Review
Ageing
Assisted dying
Culture
5 min read

For love there is no charge

Out of mind old people are at the centre of Allelujah! Sian Brookes reviews the film adaptation of Alan Bennett’s play.

Sian Brookes is studying for a Doctorate at Aberdeen University. Her research focuses on developing a theological understanding of old age. She studied English and Theology at Cambridge University.

In a hall decorated for a celebration a person stands in front of a seated group, all have their arms raised in celebration.
Jazz hands at the hospital.
BBC Films.

Spoiler alert – this film review reveals significant elements of the plot. 

Allelujah! is not a film that shies away from the big issues. In fact, you would be hard pressed to find a big issue this comedy/political commentary/drama/part-thriller doesn’t at least make reference to (and yes, it spreads itself across all of these genres too). With such an eclectic approach it is difficult at times to keep up with the narrative, and the deeper meaning of the film. Based on the Alan Bennett play, the plot centres around The Bethlehem, a small northern hospital for geriatric patients, which is facing closure due to the Tory government’s efficiency drive. It focuses on two members of staff, Alma Gilpin, a stoic and matter-of-fact but seemingly excellent nurse who has served the hospital her entire career, and a younger Dr Valentine. Other protagonists include an ex-miner patient and his son, a management consultant who has “made it” to London and is currently advising the Health Secretary to close hospitals such as the one in question for the sake of government finances. 

Whether it’s politics or the personal, this film has it all. It deals with levelling up, the cultural and economic gap between the north and south, the challenges of budget cuts in the NHS, the problems of a national health service claiming to 'care' but with managers more preoccupied by Westminster’s economic priorities. It depicts families waiting for older relatives to die in order to grab their inheritance, the broken relationship between an ageing man and his son, and those all-important stories of the older patients’ lives well-lived. And yet as the story line develops, a plot twist emerges which comes to overshadow the entire film, and in the process speaks to what is perhaps the most poignant of the many discussions it raises. Nurse Gilpin, who, until now has appeared consistently caring and committed to her patients, has been quietly administering fatal beakers of milk and morphine to those who she deems to be on “her list” of those who most need relief from their situation. When confronted by the doctor she justifies her actions with a multifaceted answer based on the requirement to provide more beds to a broken healthcare system, but also insisting “I had ended someone’s suffering”.  

When Dr Valentine remarks, “I like old people” a visitor responds “not even old people like old people”.

The manner in which Nurse Gilpin goes about what is effectively enforced euthanasia, is deeply chilling. And yet her reasoning is not entirely foreign to us – to end suffering could be deemed a noble cause. In fact, the need to simply delete the reality of suffering, particularly the suffering of the old is one that perhaps is not so uncommon. Throughout Allelujah!,we are reminded of our tendency to run from, to detest, to reject the suffering of the elderly in our society. When Dr Valentine remarks, “I like old people” a visitor responds “not even old people like old people”. A teenage intern declares to a patient “I hope I never live to be your age”. At the same time, characters look back on the days “when the elderly weren’t farmed out”, and questions are asked of families “if they love them, why do they put them away?”. A very good question. Of course, care needs are often too great for families to endure, yet it is still important to ask why the suffering of the old has become a professionalised service, which most of us avoid at all costs. Perhaps the answer to this is that we don’t like to watch the old suffer, we don’t like to watch them die, because their suffering and their death remind us of our future selves, our future suffering, our future death. In our sanitised, anything-is-possible-with-medicine-and-science society, death and the suffering that comes with it, is something from which we flee at all costs. Instead of acknowledging and working with it, we would rather pretend it wasn’t there at all.  

And yet, even as we try to avoid it, suffering and death are both certain parts of all our futures. 100% of us will die. For Nurse Gilpin, the solution to this is to bring on death prematurely, to erase the pain, overcome the misery by offering a false hope – that it doesn’t need to exist at all. In direct contrast to this, in a film which is littered with Christian references (Allelujah, The Bethlehem), there is a different approach taken by a messiah-type figure who seems to get everything right. Dr Valentine is compassionate and understanding. He not only challenges the political systems which undermine those most at the margins of society, but also has the kind of bedside manner we would all hope for in a doctor. In a closing monologue Dr Valentine utters the words of the doctors in the NHS, “We will be here when you are old, and we would die for you, we are love itself and for love there is no charge”.  

It is this suffering with which is so compelling, this suffering with which is truly sacrificial.

Nurse Gilpin and Dr Valentine offer two fundamentally different approaches to end of life care. One hastens the end quickly, deletes the suffering as efficiently as possible in order to make way for those in less pain. The other sits with those who suffer, holds their hand, gently cares for the human person that is in front of them. Even more, and perhaps most significantly Dr Valentine does not only watch from afar, but is willing to suffer himself for the sake of those in pain - working tirelessly, giving himself over day after day, fighting on with little sleep for limited pay just to make things a little less painful. It is this suffering with which is so compelling, this suffering with which is truly sacrificial, this suffering with which speaks of something much greater than politics, efficiency or inheritance, this suffering with which is indeed “love itself”, completely free of charge.  This is the logic that Christians see in the ancient notion of the incarnation, celebrated every Christmas, of God with us. This is what our older people need, this is what we will all need when we grow old. Let us only hope that when we get there, we find the one who is willing to offer it.

Review
Books
Culture
Digital
4 min read

Filterworld: algorithmic anxiety is flattening our culture

The rule of vanilla lets our unfeeling gadgets decide what’s best for us.

Simon is Bishop of Tonbridge in the Diocese of Rochester. He writes regularly round social, cultural and political issues.

A podcast guest speaks in front of a mic.
What's next on the playlist?
Sebastian Pandelache on Unsplash.

Here’s another diagnosis to add to modern malaise: algorithmic anxiety.  It’s described by Kyle Chayka in his excellent book Filterworld (Heligo Books, 2024) as the: 

 …awareness that we must constantly contend with automated technological processes beyond our understanding and control, whether in our Facebook feeds, Google Maps driving directions, or Amazon product promotions. 

We don’t understand algorithms.  Even if we did, we wouldn’t know how they actually work on us as every tech company keeps it a secret, lest competitors learn from them.  This has led to the algorithm becoming the century’s newest bogeyman, a phantom we can reference in conversation to make us sound tech savvy and culturally knowing even while we remain in the dark. 

‘Algorithmic has become a byword for anything that feels too slick, too reductive, or too optimised for attracting attention’.   

Kyle Chayka

One of the oddest outcomes of the ascendency of the algorithm is the seemingly diametric effects on politics and culture.  In politics it has polarised people, sorting us into opposing camps and then ensuring we hear only good things about our ‘side’ and only maddening things about the ‘opposing’ side.  Instead of calmly listening to a different view, we hurl insults, as performative as Prime Minister’s Question Time and about as enlightening. 

Something different is happening with culture.  Here, the algorithm makes culture more homogenous; in the words of Kyle Chayka, it is ‘flattened’.  The basic rule of what he calls Filterworld is that ‘the popular becomes more popular, and the obscure becomes even less visible’.  It is a strange re-mix of Jesus for the digital age: ‘to all those who have, more will be given…but from those who have nothing, even what they have will be taken away. 

The life of an Instagram post is said to be determined in the first five minutes.  If it has engagement, it can be sure of more; if it gets none, it will sink.  Visibility on social media is vital for artists of all kinds, because this is where all publicity begins.  Artists try and game the system, figuring out what kind of content the algorithm will promote.  In the process, their creative expression is subtly compromised.  People begin to write in a style that gets attention, and what gets attention is decided by the algorithm.  Those who tweet will know how the short, pared back medium starts to influence their life away from X. Musicians know that art which is safe and mainstream – the public’s crowded middle where performers like Ed Sheeran have thrived – is likely to succeed.   

‘Much of culture now has the hollow, vacant feeling of having been made by algorithm’ according to the cultural commentator Dean Kissick.  Chayka observes that: ‘algorithmic has become a byword for anything that feels too slick, too reductive, or too optimised for attracting attention’.   

It is often at the margins that breakthroughs emerge; art that makes us see this world in a new and divine light.   

There is a valid counter to this development.  Previously, what we read, heard and saw as cultural consumers was determined by a small set of experts who filtered content for us.  These experts were often drawn from a narrow section of society who inevitably brought their own biases to bear.  While this may be true, it is hardly a triumph for the public to have an unfeeling gadget decide what’s best for them, based on what we have liked before and what seems to appeal to most people.  At the ice cream vendor, this is like reaching for vanilla every time.   

The truth is, in necessarily surrendering to the algorithm (for what alternative is there online?) we miss huge volumes of culture that might appeal to us.  It is about as effective as deciding what sea life we like based only on what pops up to the surface of the water. 

The best art is not always the most popular and there is a risk that the divine spark of invention that the creator God has placed within each of us – the unlimited potential of being made in the image of God – will not be fanned into existence as often as it could be.  Chasing likes is no substitute for patient inspiration.  It is often at the margins that breakthroughs emerge; art that makes us see this world in a new and divine light.   

‘Behold, I am making all things new’ says the one who sits on the throne in Revelation.  That algorithms are making all things similar is the reality we are learning to live with.