Attending plays is not always just a passive experience. Through various means playwrights, producers, composers, choreographers, set designers, and others have available to them, they can make plays immersive and interactive for audiences. A good example, among many, is Florian Zeller’s play, The Father. 

The Father is the story of an older man with Alzheimer’s disease (André) and his progression through first living on his own, then living with his daughter (Anne), and finally living in a nursing home. Or, is it? It’s hard to tell, and that is the intention of the playwright, Florian Zeller, who in a 2021 interview with Forbes Magazine,* said his aim was, 

to tell the story from the inside and put the audience in a unique position as though they were going through a labyrinth—questioning everything they’re seeing. It also was a way for me to play with the idea of disorientation because I not only wanted The Father to be a story but also an experience. The experience being what it’s like to lose everything, including your own bearings as a viewer and to be uncertain of what is and isn’t real. It was a way for the audience to experience a slice of dementia.

The director, Doug Hughes, creates the audience experience through an interplay among set designs, lighting effects, repeated scene sequences, and time loops as circumstances for various behaviors like memory loss, paranoia, anger, and lasciviousness. All the scenes take place in one room that serves at different times as André’s flat, Anne’s flat, and André’s nursing home room. The furnishings of the room change based on the supposed setting, but the walls are exactly the same for all of them. In different scenes, André is not always sure where he is, and neither is the audience.  

Early in the play, André hears Anne tell him she’s relocating from Paris to London with her lover, but she is present to him in most of the scenes thereafter and until the end of the play when he’s told by a nurse that Anne had moved to London some time ago. Had she really left Paris and was never actually there in all those other scenes? He wonders and so does the audience. In other scenes, the way characters from the past and present enter and exit distorts time for André, and so while audience members know the linear trajectory of the disease course, they can’t be sure of where they are in that course during a given scene. With the last scene taking place in André’s nursing home room with the same walls seen in his flat and Anne’s flat, the audience can’t be faulted for wondering whether all that came before was just one of André’s hallucinations. 

The Disorienting Is Clarifying

If the play had been staged as the customary audience view of outside looking in, the audience would have merely witnessed the familiar manifestations of Alzheimer’s disease and a familiar progression of events. This view would have afforded a new appreciation for the trauma it causes to those who are not closely acquainted with the symptoms of Alzheimer’s, while those who are familiar with them could possibly achieve a measure of catharsis. Zeller endeavors to do much more by offering a view of Alzheimer’s from the inside looking out and a means to grasp the actual experience of it. He is successful when audience members find themselves working as hard as André is to discern fact from fiction, past from present, and here from there.   

This can be no easy feat for the stage, and no wonder then that the Broadway production team enlisted an “illusion consultant” (Jim Steinmeyer) and a medical advisor (Dr. Randi Diamond). The intimate experiences the actor playing André (Frank Langella) and the director (Doug Hughes) have had with Alzheimer’s disease through family members no doubt contributed to the production’s authenticity as well.  

Zeller doesn’t leave the audience members defenseless in their efforts to orient themselves. He associates André’s grasp of his own situation with the whereabouts of his watch: “I need to know exactly where I am during the day. I’ve always had this watch, you know. If I were to lose it, I’d never recover.” As André’s dementia progresses and his powers of perception weaken, we see fewer objects in Anne’s flat. In the end, Zeller is hoping that confusing and disorienting the audience members will clarify the dementia experience for them.

Notes:
*Dawson A. Florian Zeller takes viewers into the labyrinth of dementia with The Father. Forbes. March 30, 2021.
This essay is based on a live performance of The Father presented by the Manhattan Theater Club at the Samuel J. Friedman Theater in New York City that ran between April and June of 2016. 
Translated from French by Christopher Hampton.
Brain photo:  Processing language, left brain hemisphere (sagittal view). Stephanie Forkel, NatBrainLab. Source: Wellcome Collection
License: Attribution 4.0 International (CC BY 4.0)
Watch photo from Wikicommons images and licensed under the Creative Commons Attribution-Share Alike 3.0 Unported license.

Junger’s memoir, In My Time of Dying, begins with a vivid account of that potentially fatal event. An aneurysm of a mid-sized artery in his pancreas had burst, causing unchecked internal bleeding. At the hospital, Junger slipped into hypotension, hypothermia, and semi-consciousness before surgical repair, which gave him a last minute surgical “save.”  

However, the main focus of Junger’s memoir is his experience of coming “face-to-face with an afterlife.” In the hospital, his dead father appeared to him. His father “exuded reassurance and seemed to be inviting me to go with him.” (p. 37) While this was happening, Junger recalls being awake and speaking to a doctor. Much that follows is a sustained reflection on the meaning of near-death experiences, drawing on the published literature, anecdotal accounts, as well as his own encounter with dying. 

He recounts the story of Tyler Carroll, a combat medic in Afghanistan, who was critically wounded and, as he was near death, “his whole life presented itself to him simultaneously and in great detail, as if twenty-one years of experience could exist outside linear time.” (p. 80) This so-called “life review,” is a common feature of such experiences, as well as encountering deceased loved ones, hovering outside the body, moving through a tunnel of light, and “being filled with love and bliss.” (p. 82) Junger is particularly impressed with the feelings of universal unity, often followed by a profound change in patients’ perspectives on the meaning of life. In the bibliography, he cites dozens of studies documenting the prevalence and characteristics of such phenomena.  

The author was initially skeptical, “Was I blessed by special knowledge or cursed by it?” (p. 93) He first considers the view of most neuroscientists that near-death experiences are hallucinations created by the dying brain, “The overwhelming likelihood is that our sense of another reality is just a comforting illusion that helps us live our lives.” (p. 118) He then considers the minority report, i.e. well-structured visions and thought processes, along with specific memories of external events (e.g. happenings in the room) raise a number of perplexing questions about the functioning of an oxygen-starved brain.  

We have absolutely no idea how the interior world of subjectivity arises from electrical impulses in the brain. Subjectivity exists, although nothing we know about the most basic components of the universe as we know it—quarks, electrons, waves, fields—permits it. Consequently, the belief that further research on the brain itself will yield a key to consciousness must be mistaken. Junger sums up the situation, “Our understanding of reality might be as limited as a dog’s understanding of television.” (p. 118)  

Junger points out that reality at the deepest level (i.e. the quantum world) is full of paradoxes and seeming impossibilities. It fails to answer many questions about the universe, in addition to the origin of mental phenomena. Consequently, he provisionally accepts the philosophical theory of panpsychism, i.e. “consciousness is woven into the very structure of matter” (p. 136) In other words, every component (e.g. quarks, fields) of the universe has a mental aspect, as well as a physical one. (I might interject here that panpsychism is not a prevalent theory among philosophers of mind, because they believe it raises more problems than it solves.) Given this framework, Sebastian Junger concludes that human consciousness might continue after death as part of a universal consciousness. From the text, I don’t think he believes this afterlife would necessarily retain a sense of individual identity.  

My Time of Dying is a thoughtful reflection on the meaning of life from a man who has experienced a close encounter with death. Junger has created a compelling narrative, making his memoir worth reading whether you believe near-death psychic phenomena point the way toward an afterlife, or think they are hallucinations generated by the dying brain.  

1. Van Lommel P, R. van Wees, V. Meyers, and I Elfferich. Near Death Survivors of Cardiac Arrest: A Prospective Study in the Netherlands. Lancet 358 (2001): 2039=2045 

2. Parnia S. and P. Fenwick. Near Death Experiences in Cardiac Arrest: Visions of a Dying Brain or Visions of a New Science. Resuscitation 52, no. 1 (2002): 5-11 

In My Time of Dying
Sebastian Junger
New York, Simon & Shuster, 2024, 162 pp.
http://www.sebastianjunger.com/in-my-time-of-dying 
Web photo byu Sebastien Gabriel

“Should we worry about the reliability of medical knowledge?” asks philosopher John Huss (University of Akron). We consider this question from the perspective of Thomas Kuhn’s classic, 1962 book, The Structure of Scientific Revolutions. Kuhn explains how science does not evolve incrementally, one step following another, but rather undergoes wholesale revolutions disconnected from all that came before. He called these revolutions, “paradigm shifts” (to his everlasting regret). While Kuhn draws mostly from astronomy to make his case, we draw from recent and past medical examples to show how his concept applies to medicine as well. We talk about how various groups dependent on reliable medical knowledge (e.g., patients, health care professionals, educators) can be affected by the possibility of major shifts in established approaches to health care at any time. There’s no escape from reality, as the song goes.

Primary Source Citation
Kuhn T. The Structure of Scientific Revolutions, 3rd ed, Chicago: The University of Chicago Press; 1996.

Links
Russell Teagarden’s related blog posts on According to the Arts:
-Kuhn’s book, The Structure of Scientific Revolution
-Michel Foucault’s book, The Birth of the Clinic

Dr. Barry Marshall’s story of how he and Dr. Robin Warren engineered the change in peptic ulcer disease from acid based to infection based.
The Clinic & The Person Episode 12 (September, 2023), featuring the paradigm shift from lobotomies and other forms of psychosurgery to psychopharmacology.
Sir Brian May’s bio (guitarist for Queen and PhD-level astrophysicist).

The Clinic & The Person is a podcast developed by our editor Russell Teagarden to summon or quicken the attention of health care professionals, their educators, researchers and others to the interests and plights of people with specific health problems aided through knowledge and perspectives the humanities provide.

Feature photo by National Cancer Institute