Line #12 Headscratchers/RequiemForADream


1	!!That's not how to treat patients!
2	* Is shock therapy really the standard procedure for patients disoriented by drugs? Or was that put in the film just for its horror value? And not disclosing what shock therapy is to a drug-addled patient who is clearly out of her mind? Kind of against standard disclosure procedures. Obviously improper disclosure happens all of the time, but it feels like the writers just put it in to make the movie as brutal as possible.
3	** Written in the Seventies.
4	*** To clarify, the original novel was written in the seventies.
5	*** Yeah, I later found that out. However, giving no hint it's supposed to be set in another time makes it confusing.
6	** Yeah, I didn't buy that at all. I think a few months on speed is too short a time to have any permanent effects from it. It also bugs me that this film presents ECT as something sadistic and brutal when it's actually [[http://www.slate.com/id/2181158/ humane and effective]]. (In real life she would have been anesthetized.)
7	*** You're forgetting that, once again, this was written in the seventies; back then, ECT was basically used for everything and the doctors didn't really know how to utilize the technology effectively. Back then ETC usually WAS brutal and sadistic.
8	*** Agreed. ECT has developed a lot from its origins a good 80-something(?) years ago. And anaesthetic was not used, although even in the 70s, there were variations and different ways to use it that the entire psychiatric profession was arguing about. In state institutions, the state of care was downright horrifying and ECT was used as a cure for everything from simple depression to undifferentiated schizophrenia. It was either that or Insulin comas.... which were ''way'' worse. Yeah, psychiatry in America was pretty horrifying back in the day, although the quality of care varied wildly from institution to institution -- some private ones were downright wonderful by all accounts. Actually, put in the proper time context and assuming that Sara and Harry are in state hospitals and institutions - which were desperately running on low funds -- everything was a pretty bad but realistic portrayal.
9	*** The book has a minor GoodDocBadDoc subplot after Sara is hospitalized--the first doctor who treats her gives her a very cursory examination and diagnoses her with schizophrenia with orders to commit her to a psychiatric ward. A second doctor spends more time, discovers what pills she was on, and tries to argue against her being committed, pointing out that she's still being affected by the diet pills, valium, and malnutrition and her condition is likely to get at least somewhat better with regular medical care. He's overruled by his boss. In general, the last part of Sara's arc in the book is a sharp criticism of the state of psychiatric care in the 70s--the hospital she's put into is an outright BedlamHouse.
10	!!Going all the way to Florida for drugs?
11	* Why did Tyrone and Harry need to drive all the way down to Florida for heroin? Why did they need to leave NYC at all? Which, by the way, has over 10 million people?
12	** Not to mention that much of the heroin in the US comes in to New York and Newark Harbors, the absolute farthest Harry and Tyrone would have to go is across the Hudson bridge and over into Newark.
13	** None of their dealers were selling because of the gang war. Plus, IIRC, the prices in NY were getting jacked way up.
14	*** ALL of the heroin in NYC was being jacked up? Like I said before, there are 10 MILLION people in NYC, and there was that many even in the seventies.
15	*** If the gang war was big enough, yes, it could be plausible. There seemed to be several very large gangs involved and if people were angry and scared they'd stop selling. And that could be across the whole city. People who ''were'' selling would make it exclusive and profit off it by jacking up the prices.
16	*** Not to mention, the fact that Harry and Tyrone are simply not the savviest dealers on their block or any other, so they might not even know how to properly network and find better sources outside of the few they had been utilizing, and were by winter so desperate they willingly chased after a big pie in the sky possibility in the sunny climes of Florida. In the novel, there is a passage which explores the both of them realizing just how insane and far-fetched this entire plan actually is, but neither one being able to admit it to themselves or the other and turn back means they see it through to the brutal end.
17	*** I agree with the above comment. Most likely there were quite a lot of sources around if you had a clear head and went hunting for them, but Harry and Tyrone were desperate and withdrawing, with little knowledge of the drug underground. They were so desperate that they made a run for it and followed a rumor to Florida just to escape.
18	*** It's also notable lampshading that Tyrone casually gets California and Florida confused as their destination when they're talking about where they're going in the car. Their plan is quite clearly complete nonsense created out of blind desperation. It fits with the theme of what they've been doing the whole movie - chasing unrealistic pipe dreams with no exit strategy or Plan B.
19	*** As an extra note, Tyrone mentions that whatever gang war was going on, pretty much every street level dealer he knew was being killed. Clearly there isn't a drought in the whole city since Big Tim seems to have free access to heroin, but he seems pretty wealthy. By contrast, the violence level was high enough that your average addict on the street couldn't easily get their hands on any dope safely.
20	!!That's not how drugs work
21	* In the quick cut scenes when the characters use heroin, their pupil (black hole in the iris) dilates (expands) rapidly; opioids like heroin make your pupils constrict to a pin-point.
22	** They dilate very quickly because of the pain of shooting up, afterwards they constrict to a pin-point in the manner that you describe. You have to admire the attention to detail in this movie.
23	** It also seems in some scenes that cocaine is being taken - sometimes this is spliced in with the scenes in which people are shooting up. As cocaine has the opposite effect (dilating the pupils) this can also add some confusion here given how fast the camera shots are.
24	!!Mandated Reporting
25	* Well, at least Harry has the consolation that he's about to become very rich from suing the doctor and prison. Lord, ''DOCTORS AREN'T ALLOWED TO HAVE PATIENTS ARRESTED'' (unless they're threatening them).
26	** Didn't the cops arrest Tyrone (who wasn't a patient) for fleeing jurisdiction, and it wouldn't take much of a stretch to implicate Harry, seeing as he's actively helping a criminal flee jurisdiction in addition to the myriad of other crimes he could be implicated with?
27	*** Nope. The doctor saw Harry's arm, looked at him funny (while grabbing the bottles of liquid medicine), and took off, presumably to call the cops. OP is right; the doctor shouldn't have turned Harry in.
28	** 1970s, people. Nowadays, doctors are only allowed to call the police on a patient if they are a distinct danger to themselves or others. This is when there is clear evidence of suicidal or homicidal intentions, or the patient attacks someone. Back then, drug addiction was considered a sort of mental illness that was looked down upon with fear and misunderstanding. It would have been easy for a doctor to call in the cops on a sick junkie back then. Nowadays, Harry could have sued his ass off and been living in heaven. He could also have sued him for malpractice, considering the bastard didn't do anything about an obvious gangrenous and necrotizing lesion -- although back in the 1970s, the medical profession kinda sucked. Screw the Hippocratic oath.
29	*** The first known instance of "Duty to Warn" or doctors being mandated to report was back in 1976 and ''Requiem of a Dream'' debuted in 1978, suggesting it's set after 1975 but before 1978, in which case, the doctor did have grounds to have them arrested, though, it might've been more for theft than anything else.
30	!!Drugs for sex
31	* So Big Tim won't sell his drugs but will trade them for sex? Does he realize that he can use the money made from selling them to buy all the hookers he wants?
32	** It could be a power thing; he doesn't want women he can just buy off the street, he wants to control the women who need what he's offering.
33	** He seems to be doing well enough for himself as it is, maybe he's just such a rich bastard that he doesn't need to sell drugs.
34	** Not that it matters, because the main characters end up running out of money anyway.
35	** Big Tim is a pimp, not a drug dealer. He recruits addicts and uses their addiction as leverage to turn them into hookers.
36	** He seems to be quite the sadistic sociopath. Not only is he seemingly wealthy enough to not actually need money from pimping girls out, he could indeed afford to simply buy sex or use his success to attract desirable women. Instead, he seems to be a predator who gets off on degrading women and forcing them into sexual servitude. This is notable with how he constantly [[EvilLaugh chuckles with glee]] when Marion shows how desperate and isolated she is.
37	!!Using another vein
38	* Couldn't Harry just use another vein? He had lots of them. Or a different spot on that same vein?
39	** It takes too much time to search for one. He wanted the shot very fast.
40	** Yeah, it's pretty stupid. Understandable, but stupid. Also, considering the gangrenous and necrotic state of his lesion, I'm surprised he managed to shoot up through the deteriorating and thrombotic veins. Seriously, what a waste, all it is going to do is get trapped in the swelling and inflammation, rather than getting to the spine.
41	** I thought the same thing, but on a second watch: he's shooting up in a car. He's too addicted to just wait and go somewhere more private, he's got a limited range of movement due to being in the passenger seat and fully clothed, and he's right handed. He can't use his wounded arm to operate the syringe, so that's where the needle has to go in. It could also just be plain ignorance/addled judgment; at that point he's in a lot of pain and he's after the analgesic effect as much as the euphoria, he may be applying it directly to the wound in the hope of getting faster relief. Alternatively, he might think/know that the needle is filthy and he doesn't want to risk spreading the infection to a new site.
42	** As mentioned above, taking heroin in the past will have reduced the pain in the arm, which is probably one reason it took so long for him to notice the infection. Injecting it directly into the wound probably makes twisted sense in his head, as he's aware the drug is a painkiller.
43	** Depending on the person, sometimes it's difficult finding a vein. Even the medical field, it's often difficult trying to locate a good vein to tap into for collecting blood and/or injecting medicine and/or IV contrast for CT scans on people (some are easy to find, others not so much). But as mentioned above, Harry wanted to shoot up very fast and being on withdrawals clouded his judgement on looking for another vein to use.
44	!!Going cold turkey
45	* Perhaps a stupid question, but why didn't the characters ever even consider going cold turkey over the extreme fates they instead sealed for themselves? Addiction can be extremely powerful, yes, but Marion in particular seems to go completely off the deep end very quickly. If she simply bunkered down for a couple of weeks she could kick the habit, at least for as long as the dope drought lasted. Instead she goes to one of the most evil guys in the whole city and immediately sinks into completely degrading herself for drugs, seemingly for the rest of her life.
46	** Unfortunately that's truth of how it usually goes. Drugs, heroin especially, is not something you just 'quit' especially cold turkey. It's a lifelong struggle they didn't have the support or motive to do it. Maybe they will try to quit now that they have hit rock bottom or double down and stay that way the rest of their short lives.
47	*** Quitting cold turkey prolly would have made worse, as you have be ''weaned off'' heroin.
48	!!Was the call real or naw?
49	* So was the call to Sara from the TV channel real deal or was it a prank?
50	** Was there even a phone call at all?
51	*** I daresay there was, as she wasn't yet having hallucinations at that time.

Context Headscratchers / RequiemForADream