Medical Utopias and Dystopias in Science Fiction Films: The case of Elysium (Blomkamp, 2013)

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This morning we have a post from Maria Katsaridou, a PhD candidate at Aristotle University, Greece. Her fields of study include animation, films, video games, semiotics, narratology, and adaptation theory. She has published many articles and book chapters. In addition to her main studies, she holds a degree in biochemistry. You can find her at LinkedIn and Academia.edu.

The presence of innovative medical and technological breakthroughs in science fiction movies, which is offering us a glimpse of either a probable or a completely fantastic future, is far from new – it is a rather very common practice within the science fiction genre.

While many other science fiction films refer to medical advances in order to lend plausibility and reasoning to the movies, Elysium (2013) is highly focused on discussing the articulation between the possible medical and technological progress with the social structures. The film raises questions about social disparity concerning medical treatment and the access to new, innovative medical practices. The answers lie in social choices, rather than pure scientific ones: there are those who have the right to access the new, innovative medical practices and there are those who do not. Not only does this fact define quality of life for different social classes but, eventually, it also defines who will live and who will die.

The film takes place in the year 2154. Earth is a dystopic world, overpopulated, polluted and ruined. The great majority of people still live on Earth and in dramatic conditions, struggling for their everyday survival, suffering from poverty, unemployment, starvation and disease, in addition to lack of sufficient medical care and the access to advanced therapies and technologies. The very few wealthy (around half a million people) who consist the upper class, live on Elysium, a torus-shaped, high-tech utopian space station where illness, poverty and hunger are eliminated.1 The rich live a luxurious life, with access to advanced technology and private medical care, which cure any medical condition instantly and prolong their lifespan indefinitely. Any access to Elysium and its medical services is strictly forbidden to Earth’s citizens.   

Elysium resides so close to earth that it is visible to the suffering residents of the planet, who try to reach it in order to be cured, at any cost, even if this means risking their lives in the process.

Spoiler Alert: the summary reveals important plot details!

The protagonist, Max Da Costa (Matt Damon) is a suffering from severe radiation poisoning and he is left with only five days to live.

He decides to try anything in order to go to Elysium and be cured by getting in one of the “med-pods” that exist in every house in Elysium, and cure everything.2 In order to achieve his goal, he asks Spider (Wagner Moura) for help. Spider is a person who is arranging illegal flights to Elysium at a very high price. Spider is willing to send him to Elysium only if Max does a “job” for him, which is to kidnap a citizen of Elysium and download financial data from his brain to a neural implant attached to Max. As Max has no other way out, he agrees

After a long and difficult adventure, Max succeeds in getting to Elysium, but now he has to make a difficult choice: either to save himself or to activate the program that in his implant to “save” the citizens of Earth from suffering. Max heroically chooses to sacrifice himself for others, and the closing scenes show us a fleet of medical ships landing on Earth to provide care to the poor and sick citizens.

Conducting a film analysis, it is easy to identify three types of medical care in the film: a) the Elysium’s healthcare system, b) the Earth’s healthcare system, and c) the illegal medical practices on Earth.

As mentioned above, Elysium has an advanced healthcare system. Through personalized and easy to access (they exist in every house) medical pods, people can regenerate their cells and cure every medical condition, from broken bones to leukemia, prolonging their lives. Most importantly, all these cures are happening without the patient experiencing any pain or even the slightest discomfort. Interestingly, these pods have the ability not only to regenerate cells but even to totally reconstruct destroyed body parts, with a stunning accuracy in reproducing the characteristics of a person. For example, when a character’s face is blown entirely off, the medical pod not only reconstructs it, but it also reproduces the man’s aesthetic choices, regenerating even his beard!   

While these “all healing pods” reside in the science fiction realm and do not exist in any known contemporary medical practice yet, they signify the strong human wish for a prolonged life free of suffering, pain, and diseases.3 This is actually the driving force and the final goal behind most of our contemporary medical researches, namely to prevent and cure medical conditions and to improve our quality of life. In this sense, the film implies that in the year 2154, humankind will have reached this goal.

On the other hand, healthcare system on Elysium’s Earth has a lot in common with many contemporary public systems around the world. In the film, the hospitals are overcrowded with patients in need for treatment. The medical staff (doctors and nurses) are doing their best to help them, but there is a lack of adequate number of personnel and medical supplies. Also, they don’t have the new medical treatments that the “elite” enjoys at their disposal. So, they cannot treat diseases like cancer, for instance. There is a characteristic scene, where a doctor (Chris Shields) says to Frey (Alice Braga), a nurse who has a terminally ill daughter, suffering from cancer, that there is nothing more they can do for her daughter and that she has to take her home, because, he concludes, they are not a rich facility and they need her room back.

In parallel with the public healthcare system, the film highlights the existence of illegal medical practices. At one point, Max has to undertake an operation in order for an exoskeleton to be fitted to his spine. The operation room where this surgery takes place looks more like a car chop shop than a medical facility and the “doctors” look more like gangsters, or at the best, like technicians. Max suffers a lot of pain during the procedure, but he survives, something which in reality would have been impossible due both to his medical condition and the surgery’s procedures.

These types of illegal (and dangerous) practices are often present in science fiction films, such as Johnny Mnemonic (Longo, 1995) and Repo Men (Sapochnik, 2010). It appears that the illegal practitioners have knowledge and materials at their disposal that cannot be found in the premises of public healthcare system. In Elysium they have an exoskeleton that can only be obtained through the ‘black market’ health care system. The exoskeleton is obviously not common, judging from people’s reactions when they look at Max wearing it. It is interesting that while today medical exoskeletons are considered as a ground breaking research field on assisting and improving a paralyzed patient’s mobility, it might be presumed that in 2154 exoskeletons are an “old” and obsolete practice, since the medical pods can cure everything.4

Another point worth mentioning is that while Max had the accident because of the lack of safety measures in a factory belonging to an Elysium citizen, the only thing that was provided to him is a palliative treatment, in order to relieve him from the symptoms of radiation poisoning and not a cure. John Carlyle (William Fichtner), the owner of the factory, didn’t care at all about Max’s health. His only concern was that Max might besmear the bed sheets where he was lying, so he wanted to oust him out of the factory immediately.  Obviously, for the upper class, their workers on Earth are disposable.

It is also important to notice that even though the residents of Earth live in extreme poverty, most of them don’t try to “steal” from Elysium’s rich houses (with the exception of Spider, who is an illegal smuggler). They dream of living on Elysium, they collect money for buying a ticket to fly – illegally – there, but only to use the med-pods and be cured. After that, as it is impossible for them to stay in Elysium, they return to Earth. The medical treatment, therefore, is a very central social issue. This becomes clear in the resolution of the film, when the fleet of medical ships land on earth and provide medical care to all the poor and sick citizens. Evidently, for Earth’s residents, being an Elysium citizen is all about the ending of their suffering and the equality in healthcare and not in “threatening” Elysium’s inhabitants’ status quo, as Elysian Secretary of Defense Delacourt (Jodie Foster) states in the Elysium’s council. Delacourt is afraid that the people from earth will come “up” to Elysium and they will jeopardize the future of Elysium’s children. Instead of that, in the end, the medical care reaches “down” to Earth and its unfortunate citizens. Interestingly, this development is actually protecting Elysium’s society and their luxurious way of life from “intruders”, as now the citizens of Earth have no reason to risk their lives and fly illegally to Elysium.    

But while health care is a matter of life and death for the whole society, in the end of the film the change comes through individual action, the heroic decision of Max to sacrifice himself for the common good, and not through collective decisions and actions.

Even though this is a science fiction film, which is often addressing medical issues in a more artistic than scientific manner, there is a clear connection between the healthcare issues posed by the film and our contemporary healthcare systems. In the movie, as in many contemporary societies, the quality of the medical care is analogous to the social class of the sufferer: the higher the class, the better the healthcare received.

We undeniably live in an era where new and revolutionary treatments for many conditions are emerging. On the other hand, in many parts of the world, medical care is still not considered as a common good for all and many are deprived of even the most elementary health care provision.

As medical research is ongoing and our abilities for curing diseases and relieving patients from pain are increasing, we, as societies, should clearly answer questions concerning the access to these new, innovative, and sometimes very expensive therapies. In other words, who will benefit from all these medical and technological breakthroughs? Do we consider health care as a basic good that all people should have access to, or we consider it (as in Elysium) a commodity that only the wealthy can afford?

~~~Footnotes~~~

  1. http://www.geeksofdoom.com/2013/08/09/10-facts-about-the-elysium-space-station-from-elysium-the-art-of-the-film
  2. The healing pods are not new in science fiction films. For example, it appears in the film The Fifth Element (Besson, 1997).
  3. “The Medical Pods that the citizens of Elysium use to stay young and healthy were modeled on MRI machines, as the filmmakers wanted audiences to look at it and have a sense of familiarity, making it more understandable how these machines would essentially move over the body to heal these people of the future”. http://www.geeksofdoom.com/2013/08/09/10-facts-about-the-elysium-space-station-from-elysium-the-art-of-the-film
  4. https://www.technologyreview.com/s/539251/the-exoskeletons-are-coming/

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