I had not heard the plot of the movie Million Dollar Baby until the buzz when Eastwood, Hillary Swank, Morgan Freeman and the movie were nominated for Academy Awards. I went to see it knowing that in the end Maggie (Swank) became a C1-3 quadriplegic, on a ventilator and was assisted in dying by Frankie (Eastwood) her trainer.

While watching the movie, I was asking myself, “Can I be honest in writing about my feelings at the end of the movie.” I have spent 34 years in rehabilitation and have seen many newly injured spinal cord individuals (SCI) and many with high cervical fractures that prevented their breathing without mechanical assistance. All these years, many working with and serving SCI folks certainly made me biased. I believe that with proper emergency medical care, the proper surgical intervention and quality rehabilitation education and management, a newly injured person and their families need time to begin to look at the functional changes to their body, not as a death or completely unsatisfying/ poor quality life sentence, but rather as an event that, while catastrophic, does not have to remain that way.

There is no doubt that things will be different, that many of them may be difficult, however, with strong inner values and confidence, with family friends or supports from the greater community one can still control their life direction and relearn to enjoy the life they still have. I can provide many examples of persons with the level of injury that Swank played, who while still very physically limited, had or evolved the capacity to move forward and continue to participate in and enrich their lives and the lives of people around them. How they got there is hard to convey but it can be done.

Certainly, I can identify with Maggie, who felt there was no purpose for continued life. Like her, they attempted to end their lives themselves or asked others to assist. Some were successful. What I know of the common denominator of these later individuals, unfortunately experienced many of the rationales presented justifying Maggie’s choice. Maggie came from a very difficult home environment, one that seemed to become worse after her father was no longer in her life. It was apparent that she made strong efforts to get away from her home environment and try to reach her desire to be the women’s boxing champion. She came so very close!

Maggie showed determination, a sense of ownership for her path and a willingness to accomplish her goal with financial success to make her life better. After the unusual cause of her neck fracture, post round ending bell, a blindsided punch by the champion who had been previously knocked down, the stage was dramatically set to change her life.

What bothered me was that the hospitalization sequences weren’t very real; although I am certain newly injured individuals do not always get to trauma centers and don’t always get the highest quality of services that are available. Many also might have come from dysfunctional families as did Maggie, with limited education, limited self expectations and limited if any exposure to persons with disabilities. Many individuals, with support, can choose to move forward in spite of their physical limitations and experience all they can out of life.

In nursing home placements it is highly unlikely that warning systems for ventilators are not activated when breathing is disrupted. Also, other monitors should be in place so staff are alerted especially after an individual tries to end her life on two occasions.

This film had no social worker or psychologist intimations. This would be unlikely in any acute receiving hospital or rehabilitation- oriented long term care facility. The speed by which her leg was lost to bed sores was so unrealistic that is seemed comical to me.

First of all the location was unlikely to have been sustained from her bed laying position. Second there would have been several alternative treatment methods tried. Third, Frankie, who was the prime support throughout the injury period, would have most likely looked for another facility. The film spends a lot of time leading to the injury and then makes it so dramatic and repeatedly devastating that is no hope for a life with positive choices and rewarding experiences.
I cannot agree with the assisting of her death here. As a general rule I am fearful that as a society we are becoming to willing to accept uninformed individuals making their choice to end their lives. The fear of being a burden to our spouses, kids or others are commonly expressed by persons with disabilities or older American. Add to these fears, society’s constant emphasis on the health care costs and suggestions that severely disabled persons lives are costing too much money. Devaluation of individual worth is on the rise once again. It would appear that at least. The Academy is comfortable with the euthanasia option.

The Sea Inside which is based on a true story focuses on the life of Ramón Sampedro, a Spanish man paralyzed from the neck down who pursues legal action that will allow him to end his own life. Cared for lovingly by friends and family, Ramón has nevertheless reached a decision, after twenty-six years confined to his bed, that he does not want his life to continue.

While not able to view it due to its limited showing here in the Twin Cities, my questions would be, why he was confined to his bed, where in Spain did he live and was he provided with opportunities for stimulating, self directed and controlled activities. This film won best foreign film.

The Million Dollar Baby won best actress, best supporting male actor, best director and best picture. The Ragged Edge, Edition February 3, 2005 reports that Eastwood states: “I never thought about the political side of this when making the film.” There’s the rub. Eastwood and his film’s liberal supporters have somehow failed to see – and perhaps worse yet, failed to examine – why disabled people would be hurt and offended. Is the notion of preferring to die rather than choosing to live with a disability so commonplace it merits no reflection by able-bodied movie directors, film critics and audiences?

Moreover, are the feelings of real, live disabled people so irrelevant in our culture they aren’t even considered when movies such as Million Dollar Baby and The Sea Inside are made?”

In all honesty, I could see how Maggie came to her decision at that point in time. I could also feel the turmoil and difficulty of the choice Frankie dealt with as he weighed her request and ultimately gave in to her request. Still euthanasia is, it appears, being promoted for elderly, severely disabled or incapacitated including infants or children. More and more States are taking up the issue. We must stay vigilant, caring, informed and on the defense. Out of control decisions seem to be a sign of the times.