The block attacks: Barton Fink

The block attacks: Barton Fink

Insight Stafford Hospital, the Orchid View care home serious case review, and the Ombudsman’s report on unsafe hospital discharges. Some matters uncom...

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Insight

Stafford Hospital, the Orchid View care home serious case review, and the Ombudsman’s report on unsafe hospital discharges. Some matters uncomfortably resemble those 50 years ago: lack of respect for the dignity of older people; disbelief that older people can recover from illness; and overlooking their reversible psychiatric disorders while assuming that they have untreatable dementia. Despite huge improvements in provision of comprehensive old age psychiatry services, older people’s services remain less well resourced than those for younger people. It is salutary to remember that the 1960s inquiries and the Francis Inquiry resulted from the work of dynamic external pressure groups—AEGIS and Cure the NHS—and not health service staff or politicians. AEGIS and Cure the NHS demonstrated dedication and determination, and both required the resilience of their leaders to cope with hostility from people who did

not want to disrupt the status quo. Both groups were vindicated after findings that care was substandard and improvements were essential. In both cases, outcomes included substantial top-down policy changes. However, recurrence of scandals indicates that hopes for permanent eradication of abuse have not been realised. Perhaps a revised bottom-up approach would help, including improved understanding of the challenges, fears, perspectives, emotions, and experiences of frontline staff, without labelling them as disruptive whistleblowers.

Claire Hilton I am grateful to the Wellcome Trust for a Leave Award for Clinicians and Scientists in Medical Humanities (108519/Z/15/Z), which allowed me to undertake this study, and to the editor of The Lancet Psychiatry, Niall Boyce, for allowing me to use The Lancet volumes annotated with authors’ details.

20th Century Fox

Movies of the Mind The block attacks: Barton Fink

Barton Fink Directed by Joel Coen and Ethan Coen 1991 Running time: 116 min For the Yale University study see Imagination, Cognition and Personality 1981; 1: 89–109

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“We just sort of burped out Barton Fink,” one—or perhaps both—of the Coen brothers once told an interviewer. The legend that’s grown up around their 1991 film has the Coens penning it to get past the writer’s block they suffered while finishing Miller’s Crossing in 1989. But Joel Coen isn’t so sure: “It’s not really the case that we were suffering from writer’s block…our working speed had slowed, and we were eager to get a certain distance from Miller’s Crossing.” There would seem to be no shame in admitting to be suffering from a condition that has bedevilled countless fine writers—Samuel Taylor Coleridge, Graham Greene, Joan Didion, take your pick. Yet for some there remains a suspicion that writers block isn’t real. “Plumbers don’t get plumber’s block,” the poet Ian McMillan once told me. “And carpenters don’t get carpenter’s block. So why should writers get writer’s block?” Anthony Burgess went so far as to suggest that American writers were particularly prone to getting blocked because they were overpaid, and lacked the necessary economic spur for creativity. Barton Fink, a film about a blocked writer written by writers at pains to say they were not blocked, carries more than a hint of this ambivalence. John Turturro’s Fink is a left-wing, socially conscious writer who has had a critical hit in New York with Bare Ruined Choirs, an earnest tale of ordinary Lower East Side life. Fink seems based, rather unkindly, on Clifford Odets, who wrote Waiting for Lefty. Like Odets, he takes a lucrative offer to write for Hollywood and—like Odets—gets assigned to a wrestling picture. Following a baffling series of meetings

with executives at Capitol Pictures (a company that will reappear in Hail Caesar!) Barton sits in his sweaty hotel room, blank before his typewriter. He’s got nothing. But the Coens withhold their sympathy and ours. Maybe, they suggest, Barton never had anything in the first place. Maybe the good intentions of his social conscience mask a lack of talent. Well-meaning but witless Barton is so caught up with his own narcissistic worries about “the life of the mind” that he fails to notice he’s living next door to a story, in the shape of travelling salesman Charlie Meadows (a spellbinding John Goodman). In 1981, Jerome Singer and Michael Barrios of Yale University published a study in which they used music, dream states, and visualisation techniques to try to unlock the imagination of 48 participants experiencing some kind of block. Graham Greene, Singer and Barrios noted, found it helpful to pay attention to his dreams, and the composer Giuseppe Tartini composed his famous Devil Sonata following “a dream in which he handed his violin to the Devil”. Poor Barton’s dreams are tormented by a vampiric mosquito, and he can visualise little beyond the blank page in front of him. Only the picture on his wall, of a woman dressed in a bathing suit and looking out to sea, offers any possibility of escape. In the closing moments of the film we don’t know whether Barton truly meets her, or whether, like Greene and Tartini, he dreamt her into being. But she feels like the start of a new chapter.

Laura Thomas www.thelancet.com/psychiatry Vol 4 February 2017