Review
Ageing
Assisted dying
Culture
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 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.

Column
Books
Culture
Music
Space
6 min read

Magnificent or mundane: how do you react to the overview effect?

Creators of a book, an album and a game, can’t agree.
A small white space capsule orbits around the earth.
A SpaceX Dragon capsule orbits above Earth.
NASA.

As I write this, two Nasa astronauts – Suni Williams and Butch Wilmore (possibly the most USA-sounding name imaginable) – are preparing to leave the International Space Station to return to Earth. They were supposed to stay on the space station for eight days, but a technical problem with their spacecraft meant they’ve been stranded in space for nine months.  

Nine. Months.  

It sounds like the premise for a horror film. Two stranded astronauts slowly descend into madness as they become increasingly isolated and cut off from humanity. Written and directed by M. Night Shyamalan, probably. 

That’s a lot of time to be stuck orbiting Earth, gazing at the pale blue dot, contemplating our little corner of the universe. There’s a phenomenon called the overview effect: a shift in thinking astronauts go through when they see Earth from space. Putting the planet into the wider context of the entire cosmos leads observers to rethink humanity’s place in the universe, and what it means to be human.  I imagine Suni and Butch have had quite a bit of time to do just that in recent months.  

And the overview effect is currently having a bit of a moment in wider culture, too.  

If you went into any bookshop in the weeks before Christmas, you likely saw stacks of Samantha Harvey’s novel Orbital. It tells the story – although there’s not much by way of traditional ‘story’ in Orbital – of six astronauts on the International Space Station, pondering the nature of humanity from their lofty vantage point. 

Having won the booker prize, booksellers were keen to encourage readers to buy Oribtal. Praised by the Booker Prize judges for its “beauty and ambition”, I was looking forward to reading it, when I could. (And, let’s be honest, it’s a short book, which probably helped sales. Who has the time to read Ulysses or Infinite Jest in between school runs and weekly shops?) 

When I finally read it in January, I was left disappointed. I found a surprising lack of humanity in Orbital. With the exception of one astronaut – who spends her time mourning her recently deceased mother some 250 miles up in the sky – the characters feel somewhat paper thin; barely human. As the story meanders from person to person, never really settling on one character long enough to really develop them, it feels a bit … insubstantial?  

Maybe it’s a victim of its own hype. Maybe the not-quite-humanness of the astronauts and the listless quality of the narrative are intentional, designed to capture the ungrounded nature of life in space in both form and content. Maybe that’s being generous. Either way, I was left closing the book and shrugging my shoulders. If Orbital was supposed to offer a glimpse into that overview effect, it left me nonplussed. 

By coincidence, Steven Wilson has just released his eighth solo album: The Overview. Who is Steven Wilson, you ask? Only “probably the most successful British artist you've never heard of” according to The Daily Telegraph. With Wilson’s album currently sitting at #1 in the UK album charts, it doesn’t seem an unwarranted title.  

In The Overview, Wilson explores the overview effect across just two lengthy pieces of music. In the first, Wilson contrasts the mundanities of life on Earth with the chaos of space, calling us to attend to miracle that is humanity, thanks to lyrics written by the annoyingly talented Andy Partridge of XTC: 

“And there in an ordinary street  

A car isn't where it would normally be  

The driver in tears, about his payment arrears 

 Still, nobody hears whеn a sun disappears in a galaxy afar.” 

With Partridge’s help, Wilson manages to capture that humanity so sorely lacking in Orbital. Amid a sea of seemingly barren space, there is life here on this small, pokey planet, and the dramas and stresses of a man fretting about his debts don’t seem out of place, even when compared to the implosion of a star on the other side of the universe.  

All this makes a recent interview with Wilson all the more odd.  

When speaking about the overview effect, Wilson says “Your life is futile, it’s meaningless – and isn’t that a wonderful thing?” before doubling down: “And I do mean that. We spend so much of our time anxious, stressed, worried about things that sometimes we just need an injection of perspective.” 

For Wilson, this perspective – this overview effect – is liberating. It allows to stop navel-gazing, to pick our heads up and to realise our freedom to do whatever we want. After all, everything’s just matter in varying different arrangements:  

“The clouds have no history 

And the sea feels no sorrow 

The oxygen recycled 

And the atoms are just borrowed,”  

At the climax of the album’s second epic, Wilson sings – with more glee than it warrants –  

“There's no reason for anything  

 Just a beautiful infinity 

 No design and no onе at the wheel.” 

 Cheery stuff. 

It's easy to see why, in the same interview, Wilson rails against the concept of religion: “Religion is a classic manifestation of cosmic vertigo … To even understand even the very simplest, most basic facts about space, should be enough to disabuse anyone of the notion of God. But apparently it doesn’t.” 

It all sounds a bit like an angsty teenager encountering the New Atheists for the first time. And this edge to Wilson’s work jars uncomfortably with the humanitarian streak that runs through his music. Wilson wants (rightly) to celebrate the mundane, the ordinary, and the human. And simultaneously wants to tell us that we’re just … stuff. Just atoms arranged in one way or another. Wilson pays lip-service to the humanity missing from Orbital, but it’s superficial.  

And all this reminds me of my favourite video game ever: 2019’s The Outer Wilds. (Not to be confused with 2019’s also-space-based-but-decidedly-mediocre The Outer Worlds). In The Outer Wilds, you play as an alien with a ramshackle spaceship who sets off to explore their solar system. Except every 22 minutes, the sun explodes. When it does, you wake up on your home planet and start again. 

You use these 22-minute loops to explore the solar system, flying manually from planet to planet, and exploring every nook and cranny of them in the process. You see awe-inspiring sights and are confronting with the absolute otherness and horror of the vastness of space.  

And yet. As you explore, you come across notes left by long-forgotten civilizations. Mundane lists and frustrated exchanges between colleagues. You come across life, in other words, even if you don’t meet many other actual people. I can’t say much more than this without ruining the game: The Outer Wilds depends on your real-world knowledge to progress, and so, the more I tell you, the more I ruin.  

But, suffice it to say that this is exactly what is missing from Harvey and Wilson’s work. While they both ostensibly want to remind us of the value and the miracle of humanity, both leave me feeling cold. Both leave me with the impression that life is little more than atoms arranged one way and not the other. Just stuff.  

But in The Outer Wilds, the sun’s implosion – and all that is lost with it – is a genuine heartbreak every single time. I think about all the stories I’ve read, and the people I’ve met, and how it’s all about to be lost as a bright supernova washes over me. And then I wake up again at the start of the cycle, relieved that all is not lost.  

If you can, you should play The Outer Wilds. It’s beautiful. Really, really beautiful. More so than Orbital or The Overview. Our place in the universe can be overwhelming; we’re small, and the universe is strange and scary. But we’re not just insignificant stuff. Our stories and the people we share them with matter. And Outer Wilds captures this tension impeccably. Only it captures life’s miraculous nature in the way it deserves. 

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