Bigger Than Life: The Movie That Speaks to Me

“Only great pain, the long, slow pain that takes its time... compels us to descend to our ultimate depths... I doubt that such pain makes us "better"; but I know it makes us more profound... In the end, lest what is most important remain unsaid: from such abysses, from such severe sickness, one returns newborn, having shed one's skin... with merrier senses, with a second dangerous innocence in joy, more childlike and yet a hundred times subtler than one has ever been before.”

-Friedrich Nietzsche, "The Gay Science"

The movie spoke to me. It was too close to home. How often have you heard such comments from people after viewing a motion picture? I have to admit some honesty--movies rarely, if ever, "speak to me" or are "too close to home." My favorite films--"The Godfather," "Onibaba," "The Great Dictator" and others--are mostly completely unrelated to me and my experiences. But while watching a practically forgotten film from 1956, I began to feel an eerie resemblance to my situation. The movie is called "Bigger Than Life."

So let me begin with my story:

On September 26, 2012, after a somewhat long day of teaching, I had a raspy sore throat that I expected would go away. After all, several weeks before, during a remarkably stressful start to the quarter, I had suffered from a terrible cold that left me in bed most of the weekend. The sore throat didn't go away, nor would it for months and months. Since that day in September, I have had roughly a dozen or so symptoms; among the worse have been heartburn, morning throat irritation, dysphagia (discomfort when swallowing), globus (a feeling of the throat clenching in), and odynophonia (pain when speaking), the chief symptom.

But before I reveal my thoughts on "Bigger Than Life," I really need to elaborate on just what it is I've been going through. I mentioned an eerie connection to the film. Here is an eerie passage from a book called "The Chronic Cough Enigma."

A twenty-five-year-old female grammar school teacher came to see me [a laryngologist and author of the book] with a nine-month history of a sensation of a lump in her throat, breathly hoarseness (dysphonia), vocal fatigue, intense pain with voice use (odynophonia), and cough. Her cough, voice, and odynophonia made it hard for her to get through the day. By the afternoon, she was miserable, and by the end of the week she was in tears because of her voice and throat pain. Nine months earlier, she had been completely healthy with no symptoms whatsoever; her problems began following an upper respiratory infection (URI). She described having a cold that turned into severe laryngitis and pleurisy. Weeks later when she started teaching, she was already having severe symptoms that just grew worse as the school year wore on. When she came to see me, she was desperate. From my initial patient intake forms, I saw that her reflux symptom index (RSI) of 33 was very high (normal < 15), indicating severe reflux. Her glottal closure index (GCI) of 18 was also very. The GCI measures voice symptoms and is very useful in determining if a person has problems with the vocal cord nerves, specifically if the vocal cords are paralyzed or partly paralyzed. This patient’s high GCI of 18 suggested that she likely had vagus nerve damage. Examination of the voice box by transnasal flexible laryngoscopy (TFL) confirmed that she had a paretic (weak, partially paralyzed) left vocal cord. Special vocal cord function testing called stroboscopy showed that the left vocal cord was floppy, also indicating vocal cord paresis. Finally, her larynx showed severe reflux. The patient underwent tests for reflux and for vocal cord paresis (e.g., laryngeal electromyography), all of which indicated that she had suffered a post-viral vagal neuropathy. To complete this clinical anecdote, the patient responded well to an intense antireflux program and to two medications used to treat neurogenic cough and vagal neuropathies (amitriptyline 10 mg . before bed, and gabapentin 100 mg. four times a day). The drugs were given in this case for her cough and throat pain. Within six weeks, she was asymptomatic and within six months, she was off all medication.

Eerie indeed. Like this unfortunate individual, I was a twenty-five-year-old teacher when my symptoms first appeared. Unlike that teacher, however, I did not suffer from a cough, but I did (and still do) suffer from odynophonia, and as a teacher, the pain has made my job much more challenging and less enjoyable.

It was the first week of class. We were desperately short on teachers, so I had two classes of students. The first group had less than twenty, but the next class had about 40. With back-to-back classes and almost no time to eat, teaching eight hours straight from 7:30-3:30 left me exhausted and eventually suffering from a terrible upper respiratory infection by the end of the week. I remember being in bed most of the weekend, as my voice had been shattered. But I recovered in time and returned to work. A new teacher had arrived and he took over one of the classes.

About a few weeks later, just like that other teacher, I suddenly had a bad sore throat at the end of the day, but I thought nothing of it. Surely, it will go away during the weekend, I thought. It did not. Nor did it for the new few weeks. So I went on vacation to Taiwan and despite the humidity and relaxation, it seemed to be getting worse. Back in Saudi Arabia, I was told I had a fungal infection, but when the medicine didn't alleviate the pain I was told I had acid reflux, and that the reflux was reaching my larynx. I took the pills and ate "healthier" food and yet the pain did not go away. Back in Ohio, doctors at a "prestigious" clinic (I'll leave the terribly overrated institution unnamed) "ruled out" reflux (but were wrong). They explained to me that that awful cold I had months earlier could have sort of messed up my nerves, creating a neuropathy, or neurogenic pain. "Okay, whatever. I'll buy it." But that medicine didn't work and so I stopped taking it all together. "Your symptoms are atypical," they told me as they washed their hands of me and moved along. And as the one year anniversary approached, I thought to myself that if I woke up on the one-year anniversary of first feeling symptomatic, then there indeed would be proof of a God.

Instead, the opposite happened. I woke up and I had never experienced pain quite like that in my throat. I didn't know how I would be able to get to work. I truly believed I was on the verge of a breakdown. A friend calmed down and told me about Nietzsche and his struggles with chronic pain. So I picked myself up a bit and saw a (rather expensive) specialist in New York City. After five terribly uncomfortable tests, I was given quite a plateful of diagnoses: gastroesophageal reflux disease, severe laryngopharyngeal reflux, post-viral vagal neuropathy, and bilateral vold fold paresis.

What the hell does that all mean?

Everyone knows GERD--it's heartburn, or stomach acid and pepsin refluxing (flowing up) back into the esophagus. But what about LPR? LPR, reflux into the throat, is unfortunately a much more difficult battle. Whereas more than fifty reflux episodes constitute GERD, as little as three qualify as LPR. PVVN? Many patients complain of suffering from a bad upper respiratory infection and weeks later, out of nowhere, they're either hoarse or coughing or suffering from odynophonia. It's a little complicated, but essentially the infection is potent enough to damage one's vagus nerve, the nerve that runs from your brain down to your lower esophageal sphincter. Because the vagus nerve "calls the shots," it has profound effects on one's system. Allow me to quote one research article: "Patients with this condition may present with breathy dysophina, vocal fatigue, effortful phonation, odynophonia, cough, globus and/or dysphagia, lasting long after resolution of the acute viral illness." The article goes on to describe that this can lead to paresis of the vocal cords (which the director of Google, who suffered from this, can explain) and LPR.

I'm told that my LPR has essentially been cleaned up (though new problems have presented themselves due to this fight--long story), even though my vocal cords appear a bit pink. (Incidentally, refluxers are very, very vulnerable to several different types of cancer.) But unlike that teacher who required only several hundred milligrams of neurontin and 10 milligrams of amitrptyline, I have tried much, much more, and while the pain is probably not as bad as before, it remains, and I'm afraid it will do so forever.

I could go on for hundreds and hundreds of more words--on a broken healthcare system, my feelings of the pharmaceutical industry, skepticism of alternative medicine and supplements, the de-mythologizing of "doctors-as-God" complexes, the disgusting over-usage of antibiotics, my jealousy of people who can eat whatever the fuck they want--but that is not my intent. Instead, I want to describe how Nicolas Ray's "Bigger Than Life" "spoke to me." (Note: This isn't technically a review of the film.) Based on an article called "Ten Feet Tall" (a line spoken in the movie when the protagonist describes how he feels after beginning his treatment), "Bigger Than Life" stars James Mason, who also produced the film, as a school teacher. (You've probably seen at least one of Ray's two biggest films--"King of Kings" and "Rebel Without a Cause.") Mason plays a teacher (another eerie resemblance) named Ed Avery, but from the very first time we see him, he writhes in pain. Yet he refuses to show anyone, and he's under a considerable amount of pressure as he works two jobs (and he hides one of them from his wife for fear of embarrassment).

But eventually he collapses and is rushed to the hospital. Doctors there diagnose him with a rare inflammation of the arteries which will likely kill him. He is proscribed a new drug (cortisone). It begins to work: he has his life back, and soon he feels "ten feet tall." But, as expected, he begins to misuse his medication. A parent-teacher night turns into a bizarre (yet quite funny) tirade comparing the parents' children to apes. His loyal friend, the physical education teacher (played thanklessly by Walter Matthau, who is still sorely missed) tries to intervene, but this only causes suspicion from Ed. His condition worsens, and he soon becomes more and more hostile and alarming (and dangerous) to his wife and son. There's a haunting and wonderfully-shot scene where Avery, now virtually madden by it all, confronts his son after the boy tries to destroy the cortisone. It's incredibly ominous.

It should be obvious why I feels a connection to this film and its central character (though, I assure you, I've never tried to harm young children and I've never abused drugs). I am more or less on a new regime that I am cautiously optimistic about. While I am fortunate to have doctors who care about me, I'm afraid I might fall forever in the mindset of Voltaire's famous quote: "Doctors are men who proscribe medicine of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing." I could compare myself to Mason's character and succumb to the idea that "it could be worse," though this is a sort of "illness porn" that I don't think is always the best route. My mood changes frequently: sometimes feeling depressed, sometimes feeling fortunate, sometimes feeling bitter. Fear is probably the most common. It does provide one with a heightened sense of what really matters in life. I now know that I can find the rapidest increase in happiness through providing a kindness and through smiling, even if I'm not happy (try it, it works!).

I am often reminded about information I found at inc.com on happiness, specifically a quote from George Vaillant, the director of a 72-year study of the lives of 268 men: "We are happy when we have family, we are happy when we have friends and almost all the other things we think make us happy are actually just ways of getting more family and friends."

The ending of "Bigger Than Life," though it severely suffers from deus ex machina, embraces this concept. It's actually the worst part of the film. It's so abrupt and damages the pace. (Spoiler alert) We go from an exciting fight between Mason and Matthau to yet another one of Hollywood's embrace of "all's-well-that-ends-well." But regardless, Mr. Avery finds his peace and happiness, and Mr. Vaillant could likely use him in a future study. I only hope Vaillant would add that we are happy when we are healthy.