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The Lookout

1/31/2013

4 Comments

 
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 A High School hockey player suffers a traumatic brain injury, and must deal with his injury, as well as the thieves manipulating him to their advantage.    

 Hockey superstar Chris Pratt suffers a traumatic brain injury as a result of a motor vehicle accident.  The damage to his brain leaves Chris with anterograde amnesia and difficulty sequencing simple tasks.  He struggles to maintain his independence from his family, and relies on his roommate Lewis to help him get by.  Chris’s injury and job as the bank’s custodian make him a prime target for conman and thief, Gary Spargo.  Gary gains Chris’s trust and involves him in his plot to rob the bank.  Chris must overcome the deficits imposed on him by his injury to stop the robbery and protect those he loves.


Neuropsychological Review 
Cory Czuczman, Dayna Reber, & Tim Daly    

The Lookout starring Joseph Gordon-Levitt is a film depicting a young man’s life after suffering a traumatic brain injury. This critique will focus on Joseph Gordon-Levitt's portrayal of a young man living with the long-term effects of traumatic brain injury. The movie takes place... 

four years after Chris Pratt, Gordon-Levitt's character, is involved in a serious car accident - in which he was the driver. The accident results in the death of two friends, the amputation of his former girlfriend’s leg, and his own brain injury. Throughout the film, many scenes show examples of the major and minor deficits that Chris faces as a result of his accident and injury. Each of these examples serves as evidence of Traumatic Brain Injury, specifically a closed head injury (CHI). Although a large scar is shown on Chris’s scalp, which might indicate penetration of the skull, the broad dysfunction associated with Chris’s case is a sign of a Closed Head Injury.  The deficits commonly associated with this type of injury are depression, problems with executive functioning, problems with planning and memory, speech difficulties, and motor control issues. All of these are present in Chris’s case, and are depicted throughout the film.

Late in the movie, the audience is given a glimpse of a card that Chris was given following his injury that he could present to people to explain his disability. The card mentions epilepsy/seizures, speech difficulties, visual problems, poor balance, memory impairment, inappropriate behavior, inability to use stairs, and disorientation, as potential symptoms one might see when in Chris’s company.  Throughout the movie, Chris only displays a few of these symptoms, as well as many not covered on the card.  These symptoms are: depression, difficulty regulating emotion, inappropriate outbursts, problems with fine motor control, sequencing errors, possible agnosia, and paraphasia.

The movie begins with a scene detailing a typical day in the life of Chris (00:02:50). It becomes immediately apparent that he struggles with depression and/or regulating his emotions.  Each morning, he awakes, showers, occasionally cries, and eats breakfast.  The reason he cries is not addressed, thus leaving the cause of this behavior unknown.  It could be a result of the guilt he feels in regards to his accident, or possibly misregulation of emotion causing spontaneous crying.  His morning routine also serves as an example of his sequencing errors.  He explains that sometimes he doesn’t shower with soap, and he is shown making coffee without first grinding the beans.  In both of these cases, he has skipped an integral step of the overall process.  After he leaves for the day, Chris attends a life skills class that includes activities such as chronicling daily activities and reviewing the processes involved in memory recall and storage.  Upon leaving, Chris is immediately faced with one of his recurring problems in which he locks his keys in his car – yet more evidence that he has trouble sequencing his actions (00:04:46).  Luckily, he has made it a habit to carry a backup in his shoe.

On multiple occasions, Chris has inappropriate outbursts, which are either aggressive or sexual in nature.  Early in the movie, Chris meets with a woman – likely a social worker – to discuss the progress he’s made (00:06:30).  During their conversation, the topic of dating comes up, and Chris’s blurts out that he often fantasizes about the woman.  This sexually inappropriate behavior is repeated in a later scene when Chris is talking with the character Luvlee.  He unintentionally states that he wants to see her naked (00:33:12).  In yet another scene, Chris explodes angrily at his family when they continually speak over his friend Lewis (00:24:57).  Chris is also shown overreacting while not in a social setting.  While preparing dinner one evening, Chris attempts to use a garlic press as a can opener – a possible sign of a visual agnosia or an error or action.  His failure to complete this basic task causes him to burst out in anger and destroy the kitchen (00:09:20).  Each of these inappropriate outbursts shows that Chris’s TBI has left him without the executive control necessary to sensor such behaviors.

It is during the scene with the social worker that Chris shows a deficit in fine motor control of his left hand.  He unsuccessfully attempts to use a spoon to stir his hot chocolate, and must instead switch to using his right hand (00:06:30).  This problem is further described in another scene while Chris describes his condition to the character Gary (00:21:00).  In his own words, Chris tells Gary that he cannot always grip things well with his left hand.  Chris also tells Gary that he mistakenly calls tomatoes lemons, despite knowing that it’s wrong – an indication of paraphasia.

Another possible condition to consider is anterograde amnesia, due to the number of incidences of memory problems present throughout the film.  However, it is difficult to say definitively because Chris’s problems with memory seem to apply in some scenes but not others.  He appears to have trouble with procedural tasks, but no trouble encoding new declarative memories.  Another possible disorder Chris may be suffering from is Post-Traumatic Stress Disorder. Throughout the movie, Chris relives events that he can remember from the night of his accident, as well as ambiguous interactions with his former girlfriend.  The ways in which these scenes take place never reveals if they are real or imagined. In addition to flashbacks, Chris also shows social impairments and difficulties coping with his situation. The fact that these symptoms all lasted longer than one month would support a PTSD diagnosis. Lastly, Chronic Traumatic Encephalopathy, which causes degeneration of tau tissue and results in impaired judgment and speech, as well as aggression, is a disorder resulting from multiple concussions (McKee, Cantu, Nowinski, Hedley-White, Gavett, Budson, Santini, Lee, Kubilus, & Stern, 2009). The film frequently describes Chris’s previous hockey career, in which a history of a physical sport may have caused repeated concussions.

When compared to actual cases of Traumatic Brain Injury, Chris’s portrayal seems mostly accurate.   In a case study, patient J.B (Matthews, 1997) sustained damage to his frontal lobes in a motor vehicle accident, resulting in angry outbursts, sequencing and sorting errors, and depression.  In another study that examined three patients who had suffered TBIs (Schwartz, 1995), Patient 1 suffered damage to his right frontal and parietal lobes, resulting in anomic aphasia, memory loss, and planning and organization deficits. Patient 2 suffered damage to his frontal lobes and right occipital lobes, resulting in an inability to carry out his morning routine. Patient 3 suffered widespread brain damage due to stroke resulting in impaired gait and memory problems.  Chris shares all but a few of the symptoms seen in these actual cases of TBI.

Overall, the movie’s depiction of Traumatic Brain Injury in comparison with the literature was realistic.  Chris experienced nearly all of the problems associated with TBI, and so possibly the film went overboard with its perfect depiction of the disorder. When compared to real cases of TBI, Chris’s symptoms fit the expected schema.  Outside reviewers also agreed that the movies depiction was realistic in explaining the disorder.  The Lookout then, despite the ever-present over dramatization of movies, paints an accurate picture of a person living with TBI, and issues he or she might face each day.


References

Matthews, H. (1997). Case Study: Head Injury. Advances in Psychiatric Treatment, 3(3), 154-
159.

McKee, A. C., Cantu, R. C., Nowinski, C. J., Hedley-Whyte, E. T., Gavett, B. E., Budson, A. E.,
& Stern, R. A. (2009). Chronic traumatic encephalopathy in athletes: progressive tauopathy following repetitive head injury. Journal of neuropathology and experimental neurology, 68(7), 709.

Schwartz, S. M. (1995). Adults with traumatic brain injury: three case studies of cognitive rehabilitation in the home setting. The American Journal of Occupational Therapy, 49(7), 655-667.

4 Comments
Chris Ehler
11/24/2013 02:27:43 pm

The Lookout is a film that depicts the struggles in daily life of the main character, Chris Pratt, who has experienced a traumatic brain injury (TBI). I agree that the film was able to portray all common symptoms of a TBI, including depression, problems with executive functioning, problems with planning and memory, speech difficulties, and motor control issues. One important detail of the movie relaying the aspects of this disorder is that consistency is not always present. There are examples of each of the symptoms listed above in this film, but there are also instances where a symptom might take affect in a scene but it does not. The best example of this is Chris’s memory. He suffers from anterograde amnesia, which is the inability to form new memories. This is evident from the notes he makes in his notebook to remember things. It is also clearly present in the scene at the bar when he first meets a girl names ‘Luvley,’ and he admits that he keeps forgetting her name. However, there is a scene at the end of the movie where he is going through his notebook and reading a note he made himself will cause him to remember the memory associated with that note. This lack of consistency could be due to inattention to detail, but it could also be due to the fact that Chris’s TBI might be a mild case and that his symptoms affect him occasionally. Overall, the film is a very good movie that portrays many aspects of a traumatic brain injury.

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rachael
6/18/2016 01:07:27 am

Actually, that is how TBI works..memory loss is triggered by stress -I have it, and I like to explain it as a flickering light. Sometimes you can see everything really clearly, the room is fully illuminated. Other times you get tiny glimpses of clarity, and the more stress you are under the less visible the room gets until, you know, the light goes out and you start acting like a raving maniac.

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Christina Conrad
11/22/2015 11:09:24 pm

This review provided a helpful interpretation of the movie “The Lookout” for me. I have not seen this movie before but it seems like it is worth watching. As I was reading the review, I was wondering how the movie would portray a traumatic brain injury because there is such a range on the scale of TBI’s that can happen. I was a little surprised by the way the reviewer said how “possibly the film went overboard with its perfect depiction” because it didn’t sound like it was too much by the way they described the movie. It also sounded like the character was able to be mobile and accomplish tasks which was good so I wouldn’t think they would be going overboard with the symptoms. Still, this was an interesting review and I think the movie would be very educational for me to watch.

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Pamela Gray
6/13/2017 09:29:08 am

I recently saw this movie on TV. Wow! Good movie! I am a special educator who deals with children and young adults with traumatic brain injury. That includes children who were brain injured due to toxic substances ingested by the mother during pregnancy. Drugs and alcohol do a number of the prefrontal and frontal cortex, resulting in children and young adults who have many features of TBI. The hardest part is getting other adults who work with these students to see behavior as being related to disinhibition and to respond accordingly. I have come to the conclusion it is easier to cure disinhibition than to convince someone else that this behavior cannot, without great effort and devotion, be controlled by the person with TBI.

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