Saturday, April 26, 2014

Best Documentary Short Highlights - Man Alive! (1952)

Well, well. Who knew that I still have stuff to review that didn't require me to travel all the way to Miami? As you know there have been a handful of animated shorts that competed in the Best Documentary Short category instead of the more traditional Best Animated Short category that I've spent the past two years reviewing. I've really tried to pick out the ones that were animated, but it's been a challenge since the Best Documentary Short is the ugly stepsister of the short categories, and most of the nominees fade away to obscurity. I've tried searching which of the nominated films had been animated, but there's just been such a dearth of information about each nominee that I really have no idea which ones are animated or not.

Well, as it turned out there was one animated documentary out there. And it was none other than Steve Segal, my old History of Animation professor, that clued me in about it.

Earlier this month Steve Stanchild of Thunderbean Animation posted an article about his Top 5 Favorite Finds and invited users to list their own favorite finds or most wanted films. Well, I check the comments and there was Mr. Segal dropping a list of Oscar nominated short films among his most wanted: How War Came, Rippling Romance, Why Man Creates. And then he dropped a bombshell:

Man Alive! by Bill Hurtz – UPA (Oscar nominee in the documentary category)
I was stunned. Was there really a film made by UPA made in the Best Documentary Short category? I went and checked, and while the Wikipedia was unenlightening other than such a film exists, having been nominated in 1952, the IMDb page showed that yes, it was produced by UPA, the animation studio behind such classics as Gerald McBoingBoing, Rooty Toot Toot, The Tell-Tale Heart, and Trees and Jamaica Daddy. Well, I thought, if such a film exists, then I'd better go about watching it. Unfortunately, it doesn't seem to be hanging out online, but I saw in the original post that Mr. Stanchild add that Man Alive! was available in the Mid-Century Modern Animation Volume 2 DVD that Thunderbean Animation put out. I quickly snatched up a copy, and while the shipping was a bit slow, it finally came in when I was at San Francisco for Babscon, and I was able to watch the film and review it.

Man Alive! tells the story of Ed Parmelee, an anxious fellow that deals with any problems he's facing with outright denial driven by fear. It can present itself in ways that include playing dumb, humor, icy disdain, or anger, but he always ignores the problem, at least until he can no longer do so anymore. Initially his anxiety was related to his car after it started to make strange noises. He ignored the problems until his car stopped running at all. He listened to the advice of some people standing nearby, tried buying a liquid at a local car shop, and even took his car to a shady garage. In the end, he had to take his car to the local garage, where his repairs cost him more. However, that's not the only worry that's been on Ed's mind. He's been having indigestion problems, and he saw a billboard listing it as an early warning sign for cancer. It's been causing him a lot of anxiety, but he's going about it the same way as he did his car. Is that the right thing to do?

Ah yes, cancer. It's the medical scourge of modern society. It's one of the medical entities that everybody knows but few people ever want to talk about. The fact is that just being alive is enough to put anybody at risk for getting cancer, since practically everything can be something that can lead to cancer, whether it be sunlight, fatty foods, burnt food, alcohol, acid reflux, or everybody's favorite vice: smoking. Of course it's not a new problem. The American Cancer Society was established 100 years ago, and it's been over 60 years since they commissioned this film. There have obviously been a few advances in the study of cancer since 1952. At one point the film espouses some facts about cancer that aren't quite true. For example, it says "cancer is not contagious" and while most cancers aren't, there are a few cancers related to infections, most famously human papillomavirus causing cervical cancer. Then it says "cancer is not hereditary" and while most cancers aren't hereditary in the Mendelian sense, there are numerous cancers related to genetic mutations, most famously BRCA1 mutations leading to increased risk of breast and ovarian cancers. And finally it says "cancers are curable" and while there are cures for many cancers, there are unfortunately certain cancers that are beyond cure, and most of them are related to cancers not detected until it is in the late stage, and that's what makes early detection important. And that is something that is as applicable today a it was in 1952.

One key component of the film was the identification of seven warning signs of cancer, and wouldn't you know the American Cancer Society still uses those same signs. They are very non-specific, meaning there are many things other than cancers that can cause these signs, but it is still important to consider.
  • Sores that do not heal can be certain forms of skin cancer or oral cancer, or it could be related to conditions unrelated to cancer such as diabetes or infections. 
  • A lump or thickening in the breast or other parts of the body can be breast cancer, testicular cancer, or lymphomas
  • Unusual bleeding or discharge can be a sign of various cancers depending on where the cancer occurs. Abnormal vaginal bleeding can be cervical or endometrial cancer in post-menopausal women. Blood in the stool can indicate colon cancer. Blood in the urine can be bladder or kidney cancer. Bloody discharges from the breast can be breast cancer, and bloody sputum can indicate lung cancer.
  • Changes in a wart or a mole can be any type of skin cancer, of which the greatest concern is with melanoma, which is just the most invasive skin cancer out there. 
  • Persistent indigestion or difficulty in swallowing can be a sign of esophageal cancer (of which long-standing acid reflux and alcohol / tobacco use are known risk factors), stomach cancer, or oropharyngeal cancer.
  • Persistent hoarseness or cough can be lung cancer or oropharyngeal cancers.
  • Change in bowel or bladder habits could indicate colon, bladder, or prostate cancer. 
There are others of course, including white patches in the mouth that can't be scraped off (known as leukoplakia, which is a harbinger for oral cancers), unexplained fatigue, persistent pain or fevers. As I mentioned, these signs don't necessarily mean cancer, but as the film argues if you have these signs you shouldn't sit on these but rather go see a physician right away.

There are other screening methods for early detection of cancer that have come up since 1952, including the colonoscopy, mammogram, and pap smears. Colon cancer is the third leading cancer killer in both men and women, partially because it is so prevalent. While signs such as unexplained weight loss or changes in bowel habits can be sign of cancer, it can often go undetected, which is why the development of the colonoscopy has been such a great tool. Colon cancers don't just appear out of nowhere. They usually start out as benign polyps that progress to cancer. With the colonoscopy, gastrointestinal specialists can visualize the entire colonic tract and look for any polyps that they can snip off and send to pathology. It is highly recommended that everybody get a colonoscopy at 50 or even 40 if you've had a first degree relative that had been diagnosed with colon cancer before the age of 50. Unfortunately, a lot of people avoid the colonoscopy because of their fear of the procedure, but then you would become like Ed in Man Alive!

Similarly, the mammogram has done the same in the detection of breast cancer, which is the most common cancer in females and the second leading cancer killer among females. The mammogram is relatively quick and painless, and can detect unexplained densities that could mean cancer. The American Cancer Society recommends annual mammograms starting at the age of 40. Finally as we mentioned cervical cancer is caused by infection with the human papillomavirus. These infect the cells in the cervix that leads to changes in the cervical cells. With the pap smear, cells from the cervix can be obtained and looked under the microscope to look for these changes. It is highly recommended for females above the age of 21 to have a pap smear done regardless of sexual history and can be repeated every three years if normal. Once they hit 30 the pap smear can be combined with testing for HPV RNA that can be done every five years if normal.

Some of the guidelines for screening testing are a little bit more unclear. For example, prostate cancer is the leading cancer and second most common cancer killer in men. The PSA screening test has been done to screen for prostate cancer, but the US Preventative Services Task Force has recommended against doing the test as according to their studies it is rather non-specific (levels may still increase in benign prostatic hyperplasia) and has not been shown to decrease the mortality rate in patients with prostate cancer. Still, there is some utility to the test, especially looking at rates of increase, and urologists (the specialty that specifically deal with prostate cancer once it is diagnosed) have said that it is still important to test, although it may be done at the age of 55 as opposed to the usual 40, and to stop at the age of 75. Similarly, lung cancer is the leading cancer killer overall, and there have been proposals of doing screening CT scans in patients with risk factors, namely smoking. There are still no recommendations to doing this screening test, although that is something that may be changing soon. Nevertheless, it is still important to talk to your physician about the risks and benefits of these tests, as is the case with any test.

And there is no better way to treat cancer by preventing it from happening in the first place. While many carcinogens are unavoidable, there are a few that are, the leading of which is none other than...SMOKING! That's right, everybody's favorite vice has the nickname "cancer stick" for a reason. I've already discussed the dangers of smoking in my review for The Drag, but it's well worth repeating. It has been implicated in not only lung cancer (#1 cancer killer by the way), but also esophageal, oral, oropharyngeal cancers, kidney and bladder cancer, and pancreatic cancer (which is only the #4 cancer killer, but is #1 in terms of mortality rate.) Not only that, but it is a major risk factor in some other deadly non-cancer conditions including heart disease, stroke, and chronic obstructive pulmonary disease (which are the #1, 3, and 4 killers overall) as well as osteoporosis and even cataracts. Smoking is such a health hazard I don't see how tobacco companies can get away with all that they do. Quitting smoking is the best thing that you can ever do for yourself.

Anyways, more about the film. It does have some didactic moments regarding basic pathophysiology of cancer, but overall it plays out in a rather simple but wholly entertaining way, showing Ed as he argues with his wife about the car and his gastric problems. It first shows Ed's problems with his car before going on to discuss the issues with his health. The car analogy is quite apt as it's a frequently used example when dealing with patients who don't go to the doctor because they "never feel sick." The narration is done in simple terms that should be understood by all, and the narration is accompanied by clean, simple imagery. The film does use the age old technique of having Ed transform to fit the particular archetypes. For example, when feigning ignorance he turns into a kid with a Dunce cap, and then into a clown when he uses humor (in a scene highly reminiscent of John Canemaker's The Moon and the Son.) The technical shots are mostly static imagery but should be understood by all. The animation doesn't quite get to the level of detail of Disney or MGM or even Warner Bros., but it is quite detailed for UPA. The backgrounds are quite complete, and the character design has that nice caricatured look. It's serviceable for the purpose of the film. The voice over work is fairly well done.

Man Alive! is a film in the same vein as Chuck Jones's Oscar winning So Much for So Little, a film that uses animation to promote public health concepts. It's both entertaining and educational, and one that may still be relevant today, especially as cancer is still very much an important cause of morbidity and mortality. It received a well deserved Oscar nomination, but alas it went up against Norman MacLaren's masterpiece Neighbours, competing in the wrong category, and predictably lost. Still, it is a film worth watching not only for its place in animation history, but to help spread the message of cancer detection and close follow-up.

Sadly, the film is not readily available online. It is available on Thunderbean Animation's Mid-Century Modern Animation Volume 2 DVD, which not only includes Man Alive! but many other classic UPA films such as their famous The Brotherhood of Man. I also highly recommend you to go out and get your colonoscopy / mammogram / pap smear if you are within the age range and haven't gotten it yet.

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