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Angels in America (2003)

Starring Al Pacino, Meryl Streep, Emma Thompson, Jeffrey Wright,
Mary-Louise Parker, Justin Kirk, Ben Shenkman, Patrick Wilson

Directed by Mike Nichols

Screenplay by Tony Kushner, based on his play

HBO Films

Nursing rating 4 stars
Artistic rating 4 stars

Jeffrey Wright, Al Pacino, Angels in AmericaMike Nichols' "Angels in America," based on Tony Kushner's extraordinary play, includes one of the best depictions of nursing in feature film history. The six-hour movie is a dazzling exploration of faith, politics and sexuality in the United States soon after the start of the AIDS era. It features Nichols' assured, inventive direction and excellent work by Jeffrey Wright, Meryl Streep, Al Pacino and the other major actors, some taking multiple roles, as in the play.

"Angels in America" is set mainly in late 1985 and early 1986 in New York City. Adapted from a play subtitled "A Gay Fantasia on National Themes," it focuses on two AIDS patients: Prior Walter (Justin Kirk), a stylish, witty young man from a very old family, and Roy Cohn (Pacino), the corrupt lawyer and power broker who made his name as a key aide to the witch-hunting Sen. Joseph McCarthy during the 1950's "Red Scare."

As Prior begins to deteriorate soon after his diagnosis, he is abandoned by long time lover Louis (Ben Shenkman), whose self-involved, progressive intellectualizing leaves little room for others--especially others with a scary and messy terminal illness. Prior's close friend Belize (Wright), however, is an AIDS nurse and ex-drag queen who employs skill, cynical wit and tough love to keep Prior alive and sane. Cohn gets his diagnosis while trying to fend off attempts to revoke his license to practice law, in part by placing a young protégé, the straight arrow Mormon lawyer Joe Pitt (Patrick Wilson), in the upper reaches of the Reagan Justice Department. Joe, a federal appellate court clerk, is trying, but failing, to keep himself in the closet and his unsatisfied, Valium-addicted wife Harper (Mary Louis Parker) from falling apart.

When Joe meets and starts to fall for Louis, who works as a word processor at the court, the two plotlines converge. Cohn ends up on Belize's AIDS ward, where Belize provides him with a measure of comfort and dignity, even as they trade high grade invective across a chasm of mutual loathing. Prior, who is in and out of the hospital, is visited by the hermaphroditic, sexually charged Angel (Emma Thompson), who urges him to spread a prophecy of stasis--to stop moving--until the return of God, who abandoned the world after the 1906 San Francisco earthquake. Prior also develops a relationship with Joe's mother, Hannah (Streep), who has come from Salt Lake City to sort out her son's homosexuality and find the missing Harper.

Kushner and Nichols develop something approaching a gay male cosmology, a seemingly apocalyptic yet comic and hopeful meditation on faith, morality, mortality, love and sex: the Book of Miss Thing. It is also a work of political outrage. Kushner sees deadly hypocrisy everywhere, not only in Cohn's corruption and intolerance, but in Joe's naive conservatism and Louis' facile, self-centered liberalism. He does not see two sides to every question: there really are no positive conservative characters, and when Louis finally realizes the full import of Joe's politics, confronting him with some of his court opinions, Joe's defense is notably weak.

Countering the play's vision of right wing oppression is the kind of hard-nosed, compassionate effort to help others that Belize displays--what we might call nurse humanism. Indeed, the harsh, bigoted land the characters inhabit seems redeemable not so much by any divine grace as by the daily efforts, the "Great Work," of people like Prior, who actually resists the Angel's vision, Hannah, who overcomes her homophobia to forge new bonds, and of course, Belize. AIDS will kill many, but the gay community--and the human community, black and white, Jews and Mormons--will not be still or go back, for as Prior declares, "[t]he world only spins forward."

Not everything works. Nichols and Thompson don't seem quite sure how to present the Angel and some of her scenes come off as confused. At times we have the impression of watching someone film a dress rehearsal of a play, which can be a little dry. And though Kushner has trimmed some of the massive play's more extraneous bits, others remain.

Emma Thompson as Emily NP, Angels in America"Angels in America" rightly places nursing at the center of AIDS care. Thompson turns in a linguistically odd but engaging performance as the autonomous nurse practitioner Emily, who appears to direct Prior's AIDS care. No physician is shown here. Emily (right) confidently assesses Prior's condition, monitors his treatment and helps him confront his fears. She does not share Louis and Prior's cultural knowledge--she has not heard of the Bayeux Tapestry--but her constancy and positivity make Louis look painfully inadequate. Emily, as Thompson plays her, with a butch haircut and arm tattoo, might be seen as a lesbian stereotype, but nothing is said about her sexuality, and there is nothing stereotypical about her expert, caring work.

The main nurse character is Belize, masterfully played by Wright. Belize is the strongest positive character in the film, as he works relentlessly to meet his obligations as a friend and a nurse while his community seems to fall apart. Yes, he is a flamboyant gay male nurse, but with his moral courage, piercing wit, and flashes of anger and bitterness, he is not a stereotype. Belize continues to see the guilt-ridden Louis even after Louis has betrayed Prior. Belize treats Louis with a mix of weary tolerance and righteous impatience.

When Cohn's upper-crust physician Henry comes to have the dying sociopath admitted to Belize's AIDS ward one night, Henry is clearly annoyed that Belize, who is on the phone with Prior, does not jump to attention at his arrival. Henry sniffs that nurses are supposed to wear white. Belize responds that physicians are supposed to be home in Westchester, asleep. When Henry informs Belize that the new admit is a "very important man," Belize responds: "Oh, OK, then I shouldn't [mess] up his medication?" In other words, I am a professional, just like you.

But Belize's most striking interactions are with the impossibly obnoxious Cohn. Cohn himself notes that Belize is his "negation," an openly gay black nurse who will "escort me to the underworld." Cohn lashes out at Belize from the first moment, as he doubts Belize's skill in starting his IV and calls him names. Belize immediately puts Cohn in check by threatening to make it hurt--not necessarily a model for nursing practice.

Yet when Cohn admits to his own need for human contact, Belize is honest with him about his likely fate. He also advises Cohn to avoid the radiation the physicians will push on him, and when Cohn wonders why he should trust a nurse instead of his "very expensive, very qualified WASP doctor," Belize snaps: "He's not queer. I am." With luck viewers won't think this is the sole reason for Belize's expertise--any good AIDS nurse could have given the same advice. Belize even advises Cohn, who has pulled strings to get into an exclusive early AZT trial, to beware of the "double blind," which may result in him getting a placebo instead of the real drug. Obviously, this is contrary to standard practice--clinical trials of experimental drugs would be hampered without control groups--yet Belize is convinced, as many AIDS activists were in the 1980's, that things are moving far too slowly, while thousands die. He views the studies that might result from such research as generating "the kind of statistics they can publish in the New England Journal of Medicine"--linking it more to physician ego than patient care. In his view, he is protecting his patient from a dysfunctional health care and political system.

Later, after Cohn has secured a huge private supply of AZT, far more than he will ever need, Belize begs him for some to help his ailing friends. Cohn refuses until, after a furious exchange of insults and slurs, Belize calls Cohn a "greedy kike." Cohn immediately grants him a bottle (Belize takes three). Though the film is concerned with the double-edged interactions between blacks and Jews, it's not at all clear that Belize is anti-Semitic; possibly he has found the way to get the pills, realizing what Cohn respects and giving it to him, thereby helping him and other patients. Of course, calculated bigotry is not on the curriculum at most nursing schools.

Cohn endures tremendous pain and becomes increasingly delirious from his medications. At one point, he asks Belize about the afterlife. Belize launches into an extraordinary vision of Heaven, which is, of course, "like San Francisco." Here, there are "big dance palaces full of music and lights and racial impurity and gender confusion...Race, taste and history finally overcome." And Cohn "ain't there." Cohn, unsurprisingly, doesn't see this as Heaven anyway. But again, Belize gives Cohn what he seems to need: a strong antagonist.

Just after Cohn's demise, Belize summons Louis to the hospital to smuggle out the remaining AZT, but not before forcing the Jewish Louis to say Kaddish, the prayer for the dead, as a thank you to Cohn, explaining that a "queen can forgive her vanquished foe. It isn't easy, it doesn't count if it's easy, it's the hardest thing. Forgiveness. Maybe that's where love and justice finally meet." Thus, contrary to law and nursing ethics, Roy Cohn and his "Negro night nurse" save--or at least prolong--human lives.

"Angels in America" does not really suggest that the nurse characters are angels, or at least, that they in particular are angels. It's true that Emily and Belize are positive characters, and that the actors who play them--because of Kushner's explicit stage directions--also play (respectively) the Angel (Thompson) and Mr. Lies (Wright), a wacky spiritual "travel agent" who helps Harper take Valium-laced mental journeys of liberation from her dead marriage. An argument could be made that the two nurses and the others who struggle forward against all odds, Prior, Hannah, even Louis, are the real "angels in America." Suggestions that nurses are "angels" can be troubling because of the association with spiritual but unskilled beings who help others simply because they're so morally pure, an association that does not advance understanding of modern nursing. But that is clearly not Kushner's vision of "angels;" the Angel, for instance, does not exactly conform to the common stereotype of chastity and self-sacrifice.

Belize and Emily are imperfect real people who bring expertise and care to others in extremis--a professional expression of human decency. There is nothing otherworldly or cute about this vision of nursing. Genuine care for people like Cohn and Prior is not for angelic handmaidens. It requires a combination of courage, intellect and skill. And initiative: Belize seems to violate every ethical rule in sight in the service of what he views as the interests of his patients and his community. Perhaps Kushner lets him off a little too easy; no one defends the health care rules he flouts.

Even so, the depth and range of this characterization easily make Belize one of the most compelling nurse characters in movie history. And the inclusion of a highly skilled nurse practitioner, the portrayal of nurses as men and women with significant intellect, the placement of nursing at the center of the care of those with serious illness--these elements make "Angels in America" a landmark in the history of feature film portrayals of nursing. It's sad that these commonplace aspects of the profession are shown so rarely that this seems revolutionary. But of course, though the world only spins forward, history has not yet been overcome.

Reviewed by Harry Jacobs Summers
Nursing Editor: Sandy Summers, MSN, MPH, RN
Reviewed April 4, 2004

FAQ: How can I see "Angels in America"? Buy the DVD or the written play. Or you can get it as a free gift from The Truth About Nursing when you donate $100 or more to support our work.

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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