Wednesday, October 31, 2012

Movie Review: The Bride of Frankenstein (1935)

[Note: As with the my previous Frankenstein review, this review will also contain spoilers.]

As is fairly well known, Frankenstein; or, The Modern Prometheus was written by a young Mary Shelley in the early 1800s. The novel was the result of a competition between Shelley and several friends to see who could write a better horror story. While the 1931 Frankenstein was introduced by a speaker warning the audience of the impending horror, The Bride of Frankenstein begins with a highly fictionalized account of the origin of Shelley's story.

One stormy evening, Mary Shelley (Elsa Lanchester), her husband Percy Shelley (Douglas Walton), and the famous Lord Byron (Gavin Gordon) find themselves with little to do. Inspired by the storm (and with an atrocious "Scottish" accent), Lord Byron reminisces about the story that Mary had once told about the mad scientist and his monster. As he speaks, key scenes from the original film flash across the screen for the benefit of an audience that, in all likelihood, had not seen Frankenstein for four years. Mary tells Lord Byron that her story isn't yet finished and launches into the second half of her tale.

This opening is just plain odd, and not just because Lord Byron's accent is horribly obnoxious. Since the film begins as the windmill is burning, leaving little time for exposition, I understand that the filmmakers would feel the need to insert a summary of the original movie. However, bringing Mary Shelley herself into the film has bizarre consequences. Shelley and her friends are shown wearing clothing appropriate for members of early 19th century England's upper class. However, American accents notwithstanding, Frankenstein clearly takes place in Germany in the very decade in which the film was made. Except for the traditional clothing worn by villagers preparing for the marriage of Baron Frankenstein's son, the men all wear 1930s style hats and suits. Even Elizabeth's wedding gown is characteristic of '30s fashion. The machinery used to bring the Creature to life are of 20th century manufacture and are well beyond anything Shelley could have dreamed up.

It seems like the filmmakers decided to retcon the series by changing the era in which Frankenstein's sequel takes place. Gone are the '30s hats and coats; now the Bürgermeister (E. E. Clive rather than the original's Lionel Belmore) and the villagers continuously wear traditional German clothing. Later in the film a character uses a device that is obviously a telephone but has to inform Henry Frankenstein, an accomplished scientist, what the device does. Since The Bride of Frankenstein is a direct sequel to Frankenstein and goes as far as to bring back several secondary characters (if not their original actors), this sudden change in setting is disconcerting.

Anyway, our film opens as the windmill is burning. Henry Frankenstein (still Colin Clive) has been thrown from the top of the building and the villagers have placed him on a makeshift stretcher. At the very end of Frankenstein we saw that Henry had been returned to his family home and was recovering. For whatever reason the villagers now believe Henry to be dead or dying (they're not clear on which). It's at this point that we meet Minnie (Una O'Connor), Baron Frankenstein's housekeeper. In my previous review, I said that the role of Odious Comic Relief would be more than adequately filled in this movie. That role goes to Minnie; a shrill, obnoxious, and opinionated old woman whose antics are supposed to be amusing and funny. They are neither. Minnie dominates every scene she's in and annoys every character as much as she annoys the audience. And, for whatever reason, the writers put her in multiple scenes. In fact, I hate this character so much that she's a major reason why I give this film a lower grade than the original.

The Creature makeup was refined to
allow Karloff to be more expressive
As the villagers take Henry back to his home, certain(?) that he's dead, the Bürgermeister tries to herd the peasants back to the village. Although the original film explicitly showed that only the men had gone out to hunt for the Creature, the mob of townsfolk now contains a large number of women. Hans, the drowned girl's father (Reginald Barlow in place of Francis Ford) who effectively started this whole party, refuses to leave until he sees the monster's charred bones. As his distressed wife looks on, Hans climbs into the smoldering ruins just to fall into a water-filled cistern underneath the windmill's foundation. Needless to say, the man finds a Creature that, despite a few burns on its face, is very much alive and very upset. Dad is quickly dispatched. Believing that the grunting figure emerging from the ruins of the windmill is her husband, Hans' wife finds herself helping the Creature out of the wreckage. Mom finds herself in the cistern, too.

Unaware that the Creature is on the loose again, the locals return the young Frankenstein to his home (oddly, the ubiquitous Baron Frankenstein from the first film is nowhere to be found). As his fiancée, Elizabeth (who is now Valerie Hobson, a brunette with long hair, rather than Mae Clarke, a blonde with shorter hair) and his household begins to mourn him, the not quite dead Henry begins to stir. This causes Minnie to go into "comical" hysterics (man, I hate this character). With Elizabeth's help, the scientist begins his long recovery, regretful that he ever played God and brought such a curse on his family and his village. I said last time that Colin Clive's Frankenstein is great when he's in mad scientist mode. Unfortunately, there's nothing quite as dull as a penitent and self-pitying mad scientist. At the same time, Elizabeth's character seems to be on the edge of insanity. Her premonitions from the first movie have become outright hallucinations as she imagines that an ominous specter seeks to claim Henry (this never comes up again, by the way).

Fortunately, after inflicting us with Minnie and damping Frankenstein's enthusiasm for meddling in God's domain, the writers give us Dr. Pretorius (Ernest Thesiger). Pretorius was one of Frankenstein's professors until, like Henry, he was shunned for the nature of his work. The doctor has heard of Frankenstein's success in reanimating dead tissue and has come to solicit his aid in his own experiments. Although he insists that his monster-making days are behind him, Henry can't help but to be curious and agrees to see the results of Dr. Pretorius' work.

Dr. Pretorius is the second best thing about The Bride of Frankenstein. Frankenstein gets enthusiastic about his work; Pretorius becomes downright giddy. And while Frankenstein has enough morality left to restrict his activities to a little grave robbing and stealing a slightly used brain from the local university, Dr. Pretorius has no such scruples. He's not just a mad scientist, he's an evil mad scientist. He's probably best characterized by the toast he offers to his potential partnership with Henry Frankenstein: "To a new world of gods and monsters!"

Unlike Frankenstein, who has bestowed life on dead tissue, Pretorius has been creating human-like creatures from "seed", similar to the way that one would grow a bacterial culture. Unfortunately, his experiments have merely resulted in doll-sized beings which he keeps in jars. It's Pretorius' conclusion that a combination of the scientists' techniques could successfully produce a race of artificially created human beings.

It was when Pretorius pulled out the little jars that my friend leaned over and said, "this is pretty weird", to which I could only agree. First of all, this whole scene is utterly ridiculous. The tiny people are dressed in various costumes and speak in sped-up cartoonish voices. One little person, who's dressed as a king, keeps trying to sneak into the jar of the person dressed as a queen while a tiny bishop wags his finger in disapproval. Why the former professor believes that his discoveries can improve on Frankenstein's work, or how the ability to reanimate dead tissue will correct Pretorius' failures is completely unexplained at this point. The doctor's gleefully over the top performance is the only thing that prevents this sequence from becoming unbearable.

It's bizarre that this scene exists in the same movie where a hideous and misunderstood monster roams the countryside, desperately seeking companionship. The Creature is now more lonely than angry and his occasional acts of violence occur only in reaction to the locals' attacks on him. That Pretorius' absurd doll-sized failures share a film with the Creature's tragic quest is absolutely mystifying. It's even stranger when we find out how Pretorius contributes to the titular Bride; specifically, he grows a new brain for his and Henry's joint creation. Why couldn't the filmmakers have Pretorius display jars with living organs and explain that he was still unable to reproduce an entire human being? Not only would the tone of the film have remained consistent, but the usefulness of this ability would have been immediately obvious given how hard it was for Frankenstein to find a suitable human brain the first time around. It's frustrating that such an obvious opportunity was missed.

And then, suddenly, the film takes a sharp turn and starts getting good.

While Frankenstein mulls over Pretorius' offer, the monster continues his wanderings. At one point the townsfolk actually succeed in capturing him and chaining him in a dungeon, but he breaks his bonds and escapes. Eventually, attracted by the playing of a violin, he enters the home of a blind hermit (O. P. Heggie). Thus far the Creature has been despised by everyone who's seen him. The hermit, unable to see the Creature's ugliness and just as lonely as he is, believes that God has finally answered his prayers and sent him a companion. He feeds the monster and tends the gunshot wound that the Creature suffered while being hunted. As time passes, the hermit teaches the Creature simple speech and Frankenstein's creation finally knows friendship. Of course this can't last and two villagers passing by the hermit's cottage "save" him from the monster while another angry mob resumes the chase.

While being pursued through a cemetery, the monster hides in a large crypt that is occupied by more than just the dead. Dr. Pretorius and his henchmen Karl (Dwight Frye, who played the hunchbacked Fritz in Frankenstein) and Ludwig (Ted Billings) have taken a page from Henry Frankenstein's playbook and are doing a little grave robbing of their own. In a morbid mood, Pretorius sends his goons away and breaks out a bottle of wine while talking to the bones of the long-deceased woman who will apparently be contributing to the professor's next experiment. When the Creature approaches the tipsy scientist, he's surprised to find the professor happy to see him. Pretorius begins questioning the monster and asks him if he knows who Frankenstein is. The Creature's answer, given in his halting speech, is heartbreaking: "Yes, I know. Made me from dead. I love dead... hate living." The professor promises to create a female companion for the monster, which interests the Creature very much.

When Pretorius visits Henry again to convince him to continue his work, he brings the Creature along to help emphasize his point. Frankenstein is rather surprised to hear his creation firmly tell him to "sit down"; one of the first things we heard Henry say to the monster in the original film. When Pretorius feels like Henry has been adequately intimidated, he commands the Creature to wait outside. When Henry finally refuses to build another monster, he hears screams; the Creature has decided to force his creator's hand by abducting Elizabeth. Left with little choice, Henry returns to the watchtower and, with the help of Pretorius, begins to construct a new creature.

Unlike last time, Henry has a much tighter schedule and is trying to incorporate Pretorius' innovations into the new monster. As he works, the Creature roams the watchtower, anxious to have a friend and companion made especially for him. Henry's short-tempered creation refuses to allow him any rest. When Frankenstein demands to see Elizabeth, he is only allowed to speak to her through "an electrical device"; i.e., the phone that I mentioned earlier. Although it's not entirely clear, it seems that Elizabeth is being kept in a nearby cave or dungeon.

The brain that Pretorius has grown appears to be satisfactory, but the heart isn't strong enough. The professor orders Karl to obtain a new heart, which he gladly does. Henry is amazed by the freshness of the organ, which Karl hesitatingly states was obtained from "an accident victim". As Pretorius well knows, the heart's donor was very much alive when Karl found her. With the organs installed, the body on the table awaits the quickly approaching thunderstorm.

The Bride of Fankenstein's creation scene is just as fantastic as the similar scene in Frankenstein, even after having seen both sequences within an hour and a half of each other. This second scene has introduced the use of large kites launched by Karl and Ludwig to help attract the lighting. While on the roof, the Creature attacks Karl and throws him off the watchtower. I'm not entirely sure why he does this, but it seems appropriate since Karl is a cold-blooded murder that's played by the same guy who played Fritz.


Obviously Frankenstein and Pretorius are successful, and again Frankenstein declares "It's alive!" with nearly as much enthusiasm as before (he might be doing it under duress, but a self respecting mad scientist should always be able to muster at least a little enthusiasm when playing God). Soon the female Creature (Elsa Lanchester, who played Mary Shelley earlier in the film), has been unwrapped and is brought to her feet. Pretorius dramatically calls her "the Bride of Frankenstein" (hey, he said the movie's title!) and the original Creature slowly approaches her. The Creature is sorely disappointed when the Bride finally opens her mouth and screams at his hideousness. The Creature again tries to interact with her by taking her hand and receives the same response. "She hates me," says the monster, in a voice mixed with as much sorrow as anger.

As the situation quickly starts to fall apart, Elizabeth appears at the watchtower door, having escaped her imprisonment off-screen. The Creature, now utterly desperate, rages through the lab and eventually puts his hand on a conspicuous lever. As required by the Mad Scientists' Union, Frankenstein's equipment apparently has a self destruct switch. Henry warns the monster that pulling the lever could kill them all. Realizing that death is almost certainly what the Creature wants, he warns Elizabeth away. Elizabeth refuses to leave without Henry, but Frankenstein won't leave his creations again.

Finally, the Creature makes up his mind and commands his creator and Elizabeth to go and live. Then, looking at Pretorius, he yells "You stay! We belong dead!" A tear falls down the monster's cheek as he pulls the lever. The resulting explosion envelops the Creature, his short-lived companion, and the professor. Henry comforts Elizabeth as they watch the rest of the watchtower collapse.

Although it has a few weaknesses, Frankenstein is consistently good. It starts out with grave robbing, promptly moves on to the creation scene, shows how quickly Frankenstein loses control of the Creature, and then finishes off with the hunt for and apparent destruction of the monster. The Bride of Frankenstein, on the other hand, just doesn't just seem to do a whole lot in its first half other than to show that the Creature survived the fire. We're forced to spend time with annoying characters like Minnie, we see an otherwise acceptable mad scientist like Dr. Pretorius pull out his ridiculous little people in jars, and we get to watch Frankenstein feel sorry for himself (which is the weakest part of the novel, too).

And then, just when The Bride of Frankenstein feels like it's going to be one of the many disappointing sequels to classic monster movies (see my review on the sequels to The Creature from the Black Lagoon) the filmmakers repent of their earlier mistakes and give us a different movie. Minnie effectively disappears into the background, Pretorius' jars are put away and never mentioned again, and Frankenstein gets back into the monster-making business. And the Creature learns to talk.

Boris Karloff does a great job when he plays a mute; he's amazing when his Creature is allowed to speak. In Frankenstein he's threatening, although it's hard not to have at least a little sympathy for him. As soon as he becomes acquainted with friendship from his time with the hermit, and once he learns to talk (albeit with a vocabulary of no more than a few dozen words), the Creature becomes a fascinating and tragic character rather than just a destructive force. Of course, he doesn't lose any of his menace; his first post-windmill interaction with Frankenstein proves that. But, ironically, it's the grotesque reanimated corpse that has the most depth and becomes the most human character in the entire film. Boris Karloff makes the movie and the filmmakers knew it. His name is rightly presented first and in enormous font during the opening credits.

If only the first half of the film was as good as the second.
B

Saturday, October 27, 2012

Movie Review: Frankenstein (1931)

This past week, a friend and I took advantage of the recent Fathom Events/TCM screening of Frankenstein and The Bride of Frankenstein at the local multiplex. I had seen both films before, but that was about 15 to 20 years ago when the Sci-Fi Channel actually showed good movies, especially around October. The chance to see the two on the big screen was too good to pass up.


I was pleased with the presentation; TCM had digitally cleaned up the two films, which were projected in HD. I've seen movies made fifty years later that didn't look or sound nearly as good. Although a transmission error caused us to miss the first few minutes of the film (i.e., we didn't see the studio's "warning" about the horror we were about to see), we missed so little of the actual story that I think most of us forgot that it even happened.

[Note: Since Frankenstein is over 80 years old, this review will contain spoilers.]

Frankenstein (1931):
I've written about this film before in the 31 Monsters of October series I did in 2010 (they're still my most popular posts). I hadn't seen the film in years, so the entry has a few minor errors; e.g., I incorrectly believed that the film's Henry Frankenstein was a full-fledged doctor rather than a university student.

The story proper begins with a funeral which is under clandestine observation by a rather unsavory pair (in my opinion, anyone bringing a shovel to a funeral is suspect). After the grave has been filled but before the dirt has even settled, Henry Frankenstein (Colin Clive) and his hunch-backed assistant Fritz (Dwight Frye) rush out to do some good ol' fashioned grave robbing. (Yes, I said Fritz. There was no Igor character in the novel nor in the Frankenstein films until Bela Lugosi's "Ygor" appeared in Son of Frankenstein (1939).) Later, a second body is pilfered from the gallows. The hanged man's neck had been broken, making the brain useless, so a third trip is made to the local university (the one Frankenstein had attended until the nature of his studies started making his professors uncomfortable). A jumpy Fritz drops the first brain he grabs so he ends up stealing the one right next to it... the one in a jar labeled "Abnormal".

In the meantime, Henry's father, Baron Frankenstein (Frederick Kerr), Henry's fiancée, Elizabeth (Mae Clarke), and their mutual friend, Victor Moritz (John Boles), are worried about the fact that Frankenstein has recently secluded himself in a decrepit watchtower and thinks of nothing but his work. Elizabeth and Victor solicit the help of one of Henry's professors, Dr. Waldman (Edward Van Sloan), in an attempt to convince Frankenstein to return to his normal life.

The three have terrible timing, though. Not only do they arrive at the watchtower in a thunderstorm, but it happens to be the very night that Frankenstein and Fritz intend to bring their hideous assemblage of dead body parts to life. Henry reluctantly allows his visitors to enter, but tries to convince them to leave. It's only when Moritz refers to Frankenstein's "mad" work that Henry decides to show them exactly how mad he is. Frankenstein's unexpected audience watches as Henry and Fritz start up various machines and electrical devices surrounding a table on which lies a human body covered in a sheet. As the storm reaches its zenith, the table is raised towards the roof and lightning is conducted through the machines and into the corpse. Once lowered to the floor, the body's exposed hand begins to twitch. An ecstatic Frankenstein declares that "It's alive! It's alive!"

Elizabeth and Victor return to Baron Frankenstein and try to allay his fears about his son (while leaving out certain details), while Dr. Waldman and Frankenstein discuss what to do with the Creature (Boris Karloff, obviously), which has been allowed to wander around the watchtower. Waldman warns that it's a monster and declares that it must be destroyed, while Henry maintains that the oversized being is made from the best human tissues and can become like any other human. When Henry admits that the Creature's brain came from Waldman's own university, the professor tells the startled scientist that "The brain that was stolen from my laboratory was a criminal brain."


When the Creature shows that it's terrified of fire, Fritz insists on tormenting it with a torch. The Creature's violent personality is soon revealed when it kills Fritz and attacks Waldman and Frankenstein. After the two are able to inject the monster with tranquilizers, a penitent Frankenstein admits that Waldman is right. The old professor volunteers to dismantle the Creature and insists that Henry return to his loved ones and finally make good on his promise to marry Elizabeth.

So, any guesses on what could possibly happen when a scientist is left alone in an abandoned watchtower with a tranquilized reanimated corpse with a propensity for violence? A reanimated corpse that, according to Waldman's own notes, is gradually developing a resistance to the tranquilizers?

Anyway, as Henry, Elizabeth, and the rest of the village prepare for the wedding, the bride-to-be begins to have horrible premonitions of doom. Although Dr. Waldman's failure to arrive on time has Elizabeth worried, Henry insists that the old professor was never very punctual. Meanwhile, the Creature roams the countryside and the body count begins to rise. While the drowning of a little girl is caused by the Creature's lack of understanding rather than from malice, many deaths result from the villagers' violent reactions to the Creature.

Not long after finding out that Dr. Waldman has been killed, Elizabeth's screams and the Creature's grunting alert Henry that the monster is in his house. The arrival of Henry and Victor causes the monster to run off before he can seriously injure Henry's fiancée. When the little girl's father brings her body to the town's Bürgermeister, the bereaved father, the Bürgermeister, and Frankenstein (whose part in the whole tragedy is unknown to all but Elizabeth and Victor) are assigned to lead three groups of pitchfork- and torch-wielding villagers in a search for the monster.

The three groups eventually converge on the mountains where the Creature confronts Frankenstein, who has become separated from his group. After knocking him out, the monster drags his unconscious creator to a rundown windmill. When the villagers surround the structure, the Creature throws Henry to the ground. Only a passing windmill vane breaks the scientist's fall. The villagers set fire to the building, apparently destroying the Creature.


Although I recognize a lot of its weaknesses, I love this movie. Modern audiences may be a bit less forgiving than I am, though. As I've noticed in many other movies from the '30s, a surprising number of the actors, even some of the more important ones such as Mae Clarke (Elizabeth), give oddly stilted and exaggerated performances. And, as was par for the course during this era, the writers insisted on giving us a comic relief character in the form of Baron Frankenstein. While Kerr's befuddled Baron is occasionally funny, his antics often seem out of place in an otherwise serious film. Fortunately, he never descends to the level of Odious Comic Relief; a position that would be more than adequately filled in The Bride of Frankenstein.

There are a few logical lapses in the film as well. For example, it's never explained how the drowned girl's father knows that she was murdered. He leaves the little girl, who can't swim, to play by the lake. He never sees the Creature and therefore has no reason to suspect that her death was anything but an accident. Additionally, through an unbelievable and unexplained coincidence, the Creature makes a beeline to the Frankenstein home and arrives in time to interrupt the wedding. While the novel's monster threatens Elizabeth shortly after the wedding (okay, "threatens" as in he actually kills her), Mary Shelley's Creature is portrayed as having an above average intelligence and finds his creator's home by following him surreptitiously.

There are other aspects of the film that may turn off modern viewers. These are characteristic of movies from this period and aren't truly the fault of the filmmakers. For starters, like Dracula (1931) and other "talkies" from the very early 1930s, the movie lacks any sort of score. We've become so used to hearing music in the background of our movies that its absence can be off-putting. Also, the climactic search for the Creature occurs on a relatively small mountain set, which adversely affects some of the scene's drama. Unlike some of their foreign counterparts, early American filmmakers rarely risked their expensive equipment by doing location shooting and preferred to stick to indoor sets. By contrast, the German director F. W. Murnau filmed a surprising amount of Nosferatu (1922) on location, much to that film's benefit.

These shortcomings aside, Frankenstein is a great old film. Mae Clarke's Elizabeth or Frederick Kerr's Baron Frankenstein may not be the most engaging characters, but Colin Clive's Henry Frankenstein is excellent when he's in full mad scientist mode. Between Clive's acting, director James' Whale dynamic camera, and electrical effects designer Kenneth Strickfaden's equipment, the creation scene is still amazing even 80 years later. Boris Karloff makes the movie; his depiction of the Creature is simultaneously menacing and sympathetic. And his performance is only enhanced by Jack Pierce's famous makeup job. In fact, the makeup has become so iconic that I'd be willing to bet that most modern viewers wouldn't recognize Boris Karloff without it.
B+

Next time: The Atomic Spud meets The Bride of Frankenstein...

Saturday, October 20, 2012

Book Review: Nephite Culture and Society: Collected Papers

[This review originally appeared on www.goodreads.com]

Nephite Culture and Society: Collected Papers by John L. Sorenson
My rating: 4 of 5 stars

This interesting book collects a number of papers by LDS archaeologist John Sorenson. Subjects range from the composition of Lehi's and Nephi's group of travelers to the political structure of the Nephite (and to a lesser extent, Lamanite) civilization throughout its history. Unlike similarly-themed works, these articles are not primarily meant to provide evidence for the historicity of the Book of Mormon. Instead, the papers attempt to examine or deduce elements of Nephite culture under the a priori assumption that the Book of Mormon is true. Many LDS readers will nonetheless find the book faith-promoting given that the Book of Mormon provides sufficient detail to allow Sorenson to believably reconstruct the essentials of Nephite culture. The result is a society that appears to parallel those of known ancient civilizations.

All the papers are interesting and the majority of Sorenson's work appears to be adequately supported and well reasoned. However, some of his arguments rely on off-handed statements found in a single verse or on his interpretation of a single phrase. For example, is someone who is described as "Lamanitish" different than someone who is simply a "Lamanite" or does the term "People of the Nephites" imply something that the term "Nephites" doesn't? In another paper which claims that Nephite/Lamanite warfare was highly seasonal, Sorenson must extrapolate approximate dates for numerous battles and events based on a writer saying that a preceding event occurred during some specific month of that particular year. While his reasoning for the dates seems sound, it is less than ideal to base an argument on extrapolated data.

Nephite Culture and Society is a good book and provides a fascinating look into the cultures of Book of Mormon peoples. However, readers must realize that the Book of Mormon wasn't intended to be an anthropological text and therefore lacks explicit information about the very subjects that Sorenson discusses. Thus, it must be understood that several of Sorenson's arguments and conclusions are necessarily speculative.

One more minor criticism: I'm not sure who chose the font for this book, but it's not easy to read. I think the last thing an author wants when he's trying to convince the reader of the validity of his conclusions is for the reader to be distracted by the font.

View all my reviews

Friday, October 5, 2012

The Acid Reflux Saga

I've had problems with gastroesophageal reflux disease (GERD) since I was a teenager. By graduate school it had gotten so bad that I started taking the proton-pump inhibitor (PPI) Prilosec to control it. While it worked well for years, over the past year I began to realize that the daily pill that had controlled my reflux for eight years had started to lose its effectiveness. A little research found that this is relatively common for those who have taken a particular PPI for as long as I have.

I visited my doctor who prescribed a much stronger (and more expensive) PPI called Dexilant. Dexilant worked much of the time, but I'd have periods of one to two weeks where it just didn't seem to be effective. Concerned that the reflux could lead to serious problems like Barrett's esophagus, my doctor recommended that I visit the surgeon who removed my gallbladder earlier this year for further evaluation. The surgeon quickly scheduled me for a series of tests. These were meant to determine how bad my reflux was, what kind of damage it may have caused, and whether or not I was a candidate for a surgical solution. Given how long I've had this problem, it was believed that I might end up having surgery.

Who knew that the tests for evaluating chronic reflux could be so horrible?

Endoscopy
The first test was the upper GI endoscopy. This involved putting an endoscope with a camera on the end down my throat to take pictures of the esophagus and the entry to the stomach. They gave me a sedative for this one (thank heavens). The sedative wasn't the same as a general anesthetic, but it might as well have been given how hard it knocked me out.

The finding of the endoscopy was that I had low level esophagitis and a mild hiatal hernia. Since I had taken PPIs for years, it was possible that my reflux was still pretty bad and that the acid hadn't been able to do too much damage yet, so it was on to the next test.

Esophageal Motility and pH Study
Before doing these tests, they made me stop taking any PPIs for a week. If I thought that my medicine was no longer effective before, I was shown how well it was still working during those seven days. It was definitely a long week. When I finally I went to the gastroenterologist's office, I was glad that I was finally going to get the test over with and be able to take Dexilant again.

Then they told me what they were going to do to me. Who knew that a test with such an innocuous name could be so unpleasant?

You've got to be kidding me
I could only laugh when the physician's assistant showed me the enormous probe (okay, its diameter was probably only 1/8", but it sure seemed big) that they were going to put up my nose, down my throat, and into my stomach. Then they were going to pull it out centimeter by centimeter while I swallowed syringes of Gatorade to assess the function of the muscles in my esophagus. The test was expected to take about 20 minutes but could take longer if I inadvertently swallowed at the wrong times.

The assistant made three attempts to insert the probe, but it kept jamming into the back of my throat and getting stuck. I gagged each time and eventually asked the assistant if anyone had ever thrown up on her. She said that no one ever had, but she kept a trash can nearby just in case. She finally called for the doctor to see if he could get the tube in. "I hear we've been torturing you," the doctor told me. "This is the worst test we do without putting you to sleep." The doctor was able to get the probe to make the U-turn in his first attempt and the assistant ran the rest of it in. This was as fun as it sounds.

The probe was so thick that the slightest movement caused gagging. Swallowing wasn't much easier. For the next 20 to 30 minutes the assistant squirted Gatorade into my mouth and had me swallow once each time. After 20 seconds of data collection, she would pull the probe out another centimeter and repeat the process. Normally I'm able to mentally distract myself from a situation (and yes, it is often by thinking of Warhammer 40K). However, I found it hard to think of anything other than the thick catheter that ran up my nose and down my throat and that was being pulled out ever so slowly.

The smile is definitely forced
Once that horrible test was done, I went on to part two. Part two wasn't much better. They were going to stick yet another piece of equipment up my nose and down my throat (this one with a 1/16" diameter). The sensor end of this probe would dangle just above my stomach while the other end would protrude out of my nose and would be attached to a small computer that I could hang from my shoulder. I had to wear this thing for 24 hours, while the computer continuously monitored the pH levels in my esophagus. I was supposed to push a button on the computer each time I had heartburn to indicate when I thought reflux episodes were the strongest.

Like the bigger probe, the pH sensor made it difficult to move my head without gagging. I was supposed to eat during the test period, which wasn't too much fun given that my esophagus had to push all food past the wire. Swallowing had the unfortunate effect of causing the wire to wiggle up and down, which made me gag slightly and irritated my nose. I spent almost the entire day on the Internet trying desperately not to move too much. Obviously sleeping was a challenge. The only positive was that my heartburn was at its worst that day, so at least I felt like I was giving them good data.

After 24 very long hours I went back to the gastroenterologist's office (the receptionists didn't even have to ask why I was there). Before taking the wire out, the assistant checked the computer's data card. As she accessed the card, I had a brief moment of panic when I imagined that the card had become corrupted and that I would have to wear the wire for another 24 hours. Thankfully the card was fine and I was able to go on to my next appointment without the hardware. I was told that the data would be processed and sent to my surgeon within a week.

Barium Swallow
The next thing I knew I was at the radiologist's office and was swallowing a chalky liquid with the consistency of paint. The physician's assistant apologized for the taste of the barium and how much I had to drink, but I assured her that it was a pleasure after having to wear that probe for a day.

I've gotten more radiation exposure from things
like this than I've ever gotten at work
The truth was that drinking the barium wasn't the hard part. The hard part was drinking the ground up Alka-Seltzer beforehand and trying not to belch. The stuff is intended to distend the stomach to allow the fluoroscope (a real-time X-ray machine) to get better images. When the process required me to lay on my stomach, it took a lot of effort to keep the gas down.

The fluoroscope was a pretty neat device that was operated with a joystick. Each time I swallowed a mouthful of barium, the radiologist would follow it down with the fluoroscope's emitter like he was playing an intense (and radiation-emitting) video game. The bed of the machine could rotate from a fully upright position to a prone position and we repeated the process with me standing up, laying on my side, laying on my stomach, etc. Eventually he had me do a variety of exercises meant to produce reflux, which he was able to record.

The barium swallow confirmed what the endoscopy had told us; i.e., that I had a small hiatal hernia. Like the pH data, the radiologist's findings were sent along to my surgeon.

And the Final Verdict Is...
Yesterday I went to the surgeon and he gave me his recommendation based on all the test results. I knew something was awry when he said "You're not giving me much to hang my hat on" and asked if I had stopped taking my reflux medication a week before the pH test. Yes, I said, my heartburn had been horrible the day I had the probe in. Lo and behold, the pH test showed that the acid levels in my esophagus were within normal limits. The esophagitis that the endoscopy had found was minor and simply indicated that I have a small amount of reflux that's relatively normal. The barium swallow confirmed that I have a small hiatal hernia, but those are extremely common and hernias that size don't generally cause a problem.

So why the heartburn? Well, every few months the surgeon sees a patient with an extremely sensitive esophagus. While the reflux they have is within acceptable levels, the pain and discomfort is considerable. Apparently I'm one of those lucky patients. "I'm a surgeon by trade, and I'd love to operate on you," he told me, "but I don't think it would help you." The nearest thing to a solution for this is PPIs since the surgery still permits a small amount of reflux to occur. Since my problem is a sensitive esophagus, I would still get heartburn after the surgery plus I would have all the unfortunate side effects that come with the procedure.

I'm not really sure how I feel about this. I'm glad that I don't need surgery and it's good that my reflux isn't bad enough to really damage my esophagus. On the other hand, I've just been told that my problem won't really go away and that I'm just going to have to be dependent on medicines that may or may not be effective for me anymore.

And it means that I had that %$#& probe up my nose for nothing.

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