Review

Ageing

Assisted dying

Culture

27 March 2023

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

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

America

Books

Culture

Politics

2 November 2024

8 min read

James Davison Hunter: diagnosing America’s health

A great experiment is depleted, and nihilism slips into the void.

Roger Standing

Roger is a Baptist minister, author and Senior Research Fellow at Spurgeon’s College in London.

Riot police stand guard outside a White House fence line.

The White House, June 2020.

Angela N., CC BY 2.0, via Wikimedia Commons.

It was unsettling. Disturbing. And in the months since, it has proven to be a powerful and haunting image, etched in my memory. Thinking about it now has exactly the same chilling effect.

So, it was earlier this year. I was at the cinema with a friend, sitting comfortably and waiting for our movie to start. Our shared love of Sci-Fi had taken us there that afternoon. Not unexpectedly, up pops the reel of trailers. Fast paced, dramatic and with loads of loud music, they’re either enticingly engaging or mercifully short.

On this occasion the climax of the reel saw America engulfed in a modern-day civil war. And the image?

A man is pleading, ‘There’s some kind of misunderstanding here, we’re Americans, okay?’

There’s a pause. The music stops. Silence. It’s a long pause.

Then the camera pans to a man in military fatigues, with sunglasses and a rifle sitting ominously on his hip, cocks his head and responds:

‘Okay … [another pause] what kind of American are you?’

Guns cocked, the trailer explodes back into life.

Our movie was really good. My friend’s company, as usual, was delightfully affable. But the image that remains echoes with that question, ‘what kind of American are you?’

I have to confess, I love America. I studied there. I have good friends there. I gorge on American food. I watch American football with my son, every week, on a pay-per-view live stream with real US TV ad breaks (‘Go, Pack, Go!’). In my personal experience Americans are some of the kindest, most thoughtful and most generous of people.

Maybe that’s why I’ve found the image so troubling. Not that it was some kind of fantastical dystopian depiction, but rather that it portrayed something altogether more plausible. Especially in the light of the ‘storming of the Capitol’ on January 6, 2021, the epidemic of mass shootings and the ongoing violent rhetoric on both sides of the political divide.

How do you square the circle of America? How do kindness and generosity sit alongside gun violence? Is the country on the brink of civil war?

Back in 1991 the University of Virginia sociologist James Davison Hunter’s book, Culture Wars: the Struggle to Define America suggested that cultural controversies would be increasingly significant in American politics. At the time not everyone agreed and some even pushed back against such an overblown prediction. Time, however, has vindicated Hunter’s reading of the runes. The ubiquity of his ‘culture wars’ epithet is the proof of his pudding.

Hunter’s latest offering picks up the story once more. Using the present situation in America as a case study, his reflections ‘bookend’ his earlier thinking. However, Democracy and Solidarity is not an extended commentary exploring the rise of populism and the radical right, or the snowflake, woke elitism of the socialist left. Rather, it seeks to understand why the sentence that opens his preface is true: ‘Democracy in America is in crisis.’

Grievance and hurt issue in rage, the unchallengeable moral authority of ‘my personal experience!'

For Hunter, understanding what is going on in a culture requires diving deep into the sources it draws on. What forms it? What drives it? All too easily we focus on the observable and what we can see. The stuff that happens and the values, beliefs and institutions that comprise our common life.

But that is to miss the deeper structures of culture that are formed by our tacit assumptions and the latent frameworks of meaning that nestle unseen and form the cultural architecture that surrounds us. The power of culture is demonstrated by how far it is taken for granted’.

In an interview Hunter likened his approach to be the difference between weather forecasts and climate studies. Or, to put it another way, moving from ‘the politics of culture’ to ‘the culture of politics.’

Beginning at the beginning, Hunter goes to the origin story of the nation. Deeply influenced by the principles of the enlightenment the Founding Fathers of the United States set about their task of nation building. Proposed by John Adams, Benjamin Franklin and Thomas Jefferson in 1776, the national motto on the Great Seal of the United States, E Pluribus Unum (Out of many, one), summed up their political objective. The creation of solidarity. The glue that binds a society together.

The genius of the Enlightenment in America was that it facilitated this solidarity. What was created was a ‘Hybrid-Enlightenment’, fusing the insights of French and British intellectuals in a context deeply influenced by the faith of religious dissenters, with the Puritans chief among them. The blending of the secular and faith insights from the Enlightenment was what provided its robust inclusivity and durability. For Hunter, this proved key because:

“In the end, the hybrid-Enlightenment in America was a broad enough and opaque enough amalgamation to encompass substantial diversity and the tensions that diversity implied.”

This opacity enabled different groups to see themselves in the enterprise and gave wider American society an ability to absorb a plurality of views, opinions, and traditions. A commitment to Enlightenment rationality also then provided the tools whereby differences could be ‘worked through’ in reasoned debate. Thus, the culture was a living thing, growing, evolving and developing. All the time maintaining the wider solidarity, the ‘buy-in’ from the different communities and constituencies that comprise America.

Opacity also meant that tensions and contradictions were part and parcel of the endeavour from the start. There may have been a promise of freedom, equality and universal justice for all, yet historically these have been denied to large tracts of the American population. But still the centre held, and solidarity was maintained. As Abraham Lincoln presciently reflected in his Second Inaugural Address, given on March 4 1865, shortly before his assassination and the end of the Civil War:

“[We] read the same Bible and pray to the same God, and each invokes His aid against the other. … [Yet] the prayers of both could not be answered—that of neither has been answered fully.”

The problem today, as Hunter discerns it, is that the elements of the hybrid-Enlightenment are unravelling. He sees a number of contributory causes to this escalating collapse.

Right at the centre is an amoral, materialistic and individualistic neoliberalism which reduces everything to economics and the market. This is deeply corrosive of community and solidarity.

Then there is the fruit of postmodern scepticism that has filtered down from the intellectuals into the general population. Truth is deconstructed, experts are distrusted and misinformation, disinformation and fake news abound.

Widespread immigration also plays a part. It intensifies American pluralism and brings into the country those who are unfamiliar with the legacy of the hybrid-Enlightenment and for whom the national mythos of America is either strange or incomprehensible. Far from being taken for granted, their worldview does not fit.

The growth of identity politics further complicates the unravelling. Solidarity, rather than being found in the national vision, is achieved by defining ‘us’ over and against ‘them’. It doesn’t foster cohesion, it seeds division. Grievance and hurt issue in rage, the unchallengeable moral authority of ‘my personal experience!’ As with Nietzsche, this acts as a narcotic against the hurt, an anaesthetic for the pain.

Of course, identity politics has no room for reasoned debate and mutual resolution. All that matters is the outcome of the zero-sum game where the justice of my position is both acknowledged and acted upon, and you lose. Whether that identity falls on the political right or left, it doesn’t matter. Family, sexuality, public education, the news media, the arts, the law, electoral politics, you name the issue the game play is the same.

Solidarity always involves drawing boundaries. Even the hybrid-Enlightenment drew the line between what was acceptable and what was unacceptable. Who was a part of us, and who was not. Without boundaries there is no identity. It is just that now, identity politics require the boundaries to be much more tightly drawn. “What kind of American are you?”

In all of this, America’s cultural resources for ‘working through’ these issues have been seriously depleted as the hybrid-Enlightenment has unravelled. Into the void, observes Hunter, a form of cultural nihilism slips in. It is far from being all-pervasive, and he maintains that few Americans are nihilists. Yet as a cultural reality he sees it in the prevailing tendencies towards ‘epistemological failure’, ‘ethical incoherence’ and ‘existential despair’. Then, deriving from these he adds a fourth, ‘political annihilation’ and the will to obliterate everything that obstructs acquiring power by destroying enemies completely.

Does it all seem rather depressing?

Hunter admits that he has neither proposals nor a plan to address the crisis he so eloquently describes and accounts for. Yet he concludes:

“… truth be told, I myself am very hopeful – not because I don’t see the seriousness of the problem and its dangerous implications, but because I believe that the times are full of real opportunity if one has the eyes to see them. Sadly, my eyesight is not very good. … [but] without real images of a better world, without myths of a completion of the past in the future, without a world ordered towards goodness, truth, and beauty … We become something like Nietzsche’s ‘last men’.”

I’m grateful to Hunter. I think I understand my American friends, their country and their present challenges better for his insights. As for the possibility of a civil war, he thinks it’s unlikely as the ‘red and blue’ are too intermingled and economically interdependent across the country. In the meantime, political violence will continue to be a very real threat.

As for the future he hopes for, it requires a paradigm shift to imagine and articulate a new vision of public life. It needs the cultural resources of a reconstituted humanism, drawing on the rich insights available in a genuinely pluralist society. Resources that embrace the faith wisdom of exemplars like Martin Luther King, Mohandas Ghandi and Thích Nhất Hạnh. Resources that include a retrieval of the fundamental principle of forgiveness. Without the realism to accept that none of us are perfect, we’ll never be able to live together. As the influential political theorist Hannah Arendt wrote in The Human Condition (1958):

“Without being forgiven, released from the consequences of what we have done, our capacity to act would, as it were, be confined to one single deed from which we could never recover; we would remain the victims of its consequences forever.”

Arendt’s insight is altogether more telling when seen in the light of her experience as a German Jew under the Nazis. And if forgiveness is too high a bar, at the very least we have to somehow learn to let things go and move on.

Hunter is under no illusions, such a paradigm shift remains a long haul away.

But he is hopeful.