Medicine Men

The age-old question "Is there a doctor in the house?" is answered in duplicate this week with The Doctor and Doc Hollywood. In the wake of a bombs-away July in which Hollywood hardly showed a pulse, these early-August offerings, both about physicians, both based on books written by physicians, have got a sure-fire cure for the summertime blues. Radically different prescriptions, though - one's heavily dramatic and eloquent, the other weightless and guilt-free.

The doctor of The Doctor is Jack McKee (William Hurt), a big-shot San Francisco physician who must reappraise his manner (bedside and otherwise) when he contracts cancer. A respected, successful cardio-thoracic surgeon, Jack keeps himself well above his work, and he likes it that way. In the operating room, he plays Frankie Valli's "Big Girls Don't Cry" and Jimmy Buffett's "Why Don't We Get Drunk and Screw." When patients ask him questions, he answers with aloof wisecracks; to one woman who places a frantic nighttime call asking if her husband can mow the lawn, he responds, "Well, it's kind of dark now." Jack's not a bad surgeon, merely one without any emotional commitment to his patients. "I'd rather you cut straight and cared less," he brusquely advises a group of interns.

But the chronic sore throat that's been dogging Jack doesn't go away, and when he finally drags himself to the doctor, he's in for a rude surprise. A tumor in his throat. Malignant.

The difficulty of patients, and especially cancer patients, in squaring themselves with the medical establishment has been detailed before; Susan Sontag's Illness as Metaphor is a good primer. Since The Doctor's protagonist rides the doctor-patient fence, the film can investigate the same sort of alienation more concretely, replacing Sontag's sociohistorical analysis with a subtle, but still scathing, indictment of the politics of American health care. Recast in the role of the indignant patient, McKee bristles at filling out forms in triplicate, screams at nurses when doctors don't keep appointments, refuses to ride through the hospital halls in a wheelchair even when an orderly explains that the practice is necessary for insurance liability.

With solid direction by Randa Haines, who also helmed Hurt in the 1987 adaption of Mark Medoff's Children of a Lesser God, The Doctor is sparse and institutional without insisting on its visual anesthesia. In the name of dramatic compression and fair representation, the script indulges a Noah's Ark theory of ensemble drama, with representatives from every species - the nervous partner being sued for malpractice (Mandy Patinkin), the beautiful female surgeon (Wendy Crewson), the staff's unassuming humanitarian (Adam Arkin). It's a thoughtful mix, more satisfying than the average motley crew, but calculating enough to ossify the story at times.

Good thing, then, that the movie is so centrally dependent upon its star. A difficult actor to cast because of his slightly blank look and his tetchy haughtiness, Hurt gives a huge performance here. Male-illness movies have been all the rage lately, with films such as Awakenings and Regarding Henry vouching for the theory that only the sick man can know himself entirely. But those films were miraculous in the treacly, pandering, quasi-religious sense. Here, there's none of that. Jack is logical to a fault, smart, and inimically inarticulate -it's not that he can't express himself, it's just that you're not worth his time. In this new, slightly off-putting genre, the cerebral tear-jerker, when the hero decides to open his heart, you'll notice the change.

That's why it's entirely believable when Jack comes to respect, and then to love, a young woman named June (Elizabeth Perkins), a fellow cancer patient suffering from an advanced brain tumor. In the kind of doomed-angel role that has become as stereotypical as the hooker with a heart of gold, Perkins gives a performance as insular as Hurt's, marvelously precise work free of both rage-against-the-dying-night fireworks and underwritten-by-Kleenex waterworks. Christine Lahti is equally superb in an even more difficult role, that of Jack's wife Anne, who grows to resent his coldness and denial. ("We'll beat it," Anne says after she learns of her husband's tumor. "We?" Jack sneers in return. "This isn't about we. We don't have it.")

As Jack passes through a series of small revelations, as he comes to reconsider his role as a surgeon, as he wonders if he, as a patient, would want to place himself in the care of a surgeon who cuts straight and cares less, Haines earns points for her restraint. The Doctor holds back from hammering on the big keys, from giving Jack a swirling, nonlinear monologue about seizing the day (and how to do it), from falsifying a love scene between Jack and June just to satisfy the audience's prurience. Clipped and severe despite its occasional sentiment, this is a film that understands how people really deal with trauma, or at least how they deal with it when there's no Hollywood around to manufacture naked honesty. They erect defenses, they maintain distances; the forthrightness of the movie lies in its willingness to admit forms of self-deception. Jack's gains are hard-earned, genuine, and not entirely accessible, more potent for their opacity than a hospital full of overemotive epiphanies.

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