narrative medicine · neuro

Heureusement

In April 2009, France Alzheimer, a national organization created to “soutenir les malades et leur famille” (“support patients and their families”) released an advertisement entitled “Heureusement” (“Fortunately”). The commercial, developed by the advertising firm Saatchi & Saatchi Paris, stirred up a minor controversy in France due to its bleak and unrelenting portrayal of Alzheimer’s disease as a progressive, isolating illness.  Taken together, the ad and the response it generated demonstrate the fear that our society has at the thought of living with Alzheimer’s disease.

The forty-seven-second commercial opens with a long-shot of a woman on a city street at night.  As she walks past the shuttered businesses, the camera cuts forward to show us her feet, one slippered and one bare, her fluttering nightgown, and finally her face, gazing around her with child-like wonder that turns into confusion as she—and the viewer—tries to understand how she came to this situation.   The implication is that this woman lives alone, or at the very least has no individual in her life that might be able to stop her from wandering in possibly dangerous locations.  From this bleak beginning, the commercial shifts to similar vignettes: a man walks about his kitchen eating dog food out of a can while his dog barks unheeded; a woman sits on the edge of her bed and hums softly, apparently unconcerned that blood is dripping down the side of her face.  The individual with Alzheimer’s is the only person depicted in each of these vignettes.  As a group of three, however, they demonstrate a seemingly inevitable progression.  The woman in the nightgown may be hurt as she wanders through the city; the man eating dog food will be hurt as his stomach rebels; the woman on her bed has already been hurt, as evidenced by the fresh wound on her forehead. These vignettes reinforce, shockingly, the social isolation and the physical danger of Alzheimer’s disease.

The commercial’s fourth vignette contains the only spoken words of the entire piece.  Without any context, we are shown a close-up of a man screaming “Bande de voleurs! C’est chez moi ici! Sortez!” (“Thieves! This is my house! Get out!”) In a reversal of the opening move, the camera pans outward to show the man’s grown children.  The son avoids his father’s accusatory gaze, and the daughter stares up in wondering disbelief.  Unlike the older individuals in the first three vignettes, the man depicted here is middle-aged and apparently surrounded by others who love him and would wish to care for him.  However, the failure of recognition that accompanies Alzheimer’s disease, coupled with their own inability to comprehend their father’s fear, is a barrier to care.  Even within a family, the vignette implies, an individual with Alzheimer’s is fundamentally alone.

The fifth and final vignette reinforces the message of social isolation by implicating the viewer in the isolation of those with Alzheimer’s disease.  We watch as a woman in an overcoat stands before a frozen case in a grocery store.  She lowers herself to the ground momentarily as though sitting in an invisible chair, then stands again.  Behind her, an out-of-focus woman continues with her shopping, too busy even to notice the struggling elderly woman.  This segment aims to shock not through visual depiction or harsh words. Rather, it demonstrates the failure of an ethical response on the part of someone who has the opportunity to help the woman with Alzheimer’s disease—someone like the viewer.

Fittingly, the commercial ends here, with a cut to black.  The words “Heureusement, ils ne s’en souviendront pas,” appear. (“Fortunately, they won’t remember this.”)  The ironic text blows away as though it is composed of sand—or the patient’s fading memory—to be replaced by the logo of France Alzheimer.  Unlike many other Alzheimer’s Association ads, this commercial does not explicitly ask anything of the viewer.  Instead of being told to donate money or volunteer to raise awareness, the viewer is left with the impression that Alzheimer’s disease is bleak, unstoppable, and hopeless, that the best thing one can do about the loss of memory and human connection is to joke ironically.

The structure of the commercial, too, reinforces the disorientation that Alzheimer’s disease produces in its late-stages.  The five vignettes depict five unrelated individuals, and the commercial cuts from one to the other without warning and without commentary.  We are treated to a visual version of what Arthur Frank categorized as a chaos narrative. The muted color palette and the eerie piano score that plays single notes (rather than harmonious chords) with a minor progression, further enhance the viewer’s sense of abandonment and bleakness.  Thus, Saatchi & Saatchi mirror France Alzheimer’s desired content—the social isolation of individuals with Alzheimer’s—in their stylistic choices, producing an ad that shocks the viewer visually, aurally, and cerebrally.  For forty-seven seconds, we become an individual with Alzheimer’s disease.

Unsurprisingly, the commercial generated a great deal of controversy when first aired in France, including an internet petition of families, physicians, and caregivers of those with Alzheimer’s. The petition argues that the hidden agenda of the devastating commercial is not to raise awareness about the disease but to “effrayer des millions de gens et remplir les caisses de Alzheimer Big Bussiness [sic]” (“scare millions of people and fill the coffers of big business”).  In particular, the petition feels that this commercial presents social isolation as “une vérité scientifique” (“a scientific truth”) and that the care of individuals with Alzheimer’s disease “demande une connaissance intime et non pas scientifique de la maladie” (“requires a personal and not scientific knowledge of the illness.”)  Thus, the petition serves as an explicit call to personal action, rather than the passivity perceived in the commercial.

In a statement of apology posted on the Alzheimer Autrement petition website, France Alzheimer asserts that their commercial was intended to “attirer l’attention du public sur …un stade avancé de la maladie. Nous avions ainsi voulu sensibiliser le public au fait que la maladie d’Alzheimer ne se réduisait pas à l’amnésie” (“focus the attention of the public on … the late stage of the illness.  We wanted to make people aware that Alzheimer’s disease is not just amnesia.”)  The controversy surrounding the ad ultimately led to the decision of France Alzheimer to voluntarily withdraw the commercial from television and their website.   The internet petition continues, however, now serving as a repository of testimonials to counteract the bleakness of the France Alzheimer ad.

Both the France Alzheimer ad and the internet petition/testimonials it generated have the same ultimate goal: to improve the quality of life for individuals with Alzheimer’s by emphasizing the need for human connection, especially in the late stages of the disease.  The commercial depicts this visually and musically by showing the viewer the negative consequences that arise when society abandons those with Alzheimer’s.  The internet petition, on the other hand, attests to the grassroots power of the individual caregiver in improving life for the patient.  In both cases, an ethical call is sounded: we as a society must have options in place for those with Alzheimer’s if we are ever to counteract the devastating effects of this disease.

(Originally submitted as a class assignment; copyright me; all rights reserved, etc etc legalese.

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