Laura R. Kremmel
Bestselling author Paul Sheldon (James Caan) is indeed fortunate to have been rescued from a near-fatal car accident off a remote Colorado road in the middle of a blizzard. He is even more fortunate that his rescuer is a nurse with years of experience and a home well equipped to care for a patient sustaining major injuries that require long-term care. Scholarly discussions of Annie Wilkes (Kathy Bates) in Rob Reiner’s Misery (1990, based on the 1987 novel by Stephen King) often fixate on two of her qualities. Her demonstration of aggressive reading practices in part represents the obsessive fans who dogged Stephen King himself, and her subversion of traditional gender expectations psychoanalytically castrates Paul as her hostage, unmanned writer. Much less is written about her role as a nurse. Yet, this is the first impression the viewer encounters. In the opening scene, Annie performs the services of EMT and nurse, prying open the door of Paul’s car, giving him mouth-to-mouth, and carrying him over her shoulder into the storm.
Before we as viewers see her face, we see an IV therapy bag hanging from its pole, which comes into focus as she cheerfully proclaims, “There’s nothing to worry about. You’re gonna be just fine. I’ll take good care of you. I’m your number one fan.” She stands over his bed authoritatively, introducing herself and answering his questions calmly and kindly before assuring him, “I’m also a nurse” and giving him pain pills. The next scenes show her changing his IV, providing more medication—Novril—helping him to drink, and cooling his face with a wet cloth. These opening scenes portray her as competent, selfless, and trustworthy. Later scenes show her carefully feeding or shaving him. In one particularly moving scene, she tells him the story of her husband leaving her, then accepts a jug of urine from Paul without a hint of embarrassment, disgust, or resentment. Her words are sympathetic and full of hope: you must be in pain, but you’ll be better in no time. Taking care of you is no problem.
Annie views her own identity as twofold, both articulated in that opening scene: Paul’s number one fan and a nurse. The film channels her multiple personalities through these two identities—and Annie is clearly damaged as both. Her caring side surfaces when she nurses Paul back to a semblance of health and attends to the violence that the other personality, the fan, inflicts on him. The moment Paul realizes the amount of danger he’s in is when Annie the fan learns that her beloved character Misery dies at the end of his latest book and attacks him in the night. Annie the nurse, meanwhile, assures him he’ll be able to walk again, is proud of “the work [she] did on those legs,” and inspires confidence by rattling off his status using medical terminology: “a compound fracture of the tibia,” and “the fibula” is fractured as well. It is, therefore, tempting to see her fan personality as the villain. In this article, however, I suggest that Annie the nurse is every bit as dangerous and villainous as Annie the number one fan. I argue that the metatexts beyond the Misery novels—most importantly, Annie’s album—are useful as records of her profession: medical narratives that Annie uses to guide and document care that kills.
Annie uses texts in two ways throughout the film: to monitor Paul’s health and to record a history of her patients. The impact of reading on the body has long been documented, and so Annie is also protecting her own health from the disease she perceives in her patient’s novels. Horror and the Gothic in particular have been accused of being “not good for people” since the eighteenth century, an indicator of both a writer and reader’s state of mental and physical wellness or decay. Stephen King’s own number one fans may have proved this theory, finding behavior such as stalking, breaking and entering, and mailing unsettling objects to his home acceptable in their obsessive state.[i] At the same time, authors who publish insalubrious works are deemed sick themselves, perhaps needing to be put out of their misery. Bret Easton Ellis, for example, received thirteen death threats after publishing American Psycho.[ii] Paul Sheldon receives only one, from Annie, but he receives it over and over again.
Nurses in popular culture fall into three categories: saintly, sexy, or satanic with just a touch of insanity. Suzanne Gordon suggests that this is because of a general lack of understanding of the everyday tasks performed by nurses, some of which do include kindness towards a patient, but no more than a physician or any other medical staff member should show. Rarely is the extensive medical knowledge and skill of nursing ever portrayed, a negligence fraught with gender politics and assumptions that damage the field to this day. “In a variety of polls, nurses consistently get high marks for their ethical and honest behavior and trustworthiness. The widely held view that nurses are honest and ethical but that their field is not dynamic, challenging, or intellectually demanding is the result of a complex set of factors that include media presentations of nursing.”[iii] But, we know that Annie is skilled at what she does, that she both physically and intellectually rises to the occasion of caring for Paul in her makeshift hospital and out of her own pocket, unafraid to make difficult decisions about his care without consultation or support. She is far from the first aggressive and capable—and, therefore, villainized—nurse in Hollywood, and much could be said about her similarities to Nurse Ratched (Louise Fletcher) in One Flew Over the Cuckoo’s Nest (1975): another “big” nurse who, one could argue, is simply trying to do her job and do it well. As Gordon writes, “Nurses tend to be handmaids or horror shows,” and transgressive gender performance rather than skill or motive may determine which.[iv]
When Annie asks Paul to burn his new book—one she deems distasteful and full of profanity with “no nobility”—she claims she’s trying to help him, using the same tone she had in the beginning nursing scenes. Paul’s book indicates a state of unwellness, one that is so malformed it doesn’t even have a title. Its own author doesn’t understand it, asking Annie to tell him what it’s about: in other words, asking Annie to diagnose it. Burning the book is, therefore, an act of mercy and healing that is accompanied by pain. As with most of the procedures she performs on him, Annie gives Paul Novril afterwards and sets him up as a writer again, just as she set his legs. The writing studio, with its makeshift typewriter and problematic paper, is a split meant to re-form him into his previous state of writing health. The healing novel, Misery’s Return, becomes directly connected to healthcare as it is, as Annie says, “a book in my honor, for saving your life and nursing you back to health.” It is during this exchange that Paul acknowledges her to be “his favorite nurse,” the missing “N” on the typewriter matching two letters in her name. It is when Annie is administering harsh medicine to heal his ailing writing that she becomes most aggressive in her care, confessing that she loves him. And then breaking his ankles.
While Annie uses Paul’s writing to monitor his health, Paul also encounters a collection of texts that indicates her approach to medicine more broadly. When he escapes from his room, he finds a scrapbook in Annie’s living room, “Memory Lane,” which includes newspaper clippings and other memorabilia from her past. It catches his eye because it has been left open at a “medical record” in progress: his own. Two clippings report his disappearance and that he is presumed dead. Annie likely suspects these will be the last stories about her current patient. Yet, the ambiguity of them, so unlike the rest of the entries, indicates that her treatment is not yet finished. Amy Palko theorizes that the fragmented and skeletal nature of the scrapbook “allows [the textual poacher] to pick out the narratives that are most relevant to them and to remove them from their original context in order to re-position those narratives in a text of their own devising…. As the pages are turned, one can follow the meandering gait of a textual poacher; a consumer that refuses the passivity demanded of them.”[v] In repurposing newspaper clippings that are about her without mentioning her, Annie actively reclaims them and her role within their stories. And not just within them, but as the orchestrator of their events, the head nurse.
Other pages include obituaries and news reports. The accidental and near identical deaths of her father and a fellow nursing student document her early work before pursing medical education. Records show cancer patients, both sports coaches, who die after agonizing illnesses. A used car salesman and a pediatrician are both permanently relieved of unstable conditions. These clippings are interspersed with announcements of Annie’s own successful career in school and within medical units, as well as cheerful greeting cards and scraps that frequently say, “Bon Voyage.” The cheerful cards are just as much part of Annie’s records as the newspapers, denoting her involvement in each death and documenting it as a success: the responsible act of a caring nurse putting her patients out of their misery, not the hateful violence of an evil person committing murder. Except for the early cases, most of these stories describe the deaths in medical terms—cancer, pneumonia, stroke—suggesting that she knows how to make her treatments resemble expected fatal conditions. The viewer sees little of the details[vi] of what exactly she is curing—the patients in pain or coma might be most obvious—and it’s likely that patients were either unaware of her involvement or unwelcoming of it. And then she started to euthanize babies.
Four separate clippings report infant deaths, some claiming they died peacefully in their sleep while others mention formula, suffocation, or brain hemorrhaging. King’s novel suggests that Annie saw these babies as “Poor things. Poor, poor things,” too pure for the world, and the cheerful pictures of babies and flowers around these announcements in the scrapbook suggest the film might make the same insinuation.[vii] Perhaps she thought to save them from parents whom she deemed unworthy, or perhaps she interpreted their crying as a sign of internal disorder that must be cured before it could grow. Whatever the malady, death was the treatment. The last clippings show her arrest, trial, and innocence. And, of course she’s innocent. She’s only being the best nurse she can be. So, when she attacks Paul for insisting that Misery’s death in childbirth in the eighteenth century was by chance—that “she just slipped away”—she accuses him of murder. She knows, despite what her newspaper clippings say, that patients do not “just slip away.” They need the help of a good nurse to make that happen.
Annie, then, doesn’t just struggle with the limitations of her role as nurse, she has no limitations. Her reading practices as number one fan are inseparable from her medical practice as number one nurse. While Annie clearly lies to Paul about contacting the hospital or his agent, the genuine cheer with which she delivers this news makes it less clear whether she believes it herself. When she claims to have talked to the head orthopedic surgeon, who “said,” “As long as there’s no infection, you’re not in any danger,” she’s praising her own healing work. Coaxing the unwell body into a state of dependence is part of her care, taking medical authority to the extreme for the “good” of her patient. And Paul learns that he can use this authority to his advantage. To hide the pills he’s stolen, all he has to do is plead, “please make the pain go away,” handing her the medical power she guards so closely and enacting dependence that Foucault would say is part of the authoritative medical gaze.[viii] After all, she had told him, “You’d better hope nothing happens to me. If I die, you die,” though it seems all along that this might happen anyway.
Thus, Misery is not just a satirical horror statement about fan culture and obsessive reading; it is an important entry in the subgenre of medical horror. Kathy Bates said in a 2015 interview that she was originally disappointed that the scene in the novel in which Annie amputates Paul’s foot was changed to breaking his ankles for the film.[ix] Whether she meant it this way or not, her character would have said the same: breaking an ankle is not a medical procedure, but amputation certainly is. It is this subversion of medical practices into methods of captivity, and the hidden subtext of the newspaper clippings about patient deaths, that prompt questions about the underlying potential for all medicine to turn dark and foreboding. In situating herself outside the regulated and institutional space of the hospital—having become unwelcome there—Annie and her continued use of its practices show how easily the power with which patients entrust their doctors and nurses might become the power of a kidnapper over their hostage—a villain over their victim.
Notes:
[i] Lant, 89-91.
[ii] Benedictus.
[iii] Gordon, 152.
[iv] Gordon, 154.
[v] Palko, 60
[vi] Some clippings consist of the same paragraph repeated several times, obviously because they shot doesn’t last long enough for the viewer to read beyond the first few lines. This also speaks to the repetition and fixation on just a few details that characterize Annie’s care.
[vii] King, 192
[viii] See Michel Foucault’s The Birth of the Clinic (1963).
[ix] Serico
Works Cited:
Benedictus, Leo. “Would American Psycho Be Published Today? How Shocking Books Have Changed with their Readers.” The Guardian, 2 May 2019.
Gordon, Suzanne. Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, and Medical Hubris Undermine Nurses and Patient Care. Cornell University Press, 2005.
King, Stephen. Misery. Signet, 1988.
Lant, Kathleen Margaret. “The Rape of Constant Reader: Stephen King’s Construction of the Female Reader and Violation of the Female Body in Misery.” Journal of Popular Culture, vol. 30, no. 4, 2004, pp. 89-114.
Misery. Directed by Rob Reiner, Columbia Pictures, 1990.
Palko, Amy. “Poaching the Print: Theorising the Scrapbook in Stephen King’s Misery.” International Journal of the Book, vol. 4. no. 3, 2007, pp. 59-62.
Serico, Chris. “‘Misery’ Loves Company! Kathy Bates, James Caan Reunite to Discuss 1990 Film.” Today, 11 Oct. 2015.
