1. Simone, Joseph V. MD

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Some years ago, I splurged and bought "Essential Art House-50 years of Janus Films." This anniversary collection of DVDs contains 50 films released in the U.S. by Janus, which was the major source of foreign and art films in the 1950s and 60s.

Joseph V. Simone, MD... - Click to enlarge in new windowJoseph V. Simone, MD.

Watching the films has reminded me of many visits to small, off-beat movie theaters with sticky floors and one guy who sold and collected tickets, made the popcorn, and probably ran the film. But most of all, I was reminded of experiencing the pleasure, wonder, and mystery of these decidedly non-Hollywood movies (even though some were made in the U.S.). Though I didn't always grasp nuances, the films made me think and often left a lasting impression.


The foreign films with the greatest lasting impact on me were mostly made by Ingmar Bergman. Because I am a physician, I believe, his single most memorable and thought-provoking film is Wild Strawberries. It was released in Europe in 1957 and had its premiere in the U.S. in 1959 at the Beekman Theatre in New York City. When I watched it at home, it had the same impact as when I first saw it, the difference being that I grasped its themes much more fully, probably because the protagonist is a physician celebrating 50 years in medicine and I was very close to that mark.


One Physician's Journey

The story begins as Dr. Isak Borg, an esteemed professor emeritus of medicine, is preparing to drive from Stockholm to Lund to be honored for his 50-year career. His first words foretell a basic theme, "Our social relationships are limited, most of the time, to gossip and criticizing people's behavior. This observation slowly pushed me to isolate myself from the so-called social life. My days pass by in solitude." His daughter-in-law accompanies him on the drive. He has had an unhappy family life both as a child and as an adult. His wife left him for another man, largely because of his unsympathetic and cold demeanor. And it is clear that his son, who also is treated coolly by his father, is imbued with the same sadness and loneliness.


Throughout the movie, he has dreams of his life. In his first dream, he is lost in a sterile looking city with a large clock having no hands. A horse-drawn hearse without a driver rapidly approaches and when a wheel of the carriage hits a post, the casket falls to the street and pops open. He looks in, and it is him lying in the casket. As the movie progresses, one thinks it is as much about the death of his soul rather than the body that the dream shows him.


As the journey progresses, he and his daughter converse. She eventually tells him, "You are a selfish old man. You don't care about anything, and you never hear anyone but yourself. All this is so well hidden behind your benevolent, kind mask. But you are as hard as stone, even though everybody says you are a great humanitarian person. But the ones close to you know how you really are."


She then reminds him of what he said (and had forgotten) when she asked to spend a few weeks at his house; there was a problem in her marriage (she was pregnant and wanted the child, her husband did not) and she wanted time to think. She reminds him that he said, "Don't try to bring me into your conjugal problems, because I don't care at all. Everyone has his things to think about. I don't have any respect for the pain of the soul; so don't come here to cry. But if you need spiritual support, I can tell you the name of a priest or analyst."


No wonder his wife left him and his son is estranged. But it isn't that simple. As the movie progresses, instead of being repelled by him we gradually begin to feel sympathetic as the doctor slowly faces his past honestly. This is made possible by the magic of the movie and especially by the remarkable acting of Viktor Sjostrom, who plays the doctor. He (and the doctor) were 78 years old at the time.


During the journey his second dream is of a happy time in his youth picking wild strawberries with his first love, Sara. But she ended up marrying his best friend and he never got over that loss. In a heartbreaking scene, the young Sara, as he remembered her, tells him, as the old man, that she will not marry him. Finally, she tells him to look in the mirror. He refuses at first then looks and says, "It hurts me so." And she replies, "You should know why it hurts so much. But you don't, in spite of your science, you don't know anything indeed."


Immediately following his meeting with Sara in the dream, he walks into a classroom like the one he taught in. This is the scene that led me to write this essay. In the scene, Dr. Borg is the student, not the professor, but he is still 78 years old. The professor is giving him a test. He is asked to identify something under the microscope, but he can't see anything. He is then asked to interpret something written on the blackboard, but he does not comprehend the writing. He then is asked to diagnose a woman lying on a bed. He looks at her and says she is dead. The woman promptly gets up and laughs loudly at him. The professor writes down his conclusion, "You are incompetent."


Importance of Humility

But I left out one detail, which has occupied my thoughts more than any other aspect of the film. When he was asked to read what was on the blackboard and couldn't, he was told it said, "The first duty of a doctor is to ask for forgiveness." That hit me right between the eyes the first time I saw it over 50 years ago and the last time I saw it more recently. Strangely, despite many detailed critical analyses of the film over the years, I could find none that considered what it meant.


The statement can be interpreted in many ways; here is my understanding of it. I believe the movie, at its heart, exposes in Dr. Borg (and in us, if we care to look) a devastating lack of humility, even as he is honored and esteemed in his profession by colleagues and the public.


The soul of practicing medicine is a solemn social contract under which patients surrender themselves to us and trust us to do what is best for them. Because of patients' vulnerability and trust, we doctors have a great deal to ask forgiveness for, our relative ignorance, the times we act without charity, and the invasion of patients' bodies with knife or rays or chemical. A doctor without a substantial and persistent sense of humility every day is a poor doctor.


Unlike many of Bergman's movies, which are often unrelentingly dark, toward the end of Wild Strawberries Dr. Borg begins to see and accept his shortcomings and move toward deeper insight and reconciliation-the first steps toward humility and redemption.