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Atonement (2007)

Starring: James McAvoy, Keira Knightly, Saoirse Ronan, Romola Garai, Vanessa Redgrave

Directed by Joe Wright

Screenplay by Christopher Hampton

Based on the novel by Ian McEwan

Produced by Tim Veban, Eric Fellner, Paul Webster

Working Title Films; Relativity Media

Rated: R

Nursing rating 2 1/2 stars

Rating guide:
excellent = 4 stars; good = 3 stars;
fair = 2 stars, poor = 1 star

Artistic rating 3 1/2 stars

The beautiful film adaptation of Atonement follows novelist Ian McEwan's characters into the carnage of World War II. But like McEwan, the filmmakers are less concerned with bombs than with the deceptive power of words, especially in the act of telling stories--stories like the book, or the movie, which adds a level of artifice in being a story based on a story. Scripted by Christopher Hampton, the film shares the novel's slightly implausible central premise. But with Joe Wright's focused direction and intense performances by the leads, the film is a compelling account of our efforts to cope with what we say to each other. Atonement also includes a limited look at the wartime nursing of aristocratic character Briony Tallis. The movie adds visuals to the book's nurse-centered account of hospital care, showing the courage required of nurses in mass casualty events and the formidable authority of senior nurses. Wright's movie does not match the force of McEwan's vision of the trauma the nurses face, the full rigor of their training, or Briony's growing skill. The film, like the book, also conveys little of the technical expertise nursing requires, and may suggest that nursing is more a vehicle for atonement than a modern scientific profession. Still, few feature films (let alone major Oscar contenders) include a nurse-centered vision of care, or convey any of the real challenges of nursing.

In 1935, on the Tallis estate outside London, 13-year-old Briony readies her first play for a family production. Briony's older sister Cecilia has recently returned from Cambridge, unsure of her next move--or her feelings for promising fellow alumnus Robbie Turner, the son of a family servant whom patriarch Jack Tallis has put through the prestigious university. Robbie considers becoming a physician. As guests arrive for a family dinner, Briony's imagination and her frustrations with her play's production distort her view of the interactions among Cecilia and Robbie. Briony does something that drastically changes all their lives. The film moves into World War II. Robbie, now a wounded soldier, joins the British retreat from France. Meanwhile, Briony and Cecilia both become nurses, despite their upper class roots, in efforts to deal with what has happened at the Tallis estate. Even as Briony trains to be a nurse, she continues to dream of writing.

The film only touches on McEwan's lengthy description of Briony's hospital-based training in London, which is a vivid, persuasive account of British nursing of the era. But the film does at least share the book's nurse-centric vision of health care. This turns the tables on the all-physicians-all-the-time model that has dominated highbrow and popular culture for decades. At least in the few scenes we get, it is the nurses who take center stage in caring for the horrifically wounded soldiers who inundate the hospital, and the physicians who are so peripheral to the story that they have no names or lines.

A picture is not always worth a thousand words. The film merely hints at aspects of the nursing experience that the novel makes explicit. We do get a sense that Briony has entered a "cult of hygiene" which resembles basic training in the military, with senior nurses as the drill instructors. To most viewers, the nurses' work will seem largely menial, scrubbing bedpans, floors and bed frames, and there is no indication here that there is also serious study. This depiction obviously does not convey the university-based education that most nurses receive today, or the scientific assessment and intervention that underlies nursing actions. In fairness, most viewers will understand that 1940 is a long time ago--though some may see parallels between the overwhelmed nurses at Briony's hospital and the short staffing most nurses face today.

Another issue is the suggestion that nursing is a potential vehicle for "atonement," rather than a profession with rewards independent of any prior obligation. The last thing nursing needs today is reinforcement of the idea that it is just a noble calling, rather than skilled, life-saving work that requires adequate resources. However, it is not improbable that these characters would choose nursing at least partly because of a special sense of duty.

When a crush of wounded soldiers arrives and pushes the nurses at Briony's hospital to their limits, the harsh regimentation of the training gives way to heroic efforts to handle extreme suffering and many patients on the edge of death. We briefly see Briony caring for their wounds, but the film cannot make as clear as the book how much her skill and confidence grow. Much has been made of the movie's five-minute tracking shot of the devastated humanity Robbie sees at the beach at Dunkirk. But the film does not devote the effort that the book does to showing how overwhelming and exhausting the wounded are for Briony and the other nurses.

The film does include one striking scene in which a senior nurse commands Briony, who speaks French, to sit with a critically wounded French soldier. Briony does so, and immediately finds herself playing along with the soldier's delusion that she is an English girl in his home village who was something of a love interest. Briony struggles with her professional role--should she play along with the soldier, potentially violating the strict codes of her supervisors? Though this scene may strike some as high-stakes handholding, it points to the vital psychosocial care skilled nurses can provide--and echoes McEwan's themes about the power of words to deceive, to inflame, and to heal.

Atonement has a brilliant final twist that throws a different light on the rest of the work, which is full of smaller twists and sly comments. Book and film constantly probe the meaning and effects of words. The film's soundtrack repeatedly features the rhythmic clacking of a typewriter, which might be a bit much.

But events while the film's production was underway add even more delicious postmodern twists to these linguistic themes. McEwan has been accused of lifting certain elements of his book from No Time for Romance, the memoir of World War II nurse Lucilla Andrews, who later became a best selling romantic novelist. McEwan has acknowledged, in Atonement and elsewhere, that Andrews's work helped him recreate the wartime hospital setting, but he has denied that Andrews was the basis for Briony.

So esteemed novelist McEwan has allegedly swiped some of the work of a nurse and romance novelist for a "serious" literary work that actually defies the prevailing cultural trend of crediting esteemed physicians for the work of nurses. McEwan stands accused of stealing from a nurse in order to give nurses an unusual level of recognition. But even more, the author of a work presenting humanity as an unreliable witness is claimed to have misrepresented the source of part of the work itself.

If McEwan is looking to atone, perhaps he should consider a nursing career.

Reviewed by Harry Jacobs Summers
Nursing Editor: Sandy Summers, MSN, MPH, RN
Reviewed January 13, 2008

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The views expressed herein do not necessarily reflect those of the Board Members or Advisory Panel of The Truth About Nursing.

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