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  1. #1
    Join Date
    Feb 2007
    Location
    Boston, MA

    Joker Movie - Spoilers

    I know there's another thread, but it didn't have a spoiler header. Mods feel free to combine these two if you want.

    Saw it over the weekend. Really, really enjoyed it. So did my spouse and son. Very little not to like about it. Things I thought were great:

    Phoenix. Man oh man. If H. Ledger won an Oscar for Dark Knight, then Phoenix deserves one for this (and it would only be the 2nd time that someone won an Oscar playing the same character that another actor won an Oscar for playing). He was outstanding. And in pretty much every scene of the movie. Not many actors could have pulled that off (maybe J. Gyllenhall...maybe). He was outstanding, and made the movie. One tiny example - every time Joker ran in the movie, he ran as though he had clown shoes on, even when he didn't. So cool.

    The standup scene. Just so unbelievably painful to watch. And doubly so because of Phoenix's performance.

    The other major characters. From the mom, to the "girlfriend" to the Waynes, to the Arkham Clerk...they really cast this movie well.

    The big twist about Batman's relationship. When they put out the possibility that Batman was his brother, my mouth hit the floor. I thought it was brilliant. Then, of course, they (sort of) denied it. But did they? When the movie was over my wife was all "absolutely they are related. Bruce's dad killed it because he didn't want anyone to know. The photo at the end (with his comments about loving her smile) proved it." Of course there is no right answer, but I tend to think she's right. And what a cool twist that would be. By the way, the scene with Joker and Mr. Wayne in the bathroom was exceptional as well. In every way.

    The girlfriend. As it was happening, I was thinking "don't know if I buy this relationship," and then of course it's all in his mind. We really debated if Joker killed her and her daughter. I'm not sure. My wife and son were convinced that he did.

    The theme that it's mostly nurture that causes people to go dark. Joker was beaten as a child. Ignored by the system. Mocked by people who didn't understand his disability. And then funding was cut that helped him get treatment and medication.

    The subtle references to Batman lore. Little Bruce sliding down the pole - fantastic. Dr. Ruth as the guest when Joker comes on - fantastic. I even liked the parents getting killed, though I know some did not like that at all (hello JE)

    What I didn't like (and it's mostly nitpicking)

    DeNiro. Just thought he was poorly cast here. Would have been wonderful if they had Letterman in the role. I also didn't really buy the interaction at the very end, when Joker was on the set. Though I liked the way it all ended.

    Didn't like (at all) the song choice as Joker was going down the steps after killing the guy in his apartment. The preview had a symphonic song, that was much better. It was really the only modern song in the movie, and it didn't work for me (and then I read about the guy who wrote the song, and liked it even less).

    Not sure if I liked the final ending. My interpretation is that many years had past, and that maybe Joker was about to break out. Some have said it's possible that it all was in his head (that would be a terrible ending to me).

    Overall was intense and enjoyable. Best movie of the year thus far. By the way, it did $22M on Monday and Tuesday combined. Yes, $22M. It's an absolute lock for our Top 5 and could break $300M when all is said and done. Read there is talk of them doing a sequel. Would be great if they could do one that included Batman.

  2. #2
    Join Date
    May 2007
    Location
    Winston-Salem, NC
    This is an excellent article from a forensic psychiatrist on how mental health is depicted in Joker:

    https://www.mdedge.com/psychiatry/ar...misconceptions

    I agree with the article. But I also thought that Joker actually did much better depicting mental health themes than most Hollywood movies. Arthur writes that the worst part about having mental illness is that people expect you to act like you Don't. That is so true and so sad.

    The idea that a child enduring head trauma from severe physical abuse could be left with pseudobulbar affect seems quite plausible (though would be very rare) to me. (Though I'm not a neurologist, and I've never treated a patient with that condition). Severely physically abused kids are sometimes left with head trauma and subsequent neurological sequelae. That happens for sure.

    The scene where Arthur is seeing the community mental health provider who explains to him that funding has been cut, so he won't be able to get his medicine or see her again is a dead-on accurate theme. Her statement that the system doesn't care about the patient or the provider is dead on. (The system cares about money, and only money.) It's the rule, not the exception, for caring mental health providers to burn-out from being severely overworked with the surplus of patients they're expected to care for in horrifically limited time slots. So patients will usually lose their provider after about a year or two. This is driven by a system that doesn't pay for indicated multi-systemic treatment services. So they usually just don't happen. Reimbursement for mental health services are low, insurances often just won't pay for them, and it's constantly getting worse. NC, for example, is about to change their Medicaid to a system managed more by private health insurers who pay for even less. Patients right now, children in NC (and everywhere no doubt), are being told they'll need to change their pediatrician and may no longer be able to see their therapist or doctor. Or they'll no longer be able to see their provider because their provider just quit, and you'll have to go somewhere else. And there are few or sometimes no alternatives, even fewer who know what they're doing. Sorry for the soapbox.

    Just meant to say that the psychiatrist in the article above is correct in all her assertions. But Joker and Phoenix's brilliant performance also get a lot right with their portrayal of problems with modern mental health "care." (and lack thereof in every sense of that word).

    Of course the answer is not and should never be just shooting people, regardless of whatever cruel thing they have done. That theme may anger and turn-off many viewers, as well it probably should.

    But I liked much about this imperfect and sad movie. I'll see it again.
    Last edited by richardjackson199; 11-02-2019 at 01:43 PM.

  3. #3
    Join Date
    May 2007
    Location
    Winston-Salem, NC
    https://www.mdedge.com/psychiatry/ar...misconceptions

    I'm going to further disagree some with the article written above, which, like I said does make lots of good points.

    But I don't think Arthur's mental illness is as "unclear" as they hint. Just because we aren't told his diagnoses doesn't mean they aren't realistic.

    What are his likely diagnoses? Certainly the pseudobulbar affect from the traumatic brain injury for which he'd need to see a neurologist. A psychiatrist would also screen him for PTSD. But Arthur doesn't appear to have PTSD even though he certainly has a history of severe trauma. Arthur doesn't remember his trauma presumably because he was so young and injured, he isn't having flashbacks or nightmares of it, he isn't showing avoidance, and he isn't really aware of the trauma until he reads his Mom's medical records.

    What Arthur likely has is Schizoaffective Disorder, bipolar type. Severe Major Depressive Disorder with psychotic features would also be on the differential. Bipolar 1 Disorder with psychotic grandiose delusions is on the differential. But Arthur's meds are helping him. Because when the meds are stopped he becomes more grandiose, more euphoric, and more manic. It actually makes perfect sense that as a patient stops his meds and becomes more manic that he dresses with exaggerated, flambuoyant colors, gets more confident, more self-esteem, and becomes a better dancer. Grandiose manic patients are going off the rails, but often don't realize that because they feel better. Arthur's journal shows disorganized, probably tangential or loose associations of thought disorder or mania. He clearly has positive symptoms of psychotic delusions. The most unrealistic part is the visual hallucinations of the girlfriend, but that can be forgiven because it made great Hollywood and helped their twist. Real psychotic psychiatric patients like this don't usually include complex visual hallucinations with their delusions unless they are on drugs. And in addition to manic episodes without meds, Arthur has major depressive episodes with meds. Bipolar depression in a bipolar (or schizoaffective) patient can be tough to treat even when on meds.

    Is seeing a patient like this unrealistic? No, not really at all IMO. Arthur has a family history of Mom with a psychotic disorder. His brain would be even more predisposed to a psychotic disorder with a history of malnourished neglect and traumatic brain injury. And any psychiatrist who sees lots of difficult patients knows they often present with multiple comorbid psychiatric problems, including some rare neuro diagnosis like this. The toughest ones will have something more rare and organic medical that just makes everything that much tougher. After a TBI, that wouldn't be unrealistic.

    Is 7 meds bad medicine? Not necessarily. Sure we would try to stabilize someone like Arthur on something like Abilify which ideally would stabilize any mania, help depression, and treat the psychosis. But tough psychotic patients especially with delusions and traumatic brain injuries often cannot be stabilized well on 1 medicine. A good psychiatrist might need to have Arthur on an anti-epileptic mood stabilizer (like Depakote, Lamictal, or both at appropriate dosages); an anti-psychotic, possibly low dose of an SSRI if it helped the depression and anxiety, something for sleep, maybe something for autonomic anxiety or hypervigilance (like Intuniv), and something prn for anxiety. Or more likely a patient like this who has been passed around to different community mental health providers with likely past hospitalizations can just end up on multiple meds that are not best treatment. If the patient is relatively stable on the meds, then the meds often aren't changed or aren't changed much at one time.

    So the author of the article is right in that most mental health patients are not violent. But they clearly need help, and they certainly can be. It's true the patients probably feel like many of their providers don't listen because the providers are so rushed for time in the visits they just "ask the same questions." But any competent provider HAS to ask if they are thinking about hurting themself or someone else.

    So I think Joker's film-makers and certainly Phoenix actually did an outstanding job portraying many mental health themes in a mostly realistic way.

  4. #4
    Join Date
    May 2007
    Location
    Winston-Salem, NC
    Quote Originally Posted by Udaman View Post
    I know there's another thread, but it didn't have a spoiler header. Mods feel free to combine these two if you want.

    Saw it over the weekend. Really, really enjoyed it. So did my spouse and son. Very little not to like about it. Things I thought were great:

    Phoenix. Man oh man. If H. Ledger won an Oscar for Dark Knight, then Phoenix deserves one for this (and it would only be the 2nd time that someone won an Oscar playing the same character that another actor won an Oscar for playing). He was outstanding. And in pretty much every scene of the movie. Not many actors could have pulled that off (maybe J. Gyllenhall...maybe). He was outstanding, and made the movie. One tiny example - every time Joker ran in the movie, he ran as though he had clown shoes on, even when he didn't. So cool.

    The standup scene. Just so unbelievably painful to watch. And doubly so because of Phoenix's performance.

    The other major characters. From the mom, to the "girlfriend" to the Waynes, to the Arkham Clerk...they really cast this movie well.

    The big twist about Batman's relationship. When they put out the possibility that Batman was his brother, my mouth hit the floor. I thought it was brilliant. Then, of course, they (sort of) denied it. But did they? When the movie was over my wife was all "absolutely they are related. Bruce's dad killed it because he didn't want anyone to know. The photo at the end (with his comments about loving her smile) proved it." Of course there is no right answer, but I tend to think she's right. And what a cool twist that would be. By the way, the scene with Joker and Mr. Wayne in the bathroom was exceptional as well. In every way.

    The girlfriend. As it was happening, I was thinking "don't know if I buy this relationship," and then of course it's all in his mind. We really debated if Joker killed her and her daughter. I'm not sure. My wife and son were convinced that he did.

    The theme that it's mostly nurture that causes people to go dark. Joker was beaten as a child. Ignored by the system. Mocked by people who didn't understand his disability. And then funding was cut that helped him get treatment and medication.

    The subtle references to Batman lore. Little Bruce sliding down the pole - fantastic. Dr. Ruth as the guest when Joker comes on - fantastic. I even liked the parents getting killed, though I know some did not like that at all (hello JE)

    What I didn't like (and it's mostly nitpicking)

    DeNiro. Just thought he was poorly cast here. Would have been wonderful if they had Letterman in the role. I also didn't really buy the interaction at the very end, when Joker was on the set. Though I liked the way it all ended.

    Didn't like (at all) the song choice as Joker was going down the steps after killing the guy in his apartment. The preview had a symphonic song, that was much better. It was really the only modern song in the movie, and it didn't work for me (and then I read about the guy who wrote the song, and liked it even less).

    Not sure if I liked the final ending. My interpretation is that many years had past, and that maybe Joker was about to break out. Some have said it's possible that it all was in his head (that would be a terrible ending to me).

    Overall was intense and enjoyable. Best movie of the year thus far. By the way, it did $22M on Monday and Tuesday combined. Yes, $22M. It's an absolute lock for our Top 5 and could break $300M when all is said and done. Read there is talk of them doing a sequel. Would be great if they could do one that included Batman.
    I agree - Phoenix deserves an Oscar. I'm shocked if he doesn't win best actor.

    I think your wife is right - the photo at the end with "I love your smile" reveals the relationship between Batman and Joker is real. And how cool is "I love your smile" as that reveal in a Joker movie?

    I actually liked DeNiro in the movie, given the obvious Taxi Driver parallel. You're right - Letterman would have been perfect and better in that role. But I think DeNiro is always fantastic, and I thought he pulled this off. He's a little stiff as a comedian, but he had a dry, wry smile about it that worked well enough.

    I agree - the song choice on the stairs was garbage and seemed out of place in the movie. I loved the rest of the soundtrack. I assume this song was meant to apply to younger audiences and help box office numbers since it sounds more like something poppy they would listen to on the radio.

    I agree with you on the Final ending, though I liked it. It would be terrible if the whole movie was all in his head. Sure that's possible, but that's not it IMO. I agree with you that years have passed and he's about to break out. It sets it up perfectly for a possible sequel. And with this kind of money, I'd bet a pie that there will be one.

    Loved your post.

  5. #5
    Join Date
    Feb 2007
    Location
    Hot'Lanta... home of the Falcons!
    There has been a lot of talk about a sequel. Well, still no definitive word on that but the success of Joker has inspired Hollywood to try similar projects. Here's a film coming soon that seems to really capture the essence of Joker.

    I don't know what you are doing right now, but if you aren't listening to the DBR Podcast, you're doing it wrong.

  6. #6
    Join Date
    Feb 2007
    Location
    Deeetroit City
    Quote Originally Posted by JasonEvans View Post
    There has been a lot of talk about a sequel. Well, still no definitive word on that but the success of Joker has inspired Hollywood to try similar projects. Here's a film coming soon that seems to really capture the essence of Joker.

    Is it just me, or does SNL seem like it is getting better? Of course not 70s level good, but better than the last decade or so?

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