On the Side of the Disease and Not the Cure

“I am listening to what fear teaches.”
—Audre Lorde, A Burst of Light: Living with Cancer

Looking at the representation of illness in cinema, two genres dominate: melodrama and horror. Though their differences may be obvious, both tend to conform to a therapeutic narrative whereby illness is understood, treated, and either defeated or proven fatal. This is the essence of medical discourse; disease is both identifiable and undesirable. What to make, then, of Safe—both melodrama and horror—which director Todd Haynes has claimed is “on the side of the disease and not the cure?”

Julianne Moore gives her greatest performance as Carol White, a San Fernando housewife who develops a mysterious illness that carries no credence with her doctor. The symptoms, which include dizziness, bleeding, confusion, and shortness of breath, grow so severe that Carol joins a convalescence retreat in the desert and sets about healing the alternative way. Safe is an ambiguous, enigmatic film—for proof of this just see the many different interpretations it has inspired over the years; depending on what you read, the film is an attack on suburbia, an eco-feminist manifesto, or an allegory for the AIDS crisis. With a background in New Queer Cinema and the dexterity to seamlessly blend different genre modes, Haynes puts this uncertainty right at the heart of Safe.

While these many takes on the film are rich and valid, sickness in cinema is often read as a symbol for something else, whether it’s the nauseating aspects of society or repulsion at our own mortal bodies, at the expense of discourse around the actual conditions. Indeed, Susan Sontag wrote that “nothing is more punitive than to give disease a meaning,” as it invariably leads to moralizing the biological. Yet of course illness is not strictly chemical—there is an entire power network built around its classification and treatment. And by looking strictly at illness for what it is in Safe we can begin to uncover the true terror of this horror masterpiece.

Though the issue of AIDS certainly lingers over Safe (particularly given Haynes’ activist history with the AIDS direct action group ACT UP) mapping that illness onto the film ignores the actual condition at the heart of the story: environmental illness, or multiple chemical sensitivity (MCS). MCS is symptomized by allergic reactions to everyday chemicals in levels otherwise considered safe, and is not recognized as an organic disease by the World Health Organization. In 1995, one toxicologist disparagingly deemed MCS “the only ailment in existence in which the patient defines both the cause and manifestations of his own condition.” One of the reasons for this illegitimacy, according to environmental researcher Stacy Alaimo, is that “a truly effective treatment for MCS would not be an individual matter but instead would entail a staggeringly thorough overhaul of nearly all military, industrial, manufacturing, agricultural, domestic and consumer practices.” Given Haynes’ interest in the critical possibilities of deviance, MCS is not an incidental choice.

Though it concerns a wealthy suburban housewife’s encounter with subversion, Safe is miles away from the lush, romantic visions of Carol or Far from Heaven. Haynes maintains a clinical distance from his characters with wide lenses, closed frames, and long takes. This allows the exceptional production design to take over both the frame and Carol herself, who is dwarfed by garish houses and queasy hospitals. As a vision of suburbia’s empty menace, it calls to mind Halloween or Blue Velvet. It’s unnerving to be put at such a cold remove from a character as her health declines—indeed, this critical distance may be replicating the objective eye of a doctor, and it reminds us that, from such a viewpoint, knowing everything is impossible.

In 2000, a guide for those living with MCS was published with the subtitle How to Build Yourself a Body in a Safe Space. Author Michelle Murphy advocates against the traditional doctor-patient relationship, arguing that knowledge should not come exclusively from the institution of medicine but from the individual patient’s body and experience. She explains to the “MCSer” that once you decide to let your own body dictate what you need, “while making sense to yourself, you can quickly become strange and unintelligible to others.” The MCS self, it seems, is at odds with the authority a doctor needs to maintain his status, and Murphy recalibrates that relationship, suggesting: “you will have to teach your doctor about how your body works. Try to be patient.”

Though Murphy doesn’t acknowledge her ironic use of the word “patient,” it reveals a puzzle at the heart of Safe: what Foucault called the patient’s paradox. A doctor must subtract an individual’s qualities to codify and treat the disease in their body, and yet that individual is the only source of the qualitative phenomena that describe the disease. Being “patient” would mean deferring to the doctor’s ability to determine what is a valid disease, but this would not necessarily include MCS. A patient’s meaningful engagement with their condition requires them to deny that power dynamic.

With this context in mind, we may wonder whether Carol really is sick, or if she is waking up to the fact that her environment itself is built on illness of one sort or another.

In the film’s first half, radios, planes, and domestic appliances provide a near-constant noise pollution. Though Carol fussily manages the design of her home and garden down to the exact color of her sofa, disruptive noise can’t be managed without either extreme isolation or societal overhaul—much like the experience of living with MCS.

Sound even takes us inside Carol’s body. We hear her throat muscles contract as she drinks milk, or her labored breathing that drowns out other characters’ dialogue. Though we are visually distant from Carol, aurally we share the immediate sensations of her body. This speaks to “trans-corporeality,” characterized by Alaimo as the concept that any definition of a human body needs to include its environment as well as the organic matter of the individual. This idea may seem glib, but it maps onto the aesthetics of the film: Haynes collapses the boundaries between visible and invisible, internal and external, body and environment.

As Carol’s illness grows more serious, her environment becomes more sinister. It looks the same as before, but simple formal choices (a creeping synth score, slow dolly movements, unplaceable sound effects) turn Carol’s own home and community into a landscape of terror. The uncertainty is important here; Carol is afraid precisely because she does not know what to be afraid of.

In a moment of spontaneity, Carol decides to get a perm. The scene contains the only extreme close-up in the film, showing waving lotion oozing onto Carol’s curled hair. Combined with a racking focus, gloopy sound effects, and slow dissolves, it feels like a moment pulled out of Alien. As Carol cheerfully reviews her new hairdo, blood trickles from her nose. She is scared and panicked, and the ominous soundtrack builds—but the horror is interrupted by an unplaced, casual line of dialogue: “Anyway, so…” A mash cut takes us mid-crisis to Carol’s bedroom later that day, where her husband Greg is telling a story. There is no space for Carol’s illness in her social context.

Greg will grow exasperated at Carol’s illness largely, it seems, because it means she doesn’t want to have sex. When they attempt to reconcile with a hug, she vomits on him. It appears that she is allergic to her lifestyle, even to her family—her own body is in revolt, making it impossible for her to continue playing this part. Both Greg and Carol’s doctor deny that her illness is physical—the doctor calls it “emotional strain.” But Carol feels the worsening symptoms herself, and so her faith in the world that these men govern is undermined. Her body is teaching her with fear.

Halfway through the film, Carol is back in the hospital after a convulsion. The doctor offers another dismissive psychosomatic diagnosis and Carol quashes it with a firm “no.” Instead of offering a diagnosis of her own, she stubbornly states: “I don’t know.” Rather than weakness, Carol’s uncertainty indicates possibility beyond the hospital walls and textbooks. In medicine, uncertainty is dangerous—but Carol refuses to reinscribe her doctor’s authority over her own body, and so occupies a space where she doesn’t make sense at home or in hospital.

Having rejected the toxicity of her suburban home, Carol moves to Wrenwood, a desert-bound New Age retreat (a heavily-loaded term here) built to guard against the toxicity of civilization. Such isolated centers do exist for patients of environmental illness to access non-pharmaceutical treatment—the remote town of Snowflake, Arizona has such a settlement of purpose-built houses designed to exclude potential irritants. The pricey Wrenwood retreat preaches love and forgiveness towards the world, but keeps it at a complete remove. The parallels with conformist suburbia are clear.

As Carol arrives at Wrenwood, there’s a moment ripped from a hundred horror films: a patient runs towards her screaming, “Go back! Go back!” They are only worried about the car fumes, but the dread remains—and it doesn’t go away once you hear the organization’s mantra: “we are safe, and all is well in our world.”

Carol is soon told that her feelings of isolation are normal, and that all she needs for wellness is a loving and positive attitude. If Carol’s illness opens her eyes to the world as an apocalyptic landscape (“apocalypse” originally translates as “uncovering” or “revelation”), then the folks at Wrenwood have decided to avert their gaze. They bury their heads in the desert sand and deploy considerable privilege to do so. When one patient rails against the society that made her ill, she’s chastised to strive for “a quiet mind.” Any of her anger is simply another symptom of the illness, because this context—no less than the San Fernando suburbs—will fiercely maintain its parameters for what health means.

Such individualism treats the human body itself like a hermetic building—though the truth is that each of us is “trans-corporeal,” dispersed across the body and any number of environments that body might encounter. Our identities are determined not only by the boundaries of our skin but also where we go, who we speak to, and the ideas we entertain. Carol resolves the contradictions of her illness by an aggressive attempt to seal herself off from the world. And sealed off she becomes—authentically or not—fully content.

This will be familiar to all of us in some way. Often we know what is making us ill, whether it’s air pollution, overwork, or our bank balance. With such enormous obstacles towards good health, we can feel powerless as individuals to make the necessary changes. Doctors can offer us medication or coping strategies—often vital and life-saving—but if we accept that context creates people, how can we heal the bodies without changing the places they inhabit?

This is why spaces can be scary—not because they invade us, but because they build us. If a patient is found at the meeting point between body and environment, then the whole concept of a “safe space” takes on more extreme dimensions. Carol’s retreat from a dangerous landscape doesn’t make her well; ultimately it finds her isolated inside a sanitized igloo, with only her own reflection for company.

Just before the end of the film, Carol gives a birthday speech to her fellow retreaters. In most films about illness, this would be a moment of epiphany—a chance to close the narrative with a declaration of the complete self that has persisted despite the illness. The best example of this is Still Alice, for which Moore won an Oscar (the film’s title contains everything about illness in cinema that Safe is turning upside down). Moore’s speech in Safe is the exact opposite of her Still Alice speech—Haynes positively revels in Carol’s lack of clarity. She is rambling and incoherent, full of unfinished sentences and intersecting trains of thought that trail off into silence. Still, the other patients cheerfully toast her—they participate in the performance of clarity demanded by their medical program, even if nothing makes sense.

So the illness in Safe is not understood, nor defeated, nor does it even “win.” It simply upends Carol’s view of her entire social environment, because it doesn’t allow her to make sense there. Her body becomes indigestible, unruly, dangerous. The “meaning” of her condition is that its slippery definition opens a chasm between body and self, and a puzzling paradox of existence: our very conscious minds are built by contexts that may as well be arbitrary, and yet as physical beings we have to exist somewhere. True to form for a film so insistent on the power of unanswered questions, Safe leaves this paradox unresolved.