Headache in the Movies: Inaccurate Portrayals Lead to Patient Fears and Misunderstandings

The portrayal of headache in film may contribute to patients’ misconceptions and fears about their illness, according to Bert B. Vargas, MD, clinical professor of neurology at the Mayo Clinic in Phoenix.¹ He analyzed headache and migraine in movies from 4 continents that were released within the past 74 years and found that symptoms of headache were often misrepresented. “Headaches are an effective theatrical device for portraying dramatic, unpredictable pain and disability,” said Dr Vargas. “Movies exert a powerful influence on the public’s perceptions and understanding of the medical profession and medical conditions.”

Dr Vargas began his presentation with a well-known clip from the movie Kindergarten Cop. In this film, the main character, played by now-Governor Arnold Schwarzenegger, is an undercover police officer assigned to teach a kindergarten class. While leading a class, he rubs his head, complaining of a headache. One student suggests it may be a tumor, and a number of other youngsters agree. “It’s not a tumor!” growls Gov Schwarzenegger’s character in response. While the clip set the tone for this light-hearted presentation, Dr Vargas pointed out that it also helps physicians understand why their patients may develop fears about their headaches.

Using the Internet Movie Database, he conducted his search using the keywords migraine and headache. Within the 23 films that were identified, he found 26 characters with headache-50% had primary headache and 50% had secondary headache. These characters had the following characteristics: 58% were men, 88% were aged 18 to 49 years, and none were younger than 18 years. Of interest, 46% of these characters had significant psychiatric comorbidities, and 46% died “usually in violent or dramatic ways,” said Dr Vargas. Causes of secondary headache included toxic or metabolic conditions (31%), tumor (23%), head trauma (23%), psychiatric disorder (15%), and foreign body (8%).

Previous studies have also shown that portrayals of epilepsy and coma in film have contained medical inaccuracies or inconsistencies, said Dr Vargas. Baxendale² demonstrated that “seizures are often exaggerated, and characters with idiopathic epilepsy are portrayed as mad, bad, or dangerous,” he said. “Characters with post-traumatic epilepsy are often portrayed as heroic, while epilepsy in female characters often signified exotic vulnerability.” Kerson and colleagues³ showed that seizures are often distorted and frightening as well as uncontrollable or violent. In movies depicting coma, 63% resulted from motor vehicle accidents and 60% of characters awakened.⁴

Medical inaccuracies in films may have affected the public’s perception of a number of disease states, including headache, Dr Vargas concluded. “Headache and headache sufferers have been historically misrepresented in popular culture,” he said. “The advances in headache medicine and the benign nature of most headaches are underrepresented.”

References:

References

1. Vargas B. Migraine in Modern Media. Presented at: the International Headache Conference; September 12, 2009; Philadelphia.
2. Baxendale S. Epilepsy at the movies: possession to presidential assassination. Lancet Neurol. 2003;2:764-770.
3. Kerson JF, Kerson TS, Kerson LA. The depiction of seizures in film. Epilepsia. 1999;40:1163-1167.
4. Wijdicks EF, Wijdicks CA. The portrayal of coma in contemporary motion pictures. Neurology. 2006;66:1300-1303.