Sunday, May 20, 2012

Rating Patient Satisfaction

If one could identify some of the cosmic shifts in the field of medicine over the past 25 years, at the top of the list would be computer technology and patient satisfaction. HMOs, in particular, want to be sure their medical providers are getting good ratings from patients and are eager to improve the experience a patient has in person, on the phone, or by email with doctors, nurses, and other support staff.

As a member of Kaiser Permanente's HMO, I routinely receive these marketing questionnaires. But Kaiser's approach to their patients is quite different from the attitudes portrayed in Oren Brimer's "Doctor" series of shorts from Front Page Films. Matt McCarthy and Pete Holmes star in the following videos recently shown during the San Francisco International Film Festival.

In February 2009, Berkeley Rep presented the world premiere of Sarah Ruhl's comedy, In The Next Room (or The Vibrator Play). With the recent opening of the Good Vibrations Antique Vibrator Museum, perhaps this as good a time as any to examine an area of medicine in which doctors completely misdiagnosed a patient's symptoms for centuries.

According to production notes for Tanya Wexler's new film, the idea that a “wandering uterus” (literally, female hysteria) could cause symptoms ranging from amnesia to sleepwalking and madness was first mentioned in 4th century BCE by ancient Greeks in the Hippocratic Corpus. For the next 4,000 years, unexplained behavior was directly linked to women's sexual organs (a 16th century French physician suggested sending women riding through the woods on horseback in order to cure their hysteria).

Today's women know a lot more about their bodies and bodily responses to erotic stimuli. So, for that matter, does today's medical community. Wexler's Hysteria focuses on a key moment in Victorian England which allowed women to take matters into their own hands.

As Joe Biden would say: "Literally!"  Filmmaker Tanya Wexler explains that:
“I’m a huge fan of British costume dramas, but I also love sophisticated modern comedies.We knew that we’d have to find a unique tone because, while it might be a 19th-century story, it’s a subject that still makes us blush in 2011. The fun was in creating a kind of lush, Merchant Ivory reality on the surface with a hilarious, unbridled comedy running underneath it."
Set in London in 1880, Hysteria takes place following the Industrial Revolution, during a period when when inventions include the home sewing machine, public flushing toilets, the pasteurization of food, the underground railway, the typewriter, the telephone, the phonograph, the gas-powered motorcar, and the electric light bulb. While young physicians like Dr. Joseph Mortimer Granville (Hugh Dancy) were interested in the germ theory and sanitation, their older colleagues were much more inclined to rely on leeches and amputation.

Having been fired from several jobs, Granville ends up being hired by Dr. Robert Dalrymple (Jonathan Pryce), London's leading specialist in women's medicine who boasts a large clientele of women suffering from “weeping, nymphomania, frigidity, melancholia, and anxiety.”  Dr. Dalrymple has discovered that manual stimulation of a women's genitalia can lead to a physical and emotional release which seems to relieve most women of their symptoms.

Once Dalrymple's sex-starved patients encounter the handsome young Granville -- and look deep into his eyes as he reaches under their skirts to bring them relief -- word quickly spreads through London society. At first, Granville is unaware of the effect he is having on Dalrymple's patients. The older doctor has hinted that Granville might be the perfect person to take over his practice and marry his daughter Emily (Felicity Jones), who has been in training to become a proper young lady.

Emily Dalrymple (Felicity Jones), Dr. Dalrymple (Jonathan Pryce)
and Dr. Granville (Hugh Dancy) sit down to dinner in Hysteria

Dalrymple's other daughter, Charlotte (Maggie Gyllenhaal), is a much more independent and outspoken spirit. A social reformer fighting for women's rights, Charlotte dashes around London on her bicycle trying to raise money from her father's friends while running a settlement house for poor women and children in London’s East End. She is a true Victorian-era "community organizer."

Hugh Dancy and Maggie Gyllenhall in Hysteria

When Fanny (Ashley Jensen), one of the women at Charlotte's settlement house, breaks her ankle, Dr. Granville is called into action to help splint her leg. This outrages Dr. Dalrymple, whose practice has been strictly built on paying customers.

Granville is eventually faced with some tough choices. Should he follow his heart and practice medicine to those in need or keep poking his hands between the legs of wealthy women? Should he marry the charming Emily or spend more time getting to know her feisty elder sister? Should he accept the sexual favors of Dalrymple's servant, Molly the Lolly (Sheridan Smith), or simply attend to his patients' sexual needs?

Molly the Lolly (Sheridan Smith) has a keen attraction to the
handsome, young Dr. Granville (Hugh Dancy) in Hysteria

A little too much poking and prodding leads to a severe case of repetitive stress syndrome and Granville soon finds himself without a job. But all is not lost.  His eccentric aristocratic friend, Lord Edmond St. John-Smythe (Rupert Everett), has a passion for new technology and has been trying to invent an electric feather duster. Edmond is so far ahead of the curve that he had a telephone installed before Buckingham Palace got one.

When Edmond asks Granville to try using his electric feather duster, its design sparks a brilliant idea. With a few adjustments, the feature duster is transformed into the world's first electric personal vibrator.

Molly the Lolly (Sheridan Smith) dusts off
 her new vibrator in a scene from Hysteria

Their challenge, of course, is to find some women who will be willing to test their new invention. The results prove to be quite sensational. Even the grumpy old opera singer, Mrs. Castellari (Kim Criswell), can be brought to orgasm quickly and efficiently.

Thanks to Edmond's foresight, it no longer matters if Dr. Granville is employed as a doctor. Why not? He'll be getting a handsome income from sales of his newly patented device, which will allow him to work with Charlotte tending to the women and children at the settlement house.

In real life, the battery-operated vibrator known as “Granville’s Hammer” was marketed for the relief of muscular aches and pains. Its use soon became referred to as a “medicinal massage of the female organs to the point of paroxysm” which, in the Victorian era, described a perfectly clinical release of nervous tension which could in no way be confused with sexual pleasure.

Not only does Hysteria look gorgeous, both male and female viewers will leave the theatre with fantasies of Hugh Dancy reaching between their legs to get them sexually aroused. Maggie Gyllenhaal is as radiant a presence as ever (a far more interesting woman than her insipid younger sister) and Rupert Everett has some deliciously comic moments as the sarcastic Edmond.

Wexler's film is great fun, from both historical and hysterical points of view. Here's the trailer:

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