Michael Arnold Glueck, M.D., and Robert J. Cihak, M.D.
Wednesday, Apr. 21, 2004

Way back in 2002, your Medicine Men established the "Medicine Men Caduceus Awards," which carry a cash honorarium of zero, offer neither statuettes nor trophies nor plaques, and have been generally ignored by Hollywood and the rest of the world. These items notwithstanding, the Caduceus Awards go to films that, in our highly personal but nonetheless correct opinion, significantly change the popular image and/or perception of some aspect of disease, diagnosis, and treatment, and thereby make a difference to affected individuals, their families, and society generally.

On March 21, 2002 we wrote, "This indeed is an area where Hollywood can excel. Their talents can make us pause, think, raise our awareness, reconsider. The award is merited for reasons far different from touchy-feeliness or crude moralism."

That year, we chose the movie "A Beautiful Mind," for its sensitive portrayal of schizophrenia. There was no award in 2003 (Our standards can be dreadfully high).

This year - the envelope, please - the Medicine Men Caduceus Award goes to "The Barbarian Invasion," released by Miramax to American theaters in November 2003. If a picture equals a thousand words then this film equates to millions of words. It is a tribute to the Canadian film makers that they beat Los Angeles to the hospital floor on the issue of humane pain management.

Sadly, "The Barbarian Invasion" has not been a large box office hit. But the film will endure for its unfailing heart and the story it tells.

According to "rottentomatoes.com," the consensus opinion of reviewers is: "A moving and heart-felt film from director Denys Arcand. The cast includes Remy Girard, Stephane Rousseau, and Marie-Josee Croze. The Barbarian Invasions is a story about the humor, hope and unspoken bonds that hold family and friends together against the onslaughts of life in our contemporary times." It is rated R, for language, sexual dialogue, and drug content and running time is 1 hour and 39 minutes.

The film gives an intimate look at the hopelessness and dreariness of Canadian hospitals and their system. We might add this film will not make you want to adopt the Canadian medical system. Up North, as in the United States, terminal pain is no match for an unending and stubborn bureaucracy and antiquated attitudes.

The prosperous son of a dying patient wants to make his father's death less painful. He is given no good choices by the system. The hospital and care are inadequate, the necessary pain medications are not allowed, and legal euthanasia is not a choice. As always, the lack of good choices leads to bad choices (both here and abroad). Therefore the son pursues pain medication from illegal sources in non-conventional ways so that his father may die under his own covenant.

One can interpret the film in many ways. It tells of the barbarian killers of centuries past, barbarian drug dealers now, and about the current barbarian treatment of patients -- and portrays the dilemma of nurses and doctors who can be arrested for acts of kindness such as giving pain medications.

Kathryn Serkes, spokesperson for the Association of American Physician and Surgeons thinks the message of "The Barbarian Invasion" is so strong she plans to do a screening for Congressional staff members in the near future. Says Serkes, "The entire issue is far more than just illegal drugs and prescription medications on the street. This is a distressing family issue that must be addressed by the nation."

Cinema matters. So does understanding reality.

Pain management is a subject your Medicine Men have addressed many times, especially the growing bureaucratic over-regulation and prosecutorial over-zealousness. As we noted in last week's column, "When honest citizens cannot get pain medication because ethical doctors are afraid to treat them, ours is no longer a free society."

It is, however, a society willing to tolerate the suffering of the innocent in order to gratify and appease the state. Which ain't so good, either.

We suggest, therefore, that you see "The Barbarian Invasion" or rent the DVD when released on July 13, 2004. We suggest that you see it because pain management either is or will be a concern for you or someone you care about. With the technical advances of modern medicine there is currently no need to practice barbaric medicine in the United States or Canada.

Also, we welcome your nominations for future Caduceus Awards - or even a few ideas on films that ought to be made on medical subjects. Who knows? It might start a whole new cinematic genre. "Cihak and Glueck's Mediflicks."

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Editor's Note: Michael Arnold Glueck wrote this week's column.

Robert J. Cihak, M.D., is a Senior Fellow and Board Member of the Discovery Institute and a past president of the Association of American Physicians and Surgeons. Michael Arnold Glueck, M.D., is a multiple-award-winning writer who comments on medical-legal issues.

Contact Drs. Glueck and Cihak by web e-mail.