By Michael Koresky
Dir. Gaspar Noé, France, Utopia
To depict the ravages of dementia and old age, Gaspar Noé has come up with a brilliant conceit. The problem with brilliant conceits, of course, is that they’re brilliant (effulgent, distinctive, shining from the darkness) and they’re conceits (conceptual by definition, often metaphorically driven). And when such cleverness is applied to the largely realist representation of illness, despair, and death, one could be forgiven for taking a step back and posing questions about cinematic perspective.
We might wonder what Susan Sontag, who wrote so extensively about the proliferative cultural and medical dangers of treating illness as metaphor, would think of the way Alzheimer’s and other dementias are framed in our always reductive modern discourse, and certainly the way they have been represented in contemporary film. (“That illness can be not only an epic of suffering but the occasion of some kind of self-transcendence is affirmed by sentimental literature,” she wrote.) In 1978 and then 1989, Sontag was centering her theses around cancer and tuberculosis in the former, AIDS in the latter, all as social stigmas of different ideological sorts, partly and not insignificantly entrenched in the public consciousness by literary representation. With the stats on Alzheimer’s and other dementias being so high—in 2021, there are 6.2 million people reported in the U.S. alone and 55 million people worldwide—and only continuing to grow as populations of those 65 and older increase, it’s not surprising that over the past 15 years or so, we’ve seen enough mainstream narrative movies about the disease to nearly create a mini subgenre. These films, which range from Sarah Polley’s Away from Her (2007) to Richard Glatzer and Wash Westmoreland’s Still Alice (2014) to Florian Zellner’s The Father (2020), are significantly different films, and each traffics in its own metaphor—in other words, each treats dementia less as “just” a disease than as a condition that represents something greater about the human condition, or love, or connection, or spiritual transcendence.
In all fairness, the use of dementia as a dramatic metaphor is not a stretch. After all, the central symptom, and the one most easily and often cited in relation to the disease, is the loss of memory, which is, of course, also a central literary metaphor—memory as life, memory as landscape, memory as the past, memory as the only thing that keeps us from drifting off into the outer limits of time and space. Memory is Proustian. Memory is T. S. Eliot. It is triggered by smell, by touch, by the rich, cakey pastry of a madeleine. One cannot be surprised or injured, then, by the figurative co-opting of a disease predicated on the loss one’s own past, one’s own language, one’s own place in the world, by artists who want to express something true yet literate about living with cognition damage; in a sense there is something, if not beautiful, then dramatic about an untethered, ethereal experience of our concrete world. Yet film, which is so unmistakably, irrevocably tied to point of view, complicates these lofty tendencies considerably.
Especially with realist cinema, we are always invited to witness the world through a particular perspective, whether omniscient or subjective. Studied and poetic, Away from Her flirts with the strain of sentimental literature of which Sontag wrote, watching the (largely off-screen) decline of a middle-aged woman with Alzheimer’s from the perspective of her grieving husband; through his eyes, and the merciful camera’s, she grows only more beautiful as she slips away and forgets him. She makes snow angels; she muses philosophically about forgetting the color yellow. Direct and tragic, Still Alice attempts to see things more from the perspective of the dementia patient, in this case a younger woman with early-onset Alzheimer’s, allowing the viewer to see, and perhaps experience, her slippages in memory one by one, the frustrations of living with this profound loss reconceived as a kind of suspense narrative. Tricky and austere, The Father takes this standard-issue subjectivity and pushes it further, creating a game of emotional entrapment by trying to align the viewer with the perspective of an elderly man succumbing to dementia, using all sorts of rug-pulling gimmicks (elaborate art direction, disorienting cinematography) to confound us. The lead performers from all three films—Julie Christie, Julianne Moore, and Anthony Hopkins—were nominated for Oscars, and the latter two won, which implies that the performance of memory loss is both difficult and to be lauded, a technical feat and an expression of humbled humanity—a way to represent a reality that millions of people are going through every day. It also implies, as these films do in their very existence, that dementia is somehow representable at all.
If The Father seems, to these eyes, the most nefarious of these, it’s because its conceptual scheme is so wildly presumptuous—it’s a brilliantly nasty example of sleight-of-hand filmmaking, its twists employed to make us question our own reality as viewers. The implication is that we are privileged, thanks to the miracle of cinematic grammar, to experience the terrifying world through the eyes of a person with dementia. Rooms and apartments are confused for one another, and actors play multiple roles so that we aren’t sure who is a loved one, who is a caretaker, and who is a stranger. It’s all predicated on the dubious idea that such show-off narrative gambits somehow give us insight into the mind of someone with Alzheimer’s. As if that were possible. Finally, the world collapses around the man, and, in the last scene, he is left crying for his mother. It’s astonishingly cruel, both for viewer and character, although what makes it even worse is the sense that the filmmakers believe they are creating something humane.
Vortex has been widely deemed Gaspar Noé’s most humane film. Of course, this isn’t a huge leap for a director best known for one of the most heinous and lengthy rape scenes in film history. Nevertheless, one understands this line of thinking, either as oversimplification or marketing speak: by focusing intently on the plight of an elderly couple, shuffling and shambling through their final days in their Paris flat, Noé appears to be seriously concerned with the daily struggles of two seemingly ordinary people. He’s so concerned, in fact, that he uses two cameras to capture all of their travails in intimate close-up, allowing us to see them both at once using split-screen. This results in two significant effects: it minimizes the size of the image, so that each half of the screen makes the couple’s already cramped apartment seem even more claustrophobic, and it infers that, though the two are living together, something is dividing them, keeping them essentially closed off from each other’s experience, even when they are in the same room.
Such a formally rigorous approach tends to call attention to itself, naturally inviting questions of aesthetics and perception. The film’s split points of view are magnified by the characters' separate ailments: she is suffering from dementia and is rapidly degenerating; he has heart disease. Each requires extra care that the other is increasingly unable to give. The set-up is so inherently tragic that once it’s established, Noé merely has to sit back and watch. So we watch: she wanders the apartment, down the hall, into the local pharmacy; he, an aging film journalist, tries to get writing done but is constantly distracted by her or by his concern for her. In one scene, while he takes a shower, she grabs his manuscript and flushes it down the toilet; he is angry and heartbroken, she is confused and unaware of her actions. She is played by Françoise Lebrun, he by Dario Argento; each is remembered by cinephiles for their greatest work in the ’70s—she for her starring role in Jean Eustache’s The Mother and the Whore, he for his epochal giallo and horror films, including Suspiria—adding an extra layer of slightly off-kilter recognition, as though we’re seeing images transmitted from some alternate filmic reality.
Unlike some of the films mentioned earlier, which are less rigidly aestheticized and are constructed with a commonplace cinematic vernacular that puts focus on virtuosity of performance, Vortex doesn’t attempt to get into the mind of someone dealing with memory loss. If the film had focused on Lebrun’s character more exclusively, it may have seemed as though it were from her perspective; Noé’s use of split-screen all but neutralizes this possibility. Instead, Noé’s approach introduces a different problem, one similarly endemic to supposedly realistic portrayals of disease: what does the camera confer to the sufferer or reveal to the audience about that suffering?
One might say the ethics are far trickier when the camera is turned on camera subjects who are actually suffering from dementia. Whether in a gentle documentary like Allan King’s Memory for Max, Claire, Ida and Company (2005), set in a nursing home for geriatric care; a fanciful, multilayered doc-fiction hybrid like Dick Johnson Is Dead (2020), in which Kirsten Johnson works through her fears of mortality by collaborating on a film with her dementia-afflicted father; or in a crass indie drama like Trey Edward Shults’s Krisha (2015), in which the filmmaker cast his own 92-year-old grandmother, who had dementia, in a supporting role, one is primed, almost invited, to feel a sense of perhaps productive discomfort, wrestling with all sorts of crucial questions about human agency. (“She didn't fully understand—she still doesn’t fully understand she’s in a movie, you know. But everything we shot with her was more like a documentary,” Shults told NPR upon the film's release, as though the word “documentary” somehow alleviates such ethical questions rather than compounds them.) The representation of a dramatic character, embodied by an actor attempting to understand, along with the filmmaker, the experience of memory and language loss, feels to me entirely more suspect, hubristic and suspiciously middlebrow.
Noé’s film, of course, to get back to Sontag, is not really about disease. One would be understandably mistaken in thinking it is, so gruesome and unerring is its verité focus on the mental and physical anguish of these two. (More than one have made the comparison to the similarly ghoulish Amour, but at least that film had the dubious courtesy of Michael Haneke’s clinical approach.) There is a third major character, that of the couple’s grown son (Alex Lutz), who comes by the apartment at intervals to try and help his parents navigate their declining health, overtures to which his father is particularly resistant. Himself a drug addict unable to crawl out of his own vortex, the son serves as the film’s recurrent reminder that there is a greater sickness that unites us all—that no matter what kills each of us, we are doomed to isolation and dread, young or old. Noé’s visual gambit might make the film seem economical where, for him, there is usually excess, but Vortex is also its own kind of extreme cinema, a work of durational horror that means to plunge the viewer into a downward spiral of despair.
In a Deadline interview, Noé is at least matter-of-fact about his aims with this film: “I wanted to make a realistic portrait of something that makes people suffer, but it’s an absolutely natural, organic situation. There is nothing to be ashamed of. We’re organic, and whatever is organic disappears.” These words attest to at least his attempt not to depict illness as metaphor, but his use of such a strenuously sensationalized realism (not a contradiction in terms when it comes to cinema) counteracts this: in its grandiosity of purpose, Vortex hardly demystifies disease and death. That Noé aims to “make a realistic portrait of something that makes people suffer” places Vortex neatly in line with a film like Irreversible. This director’s version of a dementia movie at the very least clarifies the voyeurism inherent in this growing subgenre. Noé’s propensity for cruelty—for making us watch—only compounds my suspicion that film, because of, not despite, its ability to capture and reproduce reality, might be the most inapt art form for representing this disease.