a way to

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deal persuasively and dramatically with life-and-death medical dilemmas in an

age when physicians were having less and less control.

Retooling the Formula, Take One

This theme, however, was not the one TV producers emphasized in their early
attempts to replicate M*A*S*Hs popularity. What stood out to them in the late
1970s was the model for focusing on physicians rather than patients. In previous programs, when physicians had personal problems, they were, for the most
part, irrelevant to their ability to take charge of a sick or injured persons care.
In M*A*S*H, however, the steady stream of patients was the source of continual
personal problems for the physicians. Moreover, unlike previous doctor shows
that explored patients personal lives along with their physical infirmities,
M*A*S*H viewers rarely got to know the patients. Most patients either died or
were sent home or back into combat. The patients and their care under duress
simply served as vehicles through which the physicians personalities could
emerge.
It was this physician-centered perspective that began to filter into other doctor series in the late 1970s. Initially, producers tried to bring what they saw as
the M*A*S*H attitude into new half-hour situation comedies, such as House Calls
(197982), AES Hudson Street (19781979), AfterMASH (198385) and E/R
(198485). It was St. Elsewhere (198288) that showed how a M*A*S*H-like privileging of physicians problems could be applied with success to an hour-long
urban dramatic series.
The setting was a teaching hospital in a run-down urban area. But the St.
Elsewhere writers did not use the poverty of the location and the inadequate
technology to explore the crisis of care in the inner city, nor to highlight its
effect on the patients. Instead, the program followed the lives of the doctors and
residents at St. Eligius as they struggled with personal problems stemming from
their work at the hospital, as well as what remained of their personal lives after
work.
Patients were a large part of what made life in a St. Elsewhere episode tough for
the doctors and nurses. Adopting the hero-as-victim perspective implicit in
M*A*S*H and the hit cop show Hill Street Blues, St. Elsewhere went further than
any previous doctor series in portraying patients as part of a threatening, problem-causing environment for doctors. Sometimes doctor and patient merged,
like the physician with chronic cancer or the doctor diagnosed with AIDS.
The shift towards physician-centered rather than patient-centered shows also
altered the doctor formula in two other ways. By focusing on the lives of physicians and not patients, St. Elsewhere and its successors tended to have storylines
that spanned several episodes instead of the neatly confined stand-alone episodes
of Casey, Kildare, and Welby. In addition, the focus on the lives of physicians

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rather than patients lent itself more easily to ensemble casts that were more
likely to include women and minorities.
Beth Hill Shafer, an associate producer of the show, explained that the creators had simply made a decision not to go in the direction of social issues.
Issues, she said, were not the point of the program; private problems were.10
Defending their decision to avoid the ins and outs of the current medical world,
creators John Masius and Tom Fontana suggested that those developments, and
the politics of medicine in general, were dull.11 Dullness, they stressed, was
certainly not their goal. As a result, they made sure that compelling tales about
their continuing characters were at the core of every episode.
This major shift in favor of physicians was encouraged by network executives,
who saw it as resonating with the me decade of the 1980s. They considered St.
Elsewhere a lure for prosperous baby boomers who enjoyed watching people with
problems similar to their own. Series created during the late 1980sKay OBrien
(1985) and Heartbeat (198789) are examplespicked up on the same
approach, though in hospitals that were modern and efficient with rarely a hint
of poverty or politics relating to the medical system. That the shows were quickly
cancelled, and that St. Elsewhere was never considered a major ratings hit, may
help explain the scarcity of medical series in the early 1990s.

Retooling the Formula, Take Two

Another reason for this scarcity may have been producers indecision about how
to present the medical system at a time of high-profile public debate. Newly
elected president Bill Clinton was emphasizing what these shows had implicitly
denied for decadesthat medicine was a scarce resource and that this fact had
to be central to Americans understanding of the health care system.12 With over
thirty-nine million non-elderly Americans uninsured, and the costs of health
care skyrocketing, Clinton insisted that major reorientations of medical priorities and health insurance coverage were needed.13 His administration failed to
carry out the overhauls he advocated, but the reverberations of the health care
debateespecially about rising costs, the narrowing of patients choice of physicians, and physicians responsibilities to higher political and corporate authorities such as HMOscontinued in the news and, undoubtedly, in viewers
personal lives.14 As part of the public debate, doctors complained loudly that
their power was increasingly being usurped by health maintenance organizations and government to the detriment of their patients.
In interviews during the late 1980s, medical-show producers said they purposefully stayed away from policy issues. They seemed to be reflecting the attitude of U.S. television show creators generally. A systematic content analysis
conducted across all television shows in 1983 found a world of unlimited medical resource, acute-care issues, and little discussion of the politics of health

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care.15 Many medical show producers expressed doubt that the politics of health
care could be woven successfully into a series on a regular basis. The logical challenge for them, then, was to create a Clinton-era medical series without deviating too much from those traditional elements of the formula that TV executives
still believed had storytelling power.
The appearance and success of ER, beginning in 1994, suggested to producers and network executives that it was possible to continue to build series around
the personal travails of doctors operating in high-intensity situations within a
hospital setting. By the turn of the twenty-first century, ER was joined by City of
Angels (2000), Gideons Crossing (20002001), and Strong Medicine (20002006)
in prime time. A systematic content analysis of all episodes of these programs
during 2000 revealed that while they occasionally reflected some of the issues
raised by the new health care environment, they rarely explored the corporate
and governmental politics behind them. When issues ripped from the headlines
did come upthe shortages of equipment in ER, for example, or a nurses
strikecharacters rarely ever pointed out that their concerns resonated beyond
their hospital to the larger, real world. Such basic constituents of the health
system as HMOs and Medicare, for example, were mentioned only twice, and
Medicaid only once, during the entire year.16
One major addition to the formula did appear, perhaps as a result of the
Clinton administrations efforts to change the medical system: Every medical
show in 2000 included a hospital administrator. The character embodied
scarce resources by consistently acting as an antagonist to doctors who wanted
to provide the best possible care for patients. In their roles as administrators, the
hospital administrator treated hospitals as businesses and not merely citadels of
healing. These administrators often cited budget constraints without mentioning systemic or widespread problems of scarcity within medicine. Moreover,
when the administrators in the programs offered arguments against the ideal
unlimited resources model of medical care, they were more often than not
presented as being in the wrong and unlikable.
At their core, then, ER, City of Angels, Gideons Crossing, Strong Medicine,
Chicago Hope (19942000), Doc (20014), Scrubs (2001present), House
(2004present) and Greys Anatomy (2005present) did not stray from the
basic medical-show mold. They were built solidly on an appreciation of the
dramatic strengths of hospital-based, high-tech, specialty-oriented health care
that goes back to Medic and Ben Casey. The programs did pay more attention
to chronic diseases than did many of the earlier shows. ER, most notably, followed a hospital staff member with HIV from diagnosed infection through
many months of treatment, tracking the characters fears and ethical dilemmas. Central to virtually all episodes, though, were the dramatic punctuations
caused by acute medical incidents, whether it was the emergency of a helicopter crash next to ERs hospital or a pregnant womans need for an operation
in Strong Medicine.

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There was a key shift in perspective, however. The doctors in these shows
might have been the central expositors about medical problems, and they might
give orders a la Casey or Welby. But unlike earlier series, the shows of the 90s
were suffused with doubt about physicians actual abilities to follow through with
successful action, making them very different from series in the decades that
preceded them.
The insertion of pessimism into the formula appeared gradually in the first
popular medical dramas of the 90s, ER and Chicago Hope. David E. Kelley, the
creator of Chicago Hope, said of the program at the time of its debut, Were
rooted in how much the world of medicine is changing today.17 Kelley didnt
mean the changing politics of medicine, but rather the personal and professional dilemmas the new environment raised for physicians. His specialty was
creating dramas such as L.A. Law (198694), Picket Fences (199296), and The
Practice (1996present), which explored the ethical and moral angst that professional people faced. Ive always liked to confront ethical issues, explore them
and give rise to exploration of character, he explained.
The creators of ER, the more successful of the two shows, took a similar
approach but explicitly justified it by pointing to M*A*S*H. Urban emergency
rooms are as close to wartime MASH units as you can get, said producer John
Wells of the making of ER. He said that he hoped to take some of that spirit to
display ordinary people in extraordinary circumstances, acting the way we hope
we would act.18 In the later years of its long run, ER used this mantra to expand
the territory for illness in U.S. medical shows. Two central doctors in the series
traveled to Africa to show the horrors of the Darfur genocide and in a bid to
help people caught in desperate poverty. Another major ER character became a
medic in Iraq and was killed when his vehicle hit a roadside bomb.
Unusual as such subplots were even in an age of globalization, they reflect a
theme from M*A*S*H that programs of the 1990s and 2000s highlighted: the
emotional and professional toll that high-intensity medicine took on doctors. In
the post-Clinton health care era, the medical action of the hospital frequently
emphasized physicians loss of control in an environment not of their own making. Doctors were often at a loss for answers, their medical training no preparation for the type of dilemmas they now faced. Alternately, as in the case of House,
a doctors attempts to solve the riddles of illness repeatedly place him at loggerheads with his hospital supervisors. Either way, storylines often underscored that
the ethical, legal, and even institutional dilemmas involved in treating patients
put the physician at risk.
In Gideons Crossing, for example, a patient arrives at the hospital complaining
of mild chest pain. Twenty-four hours and multiple major medical errors later, he
is dead. His upset and angry wife wants answers and brings a lawsuit against the
hospital. The doctors on staff struggle with their feelings of responsibility and at
the same time their desire to avoid the monetary penalties and career consequences
of the malpractice suit. On the administrative level, the two head physicians

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battle over whether to admit their errors, the morally responsible thing to do; or
to deny wrongdoing, the fiscally responsible path for the hospital.
In an episode of Strong Medicine, when a commercial airline pilot is diagnosed
with a brain disorder, her physician, Dr. Stowe, informs her that for her safety
and the safety of her passengers, she needs to stop flying. The patient refuses,
and after struggling with her obligations to her patient and to public safety, Dr.
Stowe calls the airline and reports the patients condition, thus causing the
patient to lose her job. The patient angrily threatens to sue the doctor for
breach of confidentiality. Before she can do so, she is killed when her private
plane crashes. The physician is left wondering whether the crash was a result of
the brain disease, or a suicide resulting from her revelation.
This moral ambiguity at the center of the physicians world appeared over and
over in doctor shows in the early 2000s.19 Physicians struggled with one another,
and themselves, to find the best courses of action within the hospital-based,
high-tech environment that still exemplified medicine in prime time. Answers
were not obvious, and plots even seemed to purposefully want to challenge, even
confuse, viewers emotionally and intellectually about the best way for doctors to
handle, even understand, circumstances relating to needle exchange, patient
confidentiality, the right of a desperately ill child to choose death instead of
treatment, and malpractice. Greys Anatomy, the most popular medical show at
mid-decade, depicts a class of bright, sexually desperate residents flummoxed by
the pressures of the hospital environment. They care deeply and want to help
patients, but instead often share angst about their lack of control over hospital
horrors such as the patient doomed to die after being impaled on a pole, or an
attractive heart patient who chooses death over life on a machine.
Ironically, the rise of insecurity and anxiety over diagnosis, treatment, and
powerlessness coincides with the return of the all-knowing practitionerthe
medical examinerin TVs prime time crime shows. Like Quincy before them,
doctors in Crossing Jordan (2001present), CSI (2000present), CSI Miami
(2002present), Cold Case (2003present), and CSI New York (2004present)
depicted medical examiners in their roles as biological detectives solving crimes.
Thus, while TV physicians treating the living were roiling with insecurity and
uncertainty in a chaotic environment, those examining the dead worked in relative calm and were almost never wrong in their diagnoses of how and when victims were killed.20 James Kildare and Marcus Welby would have felt more at
home in the certainty of the prime time morgue than in the instability of TVs
hospitals.
The depth of change in the definition of medical reality that these changes
represent can be illustrated by comparing episodes of Ben Casey (1964) and City
of Angels (2000). Both concern what is now widely termed battered child syndrome or child abuse, but they are very different. The Casey story revolves
around a childs death, which at first appears to be an accident, but is then
found to have been caused by a parents physical abuse. In a jaccuse monologue

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to a group of community professionals, Doctor Casey insists that abuse is the real
cause of many child accidents, and is more common than most people think.
With proper awareness and action, it can be eliminated. The role of the physician, he argues, is to be the central organizing force in a campaign to end this
kind of abuse.
The child abuse case the writers chose for City of Angels could not have been
more different, nor could the message about the centrality and power of the
physician have been more different. The storyline involves a young Somali girl
whose vaginal bleeding is found to be a result of female circumcision. The physicians involved in the case recognize female circumcision as a traditional and
accepted practice in many cultures. Therefore, though most of them consider
the practice mutilation and find it abhorrent, they can reach no clear consensus
on how to handle the case. Two of the doctors (one of whom is African
American) insist that what they see is clearly child abuse and that by law they
must inform social services. A white physician who has spent many years in
Africa contends that calling social services will lead to dire consequences, breaking up an otherwise strong family that has behaved in accordance with Somali
tradition.21 In the end, the by-the-book doctors win the argument, and officers
from social services arrest the parents, pulling them away from their children in
a dramatic and heart-rending scene. What seemed in the 1960s a straightforward topic on which all physicians could agree, has evolved in the twenty-first
century into an issue fraught with ambiguities, conflict, and deep cultural and
professional biases. The evolution presents severe challenges to physicians longstanding assurance of control and ethical superiority.

Conclusion
By the first decade of the twenty-first century, then, a formula built on characterization and plots that celebrated the power of the physician had morphed
into one that increasingly led writers and producers to depict an existential
angst resulting from their inability to dominate in the ways, and with the tools,
that the formula prescribed. For reasons of comfort, predictability, and the politics of the television industry, writers, producers, and network executives
accepted the tyranny of the formula but tried to find ways to innovate within it
in to make new shows seem fresh and contemporary. By the 2000s, at least one
result that the formulas originators could not have foreseen was a dark message
that questioned the ability of doctors to make sense of the world for their
patients and themselves, let alone to exert authority over it.
The exploration of the TV doctors dilemmas from a number of angles does
make for sophisticated television. Whether the shows gloomy perspective is any
more realistic than the more optimistic world of Marcus Welby is arguable, however. Moreover, despite a patina (and claims) of verisimilitude, several features

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of the programs work against viewers knowledge of medical realities. Presenting

health care dilemmas within the traditional formulas rather tight focus on doctors in a hospital setting fails to illuminate the changing medical policies that
give rise toand fail to resolvethese dilemmas. As we have seen, characters
rarely point out that the problems they confront have significance far beyond
their particular hospital. As in the past, nurses, social workers, and other members of the health care team hardly exist when issues are debated. Likewise,
patients and their friends and relatives appear to have little impact on health
care decisions.
The core of the traditional formula still exists, now dressed in existential garb.
Several series focusing on the work of doctors in hospitals still fail to educate
viewers about the health care system in general, or to invite public involvement
in key health policy issues debates. It may be asking too much for producers and
writers to adopt an entirely new formula around medical issues of life and death,
but perhaps it is time for making the traditional formula much more inclusive.
The goal should be to find compelling ways to invite viewers behind the scenes
of the corporate and governmental politics that shape all health care workers
approaches to life and death in a range of settings. There is drama in much of
that, and comedy, too. There may well even be high ratings.

Notes
1. See, for example, John G. Cawelti and Bruce A. Rosenberg, The Spy Story
(Chicago: University of Chicago Press, 1987); John Cawelti, Adventure, Mystery, and
Romance: Formula Stories as Art and Popular Culture (Chicago: University of Chicago
Press, 1976); and John Cawelti, The Six Gun Mystique (Bowling Green, OH: Popular
Culture Press, 1970, 1984, and 1999).
2. Joseph Turow, Playing Doctor: Television, Storytelling and Medical Power (New York:
Oxford University Press, 1989).
3. Ibid., 50.
4. Ibid., 63.
5. Ibid., 65.
6. Ibid., 29.
7. For overviews, see Paul Starr, The Social Transformation of American Medicine (New
York: Basic Books, 1982); Rosemary Stevens, American Medicine and the Public Interest
(New Haven, CT: Yale University Press, 1971); and James Robinson, The Corporate
Practice of Medicine (Berkeley, CA: University of California Press, 1999).
8. Turow, Playing Doctor, 194.
9. Ibid., 205.
10. Ibid., 251.
11. Ibid.
12. See Thomas E. Mann, ed., Intensive Care: How Congress Shapes Health Policy
(Washington, D.C.: Brooking Institutions Press, 1995).
13. Kaiser Commission on Medicaid and the Uninsured, Uninsured in America:
Key Facts, 2000.

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14. For discussions about that failure, see Henry J. Aaron, ed., The Problem that Wont
Go Away: Reforming U.S. Health Care Financing (Washington, D.C.: Brookings
Institution Press, 1996).
15. Joseph Turow and Lisa Coe, Curing Televisions Ills: The Portrayal of Health
Care, Journal of Communication 35:4 (Autumn 1985): 3651.
16. Joseph Turow and Rachel Gans-Boriskin, As Seen on TV: Health Policy Issues
in TVs Medical Dramas: A Report to the Kaiser Family Foundation (Menlo Park,
CA: Kaiser Family Foundation, 2002).
17. Rick Du Brow, All the MDs and Just One Time Slot: Two Networks, Two Medical
Shows, One NightSeries Casts Are Wondering Who Planned This? Los Angeles
Times, September 15, 1994, F1.
18. Ibid.
19. It should be noted that the type of existential angst featured in doctor programs
was also a staple of other genres like law and police shows such as The Practice
(19972004) and NYPD Blue (19932005). From that standpoint, the doctor programs can be seen as exhibiting characteristics present in the larger American zeitgeist.
20. See Joseph Turow, The Answers Are Always in the Body: Forensic Pathology in
U.S. Crime Programmes, The Lancet 364 (December 2004), 5455.
21. The challenge of understanding female circumcision as a cultural practicenot
to mention its representations in the mediais immense. Readers who wish to
explore these topics may find the following resources helpful: Rogaia Mustafa
Abusharaf, ed., Female Circumcision: Multicultural Perspectives (Philadelphia: University
of Pennsylvania Press, 2006); and Francis A. Althaus, Female Circumcision: Rite of
Passage or Violation of Rights? International Family Planning Perspectives 23:3,
September 1997. On video representations, see (as starting points) Film, Media, and
Video Resources for African Studies, Institute of African Studies at Emory University
(1385 Oxford Road, Atlanta, GA 30322); Female Circumcision and Infibulation in
Africa (David M. Westley, African Bibliographer, Boston University); and Beti
Ellerson, Howard University, online syllabus and reading list for the African Women
in Cinema Project, A Guide to African Women Cinema Studies [A Teaching and
Learning Outline for Introduction to African Women Cinema Studies].

Chapter Ten

Hollywood and Human

Experimentation
Representing Medical Research in Popular Film
Susan E. Lederer
In November 1934, Boston surgeon Elliott Carr Cutler sent a confidential letter on behalf of the American Medical Association to physician Ray Lyman
Wilbur. The chair of surgery at Harvard Medical School sought Wilburs assistance in stopping a film about to be released by Universal Pictures, a film that
featured actual footage of dead dogs undergoing re-animation in a laboratory
at the University of California at Berkeley. I can imagine nothing worse for
medicine and our antivivisection stand than to have this go through, Cutler
confided to Wilbur, the recently appointed president of Stanford University and
former secretary of the interior under President Herbert Hoover. You will do a
great deal of good for American medicine and will help our committee tremendously if you can assist us by taking action at this time.1 Why a prominent
Harvard surgeon would enlist the aid of one of Americas most visible physicians
to suppress a B movie is the focus of this paper.
The history of medical experimentation, and especially the use of both
human and animal research subjects, rarely takes popular film and the images
conveyed by the mass media into account. As historian Martin S. Pernick has
persuasively argued, American mass media dramatically shaped the early twentiethcentury controversies over eugenics and the selective withdrawal of care from
defective infants.2 The cinematic portrayals of research scientists, mad doctors, self-sacrificing human subjects, and laboratory animals similarly offered a
crucial site of cultural contestation over the moral dimensions of medical
research in the middle decades of the twentieth century. As Cutlers interest in
stopping a film that depicted reanimating dead dogs illustrates, the leaders of
the American medical research community brought more than casual attention
to the representations of laboratories and medical investigators that appeared

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on American movie screens. Like those Americans who rejected using live animals, especially dogs, cats, and other pets, for laboratory research, American
medical leaders hoped to enlist filmmakers, studio executives, and film censors
to support their cause. Both sides of the durable controversy over the use of animals in medical research believed that sympathetic screen portrayals of their
cause would aid their efforts. This paper analyzes the negotiations that produced the representations of animal and human experimentation that appeared
in popular Hollywood films of the 1920s through the 1940s, arguing that medical researchers, animal protectionists, and progressive educators deployed
these cinematic representations to advance political agendas far removed from
movie studios and theaters. In so doing, they helped shape the images of the laboratory, the clinic, the bedside, and the roles of doctors, patients, and research
subjects that appeared on screens for decades.
By the 1920s, the issue of using live animals in medical laboratories had been
controversial for decades. Beginning in the 1860s, animal protectionists such as
New Yorker Henry Bergh and Philadelphian Caroline White established organizations dedicated to animal welfare, seeking to obtain legislation to criminalize
cruelty to animals and children, and to restrict the activities of medical
researchers. These early campaigners often used visual materials to make their
case against vivisection (which they defined as any experiment involving a live
animal) and to advance the cause of legal restrictions on laboratory investigations involving animals. In the shop windows of the downtown Philadelphia
headquarters of the American Anti-Vivisection Society (founded in 1883), the
organization maintained the preserved bodies of a vivisected cat and a vivisected
dog, each bearing the placard: Have you lost your pet? Is this it? By playing on
the affection and sympathy that pet owners had for their dogs and cats and the
image of animals dead bodies, antivivisection proponents hoped to enlist popular support for banning experiments on live animals.3
These activists turned to other media to further their cause. One frequent
venue was the popular comic weekly, Life (not to be confused with the photographic magazine launched in 1936). The comic weeklys editor, John Ames
Mitchell, sympathetic to both the causes of antivivisection and anti-vaccination,
frequently published cartoons that featured cruel experimenters, helpless animals, and sobbing children seeking their lost pets at the laboratory door.
Mitchell also ran stories and images of vivisecting researchers and doctors with
such names as Dr. Slasher Quick and Catcarver Jones, M.D., who had grown fat
and rich through injecting human beings with blood and sera obtained from the
bodies of tortured laboratory dogs, rabbits, and horses.4
The value of such visual appeals was not lost on American physicians attempting to forestall any legal restrictions on the activities of medical researchers and
their ability to procure live animals for use as research material. Fearful that
photographs of experimental animals originally published in medical journals
would turn up in anti-vivisection journals and circulars, the editor of the leading

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American medical research journal, the Journal of Experimental Medicine, made

explicit rules about the kinds of photographs that could be published in the
journal. The editorial staff instructed potential authors that photographs were
limited to the affected part of an animal, that photographs of the entire animal
would not be permitted, and that authors who insisted on photographs of the
entire animal would have to publish elsewhere.5
Concern about visual representations of animal experimentation and its
potential exploitation as propaganda soon extended to other popular media.
Shortly after he replaced Harvard physiologist Walter Bradford Cannon as chair
of the American Medical Associations Committee for the Protection of Medical
Research, Harvard surgeon Elliott Cutler confided to his predecessor his growing concern that critics of research involving animals were exploiting both film
and radio in their efforts to win support for restrictions on animal experimentation. The antivivisectionists, he informed Walter Cannon in 1930, are now
getting into the movies which is a blow to me. To counter this unwelcome turn,
Cutler offered several novel suggestions of his own to create memorable and
moving images: What would a reel showing the production of diphtheria antitoxin accompanied by data on pre-antitoxin and post-antitoxin death rate figures mean to the public? This might be accompanied by pictures of the
strangling child without antitoxin and the smiling baby with it. One has to resort
to low down tricks when fighting bums.6
Cannon was not enthusiastic about a film showing strangling infants, even
as he shared Cutlers concern about the growing importance of movies for the
critics of laboratory research. He explained to his surgical colleague that it
would be technically difficult to obtain the film footage of a child struggling to
breathe with a dipththeric membrane [that] is not removed.7 Cutler abandoned the idea for such a film.
Cannon was no stranger to the efforts to harness popular entertainments
against medical research. In the 1920s he had carefully monitored representations that cast the laboratory and the medical scientist in a negative light. In
1922, Cannon received word from Earl Zinn, the executive secretary for the
Committee for Research on Sex Problems, about the gruesome medical setting of a Broadway play, which he warned could readily be used by the antivivisectionists. Cannon turned to Simon Flexner, scientific director of the New
York-based Rockefeller Institute for Medical Research, asking that someone
from his organization see the play and make a report on it.8 The Monster, which
opened on Broadway in August 1922, received only lukewarm reviews for the
depiction of a madman who traps chance visitors in a strange house and then
proceeds to practice vivisection.9 What troubled Cannon about the play was less
the portrayal of laboratory scenes in which the mad doctor inflicted all manner
of strange tortures, than public endorsements for the play obtained by the New
York Anti-Vivisection Society. The society published advertisements for the play,
featuring statements supporting antivivisection from such prominent individuals

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as the Catholic cardinal of Baltimore. Cannon did not try to suppress The
Monster; he did write to Jesuit friends at Georgetown University seeking to verify
that Cardinal Gibbons was correctly quoted when he blessed the antivivisection
cause and condemned experimentation on living animals.10 When the play was
revived on Broadway in 1925, Cannon did not pursue the issue, nor did he follow up on the news of a screen version of The Monster. Released by Roland West
Productions and Tec-Art, this film starred movie actor Lon Chaney as a scientific, surgical maniac with a penchant for vivisection within the mysterious walls
of his haunted sanitarium, and served by an ingenious auto-wrecking device
that keeps the sanitarium supplied with victims.11 This film, like the stage version, opened to mixed reviews, although the critic for the New York Times characterized Chaneys portrayal of the crazed surgeon as effective.12
In the early 1920s, changes in American society made Cannon more sensitive
to the popular portrayals of medical research. The extension of suffrage to
women was one development that Cannon regarded as significant, but he also
identified the development of opposition to medical research among Christian
Scientists and irregulars as cause for concern and a compelling reason to
rethink his longstanding opposition to enlisting lay people in the cause of medical research protection.13 His writing for lay audiences became more visually
oriented in the 1920s, including for the first time photographs illustrating the
benefits of medical research. For his 1926 essay, The Dogs Gift to the Relief of
Human Suffering, for the AMAs lay health journal Hygeia, he introduced
graphic before-and-after photographs of a child with diabetes who underwent
treatment with insulin, developed through experimentation on dogs. In the first
photograph, six-year-old Teddy appeared thin and listless. In the subsequent
photograph, Teddy, who started treatment with the insulin isolated by Canadian
researcher Frederick Banting in January 1923, had become sturdy and
robust, having gained twenty-two pounds in the course of his treatment.14 In
1932, when Cannon updated his essay with the assistance of physiologist Cecil
Drinker, he added more photographs, including one comparing two boys, one
with rickets, one without; a photograph of a child with diabetes, George, and his
canine companion; and a photograph of Betty, a three-year-old-girl, injecting
herself with insulin as treatment for her diabetic condition.15
After more than two decades devoted to combating the critics of animal
experimentation, Cannon concluded that pictures in movies could materially
advance the cause of medical research protection.16 In 1933, he publicly
endorsed a film depicting Russian physiologist Ivan Pavlovs experiments on the
nervous system, a film that included experiments on children. Exhibited at the
Fine Arts Theatre in Boston the week of March 12, 1933, the film Mechanics of
the Brain contained images of dogs and apes that had undergone the removal
of portions of their brains. The film also included footage of a twelve-year-old
boy with a tube passed through his cheek into the salivary gland through which
saliva was collected and the amount of secretion determined when food was

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given. Cannons endorsement of the film prompted harsh criticism from the
members of the New England Anti-Vivisection Society, who noted that it substantiates our claim that the zeal of the vivisector will never be satisfied by the
use of animals alone in his experiments.17 The Pavlov film and its representation of live animals in the laboratory was only one focus of antivivisectionist
interest in the cinematic representations of medical research involving both animal and human subjects.

Animals in the Movies

From the early days of motion pictures, American animal protectionists had
interested themselves in the welfare of animals used in filmmaking. Among their
chief concerns were some of the methods that filmmakers, attracted by the dramatic and comedic potential of animal actors, used to achieve the desired
effect. Many of these methods resulted in pain, injury, and death of the animals.
In 1924, the Open Door, the journal of the New York Anti-Vivisection Society,
printed a sworn affidavit from an employee at a motion picture studio detailing
the cruel treatment of dogs and cats in the making of comedic films. These
included attaching cats to trees using piano wire and holding them for a bulldog to attack them, smearing a bulldog with honey and loosing a swarm of bees
on it, and fastening cats to electrical wires so that they would jump at the right
moment.18
At the instigation of the Christian Science Monitor, a commission consisting of
Percival Baxter, former governor of Maine, Francis Rowley, president of the
Massachusetts Society for the Prevention of Cruelty to Animals, and investigator
Edward Lowry, surveyed the extent of animal cruelty in the making of motion
pictures. In 1925, the commissioners concluded that despite occasional acts of
cruelty to animals undertaken in the making of motion pictures, most motion
picture producers and directors were not willing to countenance cruelty or maltreatment of animals.19 To illustrate the industrys commitment to animal welfare, Will Hays, president of the Motion Picture Producers and Distributors of
America, met with representatives of the American Animal Defense League, and
agreed to the voluntary adoption of several resolutions prohibiting cruelty to
animals in the making of motion pictures and insuring protection for employees who reported cases of cruelty on a movie set. In the 1930s, cruelty to animals
in filmmaking remained a problem; the deaths of horses in the filming of The
Charge of the Light Brigade (1936) and the throwing of a horse over a cliff in the
making of Jesse James (1939) renewed attention to the welfare of animals. In part
to placate potential criticism of using animals on screen, some filmmakers, like
the producers of The Crime of Doctor Hallett (1938), a drama about medical
research in a Sumatran jungle, asked the Los Angeles chapter of the Society for
the Prevention of Cruelty to Animals to stipulate that no injury or cruelty to

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monkeys occurred on the set.20 Despite such steps, American motion picture
producers amended the Production Code in 1940, stipulating that any film
involving live animals required oversight and consultation with the American
Humane Association.21
In addition to cruelty behind the scenes, animal protection and antivivisection societies continued to sound warnings about the effect on audiences of
screen cruelty to animals. When the Capitol Theatre in New York City exhibited
a film in 1923 showing such animal scenes as a whole-sale slaughter of alligators, a dog-fight, and a cock-fight, the vice president of the Massachusetts
Society for the Prevention of Cruelty to Animals complained to the theater management, and asked the American Anti-Vivisection Society to support the cause
of humane education by preventing such spectacles to young and vulnerable
audiences.22
At the same time, antivivisectionists promoted films and plays that in their
opinion effectively communicated the horrors of animal experimentation. In
1922 a new film, The Blind Bargain, encouraged some antivivisectionists about
the value of the cinema to demonstratein the words of Nina Halvey of the
American Anti-Vivisection Societythe callousness of the vivisector.23 In the
film, the surgeon played by actor Lon Chaney agrees to perform lifesaving surgery on a woman if her son will submit to the doctors ape-gland grafting experiments (the film was inspired by Russian-French surgeon Serge Voronoffs
transplants using the testicular material from chimpanzees and baboons). A
number of theatergoers in Philadelphia, Halvey noted, considered the picture
useful for its portrayal of the moral degradation of the scientist. She recounted
the unsolicited testimony of a stranger who entered her office on business:
When you see the vivisector and experimenter as you see him exposed in the
the Blind Bargain, it makes you think twice before calling in a physician to a
weak and defenseless child. Who knows, but he may try out an experiment on
one of your own? Antivivisectionists were similarly pleased by the depiction of
animal experimentation in the 1932 Paramount release, The Island of Lost Souls
(a screen adaptation of H. G. Wellss The Island of Doctor Moreau), expressing the
hope that the publicity generated such films would rouse the complaisant and
sluggish-minded public to the danger of unrestricted animal experimentation
and take vigorous steps to abolish the abomination vivisection and those who
practice it.24

Life Returns
In 1934, newspapers around the country reported sensational experiments conducted at the University of California in which a slain dog returned to life.
Photographs of chemist Robert E. Cornish and his dog, Lazarus IV, appeared in
Newsweek, The Literary Digest, and major metropolitan newspapers in New York,

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San Francisco, and Los Angeles. Reporters closely monitored the dogs progress
( Dead Dog Gets to Feet; Slain Dog Alive, Gaining Steadily.) They interviewed prominent scientists, including Johns Hopkins physiologist W. Horsley
Gantt and surgeon Charles Mayo, about the implications of Cornishs research
for human beings.25 Fanning the flames of speculative science, reporters pressed
clergy to discuss the status of the soul in a human body restored to life from the
dead. In November 1934, newsreels describing a forthcoming film from
Universal Pictures featuring the Cornish dog experiments came to the attention
of both Cutler and Cannon. Alarmed by the intense media scrutiny of the
Cornish researches, Elliott Cutler wrote his personal appeal to Stanford
President Ray Lyman Wilbur, asking him to pressure Cornish to end his involvement with Universal Pictures and the film based on his work.
Cornish first garnered national attention in the spring of 1934. A research
associate at the University of California, where he had received a doctorate in
chemistry, Cornish worked on methods for resuscitating newly dead animals.26
He developed a protocol for reviving dogs that had been asphyxiated with nitrogen gas and whose hearts had ceased to beat for several minutes. Cornishs
method entailed placing the dead dog on a teeterboard to stimulate blood
flow, and injecting a physiological salt solution containing heparin, epinephrine, and the defibrinated blood from another dog. After two failures, Cornish
claimed that he had successfully resurrected a fox terrier, which reportedly
regained his physical functions and appetite six days following his apparent
death.
With a fine flair for newspaper headlines, the editors of News-week noted,
Cornishs first dog was named Lazarus II, but his resurrection, unlike the biblical Lazaruss, was only momentary. Lazarus III lived a few hours.27 However, the
fox terrier, Lazarus IV, lived long enough to generate enormous media interest
in the revivification studies, which Cornish, with his genius for self-promotion,
had captured on film for posterity. The San Francisco Chronicle, the Los Angeles
Times, and the New York Times, for example, published almost daily reports about
Lazaruss slow and steady progress from the grave.28
Cornishs remarks to reporters intensified popular interest in the revivification technique. In August 1934, he announced a plan to seek approval from officials at Nevada State Prison to test his revivification technique on men recently
executed with hydrocyanic gas. If the authorities should consider the debt to
society would be paid when the physician testified to official death upon the
stoppage of the heart and respiration, Cornish explained, there might be no
legal obstacle to prevent the bodys being turned over to us for experimentation.29 In October, the chemist formally approached the governors of Arizona,
Colorado, and Nevada for permission to experiment on the bodies of men killed
in the states gas chambers. A lethal gas execution case, he explained, would
be ideal for my theory.30 Despite the fact that the Colorado governor had in
1933 authorized the participation of prisoners in trials of a tuberculosis vaccine

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developed by researchers at the National Jewish Hospital in Denver, Cornishs

overtures were rebuffed.31
The governors decision apparently did not dissuade hundreds of Americans
from volunteering to undergo the resuscitation experiments.32 Cornish received
offers from prisoners, terminally ill patients, people seeking financial compensation, individuals seeking to advance the cause of science, and those whose
motives resist easy categorization, such as the middle-aged Kansas woman who
wrote: I will submit myself for the experiment in any manner you say. I have
always been in perfect health butI am 46, so you see I havent much to lose. It
is immaterial whether I return or not.33 During the Depression, unsolicited
offers from desperate individuals willing to serve as research subjects in
exchange for money were not unusual; the National Institute of Health, for
example, declined such offers.34 Moreover, those seeking employment in the
early 1930s were referred to universities and hospitals for positions as paid
research subjects.35
Cornish did not accept any of these offers. Newspaper accounts failed to mention that he had already attempted unsuccessfully to revive several dead human
beings. In his grant application seeking an additional $12,000 to continue his
experiments, Cornish explained in detail how in February 1933 he endeavored
to revive a young machinist found drowned in the San Francisco Bay, a twentyeight-year-old surveyor dead after accidental electrocution, and a sixty-two-yearold printer found dead following apparent heart failure in a hospital emergency
room. Cornish tied the lifeless bodies to a teeterboard, which was tipped up and
down for more than an hour in an effort to create an artificial circulation of the
blood.36 In addition to the teeterboard, Cornish applied electric heating pads
and electric blankets (reported unsatisfactory for maintaining body temperature
and responsible for burning the knees of the drowned machinist), and administered adrenalin. In August 1933, after members of the Berkeley Fire
Department worked for thirty minutes to revive a forty-one-year-old drug store
manager, Cornish was able to make observations about resuscitation efforts and
to evaluate some of the contemporary theories of artificial respiration.
Interspersed between his attempts to resuscitate human beings, Cornish conducted animal studies on a fox terrier and six sheep.37
If Cornish began his academic career in an orthodox fashion, his apparent
desire for public attention soon placed his scientific reputation in jeopardy. In
April 1934, the initial reports of his success in raising Lazarus IV from the dead
first appeared in the press in local San Francisco newspapers; the Cornish stories were also relayed through the Associated Press and the extensive Hearst
publishing network to newspapers around the country.38 The sensational media
coverage of the animal studies created immediate problems for the young
experimenter. After San Francisco papers reported his experiments, antivivisectionists in the Bay area telegraphed a protest to President Franklin Roosevelt,
urging that Cornishs funding from the Civil Works Administration be withdrawn.

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His experiments, members of the Alameda County Anti-Vivisection Society

claimed, were as revolting to the general public as they are useless to medical
science.39 On the heels of protests from dog lovers outraged that Cornish was
killing dogs, Cornish publicly promised to substitute hogs for dogs in
his Berkeley laboratory.40 Amid the bad publicity about using dogs, Cornish
learned that his laboratory and position at the University of California had been
withdrawn.
On May 1, 1934, university officials notified Cornish that the old anatomy
building where he was conducting his revivification studies was scheduled for
demolition, and demanded that he vacate the premises. Dean Monroe Deutsch
made it clear to reporters that more than space availability prompted the young
experimenters expulsion. Cornishs unwillingness to conform to the policy of
the universitys scientific staff and his appetite for distasteful notoriety made
his eviction necessary. The use of the laboratory in investigations, the dean
observed, should be carried out quietly and unobtrusively.41 Cornishs newspaper stories, together with his reported failure to submit the results of his
experiments to the scientific staff at the university before going public with the
results, effectively ended his academic career. In late June, he relocated his laboratory to the home of his parents, where he continued to issue reports about
the progress of his revivification and other experiments.42
Not surprisingly, the intense media interest in Cornishs experiments
attracted, rather than repelled, moviemakers. Indeed, some reporters made
explicit connections between the resurrection of the dead in the Berkeley laboratory with one of the film sensations of the 1930s, Universal Pictures
Frankenstein. The fear that such an experiment on a human being, noted one
Hearst reporter in May 1934, would evolve a fiendish Frankenstein monster will
prevent Dr. Cornishs acceptance by scores of persons to sacrifice themselves to
death as a test of mans power over life.43 The Cornish experiments eventually
became the basis for two Hollywood films in the 1930s: Life Returns (1934) and
The Man They Could Not Hang (a Boris Karloff thriller released in 1939). Whereas
the Karloff film, as the title suggests, featured the application of the Cornish
method to human beings, Life Returns capitalized on the availability of the actual
laboratory film record of the dog resuscitation experiments. As an added bonus,
Cornish appeared as himself in the film, as did his laboratory assistants, Mario
Margutti, William Black, Ralph Ceimar, and Roderick Krida.
It was the availability of the laboratory footage that spurred director Eugene
Frenke to select the Cornish experiments as the basis for his second American
film. His opportunity to move forward with Life Returns (originally titled From
Death to Life) followed the decision by Universal Studio heads to shelve his
plans for adapting Tolstoys Father Sergius for the screen.44 Working with writer
James B. Hogan, he developed the screenplay for a melodrama that would showcase the Cornish laboratory film. Frenke insisted that the screen story of a scientist furnished all the ingredients for a thrilling movie. It isnt necessary to

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make pictures mere reproductions of scientific research, he told industry

reporters. Movies need not be dry affairs that show nothing but a serious,
bespectacled scientist looking for a microbe. Behind every scientist lies a story.45
The original production synopsis for Universal Pictures Company described
how Danny, a young boy, is parted from his pet dog Shep by a heartless pound
keeper, who places the animal in the shelters gas chamber when Danny is
unable to pay the release fee. One of Dannys friends tells the disconsolate boy
about the remarkable operation developed by Dr. Robert Cornish, who successfully revives Shep and restores him to his young pal.
For the filmed version of Life Returns, Frenke nestled the dog revivification
incident within the larger story of three young physicians, Drs. Louise Stone,
John Kendrick, and Robert E. Cornish (Cornish appeared in the film as a physician although he was trained as a chemist, not as a medical doctor.) Dedicated
to the service of humanity, the three begin work on techniques to restore lives.
Kendrick, however, becomes disillusioned when the health foundation sponsoring his research is revealed as a glorified racket, a manufacturer of beauty
products. After his wife dies, Kendrick is unable to care for his young son Danny,
who is placed in juvenile hall. The boy runs away with his dog, Scooter, who is
captured and killed at the city animal shelter. Kendrick brings the dead dog to
Cornishs laboratory, where the animal is successfully revived and where
Kendrick is happily reunited with his son.46
Life Returns quickly disappeared from American movie screens, but issues
relating to celluloid medical research continued to animate the research community and their critics. American antivivisectionists increasingly complained
about the enormous benefits vivisectional medicine reaped through such
Hollywood features as Men in White (1934), The White Parade (1934), The
Magnificent Obsession (1936), The Country Doctor (1936), and The Story of Louis
Pasteur (1936). These films, argued Robert Logan, president of the American
Anti-Vivisection Society, made the task of persuading Americans to oppose animal experimentation more difficult. Although the film biography of the French
chemist did not include images of animals being used as experimental subjects,
the biopic nonetheless emphasized the importance of animal experimentation
for medical advances. The antivivisectionist spectator is very much more conscious of the propaganda in this picture than the layman, noted Logan, but
the propaganda is there and the more dangerous as it is the more subtle and
unlabeled.47 The potential propaganda value of films like Pasteur and Yellow
Jack, a 1938 MGM film dramatizing Walter Reeds demonstration of the mosquito vector of yellow fever, was not lost on defenders of animal experimentation. Facing battles to restrict animal experimentation on the local, state, and
federal level, those active in the protection of medical research actively sought
to capitalize on these positive film images.
One of the most active battlefields was the hotly contested issue of allowing
medical researchers to use the unclaimed dogs and cats housed in city animal

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shelters for the purposes of medical research. By the 1920s, American medical
schools had come to rely on city pounds for inexpensive and accessible animals.
Animal protectionists increasingly focused their efforts at the state and municipal level to obtain legislation to prevent researchers from obtaining these discarded pet dogs and cats. One of their most significant supporters in this
enterprise was newspaper magnate William Randolph Hearst, whose newspaper
chain featured frequent stories about organized pet theft and the so-called black
auctions at which stolen pet dogs and cats were sold to medical researchers. In
1938, when animal protectionists in California obtained sufficient signatures for
a statewide ballot initiative for a law to prevent medical scientists from using
pound animals in any research facility in the state, their efforts received considerable support from the Hearst newspaper chain. Both sides on the issue sought
to deploy filmmakers and film stars to further their political goals.
Stanford president Ray Lyman Wilbur and the other leaders of California
medical schools called on Louis B. Mayer, the president of Metro-GoldwynMayer, asking that some of the prominent male actors who have gained worldwide recognition because of the fact that they have played the part of doctors in
some of the most outstanding screen successes aid the fight to insure the continued sale of pound animals to medical institutions.48 Mayer did not provide
Clark Gable (the star of Men in White) or Robert Montgomery (who played a
human guinea pig in Yellow Jack), but MGM aided the cause of medical
research by producing two motion picture shorts, extolling the scientific heroism of Louis Pasteur, and Banting and Best, the discoverers of insulin.49
Short films, as the name implies, were films that ran for less than thirty minutes. A legacy of the early days of the medium when no film ran for more than
one reel (approximately eleven minutes), the short film offered a proving
ground for up-and-coming actors and directors, and by the 1930stogether
with newsreels and cartoonsaccompanied the screening of feature-length
motion pictures.50 Although they did not get the resources afforded longer
films, short films nonetheless were regarded as important to the studios and
were shown alongside major films. Thus, MGM not only invested in the two
shorts highlighting animal experimentation and medical research, but they
screened them in theaters showing major MGM feature films. The short film
Mans Greatest Friend opened with a dramatic illustration of the love between
dogs and men, harkening back to the Great War. In the short, a gallant army dog
saves his master by bringing the helmet of the wounded man to the medics. Only
after the doctors save the mans life does the audience learn that the dog was
itself mortally wounded and dies in his masters arms. The film then swiftly
segues to another dramatic encounter between dogs and men. The narrator
reminds the audience that just as some men have the lust to kill, so do some
dogs. In a dramatic reenactment, the audience sees the small boy who will grow
up to be Louis Pasteur witness a mad dog terrorizing his village. Fifty years later,
Pasteur attempts to find a cure for the disease that causes dogs to become mad:

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rabies. The narrator describes how Pasteur developed a vaccine from the saliva
of a mad dog and tested it on eight dogs. The four who received daily injections
become immune to rabies; the other four did not survive the experiment. This
experimental action occurred off-camera. All the audience saw of the four who
made the supreme sacrifice like heroic humans of science were their empty
cages.51
The scene next shifted to Pasteurs difficult decision to use the vaccine on
human beings. Begged by the boys mother, Pasteur relented and allowed the
child to receive the vaccine. The crude laboratory of Louis Pasteur next gave way
to images of the scientific citadels, where, in the 1930s, scientists sought cures
for the ills that continued to plague mankind. Emphasizing the good care that
laboratory dogs receive, the film depicted healthy dogs in swanky kennels,
enjoying private runways for exercise, fresh air, and sunshine. The short ended
with a list of characteristics that made the dog a valuable research subject, as well
as his willingness to serve mankind in this capacity.
The leaders of organized medicine in California believed that Mans Greatest
Friend and the similarly constructed They Live Again (about the discovery of
insulin) were effective weapons in the struggle with antivivisectionists. The
historical presentation of his work on insulin, Ray Lyman Wilbur informed
Canadian physician Frederick Banting, will do much to bring about a better
understanding of experimentation to the advances made in medicine. We find
it satisfactory in every way.52 In the three weeks preceding the election on the
pound-animal initiative, theaters in the Fox-West Coast Theater Chain screened
the two short films on animal experimentation.
The California Society for the Promotion of Medical Research, an advocacy
group created to forestall restrictions on animal experimentation and chaired
by Ray Lyman Wilbur, did not limit their visual propaganda to these short films.
They hired an experienced newspaper man to coordinate the strategy to defeat
the Hearst-supported referendum at the polls. William F. Benedict developed
two advertising themes: Baby Gloria, a sentimental appeal using the portrait of
a wistful-appearing baby girl with the slogan, I need your help. Safeguard My
future health and welfare by voting No on No. 2 and an appeal to the instinct
of self-preservationKill No. 2 or IT MAY KILL YOU. Using funds collected
from around the nation, the society paid for radio spots, leaflets, placards, and
windshield stickers to blanket the state in the days before the election. More
than three hundred thousand leaflets featuring Baby Gloria were distributed
before the election. (The Association of California Hospitals distributed an additional fifty thousand pamphlets with the babys picture.) Benedict was especially
pleased when he was able to take advantage of trick advertising to counteract
the celebrity endorsement for the pound animal vote.
When California animal protectionists deployed a photograph of a celebrity
animal, Asta, the fox terrier from the popular Thin Man movie series of the
1930s, to encourage voters to restrict access to pound animals, Benedict turned

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the tables by using a photograph of Astas father with the caption Station
DOG Calling All Humane Voters. This is Astas father speaking! Father Knows
Best . . . Save All Pets LivesVote No on #2.53 When the votes were tallied on
November 8, 1938, California medical leaders credited the defeat of the pound
animal act, by a margin of two to one, to the adroit use of visual imagesboth
photographs and filmsin the campaign.54
Outside of California, leaders of American medical research lent their support. As the referendum on the pound animal issue in California approached,
Elliott Cutler carefully orchestrated an extensive photo spread on animal experimentation for Life magazine, a new large-circulation magazine. The Harvard surgeon believed that the Life photo spread would prove more valuable than money
in influencing California voters about the value of animal experimentation.55
Issued just two weeks before the California election in 1938, the magazine sent
photographer Hansel Mieth to obtain the first photographs ever made for publication in the animal research laboratories of the Harvard Medical School.56
The photographs of dogs undergoing experimental surgery and cats in artificial
respiratory devices explicitly emphasized the careful treatment animals
received, and drew a direct connection to the benefits that children enjoyed as
a result of animal experimentation.
At the suggestion of Roy Larsen, one of Lifes editors, Cutler coordinated a
stunning visual contrast between the women who criticized animal experimentation and the men who championed continuing progress in medicine.57 Fulllength photographs of two women against vivisection were juxtaposed against
only the heads of six men notable in science, medicine, and the church, who
supported animal experimentation. Representing the anti-position were two
women from the entertainment industry, dancer-actress Irene Castle, clad in an
evening gown and feather boa, and actress Marion Davies, wearing a fur cloak.
Castle had actively supported animal protection in Chicago; Marion Davies was
more than an actress: she was the well-known mistress of William Randolph
Hearst, and depicting her wearing a fur was a thinly veiled attack on the newspaper publisher. Cutler carefully selected the men who supported medical
research, including Thomas Parran, the U.S. Public Health Service surgeon general; Nobel laureate Alexis Carrel; MIT president Karl T. Compton; Clifford
Morehouse, editor of the Living Church; Archbishop John Cantwell; and
Stanford president Ray Lyman Wilbur, the man whose help Cutler had sought
to stop the Cornish picture. Cutlers initial list had included at least one
notable American woman, First Lady Eleanor Roosevelt, but he proved unable
to obtain her permission. In addition, Cutler had hoped to obtain endorsements
from William Edgar Borah, Republican senator from Idaho, and aviator Charles
Lindbergh. Indeed, Cutler initially approached Carrel to secure Lindberghs
permission to use his photograph. Although the aviators image failed to appear,
the caption for Carrels picture described the French surgeon as the co-inventor
of the artificial heart with Col. Charles A. Lindbergh.

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Sexual stereotyping had long been a feature of the controversy over animal
experimentation.58 The editors of the new Life magazine underscored the gender dynamics of the controversy over animal experimentation, as they compared
the old Life with the new: The old Life, though a humorous weekly, was a violent crusader on some subjects. One of these was animal experimentation, or
vivisection, against which it waged a thirty-five-year battle. Lifes cartoons,
depicting diabolical scientists performing orgies of cruelty, gave a cause to
thousands of elderly spinsters and restless matrons.59 The new Life, the editors
noted, after thorough reconsideration of this old controversy, concluded that
the sentimental, if highly articulate, critics of animal experimentation were
wrong. Animal research, they contended, was critical to the success of modern
medicine.
Large photographs of children in giant respirators conveyed the message
visually. As white-uniformed nurses sat in attendance, four children suffering
from infantile paralysis or polio lay encased in iron lungs developed by engineer
Philip Drinker, shown experimenting on a cat in a laboratory. To make the point
about the careful and respectful use of animals in the laboratory setting, Mieths
photographs presented thirty-two second-year medical students operating on
anesthetized dogs at Harvard Medical School. In addition to showing the injection of an anesthetic into a vein in a dogs leg, Mieth included a close-up photograph of skin incisions on a dogs abdomen, together with groups of gowned
medical students using sterile technique in their operations on the dogs. The
photo spread concluded with a large photograph of a horse whose blood was
drawn to produce diphtheria antitoxin, and a rabbit on which the serum was
tested. The image of the horse and rabbit was paired with the image of a young
child receiving an injection of diphtheria antitoxin. The accompanying text
offered a graphic description of the child who failed to receive such injections:
Anyone who has seen a diphtheric infant suffocating, clutching at his neck as if
to tear out the disease, pleading with eyes filled with terror, twisting his puffy
fevered face, knows the value of the anti-toxin. Cutler was at long last able to
exploit the image of the suffering child.

Hollywoods Human Guinea Pigs

In the 1930s, a growing number of Hollywood films featured doctors, nurses,
patients, and research subjects. Medicines growing cultural authority made the
hospital, clinic, and laboratory attractive to filmmakers; so too did the potential
of dramatic scenes involving injury, death, sickness, and self sacrifice. One of the
first films to exploit the dramatic potential of human experimentation was
Arrowsmith (1931). Adapted for the screen by Sidney Coe Howard from Sinclair
Lewiss 1925 Pulitzer Prize-winning novel, the film Arrowsmith drastically compressed the story of the young doctors lengthy education and his forays into

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private practice and public health, and made his experience as a medical
researcher central to the film. Critical to the films portrayal of the medical
researcher was Arrowsmiths efforts to reconcile the goal of the scientist to
advance knowledge with the responsibility of the physician to heal a patient.
When the plague breaks out on a Caribbean island, the young doctor finally has
the opportunity to test his newly developed plague serum. As in the book,
Arrowsmith initially proposes to conduct a controlled study. But when he outlines his plan to administer the serum to only half of the island population and
to withhold it from the rest, he is angrily rebuffed by the islands white elite.
Arrowsmith is only able to proceed when Oliver Marchand, a black physician
trained at Howard University and the first black physician in mainstream
Hollywood film, offers his people for the study. In a striking scene, the islands
black population compliantly forms a line in which some will receive the plague
serum, and others will be turned away by the researchers. In the film,
Arrowsmith experiences little difficulty supervising the trial of the plague serum
in the islanders, until, in a visually stunning scene, he encounters a wealthy
young white woman, whose pale, naked arm is juxtaposed against a black, muscular arm. She receives her injection, and Arrowsmith continues the clinical trial
until the death of his own wife from the plague leads him to abandon his scientific pursuit. He sabotages the trial by insisting that every one receive the serum,
and thus, he lacks the data to evaluate whether it works or not.
Arrowsmith was fictional, but real cases of human experimentation also made
appearances in 1930s popular film. In 1936, Warner Bros. released The Story of
Louis Pasteur; four years later, the studio produced Dr. Ehrlichs Magic Bullet,
which included scenes of children undergoing experimental treatment for
diphtheria, as well as the experimental treatment of syphilis with the new,
chemotherapeutic agents called magic bullets. In 1938, Metro-Goldwyn-Mayer
released Yellow Jack, a film about Walter Reed and the yellow fever experiments
conducted on human volunteers in Cuba in 1900. These three films celebrated
heroic medical research and the explicit use of human guinea pigs in the
advance of medical knowledge.
Producer Jack Warner notoriously resisted the idea of making a film based on
the life of the French chemist who introduced both pasteurization and the
rabies vaccine. Despite the lack of enthusiasm for making a film about the story
of a milkman, Warner Bros. assigned director William Dieterle to make The
Story of Louis Pasteur in 1936.60 Dieterle, who would go on to direct five additional great man or woman films between 1936 and 1940 for Warner Bros.,
incorporated dramatic scenes involving the French chemists decision to use the
untested rabies vaccine to save the life of a child savagely bitten by a rabid dog.61
On screen, the filmmakers emphasized how the scientist experienced agonies of
conscience before ultimately deciding to administer the untested vaccine to the
boy, and celebrated his emotional response to the childs recovery. In perhaps a
curious twist, the script for Pasteur, like the scripts of other films that featured

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medical and surgical scenes, encountered little difficulty with the Hays Office,
the movie industry bureaucracy charged with enforcing the Motion Picture
Production Code, over the depictions of human experimentation. The filmmakers faced considerably more trouble with the portrayal of Pasteurs animal
experiments.
The Hays Office (the Production Code Administration) was created in 1934,
largely in response to public concerns about screen portrayals of sexuality and
violence.62 But Hays and his administrators also concerned themselves with
other potential critics of screen portrayals, including animal protectionists and
antivivisectionists who objected to the representations of laboratory animals in
Hollywood films. Filmmakers whose scripts included scenes of laboratory monkeys, dogs, and sheep, received warnings about graphic depictions of animal suffering on screen. For Pasteur, the office informed the films producers that no
sick or dying animals should appear, and insisted that scenes showing the actual
inoculation of animal bodies would not be approved.63 In contrast, scenes
involving daring experiments to save a dying child resonated with the publicly
sanctioned method of medical progress. Even antivivisectionists accepted the
utility of such experimentation. As a writer in the Hearst-owned American Weekly
noted in 1931, physicians were permitted to carry out only three types of experiments. One involved experiments that entailed no risk to human subjects;
another allowed physicians to experiment on themselves; the final form of
acceptable experimentation was made on people who [were] at the point of
death anyway and [could not] be saved by any orthodox procedure.64 The
scenes of the young boy receiving the rabies vaccine met this test. The popular
reception to Pasteurs administration of an untested vaccine on a child would no
doubt have been much different had Joseph Meister not recovered in life, as on
screen.
Both Arrowsmith and The Story of Louis Pasteur were highly successful films. The
critical and box office success of Arrowsmith had encouraged screenwriter Sidney
Howard to go forward with a project involving another historic figure, Walter
Reed, and the yellow fever experiments in Havana in 1900, in which human
experimentation necessarily played a central role. Inspired by a chapter in medical journalist Paul de Kruifs enormously popular Microbe Hunters (1926),
Howard began preliminary notes for Yellow Jack in 1927. As he explained to his
literary agents, the play undertook, in the character of the doctors, to dramatize scientific obsession in one of its finest and most determined frenzies, and,
in the characters of the soldier volunteers for infection, to draw the contrast
between true heroism and heroism as popularly conceived and rewarded.65
Howard did extensive research for the play, including a visit to Cuba, where he
spent several days with John Moran, one of the soldier-volunteers in the efforts
to determine the mode of transmission of yellow fever.
The play opened on Broadway in March 1934. Volunteer John Moran came up
from Cuba for one of the performances, and enjoyed seeing himself portrayed

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by the young actor Jimmy Stewart. The families of some of the other participants
were less pleased. The friends of Private William Dean not only resented the
playwrights depiction of Dean as a nondescript, hick-like sort of person, they
also objected to the plays suggestion that Dean had been shanghied [sic] into
becoming a human guinea pig.66 Dean volunteered, his friend insisted, and had
not been the unsuspecting victim of medical researchers. Critics also found
Howards portrayal of the researchers as less than heroic objectionable. Whereas
Howard used this incident to illustrate the lengths of scientific obsession (how
even well-intentioned medical researchers might overstep the line between
appropriate and inappropriate human experimentation), one critic complained
that representing Dean as an unsuspecting victim presents an unnecessary
blemish upon the integrity of those conducting the experiment, as it is one
thing to have men risk their lives voluntarily for the sake of saving thousands of
other lives. It is quite another thing to use a human being as an unsuspecting
guinea pig.67 It is unclear whether the critic objected to the specific indictment
of the Reed expedition or, more generally, to the idea that medical researchers
would be less than scrupulous in their efforts to advance medical science.
Despite such cavils, Metro-Goldwyn-Mayer Studios acquired the rights to the
play for $30,000 and released the film Yellow Jack in the spring of 1938. There
were some significant changes in the film adaptation. Private Dean and the circumstances of his participation in the yellow fever studies had disappeared.
Love of a crusading nurse, rather than heroism, prompted the Moran characternow played by screen actor Robert Montgomeryto volunteer to be bitten by infected mosquitoes.68 Howards emphasis on the role of a researchers
obsession had given way to a more simplistic stress on the soldiers who risk their
lives for science. Nonetheless, the films producers did preserve Howards practice of giving credit to the surviving participants in the experiment. These
words appeared at the end of the film: Yellow Jack celebrates what these men
did, not what they were. That their heroism however, should not go
unrecorded, their true names are here given. This practice served to underscore the historical realism of the film, and to exalt the sacrifices made in
Havana.69
Buoyed by the popular and critical success of its Pasteur film (the screenplay
and actor Paul Muni both received Academy Awards), Warner Bros. pursued
another film biography of an eminent medical scientist whose work included
human and animal experimentation. In 1940 the studio released Dr. Ehrlichs
Magic Bullet, starring Edward G. Robinson as the German scientist who developed a treatment for syphilis.70 The films subject matter not surprisingly
prompted considerable difficulty with the Hays office. Despite Surgeon General
Thomas Parrans highly publicized campaign to eradicate the shadow on the
land, syphilis had remained unmentionable in mainstream Hollywood films.71
In order to placate the Production Code office, producer Hal Wallis agreed to
keep references to venereal disease to a minimum (the word syphilis was used

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only twelve times in the film). Wallis also pledged to cut any clinical scenes dealing with syphilitic patients.72
The Hays Office once again expressed concern about the depiction of experiments involving animals, but they passed without comment two sequences involving human experimentation. Early in the film, Ehrlich and Emil von Behring are
shown conducting a trial of diphtheria antitoxin in a childrens ward in a Berlin
hospital. In a later sequence, syphilitic patients are recruited to participate in a
trial of the new compound. The script for the Ehrlich film makes clear that physicians associated with the clinical trial of 606, the arsenic compound or magic
bullet, did not exploit unsuspecting patients. Instead, patients afflicted with the
disease clamor to participate in the trial, despite the risks of the unproven treatment. In the scene in which doctors recruit the first patients for the drug trial,
the dialogue makes clear the responsible conduct of the investigators:
Dr. Lentz: Gentlemen, I have asked you here today hoping that out of your number a few would volunteer to undergo a new treatment for the disease that afflicts you.
This new treatment involves some dangerand neither the hospital nor I, personally,
can guarantee any results whatsoever.
Man: Is there any hope, Herr Doktor? I mean, might one be cured?
Dr. Lentz: Yes . . . (corrects himself) . . . perhaps . . . (then brusquely) . . . but that
is a very remote possibility . . . very . . . and you must bear in mind the danger involved.
Man: I would like to volunteer, Herr Doktor.
Voices: Take me, Doktor. You must take me . . . I beg you, Doktor . . . Me . . . Me.
Me.73

This depiction must have cheered defenders of medical research, for it exemplified their claims that clinical trials were conducted only after animal experiments had been performed, and then only on the bodies of volunteers who
had been apprised of the risks associated with undergoing an unproven
treatment.
The Hays Office did not express concern about the scenes involving the doctors human guinea pigs, but the publicity developed for the film suggests that
there was some concern about the portrayal of the trials involving children.
Press notes for Ehrlich emphasized the historical accuracy of the laboratory
sequences, the most painstakingly real and accurate settings ever built in
Hollywood, as well as the scientific reputations of the films technical advisers.
But the publicity also stressed:
The scene where Drs. Ehrlich and Behring are supposed to conduct a controlled experiment by treating only half the children in a diphtheria ward to check results against the
untreated half, are historically true. Their humanitarian sympathies forced them to
abandon objective science, and treat all the children. Even to this day there has never
been any technical proof of the effectiveness of serum adduced by giving it to one
group and withholding it from another. Any doctor who withheld treatment from diphtheria patient would be guilty of grossest negligence.74

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In this case, the press agents for the film were not interested in the films authentic portrayal of events, but rather in preempting potential criticism from medical
researchers, physicians, and medical societies about adverse portrayals in films.
The requirement that medical experimenters be depicted in a positive light
applied not only to prestige pictures like Pasteur and Ehrlich, but to other films.
In 1940, for example, when RKO submitted the script for Millionaires in Prison,
Joseph Breen informed the filmmakers that several scenes would require attention. In addition to deleting scenes showing mice being injected, Breen
explained that scenes that indicated that the doctor had inoculated prisoners
before explaining to them that the injections were experimental had to be
deleted: The dialogue between Dr. Lindsay and Dr. Collins gives the suggestion
that Dr. Lindsay may have already injected these prisoners with leukemia before
the experiment begins. We believe that you do not wish this impression since it
would result in protests from the medical associations. Breen further advised
the studio that any gruesomeness as to these four convicts, upon whom these
experiments are being conducted should be avoided.75
In contrast to films that offered naturalistic and historically accurate portrayals of medical research, the horror films of the 1930s and 1940s delivered
screen scientists and psychotic surgeons who performed a bewildering variety of
unnatural experiments, including revivifying the dead, transfusing human
beings with various animal bloods, and transplanting animal tissues into human
bodies. Films involving manipulations of ape and human bodies (involving
blood serum, brain transplants, and so on) were especially popular with
Hollywood filmmakers in these decades. Officials at the Production Code
Administration sought to limit the gruesomeness of horror films, but they did
not require that the protagonists of these films shrink from experiments on
unwilling human subjects. Indeed, part of the horror in these films was the vulnerability of human beings to the depredations of mad scientists.76
What effect did portrayals of human experimentation in Hollywood films have
on audiences? Certainly some educators sought to capitalize on these representations in order to foster public discussions of the use of human beings in medical experiments. In 1939, the Commission on Human Relations of the
Progressive Education Association in New York City developed a study guide to
accompany screenings of excerpts of The Story of Louis Pasteur (1936) and
Arrowsmith (1931) to high school and college students. Largely funded by the
General Education Board of the Rockefeller Foundation, the project used films
to explore issues of human relations.77 After screenings of the short films, facilitators using the study guides were encouraged to discuss themes in the films.
For screening of Pasteur, the study guide, for example, provided synopses of
two scenes, the rabies sequence and anthrax sequence. For the hydrophobia
sequence, the guide offered the following questions for discussion: Do you
think it is necessary for the medical profession to insist on caution in announcing cures, and why? What do you think about experimentation on human

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beings? What factors have prevented the full utilization of medical knowledge
today?78
The Commission on Human Relations study guide offered similar questions
for scenes from the film Arrowsmith. In the guide, Arrowsmiths plan to withhold
the serum from half the population, rather than racial politics, was the suggested focus for discussion. The guide instructed group leaders to ask: Do you
believe it was necessary to test the serum in this fashion? Is such wholesale experimentation of particular value? What alternatives do you suggest? In addition to
questions about the scientific method and the medical response to innovation,
the author(s) of the study guide prompted exploration of the moral issues in
greater detail: What do you think about experimenting with human beings? Is
it justifiable? Under what circumstances? What do you know about Walter Reeds
experiments with yellow fever? What similar experiments do you know about?79
No transcripts of the discussions fostered by these explicit questions about
human experimentation survive. But the questions suggest how some educators
believed that screen representations of human experimentation could be harnessed to promote dialogue about the limits and constraints of medical
research.
In the late 1930s, after a decade of films depicting laboratory animal and
human experimentation, officials at the National Institute of Health received
offers from Americans volunteering to serve as human guinea pigs in medical
research. I am wondering, wrote one St. Louis man who in 1939 offered to
undergo experimentation for any ailment from chicken pox to bubonic plague,
why it is necessary that valuable men of science who are doing so much to promote public health should have to expose themselves to unnecessary risks by
making themselves human test tubes when there are other people of little use
to themselves or anyone else who might be willing to assume these risks?80 In
his letter, F. W. Held did not explain how he had learned that valuable men of
science risked their own lives in medical research on behalf of their fellow
Americans. Film was not the only popular medium through which Americans
like Held gained familiarity with developments in medical science. When John
Moran, one of Walter Reeds guinea pig soldiers in the 1900 yellow fever experiments, appeared on Lowell Thomass radio program in 1937, Moran received
over three hundred letters from listeners impressed by his willingness to risk
death in the name of science.81 But Morans appearance on the program followed the success of Sidney Howards play Yellow Jack on Broadway, and was
broadcast one year before the release of the Metro-Goldwyn-Mayer film in 1938.
(Sidney Howard was unavailable to write the film adaptation of the play; he was
busy adapting Margaret Mitchells novel Gone with the Wind for the screen.)82
Films provided a powerful vehicle for the transmission of ideas about medical
research in the 1930s and 1940s. The leaders of organized medicine recognized
the increasing centrality of popular films during these decades, and strove to
constrain screen images of medical researchers, laboratory animals, and human

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subjects. Critics of medical research similarly sought to influence filmmakers

and studios to persuade American audiences of the cruelty and uselessness of
medical research. The process of negotiation over screen science fostered a particularly useful and historically contingent picture of the conduct of human
experimentation. Apart from films involving mad doctors and insane surgeons, human experimentation in Hollywood films was reserved for physicians
who agonized over the decision to subject their fellow researchers to risk. The
screen researchers suffered similar agonies of conscience when confronted with
patients and families desperately seeking relief from disease or injury and apparently willing to undergo an experimental treatment or intervention that held
any promise of relief. Elliot Cutler was right to think that such depictions would
do a great deal of good for American medicine especially if they helped to
insulate physicians and the research community from external oversight and
regulation. The extent to which public understanding of medical research was
fashioned by cinematic science has received little attention from historians who
have confined their efforts to tracing the professional, institutional, and ethical
dimensions of American medical research in the twentieth century. These struggles over screen science suggest that much can be learned in the dark.

Notes
1. E. C. Cutler to Ray Lyman Wilbur, 13 November 1924, George Hoyt Whipple
Papers, box 3, f. 11, Edward Miner Library, University of Rochester, Rochester, New
York.
2. Martin S. Pernick, The Black Stork: Eugenics and the Death of Defective Babies in
American Medicine and Motion Pictures Since 1915 (New York: Oxford University Press,
1996).
3. Susan E. Lederer, The Controversy over Animal Experimentation in America,
18801914, in Vivisection in Historical Perspective, ed. Nicolaas A. Rupke (London:
Croom Helm, 1987), 23658, and Lederer, Subjected to Science: Human Experimentation
in America Before the Second World War (Baltimore: Johns Hopkins University Press,
1995).
4. Lederer, Subjected to Science, 4144.
5. Susan E. Lederer, Political Animals: The Shaping of Biomedical Research
Literature in Twentieth-Century America, Isis 83 (1992), 6179.
6. E. C. Cutler to W. B. Cannon, 11 November 1930, Walter Bradford Cannon
Papers, box 35, f. 435, Countway Library, Harvard Medical School.
7. W. B. Cannon to E. C. Cutler, 14 November 1930, Cannon Papers, box 35,
f. 435.
8. Earl Zinn to Walter Bradford Cannon, 24 October 1922; W. B. Cannon to Simon
Flexner, 23 September 1922, Cannon Papers, box 32, f. 398.
9. Animated Scenery in The Monster, New York Times, August 10, 1922, 30.
10. W. B. Cannon to Francis A. Tondorf, 28 October 1922, Cannon Papers, box 32,
f. 398.
11. Lon Chaney is Featured at Palace, Washington Post, March 8, 1925, 39.

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12. Quoted in Michael F. Blake, Lon Chaney: The Man Behind a Thousand Faces (New
York: Vestal Press, 1993), 141.
13. Walter B. Cannon to Simon Flexner, 25 October 1922, Cannon Papers, box 32,
f. 398.
14. Walter B. Cannon, The Dogs Gift to the Relief of Human Suffering, Hygeia 4
(1926), 36.
15. Walter B. Cannon and Cecil K. Drinker, The Dogs Gift to the Relief of Human
Suffering, New York State Journal of Medicine 32 (1932), 135458.
16. Walter B. Cannon to Elliott C. Cutler, 14 November 1930.
17. Vivisection on the Screen, Living Tissue 18 (1933), 3.
18. Affidavit, The Open Door, 1924, 15.
19. R. R. L. [Robert L. Logan], Moving Pictures, The Starry Cross 34 (1925),
11516.
20. See The Crime of Doctor Hallett in American Film Institute Catalog.
21. For particular films, see entries in the American Film Institute Catalog website:
http://afi.chadwyck.com/home (accessed February 5, 2007). For the American
Humane Association, see Jack Vizzard, See No Evil: Life Inside a Hollywood Censor (New
York: Simon and Schuster, 1970), 13036.
22. Animals in the Films: A Strong Protest from a Humanitarian, The Starry Cross
32 (1923), 57.
23. For a reconstruction of the film, see Philip R. Riley, A Blind Bargain (Atlantic
City, NJ: Ackermann Archives, 1988).
24. Heard and Read, The Starry Cross 32 (1923), 59.
25. Dead-Dog Test Minimized, Los Angeles Times, May 2, 1934; for Charles Mayo,
see Dead Dog Still Gaining, New York Times, April 27, 1934, 18. Clergy Ask if Man
Restored to Life Would Have a Soul, New York American, October 19, 1934; Plan to
Revive Dead Stirs Clergy, New York Journal, October 20, 1934.
26. At the Institute for Experimental Biology, Cornish participated in vitamin
research; see Herbert Evans, Elizabeth A. Murphy, R. C. Archibald, and R. E.
Cornish, Preparation and Properties of Vitamin E Concentrates, Journal of Biological
Chemistry 108 (1935), 51523.
27. Medicine: Doctors have Some Success Making the Dead Live, News-week 3, May
5, 1934, 31.
28. Dog Dead 10 Days Ago Kept Alive in Clinic, New York Times, April 24, 1934, 1;
Doctor Watches Dog as Life is Restored, New York Times, April 25, 1934, 9; and
Dead Dog Still Gaining, New York Times, April 27, 1934, 18.
29. Revivifying Effected, Los Angeles Times, August 25, 1934, 1.
30. Says He Can Revive Man Dead Half-Hour, New York Times, October 27, 1934, 17.
31. See Jon M. Harkness, Research Behind Bars: A History of Non-therapeutic
Research on American Prisoners (PhD dissertation, University of Wisconsin,
Madison, 1996).
32. Six Bid for Death Tests, Los Angeles Times, April 19, 1934, 1; Fifty Make Offer
to Die in Dr. Cornishs Clinic, Los Angeles Times, November 11, 1934, 20.
33. Franc Dillon, A Miracle is Filmed, Motion Picture, February 1935, 4041,
7879, quote on 78.
34. See F. W. Weld to National Institutes of Health, 26 May 1939, National Archives,
RG 443, NIH 193048, General Records, Box 46, f. He.
35. Lederer, Subjected to Science, 11925.
36. Cornish Grant Proposal, University of California, Berkeley, Bancroft Library.

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37. U. C. Notifies Dog Reviver to Find New Laboratory, Los Angeles Times, May 1,
1934, 1.
38. Restoration of Life, Literary Digest 117 (May 19, 1934), 34.
39. Dog Slain by Science Improving, Los Angeles Times, May 22, 1934, 12.
40. U. C. Savant Substitutes Hogs for Dogs in Life Experiments, San Francisco
Chronicle, May 27, 1934.
41. Scientist Must Move Dog Tests: U.C. Authorities Object to Use of Building for
his Life after Death Study, Los Angeles Times, May 4, 1934, 1; Experimenter on
Dogs Vacates U.C. Laboratory, Los Angeles Times, June 28, 1934, 1.
42. Dead Felons Test Sought; Cornish Asks to Restore Life, Los Angeles Times,
October 16, 1934, 1, and Live Dead-Dog Almost Walks, Los Angeles Times,
November 17, 1934, 2.
43. Fear of Fiend Bars Reviving of Human, May 3, 1934, Clipping from Hearst
Newspaper Morgue, University of Texas, Austin.
44. See Life Returns in American Film Institute Catalog.
45. Dillon, A Miracle is Filmed, 78.
46. Universal Pictures Co., Inc. Library Properties, volume 5, file number 6417,
Synopsis for Life Returns.
47. R. R. L. [Robert R. Logan], What Price Freedom, The Starry Cross 44 (1936),
8384.
48. Frank McVeigh to Louis B. Mayer, September 13, 1938, California Society for
the Promotion of Medical Research, Ctn 1, Archives and Special Collections,
Kalmanovitz Library and the Center for Knowledge Management, University of
California, San Francisco.
49. See Final Report of Campaign to Defeat the Proposed State Humane Pound Act
Initiative in California at the General ElectionNovember 8, 1938, California Society for
the Promotion of Medical Research, UCSF.
50. Richard Ward, Extra Added Attractions: The Short Subjects of MGM, Warner
Bros., and Universal, Media History 9 (2003), 22144.
51. For heroism in science, see Lederer, Subjected to Science.
52. Ray Lyman Wilbur to Frederick G. Banting, 3 October 1938, Ray Lyman Wilbur
Papers, Stanford University Archives, Palo Alto, California.
53. See display ad, Los Angeles Times, November 3, 1938, 5; and Final Report of Campaign
to Defeat the Proposed State Humane Pound Act Initiative in California, 15.
54. The State Humane Pound Act was defeated on November 8, 1938: 1,581,258
voters against the measure; 721,126 voted in favor of the act. Final Report of Campaign
to Defeat the Proposed State Humane Pound Act Initiative in California, 52.
55. Elliott C. Cutler to William J. Kerr, 20 October 1938, Cutler Papers.
56. Editorial Page, Life, October 24, 1938, 10.
57. Elliott C. Cutler to Walter B. Cannon, August 19, 1938, Cutler Papers.
58. Susan E. Lederer, Moral Sensibility and Medical Science: Gender, Animal
Experimentation, and the Doctor-Patient Relationship, in Ellen More and Maureen
Milligan, eds., The Empathic Practitioner: Essays on Empathy, Gender and Medicine (New
Brunswick: Rutgers University Press, 1994), 325.
59. Animal Experimentation: Is it Essential to the Progress of Medicine? Life,
October 24, 1938, 47.
60. Susan E. Lederer and John Parascandola, Screening Syphilis: Dr. Ehrlichs Magic
Bullet Meets the Public Health Service, Journal of the History of Medicine and Allied
Sciences 53 (1998), 34570.

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305

61. Two of the five were medical: The White Angel (1936) and Dr. Ehrlichs Magic Bullet
(1940); see George F. Custen, Bio/Pics: How Hollywood Constructed Public History (New
Brunswick, NJ: Rutgers University Press, 1992).
62. Susan E. Lederer, Repellent Subjects: Hollywood Censorship and Surgical
Images in the 1930s, Literature and Medicine 17 (1998), 91113; Stephen Vaughn,
Morality and Entertainment: The Origins of the Motion Picture Production Code,
Journal of American History 77 (1990), 3965; and Gregory D. Black, Hollywood
Censored: Morality Codes, Catholics, and the Movies (New York: Cambridge University
Press, 1994).
63. The Story of Louis Pasteur, Production Code Administration Files, Margaret
Herrick Library, Academy of Motion Pictures Arts and Sciences, Beverly Hills,
California.
64. How Far Ought Science Experiment on Living Men and Women? American
Weekly, 1931, Clipping from Hearst Newspaper Morgue, University of Texas, Austin.
65. Sidney Coe Howard, Preliminary notes for a Dramatization, filed January 21,
1927 with Brandt and Brandt, Sidney C. Howard Papers, carton 12, f. Yellow Jack,
Bancroft Library, University of California, Berkeley.
66. Fred Field to Sidney Howard, 3 April 1935, Howard Papers, Box 9, f.-misc.
Bancroft Library, University of California, Berkeley.
67. Richard Dana Skinner, The Play: Yellow Jack, The Commonweal (19 March
1934): 580.
68. Men Against Mosquitoes: Heroes of Cuban Campaign Live Again in Yellow
Jack, News-week 11, May 30, 1938, 23.
69. See Yellow Jack, in the American Film Institute online catalog.
70. Lederer and Parascandola, Screening Syphilis.
71. For more on Thomas Parran and the USPHS syphilis campaign, see John L.
Parascandola in this volume.
72. Hal Wallis to W. H. Hays, October 24, 1939, Dr. Ehrlichs Magic Bullet,
Production Code Administration Files, Margaret Herrick Library.
73. Dr. Ehrlich, typescript, 13 October 1939, National Archives Southeast Region,
East Point, GA, RG 442, Film Scripts re Venereal Disease, 193961, Box 2, f. Magic
Bullets, scenes 137140, pp. 1089. I am grateful to John Parascandola for this
material.
74. Press preview, Edward G. Robinson in Dr. Ehrlichs Magic Bullet, Warner Bros.
Hollywood Theatre, February 1, 1940, Warner Bros. Files, University of Southern
California, Los Angeles, California.
75. Millionaires in Prison, PCA Files, Herrick Library.
76. There is a large literature on horror films; see David J. Skal, Screams of Reason:
Mad Science and Modern Culture (New York: W. W. Norton, 1998); Andrew Tudor,
Monsters and Mad Scientists: A Cultural History of the Horror Movies (New York,
Blackwell, 1989). See Bryan Senn and John Johnson, Fantastic Cinema Subject Guide:
A Topical Index to 2500 Horror, Science Fiction and Fantasy Films (Jefferson, NC:
McFarland, 1992), 7583, for ape-human experiments.
77. Most of the films selected for the project dealt with political and racial themes,
however, educator Alice Keliher chose several white coat films besides Arrowsmith
and Pasteur. She also selected White Angel, the biopic of Florence Nightingale (for
resistance to women entering a new profession); Wife, Doctor, and Nurse (for women
accepting other women as co-workers of their husbands), and the 1934 film Men in
White (an exploration of early marriage versus further study for a young doctor). See

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Susan E. Lederer, Celluloid Science: Teaching Science Using Popular Film in the
1930s and 1940s, paper delivered at History of Science Society, Vancouver, British
Columbia, November 4, 2000.
78. Study Guide to the Story of Louis Pasteur and Arrowsmith (Human Relations Series of
Films, Progressive Education Association, 1939), 8. Margaret Herrick Library.
79. Study Guide.
80. Held did ask that his family be properly cared for in exchange for his services to
the laboratory; see F. W. Held to NIH, 26 May 1939, National Archives, RG 443, NIH
193048, General Records, box 46, f. He.
81. John J. Moran, My Date with Walter Reed and Yellow Jack, 56, typescript,
Philip S. Hench Walter Reed Collection, box 34, f. 23, Historical Collections of the
Claude Moore Health Sciences Library, University of Virginia, Charlottesville, VA.
82. Sidney Howard is Killed by Tractor on Estate; Playwright is Crushed in
Berkshire Garage, New York Times, August 24, 1939, 1. Howard received a posthumous Academy Award for the Gone with the Wind screenplay: Gone with the Wind
Academy Winner, New York Times, March 1, 1940, 23.

Chapter Eleven

Technicolor Technoscience
Rescripting the Future
Valerie Hartouni
In this essay, I examine some of the ways in which genetic innovations and the
contemporary anxieties and fantasies they engender are culturally organized,
articulated, negotiated, and provisionally resolved. To stage this discussion,
I begin with Andrew Niccols 1997 science-fiction film, Gattaca, a dystopic rendering of one possible future in which the social relations of reproduction have
been fundamentally transformed.1 Gattaca invites viewers to enter a world in
which the use of new reproductive and genetic technologies is all but commonplaceand this to ensure the birth . . . of babies with the most perfect genetic
combination available.2 In this imagined world, there are basically two classes
of people: those who have been genetically designed and enhanced, known as
Valids, and naturally conceived people, or Invalids, so-called because of their
imperfect or random DNA structures. Whereas the genetically enhanced enjoy
all forms of social access and advantage, Invalids are the working drones in this
world, essential to its operation but without social worth or standing. Although
the plot and outcome of Gattaca are both somewhat predictable, for reasons
I hope to make clear, the film nevertheless raises and leaves only tentatively settled a host of questions about what, in the end, constitutes individual identity,
choice, will, responsibility, and freedom in a world fundamentally reshaped by
biology-based technologies. Humanism prevails, as indeed it must, in this imagined account of its future showdown with technoscience. However, its victory is
hardly definitive. Conventional understandingsand their anchoring assumptionsof who or what counts as distinctly human are rescued, but not without
having also been refigured.
Gattaca takes as its point of departure a biblical passage from Ecclesiastes
(7:13): Consider what God has done: Who can straighten what He has made
crooked? The film begins, then, by posing for viewers a variation on the kind
of questions currently entertained by ethics boards across the country, navigating the vast promises, and equally vast perils, of laboratory forms of genetic

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manipulation. In the world this film imagines, however, these questions have
been settled. In this new world, heterosexual couples seeking to start or expand
their familiesfor indeed, heterosexual pair-bonding and the nuclear family
remain unproblematically intact in this fantasyare compelled to enlist the aid
of a geneticist who analyzes their gametes and assists them in selecting the right,
which is to say best, genetic material for their offspring in order to ensure a
more perfect future for their more perfect children. Those produced through
heterosexual intercourse without the aid of a genetic counselor or in vitro
manipulationthose, in other words, who are genetically unregulated and thus
more likely to be genetically flawedare called Invalids, as I noted earlier, as
well as faith births, Godchildren, and de-gene-erates.
Vincent Freeman (played by Ethan Hawke), the protagonist of this story, is a
Godchild, conceived in love the old-fashion way, nostalgically depicted in the
film as passionate (or illicit) sex on a warm summers evening in the backseat of
a souped-up muscle car. Although this is perhaps outside the point of reference
for younger audiences, older viewers will clearly recognize this as a wake up, little Suzy moment, and one with similarly disastrous results. Within minutes of
Vincents birth, a genetic profile is generated from a drop of blood. It reveals that
his will be a short and troubled life: there is a sixty percent probability that he will
have a neurological condition, a forty-two percent probability that hell be manic
depressive, an eighty percent probability that he will suffer from attention deficit
disorder, and a ninety-nine percent probability that his heart will fail. His life
expectancy is to be 30.2 years. The first questions new parents might ask in the
moments following the birth of their newbornis s/he healthy? who are you?
or who might you become?are answered in Vincents case with a shocking
finality across social worlds and futures within moments of his arrival. He is
marked at birth and ostracizedsomething that is underscored when his father
reverses his decision to give his first-born son his name (Anton), opting instead
to call him Vincent. Although Vincent means conqueror, there is nothing
about the post-delivery moment of naming, or the years that follow, to suggest
that either parent believes Vincent will or could possibly live up to his name.
As the film presents it, no one pretends that Vincent can or will overcome his
genetic destiny and make something of himself; that sort of parental attention
and expectation is reserved for his genetically engineered or enhanced younger
brother, Anton (played by Loren Dean), a true Valid.3 But, Vincent nevertheless
yearns to be an aeronautics engineer and, although rejected by schools and
employers and discouraged, even ridiculed, by family members (an overly protective mother, a distant and disapproving father, an arrogant and disdainful
younger brother), he works to educate and prepare himself for a future it is not
clear he will ever realize. Eventually, he leaves home and heads to Gattaca, a corporate space center, where he cleans floors, picks up trash, and dreams of joining one of the many manned space flights that leave daily for other stars and
planets. He meets up with a DNA broker who introduces him to a recently

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paralyzed but genetically flawless Valid, Jerome Eugene Morrow (played by Jude
Law), and undergoes a radical physical make-over in order to more closely
resemble the man whose life (and social status) he will assume as his own: teeth
are straightened, limbs are lengthened, eyes are corrected, and muscles developed. Indeed, to realize his ambition, in the language of the film, Vincent borrows a ladder. Using Jeromes genetic resume for identification purposeshis
blood and urine (as well as hair, fingerprints, and skin cells)Vincent interviews
for a job at Gattaca, is hired, and subsequently is chosen for a mission to one of
the moons of Saturn. A murder occurs at the space center; one of Vincents eyelashes is picked up in a DNA evidence sweep of human hair, skin, and saliva; the
erroneous assumption is made that he, the Invalid, committed the crime; and
the hunt is on. Although Vincent eludes capture, a newly implemented security
procedure requires him to provide one final genetic specimen before boarding
the shuttle to Titan. Vincent is unprepared (he no longer carries a urine sample
from Jerome strapped to his leg) and exposed. He is, nevertheless, allowed to
board the shuttle by a sympathetic doctor/technician/genetic screener who, we
learn, has a son with great aspirations like Vincent, but who will also be prevented from pursuing them because of his inexplicably flawed DNA. The story
ends with the rocket heading for deep space.
The obvious first question we might ask is what cultural work, if any, does a
film like Gattaca perform, particularly since, as Nicholas Agar points out in his
defense of enhancement technologies, Hollywood depictions of worlds reconfigured by the use of biotechnologies (and here he mentions, in addition to
Gattaca, Straw Dogs, Star Wars: Attack of the Clones, and Star Trek: Nemesis) misrepresent at the most basic level what these technologies will actually do, how they
will actually work, and what they might actually mean for humanitys future. In
Agars view, Hollywood gives bad moral advice about enhancement technologies precisely because it gets the facts about them wrong.4 And getting the facts
wrong has consequences, at least potentially.
Thus, for example, in advance of the films release, the Boston Business Journal
speculated that Gattaca might incite an already apprehensive public and generate adverse popular responses toward the biotech industry. The Journal went on
to note that the Washington, D.C.-based Biotechnology Industry Organization
had begun to alert its members about the potential need to counter any public
confusion or anxiety the film might foster with respect, in particular, to future
applications of genetic-based therapies.5 In the words of a New England pharmaceutical companys chief executive officer: A movie like [Gattaca] could take
away years of goodwill were trying to develop in terms of the therapeutic products were developing. Were about making people better, not making people.6
On a somewhat different but related front, the Journal also reported that the
Washington-based American Society for Reproductive Medicine had complained
about the way Sony had chosen to market the film: under the banner Children
Made to Order, ads placed in major newspapers displayed a picture of a baby,

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along with a checklist of traits (from which prospective parents could presumably
choose), as well as a toll-free phone number and web address. Critics charged
that the ads looked too legitimate and could potentially mislead or confuse people by obscuring the difference between real science and science fiction. Sony
was called upon to make it clear(er) that Gattaca was only a movie.
On the other hand, notably absent from the list of companies and organizations that expressed apprehension about the film was NASA. Nor, for that matter, was the space agency contacted for comment by the popular or business
press, and I find this telling. What it suggests is that manned space travel and its
eventual privatization are now simply givensuncontroversial and unlikely, in
any event, to confuse or disturb a public that might otherwise be unable to distinguish between scientific facts and popular fictions. But consider the following
questions: how and precisely when did space travel of the sort envisioned by the
film become so unremarkable? How did our sense of ourselves and our place on
earth shift, as indeed they had to, for manned space flight to distant planets and
galaxies not to matter, to seem run-of-the-mill, or to be nothing more than a simple backdrop to more pressing issues like genetic manipulation and enhancement? And, finally, does the now apparently mundane status of manned space
flight anticipate or give us any indication, even a mere hint, of how we are likely
to regard and explain not only biotechnology within the next half century but
ourselves as well?
Contrary to any corporate anxiety that Gattaca may have momentarily stimulated, the film works on several levels to stabilize rather than threaten what we
think we know about who and what we are. Vincent is my brother, your son, your
sisters friend, your mothers cousinsomeone, in other words, who entertains
recognizable ambitions to better himself, overcomes overwhelming odds, and
succeeds in a system in which he was never meant to survive. The movie calls the
drive he displayshis yearning for freedom and individual self-expressionthe
human spirit, and reassures viewers not only that this drive is more important
than particular, socially-valued genetic traits (even those individuals with enviable helixes, after all, may not have it; indeed, all the Valids we encounter in the
film seem to lack it). It suggests as well that this spirit will triumph under even
the most severe conditions, and perhaps even because of them. In the context
of the film, therefore and not surprisingly, liberalisms particular understandings and organization of the subject as a self-made, autonomous, free individual
are recuperated along with this subjects condition of possibility, a liberal order
that may recognize natural inequality, but regards it, at least in principle, as
socially and politically irrelevant.
Gattaca embeds its novel representations of personhood within the everyday
life of the future. A decade earlier, a special report by the now defunct Office of
Technology Assessment (OTA) likewise attempted to anticipate and map the
impact of new reproductive and genetic practices as well as other, novel, biologybased technologies on the U.S. Constitution and its anchoring assumptions

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regarding human nature, individual agency and responsibility, freedom, and

equality.7 While traversing for the most part an already well-trodden terrain of
hesitation and hope, the report launched its cartographic efforts from what I
take to be an interesting if somewhat unexpected site: while extraordinary
advances in biomedical science and technique permit us now to intervene in
human life processes that only a few decades ago were mysteries to science,
these advances have also rendered that life fundamentally unrecognizable, both
politically and ontologically, in offering alternative explanations of causality in
behavior, performance, motivation, and attitude that displace conventional
understandings of choice and will.8
Indeed, according to this government study, the person hypostatized by the
Constitutionthe rational, consenting, divinely ordained, self-determining, and
free-willed being, endowed with inalienable rights and inescapable responsibilitiesmay no longer exist today.9 In the words of the report, We may cling to
ethical and spiritual truths in constitutional assumptions about personal liberty
and responsibility. But at the same time we must also recognize that major
medical miracles recently unveiled or now on the horizon may challenge the status of these truths and change our understanding of the proper relationship
between the state and the individual.10
While there are clearly persons in the world, and while the Constitution
exists to secure the rights of persons, the sign and the signified no longer
stand in easy or obvious relation: beyond the chemical and anatomical, it seems
we do not know what exactly a person now is. Noting that this fissure may ultimately precipitate a reexamination of key constitutional concepts, the OTA
nevertheless concludes the prefatory remarks of its report with a set of reflections clearly intended to reassure. Even as we appear now to be less than what
we once thought ourselves to be as persons, we are, in some respects, also
more: since the eighteenth century, what is called person has undergone a subtle but significant transmogrification with the inclusion of women, and men
and women of all races and classes.11 With the advance of scientific knowledge
and technique, this transmogrification continues. While we can no longer say
with certainty who or what we are in some irreducible, essential sense, whoever
we are in the end, whatever entity we turn out to be, that entity will still be protected by the Bill of Rights.12
One need not read a document on biology and the Constitution to sense how
deep is the confusion of government with respect to what makes or sustains persons; the domestic policies of the last three decades in the United States and
their popular appeal speak of a confusion more deadly than profound. Still,
what is striking about this document is its clear, if tentative, suggestion that a
privileged political narrative has ruptured, that the stories we have told ourselves about who and what we are can neither frame nor contain the material
practices and processes that constitute persons in this early twenty-first century
moment. Indeed, what this document suggests is that the kinds of choices we

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often think of as yet to be made, choices which will profoundly alter our identity as human beings and the identities of the communities we occupy, we have
always, already, been making. The development and deployment of the new
technologies of human genetics and reproduction and other biology-based technologies may boldly stage and dramatize such choices. The revolution of the
flesh they are said to be inaugurating, howeverwhat Aldous Huxley once characterized as the really revolutionary revolutionis enacted daily and less dramatically in legislative and legal domains, the formation of public policy, the
setting of healthcare priorities, and the funding of particular research agendas.
Thus, in fact, a much broader terrain is at stake. These biosocial technologies
work at the same deep level and with the same pervasive effect that it is feared
new reproductive and genetic technologies will do and have. Through them, not
only are particular kinds of individuals or subjects reproduced, but so too are
the social relations that organize and render them recognizable as such (to
themselves and others).
But let us back up for the moment. Since 1988, when the report from the
Office of Technology Assessment was first published, we have witnessed the
introduction of a dramatic array of reproductive and genetic innovationsin
vitro fertilization, gestational surrogacy, cloning, and the mapping of the human
genome, to name only a few. Each new innovation has generated a considerable
amount of popular discourse and debate, usually far in advance of any practical
impact, and at its moment of introduction is said to now situate us at some kind
of definitive crossroad. In the popular news media, in particular, spectacular
images of monstrosity are conjured and paraded across the cultural landscape
to illustrate what we may or will become. These subhuman creatures and transhuman caricaturesthose who have lost all humanity and on whom transgressive crossings of nature are visibly inscribedare said to represent, among other
things, the hubris of science and its potential disruption or colonization of
otherwise natural life-producing practices. To paraphrase one commentator,
echoing the sentiments of many others, There are limits to what human beings
ought to be thinking about doing; [but] where do we draw the line?13
Over the course of the last four decades, this question has been an almost constant rejoinder to new or imagined reproductive and genetic innovations and
the alternative forms and practices of life they appear to entail. Indeed, the verse
from Ecclesiastes that opens Gattaca is but a version of this question. And,
although lines of the sort implied are rarely drawn literally or even figuratively,
the question of whether and where lines will be drawn can be read as a gesture
towards fortifying extant bordersthose that (produce and) protect from incursion the distinctly human, for exampleeven as it also marks their realignment. As such, it does important cultural work: it assumes and invokes prevailing
cultural beliefs about who and what we are, while also signaling a shift in these
beliefs. Perhaps more to the point, it is a question the rhetorical force of which
is largely derived from the apparitions it typically calls up when posed: the

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biologically mutant and monstrous who live on the fringes of a frontier just
beyond the present (b)order (or line) and who represent, in Leon Kasss words,
the end of human life as we and all others know it.14
By way of illustration, consider the late 1960s and early 1970s, when the first
tentative steps were taken in the direction of in vitro fertilization. Researchers
feared and skeptics warned that creatures unrecognizable as human would
result from scientific interventions in life-producing processes. Theologian Paul
Ramsey bitterly welcomed the birth of such monsters, suggesting that only with
their birth would such interventions be halted and authentic humanity delivered from the threat of immanent erosion and loss. The late Patrick Steptoe, the
founding father of in vitro fertilization, moved to allay fears and anxieties
about his research in its early phases by reassuring critics that were monstrosities
to result from his manipulations of egg and spermand he seemed to think
they mightno such creatures would be allowed to develop or be brought to
term.
Similarly, a 1969 issue of Life magazine speculated that new reproductive
methods would precipitate the dissolution of traditional family life, marital relations, and ties both primordial and social, and give birth to a figure it called in
vitro man.15 Lifes imagined techno-human inhabited what the magazine
described as a tissue culture, a postcivilization future. Although in vitro man
might regard himself as happy and freeunencumbered by relationship or
responsibility and oriented towards play and pleasurehe belongs no where
and to no one and lives without a sense of place or heritage. Without parents,
children, aunts, uncles, or a marriage partner, in vitro man will never be
needed in precisely the ways Life imagined a man needs to be needed. Worse
still, he will never recognize his loss, and this, in Lifes view, is what renders his
predicament all the more tragic: he is a mere caricature of his viviparously produced counterpart, and he doesnt even know it. In an equally distressed and
cautious fashion, Look magazine similarly informed its readers in 1971 that One
of mother-natures most cherished rituals [was] being usurped by man. And
Looks vision of the consequences of this appropriation, like Lifes, was decidedly
dire: All hell will break loose, it reported, citing Nobel Laureate James Watson
in a statement Watson made before a congressional committee recommending
that Congress move swiftly to outlaw alternative reproductive techniques. The
nature of the bond between parents and children . . . and everyones values
about his individual uniqueness could be changed beyond recognition.16
Finally, in 1993, following the announcement of the Hall/Stillman cloning
experiment with human embryos, ethicist Albert Johnson speculated that while
our early efforts to clone would undoubtedly leave us with the possibility [of]
creat[ing] a lot of monsters,17 the possibility of monstrosity would diminish
once the procedure was technically refined.
Significantly, the biologically monstrous, unrecognizably human or transhuman
creatures it was feared might be produced by new reproductive and genetic

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interventions have not yet materialized. Over the course of the last three
decades, new reproductive and genetic practices have been assimilated into the
order of nature or brought into the service of precisely those institutions, relations, and relationships or ways of life they seemed destined to raze, their transgressive potential at least temporarily contained. They are no longer regarded
as contrary to the work of nature, but rather as instruments that promote or
assist its work, enabling, correcting, or improving natural processes that have
gone awry and that, in any event, apparently, are highly mercurial and inefficient. In this sense, and particularly with respect to reproductive innovations,
they have become part of what Sarah Franklin, among others, terms a new conception narrative, a highly sentimental narrative of biological desire and drive
that displaces the image and threat of the techno-scientist playing god with portraits of the happy, heterosexual, white, nuclear familydysfunctional, perhaps,
but hardly unrecognizablethat would not exist but for the pioneering efforts
of scientists on the frontiers of reproductive discovery.18
If monstrosities exist, they are the progeny of legal rather than biological
efforts to tell one story of origin, relationship, relatedness, and identity in the
voice of the natural. New reproductive practices have rendered such a telling
increasingly less plausible. In their wake have come a proliferation of possible
stories or forms of generation, constellations of relationship, and modes of relatedness that cannot arise in nature, that transform the meaning of natural
facts and profoundly refigure what counts as natural. And, in this respect,
they have had the effect of destabilizing dominant cultural narratives anchored
in nature about who or what is called person, mother, parent, family, fetus, and
baby.
At the same time, new reproductive and genetic practices have also been
brought into the service of dominant cultural narratives and work both to facilitate and fortify them, deploy[ing] very familiar prescriptions under increasingly unfamiliar guises.19 The rescripting that is required, however, for these
new practices to perform such work, to function ideologically, is considerable.
And it is at such moments in particulartypically when the law is called upon to
locate nature or determine which natural facts are truly natural and therefore determinantthat the production, or, as the law seems generally to view it,
presence of monsters is made visible. In the context of surrogacy, for example,
however one tells the story of the desperate-infertile-coupleand such couples are still typically represented in popular, legal, and medical discourse as
desperatethere is still a surplus of bodies, spare parts, or figures who are
positioned just outside the postpartum frame of the newly fashioned natural
family unit, at once both integral and extraneous to it. To the extent that they
enter the frame or insist on being figured within it, they enter as excess: as hosts,
receptacles, and foster parents, or delusional, self-serving interlopers whose
maternal claims are pathologized and said to jeopardize precisely what their
maternal labors have made possible and been solicited to serve.

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Notwithstanding the often destabilizing effects of new reproductive practices,

these new practices have been domesticated over the course of the last thirty
years. They are now positioned well within a set of borderscategorical and conceptual, moral and ontologicalthat while treated as fixed and given are clearly
only provisional, are themselves in a state of constant fluctuation and realignment, the site, source, and effect of ongoing cultural contests. Returning to the
question of setting limits and drawing lines, where this line seems self-evidently
set today and where it was regarded as naturally fixed or drawn a quarter of a
century ago are clearly two quite different places. And in this respect, to put the
matter in terms of Kasss remonstration, we are, in some sense, always already
encountering the end of human life as it is known (or practiced by some).
Situated anxiously and precariously on the edge of aberration, we are, in some
sense, always already successors to forms and practices of life that circumscribe
what is called the distinctly human and seem in danger of giving way for good.
The discursive processes through which new biology-based technologies are
domesticated or normalized are at work and can be seen clearly in contemporary controversies surrounding the mapping of the human genome. Although
genetic innovation has fostered a considerable amount of anxious speculation
about the many eugenic abuses to which it could be puttemporally blending
the present with some science-fictional future as Gattaca doesit is also the case
that genetics is increasingly appealed to and invoked as an evidentiary site for
conventional understandings of identity and individuality. Through the specter
of what human might become were the boundaries that circumscribe it transgressed or effaced, humanisms unique, self-contained, self-determining individual is recuperated at least rhetorically, another insult and potential onslaught
ostensibly, certainly discursively, countered and contained.
By way of illustration, consider the medical literature shaped by what is called
the science of fetology and current genetic research now directed toward discerning not merely the facts of life but the secrets of life.20 In this literature,
a curious story of origins, agency, and individuality is being produced that features the fetus as a self-made liberal subject in utero. While once regarded as a
passive and parasitic passenger, the fetus has come increasingly to be represented
in both medical and scientific literatures as the dominant, active partner in pregnancy,21 autonomous, self-regarding, and more or less self-sufficient, aware of its
own interests from conception, apparently, and capable of acting upon these
interests. As one physician describes it, the fetus is an egoist [rather than] a helpless dependent . . . [whose] purpose is to see that its own needs are met.22 Its
genetic blueprint is now said to establish its unique identity, regulate its developmental direction, and settle the parameters of its future achievement(s). Indeed,
its genetic blueprint starts its clock, supplies its purpose, and distinguishes the
fetus as the principle architect of its own miraculous transformation.23
Now, this portrait of the self-made individual/fetus proffers a clear if confused rendering of at least one version of the liberal story. It geneticizes what

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d e f i n i n g au t h e n t i c i t y, e x e r c i s i n g au t h o r i t y

C. B. MacPherson has dubbed the possessive individual; inscribes as raw biology liberal understandings of self-ownership and interest; and reinvigorates a
masculinist fantasy of autonomy, agency, and control that rivals even the more
radical ruminations of early liberal thinkers insofar as these were constrained by
some sense of the divine (however anemic). Within this framework, human
beings exist as distinct and pre-formed individuals prior to any social bonds, proprietors of their own attributes and capacities, by virtue of some genetic code.
The obvious question, however, is whether we really mean to reduce identity
or this thing that is being called the selfto genetic patterns or strands of a
few basic chemicals the complex sequencing and functioning of which we have
only the most modest understanding.24 In what sense, exactly, are these chemicals, or perhaps more accurately, their effect, what we would call a person, an
individual, or a self? By the same token, what does it mean to geneticize or
read back to the gene liberalisms atomistic and apprehensive understanding of
individuals, itself a historically recent, highly contingent formation? What precisely is solved (or postponed) by characterizing the fetus as a more or less selfsufficient, utterly self-regarding, radically self-interested, non-relational agent
who is engaged in what can, at best, be described as a thoroughly instrumental,
parasitic relationship?25 And, finally, in what ways does it even make sense to talk
about agency, control, and autonomy, when the distinct self is itself
genetically determined?
Rescuing humanisms unique, radically contained, and separate individual by
an appeal to nature in the form of genetics works, at least rhetorically, to preserve the idea of originality, authenticity, indivisibility, and natural diversity. It
also reinstalls a creature that bears a convincing likeness to the one potentially
displaced by new genetic practices, certainly a creature that is still more or less
coherent within dominant discursive systems and can (continue to) be assimilated and accounted for by them, at least superficially. However, in the process
of being discursively reassembled as a thoroughly geneticized entity, this creature has undergone a slight but significant transmogrification. In other words,
while genetic essentialism may allow for the recuperation of singularity or
individuality, it also profoundly complicates what are conventionally regarded
as other equally as integral or constitutive aspects of identityconventional
notions of agency and responsibility, for example, or freedom and autonomy.
These practices presume a rational, unified, sovereign subject, in control and
fully accountable. To accommodate an understanding of individuals as essentially driven or constrained by particular genetic traits or the legacy of a particular genetic history, they cannot be simply transposed or expanded, but would
need, instead, to be radically refigured.26 Without such a refiguration, genetically given difference can only signify (as it currently often does) as individual
pathology: deficiency, disorder, and deviance. Within the context of conventional understandings of agency, responsibility, freedom, and autonomy,
such difference will operate only to reinscribe and enforce a normative map of

technicolor technoscience

317

the distinctly or fully humanoperate, in other words, as a means for organizing and regulating certain kinds of persons and classes of people.27
And this is precisely what happens in Niccols imagined future, Gattaca, at
least for the most part. It is also what happened, for the most part and not coincidently, in Huxleys imagined future, Brave New World. Both restage a tension
that has plagued liberal capitalist formations throughout their history between,
on the one hand, the ideology of freedom and equalitywith its celebration of
the meritocracy or the notion that individuals rise by talent and are where they
are in the social world because of their own efforts or lack of themand, on the
other, the social relations and dynamics of power that generate powerlessness
and inequalities of status and wealth. Both Gattaca and Brave New World posit a
future in which this tension has been ostensibly explained and resolved, settling
on an account that sees hierarchies of advantage and disadvantage as naturally
inscribed and genetically driven. And while Gattaca does not go so far as Brave
New World in claiming to have rationalized these hierarchies, it does depict a
world in which reproductive choice and desire have been reorganized to both
contain and control aberrant biological processes. Certainly, the possibility of
engineering or producing particular kinds of people for particular kinds of jobs,
or changing human features and faculties at will, is impliedas, for example,
when the films main character attends a piano concert and learns that the
music being performed is and can only be played by a twelve-fingered pianist.
But even so, the films ambivalence is clear: Consider what God has done: Who
can straighten what He has made crooked?
New reproductive and genetic technologies appear to boldly stage a host of
questions about who and what we are as human. They dramatize the possibility
of erasing genetic errors, filtering the gene pool to remove genetic diseases and
defects, remaking human nature from the inside out it. As Ive been suggesting throughout this essay, however, such an understanding of biology-based
technologies ignores the ways in which social technologies operate and have
always operated (at the same deep level) to produce and/or reproduce new life
forms and forms of life. The kinds of choices we typically think of as yet to be
made, choices that will profoundly alter our identity as human beings and the
identities of the communities we occupy, we have already been makingin legislative and legal domains, the formation of public policies, the setting of healthcare priorities and, significantly, in the funding of particular research agendas,
like the human genome project. As Lily Kay, among others, has pointed out, the
power of this project inheres mainly in the ways it works to geneticize society in
reconfiguring our social practices and understandings of self, of health, and of
disease. In her words, well ahead of medical technologies, social technologies
have already been set in motion.28 The question, then, is not, as it is often
framed across discursive arenasin Congress, the courts, the news and popular
mediawhether we should alter our identity and the identity of the communities we occupy; the question is rather how, in what ways and combinations, and

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d e f i n i n g au t h e n t i c i t y, e x e r c i s i n g au t h o r i t y

subject to what conditions? What sort of people and society are we and are we
likely to become, should we become that sort of people(s) and society, and how
do wewhoever and however we are and are configuredindividually and
collectively decide?29

Notes
1. Gattaca. Directed and written by Andrew Niccol, Produced by Danny DeVito,
Michael Shamberg and Stacey Sher. DVD. Columbia Tristar, 1997. Gattaca is a word
constructed from the first letter of each of the four nucleotide bases of DNA: adenine, thymine, cytosine, and guanine.
2. Jackie Stacey, Imitation of Life: The Politics of the New Genetics in Cinema, in
Graeme Harper and Andrew Moor, eds., Signs of Life: Medicine & Cinema (New York:
Wallflower Press, 2005), 155.
3. Staceys analysis of the tension between the two brothers is especially provocative. As she sees it, [t]he brothers come to represent two conflicting models of the
relationship between biological and cultural design. Each stands for a different philosophy: genetic determinism versus social interactionism. Given Vincents ultimate
success in his quest to defy the laws of genetic pre-selection, we might conclude that
he personifies the triumph of culture over biology. But the film is more ambiguous.
Imitation of Life, 158.
4. Nicholas Agar, Liberal Eugenics: In Defense of Human Enhancement (Malden, MA:
Blackwell Publishing, 2004), 21. We could rectify this problem by insisting that our
moral evaluation proceed from full and accurate representations of cloning, genetic
engineering and genomics. For a discussion of the many ways in which public misperceptions (and ignorance) regarding human biotechnologies skew popular
debate and hamper scientific research, see Lee M. Silver, Challenging Nature: The
Clash of Science and Spirituality at the New Frontiers of Life (New York: Ecco Press, 2006).
5. Tom Salemi. Gattaca: Fun or Biotech Nightmare? Boston Business Journal,
October 20, 1997. http://boston.bcentral.com/boston/stories/1997/10/20/
story2.html. Accessed March 18, 2007.
6. Chief executive officer of GelTex Pharmaceuticals and head of the
Massachusetts Biotechnology Council, cited in Salemi.
7. Office of Technology Assessment, Biology, Medicine, and the Bill of Rights
(Washington, D.C.: U.S. Government Printing Office, 1988), 35.
8. Ibid., 3.
9. Ibid.
10. Ibid., 3, 97.
11. Ibid., 4.
12. Ibid.
13. See Kass, Leon R., The New Biology: What Price Relieving Mans Estate? Science
174 (November 1971): 77988.
14. Kass, The New Biology, 779.
15. Albert Rosenfeld, The Second Genesis Life 66:23 (June 13, 1969), 3854.
16. David M. Rorvik, Taking Life in Our Own Hands: The Test-Tube Baby is
Coming, Look 35:10 (May 18, 1971), 88.
17. New York Times, October 26, 1993, B7.

technicolor technoscience

319

18. Sarah Franklin, Postmodern Procreation: A Cultural Account of Assisted

Reproduction, in Faye D. Ginsberg and Rayna Rapp, eds., Conceiving the New World
Order (Berkeley: University of California Press, 1995); see also Marilyn Strathern,
After Nature (Cambridge: Cambridge University Press, 1992).
19. Sarah Franklin, Essentialism, Which Essentialism? Some Implications of
Reproductive and Genetic Techno-Science Journal of Homosexuality 24: 34 (1993): 29.
20. Franklin makes this distinction in Postmodern Procreation. See also Evelyn
Fox Keller, Secrets of Life, Secrets of Death: Essays on Language, Gender and Science (New
York: Routledge, 1992), 3955.
21. Sarah Franklin, Fetal Fascinations: New Dimensions to the Medical-Scientific
Construction of Fetal Personhood, in Sarah Franklin, Celia Lury, and Jackie Stacey,
eds., Off-Centre: Feminism and Cultural Studies (New York: Harper Collins, 1991), 193.
22. Ibid., 194.
23. Listen to the account of fetal life or what Franklin in Fetal Fascinations (193)
characterizes as the new natural facts of pregnancy proffered by one fetologist,
but certainly echoed, enthusiastically, by others:
The fetus is thought of nowadays not as an inert passenger in pregnancy but, rather, as in
command of it. The fetus, in collaboration with the placenta, (a) ensures the endocrine success of pregnancy, (b) induces changes in maternal physiology which make her a suitable
host, (c) is responsible for solving the immunological problems raised by its intimate contact
with it mother, and (d) determines the duration of pregnancy.

24. Walter Gilbert, A Vision of the Grail in Daniel J. Kevles and Leroy Hood, eds.,
The Code of Codes: Social Issues in the Human Genome Project (Cambridge, MA: Harvard
University Press, 1992), 93.
25. Ibid.
26. As Evelyn Fox Keller points out, how these practices might be refigured is itself
a thoroughly vexing question. In Kellers words: Today we are being toldand judging from media accounts, we are apparently coming to believethat what makes us
human is our genes. Indeed, the very notion of culture as distinct from biology
seems to have vanished; in terms that increasingly dominate contemporary discourse, culture has become subsumed under biology. . . . But if culture is to be subsumed under biology, and if it is our biological or genetic future that we now seek to
shape, where are we to locate the domain of freedom by which this future can be
charted? The disarming suggestion that is put forth is that this domain of freedom is
to be found in the elusive realm of individual choicea suggestion that invokes a
democratic and egalitarian ideal somewhere beyond biology. But since there is in
this discourse no domain beyond biology, since it is our genes that make us what
we are, and since they do so with definitive inequality that compromises even those
choices some of us can make, we are obliged to look elsewhere for the implied realm
of freedom. Nature, Nurture, and the Human Genome Project, in Kevles and
Hood, eds., The Code of Codes, 29798.
27. As Evelyn Fox Keller observes, molecular geneticists do not seek genetic loci for
traits that theyand weaccept as normal. (See Keller, Nature, Nurture, and the
Human Genome Project in Kevles and Hood, eds., The Code of Codes, 298). Or as
Dorothy Nelkin and M. Susan Lindee put the matter: People with problems [will]
become, in effect, problem people. See Nelkin and Lindee, The DNA Mystique: The
Gene as a Cultural Icon (New York: W. H. Freeman and Company, 1995), 129. See also

320

d e f i n i n g au t h e n t i c i t y, e x e r c i s i n g au t h o r i t y

Dorothy Nelkin, The Social Power of Genetic Information in Kevles and Hood,
eds., The Code of Codes, 179: As has often been the case in the history of medical
intervention, diagnostic techniques are far ahead of therapeutic possibilities. For the
short term, perhaps the most important social consequence of these new diagnostic
tests will arise less from their actual use than from their bearing on the definition of
deviance and disease.
28. Lily E. Kay, Who Wrote the Book of Life?: A History of the Genetic Code (Palo Alto:
Stanford University Press, 2000), 327.
29. Laurence Tribe, Technology Assessment and the Fourth Discontinuity: The
Limits of Instrumental Rationality, Southern California Law Review 46:3 (1973):
61760.

Suggestions for Further Reading

Abramsom, Paul R. and Mindy B. Mechanic. Sex and the Media: Three Decades of
Best-Selling Books and Major Motion Pictures. Archives of Sexual Behavior 12:3
(1983): 185206.
Apple, Rima D. and Michael W. Apple. Special Section on History of Science in Film.
Screening Science. Isis 84 (December 1993): 75054. Film reviews: 75574.
Berridge, Virginia and Kelly Loughlin. Medicine, The Market and the Mass Media:
Producing Health in the Twentieth Century. New York: Routledge, 2005.
Buxton, Rodney. Broadcast Formats, Fictional Narratives, and Controversy: Network
Televisions Depiction of AIDS. PhD diss., University of Texas, Austin, 1992.
Cartwright, Lisa. Screening the Body: Tracing Medicines Visual Culture. Minneapolis:
University of Minnesota Press, 1995.
Colwell, Stacie. The End of the Road: Gender, the Dissemination of Knowledge, and
the American Campaign Against Venereal Disease During World War I. In The
Visible Woman: Imaging Technology, Science, and Gender, edited by Paula A. Treichler,
Lisa Cartwright, and Constance Penley, 4482. New York: New York University
Press, 1998.
Dans, Peter E. Doctors in the Movies: Boil the Water and Just Say Aah. Bloomington, IL:
Medi-Ed Press, 2000.
Doane, Mary Ann. The Desire to Desire: The Womans Film of the 1940s. Bloomington:
Indiana University Press, 1987.
Dumit, Joseph. Picturing Personhood: Brain Scans and Biomedical Identity. Princeton, NJ:
Princeton University Press, 2004.
Eberwein, Robert. Sex Ed: Film, Video, and the Framework of Desire. New Brunswick, NJ:
Rutgers University Press, 1999.
Enns, Anthony and Christopher R. Smit, eds. Screening Disability: Essays on Cinema and
Disability. Lanham, MD: University Press of America, 2001.
Fedunkiw, Marianne. Malaria Films: Motion Pictures as a Public Health Tool.
American Journal of Public Health 93:7 (July 2003): 104657.
Friedman, Lester D., ed. Cultural Sutures: Medicine and Media. Durham, NC and
London: Duke University Press, 2000.
Gerbner, George, Larry Gross, M. Morgan, and Nancy Signorielli. Health and
Medicine on Television. New England Journal of Medicine 305:15 (October 8,
1981): 9014.
Hall, Stuart, ed. Representation: Cultural Representations and Signifying Practices.
London: Sage Publications, 1997.

322

suggestions for further reading

Harper, Graeme and Andrew Moor, eds. Signs of Life: Medicine and Cinema. New York:
Wallflower Press, 2005.
Institute for Health and Development Communication. Soul City: Heartbeat of the
Nation. Houghton, South Africa, 2000. www.soulcity.org.za.
Institute for Health and Development Communication. Ten Years of Soul City.
Houghton, South Africa: Institute for Health and Development Communication,
2000.
Kalisch, Philip A. and Beatrice J. Kalisch. Images of Nurses on Television. New York:
Springer, 1983.
Karpf, Anne. Doctoring the Media: Reporting on Health and Medicine. London:
Routledge, 1988.
Kuhn, Annette. Cinema, Censorship and Sexuality, 19091925. London: Routledge,
1988.
Kuhn, Annette. The Power of the Image: Essays on Representation and Sexuality. London:
Routledge and Kegan Paul, 1985.
Leavitt, Judith Walzer, ed. Women and Health in America: Historical Readings. 2nd ed.
Madison: University of Wisconsin Press, 1999.
Leavitt, Judith Walzer and Ronald L. Numbers, eds. Sickness and Health in America:
Readings in the History of Medicine and Public Health. 3rd Revised Edition. Madison,
University of Wisconsin Press, 1997.
Lederer, Susan E. Repellent Subjects: Hollywood Censorship and Surgical Images in
the 1930s. Literature and Medicine 17 (1998): 91113.
Lederer, Susan E., and John Parascandola. Screening Syphilis: Dr. Ehrlichs Magic
Bullet Meets the Public Health Service. Journal of the History of Medicine and Allied
Sciences 53:4 (October 1998): 34570.
Lederer, Susan E., and Naomi Rogers. Media. In Medicine in the Twentieth Century,
edited by Roger Cooter and John Pickstone, 487502. Amsterdam: Harwood
Academic Publishers, 2000.
Malmsheier, Richard. Doctors Only: The Evolving Image of the American Physician. New
York: Greenwood Press, 1988.
Mason, Carol. Killing for Life: The Apocalyptic Narrative of Pro-Life Politics. Ithaca, NY:
Cornell University Press, 2002.
Nichtenhauser, Adolf. A History of Motion Pictures in Medicine. Unpublished
Manuscript, circa 1950. In Adolph Nichtenhauser History of Motion Pictures in
Medicine Collection, MS C 380. Archives and Modern Manuscripts Program,
History of Medicine Division. National Library of Medicine. Bethesda, Maryland.
Norden, Martin F. The Cinema of Isolation: A History of Physical Disability in the Movies.
New Brunswick, NJ: Rutgers University Press, 1994.
Ostherr, Kirsten. Cinematic Prophylaxis: Globalization and Contagion in the Discourse of
World Health. Durham, NC: Duke University Press, 2005.
Pernick. Martin S. The Black Stork: Eugenics and the Death of Defective Babies in American
Medicine and Motion Pictures since 1915. New York: Oxford University Press, 1996.
Pernick, Martin S. Thomas Edisons Tuberculosis Films: Mass Media and Health
Propaganda. Hastings Center Report 8:3 (June 1978): 2127.
Petchesky, Rosalind. Fetal Images: The Power of Visual Culture in the Politics of
Reproduction. Feminist Studies 13 (Summer 1987): 26392.

suggestions for further reading

323

Reagan, Leslie J. Engendering the Dread Disease: Women, Men, and Cancer.
Journal of American Public Health 87:11 (November 1997): 177987.
Sappol, Michael. Introduction, The Public Health Film Goes to War. Historical Medical
Films on DVD, vol. 1. Washington, D.C.: National Library of Medicine, forthcoming, 2008.
Schaefer, Eric. Bold! Daring! Shocking! True!: A History of Exploitations Films,
19191959. Durham: Duke University Press, 1999.
Schneider, Irving. Images of the Mind: Psychiatry in the Commercial Film.
American Journal of Psychiatry 134 (1977): 61320.
Schneider, Irving. The Theory and Practice of Movie Psychiatry. American Journal of
Psychiatry 144 (1987): 9961002.
Singhal, Armind and Everett M. Rogers. Entertainment-Education: A Communication
Strategy for Social Change. Mahwah, NJ: Lawrence Earlbaum Associates, 1999.
Smith, Ken. Mental Hygiene: Better Living Through Classroom Films, 19451970. New
York: Blast Books, 1999.
Sturken, Marita, and Lisa Cartwright. Practices of Looking: An Introduction to Visual
Culture. New York: Oxford University Press, 2001.
Thomson, Rosemary Garland, ed. Freakery: Cultural Spectacles of the Extraordinary Body.
New York: New York University Press, 1996.
Thomson, Teresa L., et al, eds. Handbook of Health Communication. Mahwah, NJ:
Lawrence Eribaum Associates, 2003.
Tomes, Nancy. Epidemic Entertainments: Disease and Popular Culture in Early
Twentieth-Century America. American Literary History 14:4 (Winter 2002):
62552.
Treichler, Paula A. How to Have Theory in an Epidemic: Cultural Chronicles of AIDS.
Durham, NC: Duke University Press, 1999.
Treichler, Paula A., Lisa Cartwright, and Constance, Penley. The Visible Woman:
Imaging Technologies, Gender, and Science. New York and London: New York
University Press, 1998.
Tucker, Jennifer. Nature Exposed: Photography as Eyewitness in Victorian Science.
Baltimore, MD: Johns Hopkins University Press, 2005.
Turner, Graeme. Film as Social Practice. 3rd ed. London and New York: Routledge,
1999.
Turow, Joseph. Playing Doctor: Television, Storytelling, and Medical Power. New York:
Oxford University Press, 1989.
Vaughn, Stephen. Morality and Entertainment: The Origins of the Motion Picture
Production Code. Journal of American History 77 (1990): 3965.
White, Suzanne. Mom and Dad (1944): Venereal Disease Exploitation. Bulletin of
the History of Medicine 62:2 (Summer 1988): 25270.

Contributors
LISA CARTWRIGHT is professor in the Department of Communication at the
University of California at San Diego, where she is also on the Science Studies
and Critical Gender Studies faculty. She is the author of Moral Spectatorship, a
rethinking of feminist film theory through psychoanalytic work on affect and
technologies of voice and embodiment; Images of Waiting Children: The Visual
Culture of Transnational Adoption; Screening the Body: Tracing Medicines Visual
Culture; co-author with Marita Sturken of Practices of Looking: An Introduction to
Visual Culture; and co-editor with Paula A. Treichler and Constance Penley of The
Visible Woman.
VANESSA NORTHINGTON GAMBLE, MD, PhD, is director of the Tuskegee University
National Center for Bioethics in Research and Health Care, established in 1999
as a result of President Clintons apology for the United States Public Health
Service Syphilis Study. Dr. Gamble chaired the committee that led the campaign
to obtain the apology. Both a physician and a historian, her work has focused on
the history of race and racism in American medicine, racial and ethnic disparities in health and health care, cultural competence, and social justice in
bioethics. Her book, Making a Place for Ourselves: The Black Hospital Movement,
19201945 was named an outstanding academic book by Choice, the journal of
academic librarians. Dr. Gamble is a member of the Institute of Medicine,
National Academy of Sciences.
RACHEL GANS-BORISKIN completed a masters degree at the University of
Pennsylvanias Annenberg School for Communication and currently works as a
marketing consultant outside Boston.
VALERIE HARTOUNI currently teaches in the Department of Communications at
the University of California, San Diego, and has written extensively on the cultural impact of new reproductive and genetic technologies. She has recently
completed Rhetorics of Justice, which uses Hannah Arendts controversial report
on the trial of Adolph Eichmann to rethink the category, crimes against
humanity.

326

list of contributors

SUSAN E. LEDERER is professor of history and the history of medicine at Yale

University. She is the author of three books on the history of biomedical research:
Flesh and Blood: Organ Transplantation and Blood Transfusions in Twentieth-Century
America; Frankenstein: Penetrating the Secrets of Nature; and Subject to Science: Human
Experimentation in America Before the Second World War. She is also the author of
numerous articles on the Tuskegee syphilis study, medical experimentation, and
bioethics. She served as visiting curator for the exhibition on Frankenstein at the
National Library of Medicine at the National Institutes of Health.
JOHN PARASCANDOLA received his doctorate in the history of science from the
University of WisconsinMadison. He taught at the University of Wisconsin
Madison, then served as chief of the History of Medicine Division of the
National Library of Medicine, and later as the Public Health Service historian, a
position from which he retired in 2004. He is currently working as a historical
consultant and teaches a course in the history of modern biology at the
University of Maryland. He is at work on a book about the history of syphilis in
the United States. He served as president of the American Association for the
History of Medicine from 2006 to 2008.
MARTIN S. PERNICK is professor of history, and associate director of the Program
in Society and Medicine at the University of Michigan. He has written two books:
The Black Stork, on eugenics and euthanasia in American medicine and motion
pictures; and A Calculus of Suffering, on professional and cultural attitudes
towards pain and anesthesia in nineteenth-century America. He has published
historical articles on medical motion pictures, eugenics, medical professionalism, the cultural politics of epidemics, informed consent, definitions of death
and of disability, and the relation between history and bioethics. His research on
early health films has been supported by the National Endowment for the
Humanities, the National Library of Medicine, and the Spencer Foundation.
Many of the films he rediscovered are available for research use at the University
of Michigan Historical Health Film Collection, whose catalog may be found
online at: http://www.lsa.umich.edu/history/healthfilms/healthfilms.html.
LESLIE J. REAGAN is associate professor in the Department of History, the Medical
Humanities and Social Science Program, the Gender and Womens Studies
Program, and the Law School at the University of Illinois, Urbana-Champaign.
Her book, When Abortion Was a Crime: Women, Medicine, and Law in the United
States, won the Willard Hurst Prize for legal history, among other prizes. She is
also the author of From Hazard to Blessing to Tragedy: Representations of
Miscarriage in Twentieth-Century America and Crossing the Border for
Abortions: California Activists, Mexican Clinics, and the Creation of a Feminist
Health Agency in the 1960s, both in Feminist Studies, and Law and Medicine
in the Cambridge History of Law in America. With National Institutes of Health,

list of contributors

327

Mellon, and other support, she is finishing a book on German measles (rubella)
that examines the intersections of epidemic disease, disabilities, and reproductive rights.
NAOMI ROGERS is associate professor of history of medicine and womens and
gender studies at Yale University. Her books include Dirt and Disease: Polio Before
FDR and An Alternative Path: The Making and Remaking of Hahnemann Medical
College and Hospital of Philadelphia. She is also the author of Caution: The AMA
May Be Dangerous to Your Health: The Student Health Organizations (SHO)
and American Medicine, 19651970 in Radical History Review, among many
other articles. Currently, she is writing on radical health movements in the 1960s
and completing her book, Healer from the Outback: Sister Elizabeth Kenny, Polio, and
American Medicine.
NANCY TOMES is professor of history at Stony Brook University. Her most recent
book is The Gospel of Germs: Men, Women and the Microbe in American Life. With support from the Robert Wood Johnson Foundation, she is currently completing a
new book titled A Patient Paradox: The Making of the Modern Health Consumer,
19301980, on evolving conceptions of patient/consumer empowerment
from the New Deal to the Reagan revolution. While a fellow at the National
Humanities Center, she developed Medicine and Madison Avenue, a digital
collection on the history of health-related advertising, which is available on the
Duke University Librarys website at: http://scriptorium.lib.duke.edu/mma/.
PAULA A. TREICHLER teaches in the Institute of Communications Research, the
Gender and Womens Studies Program, and the Medical Humanities and Social
Sciences Program at the University of Illinois at Urbana-Champaign. Her books
include How To Have Theory in an Epidemic: Cultural Chronicles of AIDS and the
co-edited collection The Visible Woman: Imaging Technologies, Gender, and Science.
She is currently writing a cultural history of condoms in the United States since
1873.
JOSEPH TUROW is Robert Lewis Shayon Professor and Associate Dean of Graduate
Studies at the University of Pennsylvanias Annenberg School for Communication.
His work on the images of health care in popular culture has been supported by
the Robert Wood Johnson Foundation, the Kaiser Family Foundation, and the
National Endowment for the Humanities. With Annenberg doctoral student
Michael Serazio, he is the creator of the second edition of Prime Time Doctors:
Why Should You Care? a video distributed by the Robert Wood Johnson
Foundation in 2006 to first-year medical students around the United States. His
publications include Playing Doctor: Television, Storytelling, and Medical Power and
Niche Envy: Marketing Discrimination in the Digital Age.

Index
Note: Page numbers in italics refer to figures.
abortion, 5
Abraham, Nicholas, 162n58
abstinence (sexual), 73, 77, 86, 88, 116
Academy of Motion Picture Arts and
Sciences, 76
acoustic envelope, concept of, 13940,
158
Acquired Immune Deficiency
Syndrome (AIDS). See HIV/AIDs
ACS. See American Cancer Society (ACS)
Adirondacks, 46
advertising: health-related, 40
affect, 151
African Americans: and the ACS,
17677; and AIDS, 128n76, 130n87;
and medical profession, 90n19,
24244, 251, 256; portrayal of in
movies, 76, 141, 239, 240, 24658,
296; portrayal of on television, 266,
271; and sexually transmitted
diseases, 1011, 58, 7475
Agar, Nicholas, 309, 318n4
Agee, James, 141
alcoholism, 1
Alda, Robert, 55
Alger, Horatio, 50
All My Children, 100, 101
Allen, George, 48
Allen, Robert C., 98, 103, 108
Alpert, Hollis, 25758
ALS. See amyotrophic lateral sclerosis
(ALS or Lou Gehrigs disease)
Altman, Rick, 107
Altman, Robert, 273
Alzheimers disease, 36

AMA. See American Medical Association

(AMA)
American Cancer Society (ACS), 4, 6, 9,
57; and African Americans, 176; and
movies, 9, 14n10, 16465, 166, 167,
169, 17377, 178, 181, 190n28,
190n35, 192n51, 192n60; mens
cancer awareness campaign, 18384,
194n74, 194n75; self-criticism, 176;
Womens Field Army, 57, 194n71
American College of Surgeons, 171
American Lung Association (ALA), 41,
63n14. See also National Tuberculosis
Association (NTA)
American Medical Association (AMA),
3, 169, 171, 183, 200, 223, 282;
Committee for the Protection of
Medical Research, 284; and
television, 26770
American in Paris, An, 66n55
American Public Health Association, 79
American Red Cross, 19, 49
American Social Hygiene Association,
22, 7273, 77, 81, 83
American Society for the Control of
Cancer. See American Cancer Society
(ACS)
American Society for Reproductive
Medicine, 309
American Weekly, 297
amyotrophic lateral sclerosis (ALS or
Lou Gehrigs disease), 3637,
4953
And the Band Played On, 2
Ang, Ien, 98

330

index

animal protectionists: and movie

industry, 28687; and researchers,
292; use of celebrity animal, 29394
anti-Semitism, 9, 239, 251
anti-TB movement: anti-TB societies,
37, 4045, 48, 58, 63n15; media
campaigns, 4145, 58. See also
sanatorium cure; tuberculosis (TB)
anti-VD campaign, 1011, 22, 58, 72
antivivisection movement, 28287, 297;
and Catholicism, 285; and film
representations of medical research,
29193; media campaigns, 28384,
287, 28990, 29394; organizations,
28387, 29091; physicians
response to, 28386, 28789,
29295, 302; publications, 286; and
Robert Cornish, 28990
Arbuckle, Fatty, 39
Are You Fit to Marry?, 23
Armstrong, Lance, 60
Arnstein, Lawrence, 81
Arrowsmith, 1, 234n88, 29596, 297,
300301, 305n77
asbestos, 10
Astaire, Fred, 54
Atlanta Journal, 46
audience. See movie audience
autism, 1
bacteriology, 24
Baltimore Afro American, 249, 250
Bankhead, Tallulah, 51
Banting, Frederick, 285, 293
Baxter, Percival, 286
Baynton, Douglas, 135
beauty: and health, 2731; and
reproduction, 34n23
Beery, Noah, Jr., 82
Bell, Alexander Graham, 148, 161n46
Bellamy, Ralph, 49
Ben Casey, 126n62, 26769, 273, 276,
27879
Benedict, William, F., 293
Berg, Louis, 9, 98, 99, 123n29
Bergh, Henry, 283
Berlin, Irving, 55

Bielby, Denise, 103

biopic, 4, 8, 49, 199, 200, 201, 215,
234n95
birth control, 5
black physicians: and medical
profession, 24244, 251, 256;
portrayal of in movies, 76, 141, 239,
240, 24658, 296; portrayal of on
television, 266, 271
Black Sox Scandal, 42
Black Stork, The, 9, 2123, 25, 29, 30
blindness: and ego development,
13839; and narcissism, 13940
Bodian, David, 228n12
body: and blindness, 139; and disease,
13, 89, 12; and Foucault, 165; and
health, 51, 166; and health-related
movies, 24, 28, 29, 165, 16971,
182, 18586, 189n24, 213;
maternal, 145, 151; and the media,
39, 40, 47, 60; and sexuality, 30,
169, 182, 191n39; and sound,
13738, 15158, 153; womans, in
movies, 126n61, 163, 170, 174,
17879, 253
Bogart, Humphrey, 52
Bogle, Donald, 240, 251
Bold Ones: The New Doctors, The, 271
Bond, Ward, 76
Bonitzer, Pascal, 141
Borah, William Edgar, 294
Boston Business Journal, 309
Brandt, Allan, 72, 88
Brave New World, 317
Breaking Point, The, 268
breast cancer: campaigns against,
16465, 166, 17278, 18284; and
physicians, 17882; portrayal of in
movies, 16566, 167, 17880; selfexamination, 16371, 177, 180, 181,
182, 18486, 193n67, 194n76. See
also Breast Cancer: the Problem of Early
Diagnosis; Breast Self-Examination
Breast Cancer: the Problem of Early
Diagnosis, 163, 164, 17882, 185,
193n63. See also breast cancer
Breast Self-Exam Techniques, 184

Breast Self-Examination: audience, 45,

165, 169, 17172, 17377, 183,
192n51; and decency, 169, 173, 183;
portrayal of physician, 17071;
portrayal of women, 16465, 167,
168, 170, 17071, 173, 182, 185;
Spanish-language edition, 176. See
also breast cancer
Breen, Joseph, 300
Bristol-Myers-Squibb, 60
British Film Institute, 101
British Sign Language, 136, 148
Broughton, Philip, 75
Brundson, Charlotte, 102
Bunyan, John, 45
Burlingham, Dorothy, 13839
Burney, Leroy, 75, 82, 90n19
Burnham, John, 32n6
Burton, Richard, 141
Burton, Steve, 110
Bush, George H. W., 97
Byoir, Carl, 48
California Social Hygiene Association, 81
California Society for the Promotion of
Medical Research, 293
California State Health Department,
8283
Calvert, Phyllis, 135
Camille, 1, 37, 42, 45, 48, 52, 56, 59
Campobello, 46
cancer: educational materials, 165, 176;
glioblastoma, 54; lung cancer, 183,
195n80; and men, 18384; and
physicians, 17882; portrayal of in
movies, 10, 5557, 16566, 167,
17880, 191n47, 192n59; potential
for cure, 180; prostate cancer, 60,
195n80; in public health debates, 39,
45, 53, 55, 5860, 66n53, 66n59,
191n50. See also breast cancer;
American Cancer Society (ACS)
Cancer: The Problem of Early Diagnosis,
192n59, 192n60, 193n69
Cancer Progress, 181
Cannon, Walter Bradford, 28486, 288
Cantor, Eddie, 48

index

331

Cantwell, John (archbishop of Los

Angeles), 294
cardiovascular disease, 58
Carrel, Alexis, 294
Carrington, Elaine, 99
Cartwright, Lisa, 5, 12
Casey, Ben. See Ben Casey
Castle, Irene, 294
Catholic Church, 83, 85
Catholic War Veterans, 86
Cawelt, John, 263
Cedars of Lebanon Hospital, 54
celebrification: concept of, 3637; of
disease, 4851; limits of, 38
celebrity: concept of, 62n5; electric,
50, 62n7; and media, 3840, 45; and
patients, 58; use to invoke paternal
or maternal authority, 160n34
celebrity disease culture, 3640, 4245,
4649, 5053, 5455, 5760, 61n6;
and animals, 29394; and gender
conventions, 37, 45, 5657; and
race, 58
censorship: aesthetic, 30; and the AMA,
169; and decency, 8385, 163, 167;
and film genres, 3031; and medical
research, 284, 29799, 300; and
movies, 6, 7, 2223, 64n23, 79,
189n17, 193n69, 250, 25456. See
also Motion Picture Production Code
of 1930
Center for Disease Control and
Prevention, 94, 97
Chamberlain, Richard, 267
Chaney, Lon, 285, 287
Chaplin, Charlie, 54
Chicago Defender, 249
Chicago Hope, 276
childbirth, 5
childrens cinema clubs, 149
Chion, Michel, 14345
Choose to Live, 191n47
Christian Century, 97
Christian Science Monitor, 286
Christy, Howard Chandler, 49
Churchill, Winston, 137
Cinema Education Guild, 258

332

index

citizenship: and gender, 13637, 184, 186,

234; and health, 94, 167, 186, 205
City of Angels, 276, 278
Civil Works Administration, 289
Clarke, Walter, 77
class: and citizenship, 311; and disease,
45, 173, 179, 191n50, 192n51, 202;
in movies, 9, 10, 14n10, 27, 29, 134,
137, 169, 183, 184, 191n42, 191n47,
21213, 233n75, 24849; and race,
244, 24849, 251, 253, 257; and
womens clubs, 163, 17576
Cleveland, Grover, 39, 41
Clinton, Bill, 275
cloning, 313
Clurman, Howard, 257
Coffey, E. R., 77
Cohn, Victor, 47, 60
Cold Case, 278
Committee for Research on Sex
Problems, 284
Commonweal, 55
Compton, Karl T., 294
condoms, 95
consumption. See tuberculosis (TB)
Coogan, Jackie, 41
Cook, Pam, 135
Cooper, Gary, 52
Cornish, Robert E., 28790
Coronation Street, 101
Couric, Katie, 5960
Crash of Silence, 142
Cripps, Thomas, 239, 240, 245
Crosby, Bing, 55
Crossroads, 1023
Crowther, Bosley, 219, 248
CSI, 278
CSI Miami, 278
Cukor, George, 45
Curie, Marie, 219
Current Biography, 50, 51
Cushing, Harvey, 54
Cutler, Elliot Carr, 282, 284, 288, 294,
295, 302
Dallas, 98, 110
Dandy, Walter, 54

Dark Victory, 37, 5557

Davis, Bette, 37, 56, 57
Davis, Marion, 294
Day is Ours, The (Lewis), 136
de Kruif, Paul, 297
De Lee, Dr. Joseph B., 6, 78, 15n19
de Rochemont, Louis, 245
deafness: and education, 13536, 146,
14748, 150, 161n46; portrayal of in
movies, 1, 13336, 14244, 14849,
15556
Dean, James, 267
Dean, William, 298
department stores, 17475, 191n42
Deuchar, Margaret, 13536
Deutsch, Monroe, 290
Dieterle, William, 296
DiMaggio, Joe, 50
disease: dread, concept of, 3738, 60,
164, 183, 215, 216; portrayal of in
media, 3740, 4649, 5152, 9497;
portrayal of in movies, 10, 2130,
5253, 5557, 7677, 80, 8283, 86,
87, 16566, 167, 17880, 191n47,
192n59; portrayal of on television,
10418, 266, 269, 276
disease causation: concept of, 2324; in
early health films, 2425; and
individual responsibility, 18586;
and otherness, 2930; and shame,
164; and ugliness, 2830; women
and, 8788, 136
diseases: Avian Flu, 95; chlamydia,
121n10; cholera, 10, 40; Christmas
disease, 61n1; diabetes, 36;
diphtheria, 295, 296; Hartnups
disease, 61n1; leukemia, 1, 300;
Mortimers disease, 61n1; multiple
sclerosis, 220; osteomyelitis,
22021; SARS, 95. See also entries for
specific diseases such as HIV/AIDS and
cancer
Disney, Walt, 19
Doane, Mary Ann, 134, 13738, 157,
189n24
Doc, 276
doctor. See physicians

doctor series. See television medical

show
Dolce, James A., 72
Dr. Christian, 265
Dr. Ehrlichs Magic Bullet, 1, 8081, 199,
296, 299
Dr. Kildare, 1, 165, 26769, 273, 274
Drinker, Carl, 285
Drinker, Philip, 295
Duke, Patty, 1
Dumas, Alexander, 42, 45
Durbin, Dr. Meg, 195n80
Eakins, Thomas, 29
Ealing Studios, 133, 149
Early Frost, An, 96
Eberwein, Robert, 4, 6, 74, 86
Ebony, 245
Ecclesiastes, 307, 312
Edison, Thomas, 19, 21
Edmondson, Madeleine, 99
Education Act of 1944, 135, 146
ego development, 133, 13841, 143,
144, 145, 153, 158, 162n58
Elders, Joycelyn, 88
electronic media. See media
Eleventh Hour, The, 268
Ellison, Ralph, 251
Elsheimer, Skip, 9
Emergency!, 271
End of the Road, The, 21, 22, 24
Ennes, Howard, 80
ER, 1, 27677
etiology, 2325. See also disease
causation
eugenics: and censorship, 30; and Deaf
education, 161n46; and genetics,
315; and movies, 5, 9, 2022, 25, 28,
282
euthanasia, 5
Fagan, Myron C., 258
Farber, Manny, 52
Farley, James, 51
Felton, Norman, 267
female circumcision, 279, 281n21
feminism, 135, 150

index

333

feminist film theory, 133, 160n41

Ferenczi, Sandor, 162n58
fetology, 315, 319n23
Fight Syphilis, 80
Fishbein, Morris, 200, 203, 219
Fisher, Irving, 28
Fit to Fight, 2122, 24
Fit to Win, 22
fitness, Darwinian concept of, 34n23
Flexner, Simon, 284
Flick, Lawrence, 63n15
Fliess, Robert, 14344
Fones, Dr. Alfred, 19
Fontana, Tom, 275
Ford, John, 209
Ford Motor Company, 20
Foucault, Michel, 165
Fox, Michael J., 36
Frankenstein, 290
Franklin, Sarah, 314, 319n23
Frenke, Eugene, 29091
fresh air cure, 41. See also sanatorium
cure
Freud, Anna, 138
Freud, Sigmund, 14344, 153, 154
Gable, Clark, 292
Gallagher, Hugh, 46, 47, 64n28
Gamble, Vanessa Northington, 8, 9, 12
Gans-Boriskin, Rachel, 11, 12
Gantt, W. Horsley, 287
Garbo, Greta, 37, 45, 52, 56, 57
Garland, Christine, 13537, 14042,
146, 148, 149, 158
Garland, Judy, 201
Garson, Greer, 49
Gattaca, 10, 307, 30812, 317
Gautier, Marguerite, 37, 42, 45, 57
Gehrig, Eleanor, 50
Gehrig, Lou, 36, 37, 42, 4953, 55, 57
Gelbart, Larry, 273
gender: and agency, 135, 137; and
animal experimentation, 295; and
celebrity disease culture, 37, 45,
5657; and citizenship, 13637, 184,
186, 234; conventions and patients,
45, 5657, 123n29, 17981;

334

index

gender (continued)
conventions and tuberculosis, 10,
45; and disease representation, 10,
24, 37, 45, 5657; and medical
authority, 2627, 27, 14142,
200201; and melodrama, 134;
movie audience and, 10, 5657, 76,
82, 86, 98100, 113, 123n27,
124n39, 130n88, 169, 174, 176,
18283; in movies, 27, 53, 82,
8688, 164, 169, 17886, 188n12;
and physician-patient relationship,
165, 170, 179, 180, 18182; in print
media, 4043; roles and Elizabeth
Kenny, 210, 211; roles in Mandy,
13638, 14142; roles in soap
operas, 98, 102, 107, 11216,
123n29, 126n61, 130n88; Sister
Kenny and, 201, 21115, 224, 226;
and subjectivity, 133, 134, 135, 149,
150, 164; television medical shows
and, 27172, 275
General Hospital: and gender roles, 102,
107, 11216; HIV/AIDS storyline, 5,
93, 97, 10418, 205; and medical
realism, 108, 113; and race, 112;
transcripts of dialogue, 1056,
11012, 1134, 115, 116
genetic manipulation, 3078, 310, 312;
and difference, 316, 319n26,
319n27; and identity, 31517
Gentlemans Agreement, 9, 251
germs, 21, 23, 24, 5152
Gershwin, George, 37, 49, 5357
Gershwin, Ira, 54
Gesell, Arnold, 137
Gideons Crossing, 276, 277
glioblastoma, 54. See also cancer
Gobel, George, 59
Goddard, Paulette, 54
Goldwyn, Samuel, 54, 55
gonorrhea, 58, 71, 72, 86, 87, 121n10
Graham, Frank, 50, 51
Grant, Cary, 208
Grant, Ulysses S., 39
Green, Andr, 133, 157
Greys Anatomy, 1, 276, 278

Griffis, Stanton, 83
Gross, Larry, 107
Guiding Light, The, 98
Gunzberg, Milton, 21114, 233n78,
233n84, 234n90
Gurstein, Rochelle, 39
Hagen, Jean, 134
Haiselden, Harry, 22
Halvey, Nina, 287
Hampstead Nursery for Blind Children,
139
Hanks, Tom, 1, 37
Harbein, Harold, 50
Hardy, Judson, 80
Harlow, Jean, 48
Harrington, Lee, 103
Hartouni, Valerie, 10, 12
Harvest of Shame, 2
Harvey, Valerie, 208, 212
Hawke, Ethan, 308
Hays, Will, 80, 286
Hays Code. See Motion Picture
Production Code of 1930
Hays Office. See Production Code
Administration
health care, 13, 26364, 280; changing
views on, 27172; and HMOs, 184;
portrayal of on television, 114, 268,
27578
Health Maintenance Organizations
(HMOs), 184, 272, 275
health propaganda, 2526
health-related films: audience, 36,
811, 1920, 22, 2426, 28, 30,
34n33, 56, 79, 8182, 86, 163,
16669, 17273, 177, 192n53, 215;
and decency, 22, 3031, 73, 7779,
8081, 82, 8385, 163, 166, 16769,
193n69; and etiology, 2122, 2325;
and gender, 27, 82, 8688, 164, 169,
188n12; genre of, 36, 13n1, 2031,
31n1; portrayal of health and
disease, 2730, 7677, 80, 8283,
86, 87, 16566, 167, 191n47,
192n59; and race, 7476, 166, 169,
184, 191n47; recent, 184

healthy beauty, 2829, 167

Hearst, William Randolph, 294;
newspapers, 202, 219, 289, 290, 292
Hearst and Pathe, 23
heart attack. See cardiovascular disease
heart disease, 184
Heartbeat, 275
Heller, J. R., 83
Hersholt, Jean, 82
Hill Street Blues, 274
Hinds, Samuel, 76
HIV/AIDS: 2, 14, 15, 60, 61, 93132;
and celebrities, 3637, 94;
fundraising, 5; and homosexuality,
94, 95, 107, 109, 128n75, 128n76;
in the media, 9397, 119n5;
portrayal of in movies, 1, 10, 37;
portrayal of on television, 3, 6, 8, 13,
105, 10710, 11213, 11718,
128n73, 274; public health
response, 88, 94; statistics, 93,
120n9; treatment, 95; and women,
10, 131n90
Hobson, Dorothy, 1023
Hoffman, Dustin, 1
Hogan, James B., 290
Holt, Tim, 76
Home of the Brave, 10, 239, 240, 250
homosexuality, 107, 127n72, 128n75,
128n76, 132n94, 271
Hoover, Herbert, 282
Hopper, Hedda, 209
hospital, portrayal of on television,
265
House, 276
House Un-American Activities
Committee (HUAC), 258
Howard, Sidney Coe, 295, 301
Howe, Louis, 46
Hudson, Rock, 37, 94
Hugh Harmon Productions, 86
Hullett, James E., Jr., 21718
human genome, 315
Human Immunodeficiency Virus
(HIV). See HIV/AIDs
Hummert, Frank and Anne, 99100
Huxley, Aldous, 312, 317

index

335

Ian, Janis, 117

Imitation of Life, 250
in vitro fertilization, 31213
incorporation, concept of, 15455
influenza, epidemic of 191819, 46
insulin, 285
International Cancer Congress, 171
intertextuality, 188n15
introjection, concept of, 15455, 162n58
Intruder in the Dust, 239
Island of Lost Souls, The, 287
Jerome, V. J., 248
Johnny Belinda, 134, 153
Johnson, Albert, 313
Johnson, Magic, 37, 94, 96
Johnston, Albert, Jr., 241, 244
Johnston, Albert, Sr., 24044
Johnston, Thyra (ne Baumann),
24143
Jolson, Al, 53
Journal of the American Medical
Association, 200
Journal of Experimental Medicine, 284
Journal of Outdoor Life, 42, 43, 63n14
Kaiser Family Foundation, 94, 95, 97,
121n11, 121n14
Kanan, Sean, 110
Karloff, Boris, 290
Kass, Leon, 313
Kay, Lily, 317
Kay OBrien, 275
Keliher, Alice, 305n77
Keller, Evelyn Fox, 319n26, 319n27
Keller, Helen, 1, 61n4, 14244, 148
Keller, Kate, 14245
Kellerman, Annette, 46
Kelley, David E., 277
Kelly, Gene, 66n55
Kenny, Elizabeth: as celebrity, 216, 224;
challenge to medical authority, 200,
2026, 211, 21315, 21820, 224;
credibility of, 2056, 210, 220,
229n25; and gender roles, 200201,
210, 211; honors, 230n36; and the
NFIP, 2023, 207; and polio

336

index

Kenny, Elizabeth (continued)

treatment, 49, 199200, 220,
228n12; and propaganda, 219, 224;
publications, 204; and Sister Kenny, 8,
2048, 210, 216, 21826
Kenny Concept of Infantile Paralysis, The,
2056, 214, 223
Kenny Foundation, 8, 204, 205, 209,
214, 218, 219
Kenny Institute, 202, 203, 205, 214,
218, 220
Kildare, James. See Dr. Kildare
Kirk, Norman, 82
Klein, Melanie, 133, 154
Kleinschmidt, Dr. H. E., 25
Klugman, Jack, 271
Knights of Columbus, 86
Know For Sure, 76
Koerner, Charles, 209
Kohut, Heinz, 133, 138, 158
Kozloff, Sarah, 13334
Kuhn, Annette, 33n19, 88, 135, 146,
14950
Lacan, Jacques, 133; and concept of the
mirror phase, 138, 139, 143, 159n23;
and gendered subjectivity, 150
LaGuardia, Fiorello, 51
Lake, Veronica, 208
Landy, Marcia, 135
Lane, W. Preston, 255
Laplanche, Jean, 154
Larsen, Roy, 294
Lashley, Karl, 9, 26
Law, Jude, 309
Lazarsfeld, Paul, 98, 99
Leab, Daniel J., 240
Lederer, Susan E., 5, 12
Lee, Canada, 249
Lee, Spike, 2
Legion of Decency, 8385
Lerner, Barron, 61n2, 164
Letter to Three Wives, A, 251
leukemia, 1, 300
Levant, Oscar, 55
Levine, Deborah, 39
Lewis, Hilda, 136

Lewis, Jerry, 5960

Lewis, Sinclair, 295
Life (comic weekly, 18831936), 283
Life (magazine, 1936), 257, 294, 295,
313
Life Goes On, 109
Life Returns, 29091
Lincoln, Abraham, 40
Lindbergh, Charles, 39, 294
Lister, Ruth, 137
Literary Digest, The, 287
Loeb, Janice, 141
Logan, Robert, 291
Look, 313
Lopez, Ana, 102
Lorentz, Pare, 74
Los Angeles Times, 288
Lost Boundaries: African American
response to, 24950; controversy
over, 239, 24950; production and
development, 24548; realism, 247,
24950; representation of racism,
24648; success of, 248, 25051
Lost Boundaries (White), 240, 245
Lost Weekend, The, 1, 58
Lou Gehrigs disease. See amyotrophic
lateral sclerosis (ALS or Lou
Gehrigs disease)
Louis, Joe, 58
Love Story, 1, 56
Lucci, Susan, 101, 124n46
Ma Perkins, 101
Mackendrick, Alexander, 133, 149
MacPherson, C. B., 316
Madame Curie, 1, 199, 212
Magic Bullets, 81
mammography, 184
Man They Could Not Hang, The, 290
Mandy: and deaf education, 148, 152;
and deaf subjectivity, 133, 13435,
136, 14042, 14550, 15058; and
gender roles, 13638, 14142;
oralism and, 13536, 148
Mankiewicz, Joseph L., 251, 254, 258
Mann, Thomas, 29, 43n29
Mannus, Margaret, 151

Mans Greatest Friend, 29293

March of Dimes, 4849, 200
Marcus Welby, M. D., 26970, 273, 279
marriage, 5
Martin, Ricky, 117
Maryland Board of Motion Picture
Censors, 255
masculinity, 4243, 114; and scientific
expertise, 27
M*A*S*H, 1, 27374, 277
Masius, John, 275
mass media. See media
mastectomy: feminist critique of, 185;
Halstead operation, 164; medical
films and, 164, 165, 180, 193n64;
radical and super radical,
178, 180
masturbation, 24, 88
Mathewson, Christy, 36, 4146, 50, 51
Mathis, Lee, 110, 117
Mayer, Louis B., 292
Mayo, Charles, 50, 54, 288
Mayo, William, 50, 54
Mayo Clinic, 50, 51, 52, 65n39
McCann, Doreen, 214
McCarten, John, 21920
McCarthy, Mary E., 199, 2067,
21112
McClafferty, Msgr. John, 83
McCracken, Mary Kenny, 2078
McCullough, Kimberly, 105, 115
McDaniel, Hattie, 76
McGraw, Ali, 1
McLuhan, Marshall, 62n7, 102
Mead, Margaret, 137
media: campaigns and coverage, 119n3;
coverage of HIV/AIDS epidemic,
9497, 11718; electronic, 2, 4, 38,
4648, 5758; history of, 38, 61n2;
and homosexuality, 107, 128n76;
mass, 2, 5, 7, 8, 9, 12, 31, 32n6, 36,
38, 40, 50, 5860, 9397, 118,
121n11, 189n22, 282; power of,
9899; print, 4, 6, 3840, 45, 5758;
taboos in, 127n72
Medic, 26566, 273, 276
Medicaid, 267, 276

index

337

medical authority: gender and, 2627,

27, 14142, 200201; portrayal of in
movies, 16364, 171, 181, 185,
21415, 224, 265
Medical Center, 1, 269, 273
medical education films, 164, 17886
medical experimentation: on animals,
28587, 29195; campaigns against,
28384, 287, 28990; effect on
movie audience, 273, 287, 300302;
human volunteers, 301; on humans,
28586, 296302; morality and, 301;
and sex, 295; visual representation
of, 282302
Medicare, 267, 276
medicine: profession of, 200, 220,
22123, 300; scientific authority of,
2527, 33n19, 85, 14142, 164,
18182, 185, 203, 219, 295; social
power of, 26, 31
melodrama: Deaf, 13435, 149; and
gender, 134; genre of, 4, 24, 134;
maternal, 135, 137, 142, 164; and
movies, 4, 20, 133, 136, 141, 148,
248, 254, 257, 290; and television, 4,
97, 266, 267, 269
Men in White, 1, 305n77
mental illness, 5
Message to Women, A, 86
Metro-Goldwyn-Mayer (MGM), 48, 137,
209, 212, 229n19, 245, 267, 291,
292; and medical establishment,
292; and short films, 29293
Metropolitan Life Insurance Company,
19, 82
Meyer, Sidney, 141
Michel-Herf, Nadja, 110
Mieth, Hansel, 29495
Milestone, Lewis, 76
Milland, Ray, 1
Miller, Mandy, 135, 149; agency, 150;
and intersubjective voice, 151
Millionaires in Prison, 300
Miracle Worker, The, 1, 138, 14145
Mitchell, John Ames, 283
Mitchum, Robert, 82
modernist health aesthetic, 28

338

index

Modleski, Tania, 102, 13435

Montgomery, Robert, 292, 298
Monster, The, 284
Montana State Board of Health, 77
Monty, Gloria, 104
Moore, Mary Tyler, 36
Mora, Dr. S. L., 176
morality: and celebrities, 39, 141; and
disease, 21, 2324, 71, 72, 7779,
94; and medical experimentation,
282, 287, 301; and movies, 30, 31,
8386, 169, 256, 309; and race, 75,
243, 250; sexual, 30, 72, 77, 85, 169;
and television, 103, 278
Moran, John, 297, 301
Morgan, Isabel, 228n12
Moser, James, 26568
Motion Picture Producers and
Distributors of America, 286
Motion Picture Production Code of
1930: and the body, 189n22; and
medical experimentation, 5, 287, 297,
298, 299, 300; and medical issues, 30,
35n35, 40, 8081, 83, 193n69
movie audience: and class, 14n10,
17576, 179, 183, 192n52; foreign,
190n28; and gender, 9, 5657, 76,
82, 86, 98100, 113, 123n27,
124n39, 130n88, 169, 174, 176,
18283; lay, 8, 19, 30, 7374,
16677, 193n69, 205, 219, 285; lay
versus professional, 811, 16366;
professional, 8, 17881, 205, 206;
and race, 9, 7475, 130n87, 176,
191n47, 23949, 245, 254, 258; and
realism, 45, 80, 173; and sound,
14041, 15253
movie houses, 1920
Mrs. Miniver, 13637
Mumford, Laura Stempel, 102
Muni, Paul, 298
Murrow, Edward R., 2
Muscular Dystrophy Association, 59
muteness, 13335, 141
Naish, J. Carrol, 76
naming, concept of, 154

narrativization, concept of, 154

Nation, The, 248
National Aeronautics and Space
Administration (NASA), 310
National Association for the
Advancement of Colored People
(NAACP), 239, 240, 248, 249,
25556, 258
National Board of Review of Motion
Pictures, 34n33
National Cancer Institute, 169, 178
National Cash Register, 20
National Foundation for Infantile
Paralysis (NFIP): and Birthday Balls,
48; Franklin Roosevelt and, 4849;
and Kenny, 2023, 207, 224,
229n25; and March of Dimes,
4849; and movies, 9, 200202, 216;
and Sister Kenny, 214, 218, 222, 225;
Womens Division, 202
National Institute of Health, 289, 301
National Medical Association, 256, 258
National Society for the Prevention of
Cruelty to Children, 141
National Tuberculosis Association (NTA),
3, 19, 21, 41, 42, 49, 63n14, 200
National Venereal Disease Control Act
of 1938, 72
NBC, 265, 267
Negro Newspaper Publishers
Association, 255
New England Journal of Medicine, 96, 101
new journalism, 39, 62n9
New Republic, 45, 257
New York City Health Department, 20
New York Times, 97, 161n48, 219, 257,
288
New York Worlds Fair, 76
New Yorker, 99, 21920, 257
newsreel, 47, 49, 53
Newsweek, 248, 257, 287
Niccol, Andrew, 307
Nichols, Dudley, 209
Nichtenhauser, Adolf, 7, 15n19
Nixon, Agnes, 124n45
No Way Out: censorship of, 25456;
portrayal of black physicians, 240,

25354; portrayal of racism, 25257;

production and development, 239,
25152; public response to, 25658;
realism, 251, 252, 25657
Norfolk Journal and Guide, 249
Normand, Mabel, 39, 64n21
Nova, 97
Nurses, The, 268
nurses, portrayal in movies, 212
Nurses Biennial Convention, 171
Oberholzer, Ellis P., 30
OConnor, Basil, 48, 202, 203, 214, 225
Office of Technology Assessment
(OTA), 31012
Office of War Information (OWI), 82,
83; Bureau of Motion Pictures, 83
One Life to Live, 109
ONeill, Eugene, 209
oralism, 135, 148
Parascandola, John, 6, 10, 12
Parkhurst, George, 79
Parkinsons disease, 36
Parran, Thomas, 58, 7173, 8186, 88,
294, 298; Shadow on the Land, 72
Parsons, Louella, 29, 209
passing: concept of, 24042; economic
benefits of, 24243
Pasteur, Louis, 199, 214, 219, 29293,
297
pasteurization, 296
Pathe, 19
patients: African Americans as, 7475;
celebrity, 3738, 4245, 43, 4649,
5053, 5455, 5758, 60, 61n3n4,
63n15; gender conventions and, 45,
5657, 123n29, 17981; portrayal of
in movies, 35, 8, 15n19, 75, 87,
164, 165, 17071, 17980, 181, 215,
21920, 251, 29596, 299; portrayal
of on television, 10917, 130n87,
131n89, 26870, 27375, 277;
relationship with physicians, 65, 163,
164, 169, 17071, 17879, 18081,
185; self help and, 16465, 167,
168, 177

index

339

Patterson, James, 39
Pavlov, Ivan, 285
penicillin, 87
Penn, Arthur, 138
Perkins, James E., 2056
Pernick, Martin S., 6, 7, 12, 282
personal hygiene, 26
Phelps-Stokes Fund, 256
Philadelphia, 1, 37
Phillips, B. M., 249
Phillips, Irna, 99100
phonosemantics, 151
physicians: portrayal of in movies, 21,
77, 17071, 17880, 181, 21415,
21920, 240, 24547, 25154,
25657, 28283, 28485, 29091,
295302; portrayal of on television,
26571, 27375, 27779; relations
with patient, 16365, 169, 170, 170,
17879, 18082, 185
Pickford, Mary, 202
Pinky, 239, 240
Plow that Broke the Plains, The, 74
Poe, Edgar Allen, 28
Poitier, Sidney, 251, 253
polio (poliomyelitis), 8, 19, 37, 4649,
5053, 5758, 200206, 21718,
220, 222, 224, 225, 295; campaigns
against, 58, 60, 67n64;
celebrification of, 48; portrayal of in
movies, 209, 210, 21316, 225,
235n111; treatment, 199, 202,
21820, 223, 228n12
Ponce de Leon, Charles, 38
Pontalis, J. B., 154
Porgy and Bess, 54
Porter, Cole, 55
Positive: A Journey into AIDS, 114, 116
poster child campaign, 49, 60
postmodernism, 7
post-polio syndrome, 67n64
Powers, Jimmy, 51
Pride of the Yankees, 45, 5253, 55, 56, 59
print media. See media
Production Code Administration, 297,
29899
Progressive Education Society, 300301

340

index

Progressive Era, 40
projection, concept of, 154
promiscuity, 82, 84
propaganda, 137
prophylactics, 76
prophylaxis, 73, 7679, 80, 88
prostitution, 21, 24, 77, 8182, 8688,
90n27
Pryor, Thomas M., 257
psychoanalytic theory, 133, 150, 153
Public Health Service (PHS). See U.S.
Public Health Service (PHS)
Putnam, Nina Wilcox, 42, 45
Quiet One, The, 141
Quincy, ME, 271, 278
rabies, 296
race, 9, 10, 29, 166, 169, 17677, 311;
and disease education, 128n76; and
medical profession, 242; portrayal of
in movies, 169, 191n47, 23958;
and radio, 190n32
race problem films, 239, 240, 25051,
25658; commercial success of, 250
Rafferty, 272
Rain Man, 1
Ramsey, Paul, 313
Rathbone, Basil, 208
Reach for Recovery, 185
Readers Digest, 199, 200, 245
Reagan, Leslie J., 5, 12
Reagan, Ronald, 94
realism: cinematic, 37, 45, 5253,
129n80, 14950, 247, 24952,
25657, 298, 300; medical, 78, 49,
64n23, 108, 113, 214, 26568,
26970, 27274, 27580
Reed, Walter, 291, 296, 297
Reeve, Christopher, 5960
reproduction, alternative methods of:
and culture, 314; and human
identity, 317; and nature, 314, 317;
and U.S. Congress, 313, 317
Reynolds, Debbie, 134
Reynolds, Gene, 273
Rhapsody in Blue, 53, 55

Rice, Grantland, 42, 43

River, The, 74
RKO Pictures, 52, 54, 199, 200, 201,
207, 20912, 21417, 220, 224, 300
Robertson, James, 138
Robeson, Paul, 140, 157
Robinson, Edward G., 80, 298
Rockefeller Foundation, 19
Rockefeller Institute for Medical
Research, 284
Rogers, Ginger, 48
Rogers, Naomi, 8, 9, 12, 49
Rooney, Mickey, 201
Roosevelt, Eleanor, 48
Roosevelt, Franklin Delano, 37, 4649,
5053, 57, 59, 98, 202, 214, 289;
disability and press, 46, 64n28
Roosevelt, Theodore, 41, 46
Rosolato, Guy, 137
Rounds, David, 99
Rowley, Francis, 286
Russell, Rosalind, 199, 201, 204, 205,
2079, 212, 21416, 218, 231n45
Ruth, Babe, 50, 51, 53, 57
Ryan White Story, The, 2
Salt of the Earth, 910
Salvarsan, 8081
Samuels, Lesser, 251, 258
San Francisco Chronicle, 288
Sanger, Margaret, 19
sanatorium cure, 4143. See also
tuberculosis (TB)
sanitation, 40
Saranac Lake, 41, 42, 44, 50
Satcher, David, 71, 88
Saturday Evening Post, 42
Saturday Review of Literature, 248, 257
Schary, Dore, 49
schizophrenia, 38
Science of Life, The, 21, 24, 29
Scrubs, 276
Search for Tomorrow, 101
sex education, 22, 24, 33n19, 73, 77,
88
sex hygiene films, 5, 22, 24, 26, 73, 76,
77, 8088, 164

sexuality: and the body, 12, 165, 182,

185, 193n67; and Freud, 154; in the
media, 9495, 109; on television, 11,
107, 114, 116, 118, 121n14,
128n76, 271, 278
sexually transmitted disease: and African
Americans, 58; and censorship, 30,
72, 80; in the media, 95, 128n76; in
movies, 1, 20, 22; statistics, 121n10;
on television, 109, 11417
Shafer, Beth Hill, 275
Sight and Sound, 161n48
sign language, 135
Silverman, Kaja, 134, 14344
Singin in the Rain, 134
Sister Kenny: cast, 214, 234n88, 234n89,
234n92; challenge to medical
authority, 200, 212, 213, 215,
21720, 226, 234n87; and class,
21213; criticism of, 21920,
236n118; development, 206210,
21115, 233n78, 233n84, 234n90,
234n96; as entertainment, 211,
21516; and gender, 200201,
21115, 224, 226; public response
to, 21516 22023, 225, 234n97,
234n130; and sex, 211
Snake Pit, The, 10, 58
soap operas: audience, 9, 98100,
1023, 118, 123n27, 124n39,
126n61, 128n74; and consumption,
99; critical response, 9899, 1014;
and disease, 10418; fan culture,
105, 109, 125n59, 127n65; form,
99104, 1059, 128n73, 129n79;
gender roles and, 98, 102, 107,
11216, 123n29, 126n61, 130n88;
and health care issues, 114,
131n89; history of, 97101,
122n23, 124n38; realism, 108;
scholarship on, 1024
Soap Update, 115, 117
social problem film, 910, 136, 14142,
148
Society for Crippled Children, 49
Spanish language films, 9, 80, 176,
191n47

index

341

Spitz, Ren, 133, 137, 143, 153;

concept of mouth as a primal
cavity, 15354
Sponberg, Mary, 87
Spruiell, Van, 139
St. Elsewhere, 1, 27475
Stacey, Jackie, 318n3
Steptoe, Paul, 313
Stevenson, Robert Louis, 41
Stewart, Jimmy, 298
Story of Louis Pasteur, The, 199, 291, 296,
297, 298, 300, 305n77
stroke. See cardiovascular disease
Strong Medicine, 276, 278
subjectivity: and blindness, 138; and
female voice, 133, 134, 135, 149,
164; and fetus, 31516; gendered,
150; and infant-mother relationship,
14245; liberal, 310; and spoken
word, 13435, 137, 14044, 145,
14647, 148, 150; and vocalized
sound, 15058
Sunrise at Campobello, 49
superego, 156
surrogacy, 314
Sutherland, John, 76
Sutton, Michael, 105
Swenson, Inga, 142
syphilis, 1011, 21, 24, 25, 38, 58, 164,
166, 173, 210, 296, 298; prostitution
as source, 77; treatment methods,
87; treatment for women, 8788
Syphilis: A Motion Picture Clinic, 73
Syphilis: Its Nature, Prevention, and
Treatment, 7374
Syphilis of the Central Nervous System: A
Preventable Disease, 73
Taft, William Howard, 39
Taylor, Elizabeth, 104
Taylor, Robert, 48
TB. See tuberculosis (TB)
TB Association, 25
telenovelas, 102
telethon, 5960
television medical show: African
Americans and, 27172, 275;

342

index

television medical show (continued)

formula, 26480; gender and,
27172, 275; and health care issues,
268, 27172, 27576, 280; portrayal
of patients, 26870, 27375, 277;
portrayal of physicians, 26571,
27375, 27779
Temple of Moloch, The, 21, 2425, 26, 27
Tennessee Department of Health, 86
Terms of Endearment, 56
They Live Again, 293
Thin Man, 293
Thomas, Lowell, 301
Thomson, Virgil, 74
Thorpe, Jerry, 272
Three Counties Against Syphilis, 86;
African Americans and, 16n27, 7475
Thurber, James, 99, 100, 103
Thursdays Children, 141
Timberg, Bernard, 1034, 116
Time, 50, 52, 219, 254, 257
To the People of the United States, 1, 8285
Tobias, Channing, 256
Tomes, Nancy, 4, 6, 10, 12
Tomkins, Silvan, 142
Torok, Maria, 154, 162n58
Traherne, Judith, 37, 56, 57
Traub, Sidney R., 255
Traviata, La, 42, 117
Treichler, Paula A., 5, 6, 12
Trudeau, Edward, 41, 42, 46
tuberculosis (TB): and celebrity, 36, 37,
4145, 51, 64n21; and gender
conventions, 10, 45; image of, 40,
64n22; in movies, 21, 2426, 45;
sanatorium cure, 4143
Turow, Joseph, 11, 12, 108
Tuskegee syphilis study, 16n27, 58
TV Guide, 101
20th Century Fox Studios, 76, 251, 256
typhoid, 40
ugliness, pathologization of, 2830
United Packinghouse Workers, 175
Universal Film Company, 34
Universal Pictures, 282, 288, 291
Universal Studios, 81, 290

U.S. Constitution, 310, 311

U.S. Public Health Service (PHS), 10,
16n27, 22, 7188, 193n62, 294;
Committee on Public Education for
the Prevention of Venereal Diseases,
84; Venereal Disease Division, 71,
74, 79
U.S. Steel, 20
U.S. Supreme Court, 25
uterine night, concept of, 144, 146
vaccination, 25
Variety, 48, 239, 250
VD Association, 25
VD education films, 4, 6, 9, 1011,
2130, 7188
venereal disease (VD), 2, 4, 6, 9, 10, 21,
24, 58, 7175, 7782, 85, 86, 88,
169, 271, 298. See also sexually
transmitted disease
Venereal Disease Rapid Treatment Center,
8687
Verdi, Giuseppe, 42
Victor, David, 270
Victoria, Queen, 40
vivisection, 283, 284, 285, 287, 291,
29495
Vonderlehr, Ramond, 74, 77, 79, 81,
90n27
Voronoff, Serge, 287
Wakefield, Dan, 101, 124n44
Wald, Gayle, 239
Wallis, Hal, 29899
Wallon, Henri, 159n23
Walter Wanger Productions, 81
Wanger, Walter, 81
War Advertising Council, 86
War Department, 76; Commission on
Training Camp Activities, 72
Warm Springs, GA, 46, 47, 50
Warm Springs Foundation, 4748
Warner, Jack, 56, 296
Warner Bros., 55, 296
Watson, John, 9, 26, 313
Welby, Marcus. See Marcus Welby, M. D.
Wells, H. G., 287

Werker, Alfred L., 245

West Wing, 97
Wharton Brothers, 23
When the Levees Broke, 2
White, Caroline, 283
White, Crystal, 130n87
White, Jeanne, 110
White, Ryan, 110
White, Walter, 239, 248, 249, 255
White, William L., 240, 242, 245
White Angel, 305n77
Whiteman, Paul, 55
whiteness, 250, 252
Wife, Doctor, Nurse, 305n77
Wilbur, Ray Lyman, 282, 288, 293, 294
Wilde, Oscar, 28
Williams, Helen Lorenz, 44
Williams, Linda, 4
Williams, Raymond, 127n69
Wilson, Woodrow, 6, 39, 241
Winnicott, Donald, 133, 155
Wolfenstein, Martha, 254
Wolverton, Charles, 223
womans film, 5657, 13334
women: agency and voice, 135, 137;
and disease transmission, 88;

index

343

illnesses of, 61n4; in movies, 21, 22,

24, 26, 27, 37, 5557, 8688, 134,
135, 13637, 14045, 15058,
16465, 167, 168, 177, 179, 185,
109, 21112, 240; on television, 101,
115, 118, 123n27, 130n87, 271,
275. See also gender
womens club networks, 4, 166, 176,
183, 243; and Breast Self-Examination,
17172; and class, 175
womens film, 164, 182, 183
Woodlawn Puerto Rican Cancer
Committee, 176
Wyman, Jane, 134
yellow fever, 265, 291, 296, 297, 298,
301
Yellow Jack, 296, 297, 301
Yesterday, 10
Young Womens Christian Association
(YWCA), 19
Zaharias, Babe Didrickson, 57
Zanuck, Daryl F., 76, 251, 256, 257
Zinn, Earl, 284
Zola, Emile, 219