'CAKE' and Pain

CAKE (2015) Starring Jennifer Aniston. Written by Patrick Tobin. Directed by Daniel Barnz.

Executive Produced by Ms. Aniston.

CAKE and Pain

by Wendy Rolfe Evered

If only eating a nice large slice of CAKE would relieve Pain…. Wouldn’t all chronic pain sufferers love that? Instead of taking a Vicodan, or getting cortisone injections, we could simply say, “I’ll just have a nice thick slice of German Chocolate, please, ---or, no, make that Red Velvet, yes, that would suit me just fine.”

Then sit back, and ahhh…. Relief.

If only!

I had heard that a movie about chronic pain was being released, and as a SAG actress who has been on the ‘Pain Train’ since 2008, I had a burning desire* ( that’s neuropathic pain humor) to see how screenwriter Patrick Tobin would (gently, I hope) tackle the subject of Chronic Pain. I, like many other afflicted people, was hopeful that the film would throw an HMI light on the subject and immediately raise awareness of the gaping holes in Western Medical knowledge when it comes to healing pain. The majority of patients with undiagnosed pain set out on their own to tryto find their answer, but they find that information about healing is often obfuscated by bright pharmaceutical ads offering to numb their pain, but not heal their pain.

I was eager see an engaging story unfold with real gritty details of living with pain. For example, the autonomic nervous system can play beastly tricks on a mind and body, and I thought maybe I would see something as complex as that. Will Jennifer Aniston poop her pants in the grocery store?! O.K, I think not, but Julianne Moore’s ‘Alice’ did wet herself in STILL ALICE and I applaud those filmmakers for showing a real moment. But I digress. I am not a glutton for pain, nor am I insane, but in order to educate viewers about pain, we need to see specifically how PAIN works.

There are few medical details in CAKE.

Anyway, I applaud Mr. Tobin for working on this script over several years and Jennifer Aniston for coming on board to make it all happen, but I was disappointed as I saw missed opportunities for making the story more real and actually be about the direct challenges of life with pain. That said, I am heartened that someone actually started out to write about the often unspoken topic. The press was conflicted in how it presented CAKE. ‘Gallows humor’ in CAKE eluded me. CAKE is more about a woman struggling with her own demons and abusing her medications.

I refer to people who live with pain as PAIN WARRIORS-- not because we are at war with pain but because we are a group united by our resilience, persistence, and the strength to get through each day and through sleepless nights. Some warriors have evolved to become pain-free and they return to our conversations to be our inspiration. After seven years of living with pain, I have not yet become pain-free, but I have reduced my pain levels. Yay, me! I have worked hard to rehabilitate myself through Pelvic Floor Physical Therapy, complex strengthening exercises, and an ever evolving combination of supplements & one mild pharmaceutical drug. I try to balance pain management with my daily life so that I can slowly return to work as an actress. Some days are good. Some days my neuropathic pain gets the best of me. The good thing is, there is always a new day, Tomorrow.

I write this article for my fellow PAIN WARRIORS with the hope that we get a spotlight on the unbelievable and unnecessary challenges our community faces.

So, CAKE the film, is described as a character study of ‘Claire Bennett’ portrayed by Aniston. Claire is a soon-to-be divorced, 40-something, pain pill addict who has become obsessed with the suicide of Nina Collins, a woman from her ‘chronic pain’ support group. Claire imagines some awkward and creepy ‘‘ghost visitations’ by Nina the suicide temptress (played by Anna Kendrick). Nina jumped off the I-5 overpass leaving her 5 year-old son and his young father in their own “hell”, and Claire wonders if she has it in herself to commit her version of hari kari.

Claire is in the support group, we assume, because her chronic pain stems from leg surgeries-- (titanium pins and all) that she underwent following a car crash that tragically took the life of her 5 year-old son within the past year. Losing a child is enough to trigger such extreme anguish, anxiety, anger and sadness to send one spiraling into a debilitating state. The despair and unrelenting depression, can turn into a myriad of physical and mental health problems: lack of nutrition, sleep, possible drug and alcohol abuse--all which can weaken one’s immune system lowering the threshold for pain and opening the door to other secondary low level illnesses like allergies or infections, or even cancers.

But what is Claire’s real problem? Is it her knee joints? stiffness ? Does she have Central Pain Sensitization? Is it nerve pain? Did she not allow herself to mourn her son’s death? Does she question that she was ever a good mother? Did she really never ever bake him a homemade yellow cake with fudge frosting? Should she have rolled Play-Doh more with her son and spent less time practicing law to afford their ‘Architectural Digest’ house and pool?

(Not to mention the services of that hot, Latino, 35 year-old pool ‘boy’)? What is the source of Claire’s pain?

[And by the way, though patients with crippling pain may still ‘think’ about sex, actually engaging in sex is far less appealing when it might bring something other than pleasure-- like increased nerve pain.] Very early in the film Claire sends her housekeeper away off through the palm trees, to clear the way for her afternoon tryst. Claire lies on her lovely bed in her boudoir, in the late day’s shadows, for Arturo, the hombre actractivo caliente to finish cleaning her glowing turquoise pool so he can slip inside her slider, and well, slip inside her. So, though Claire is in pain, medicated, and sipping her ever-present glass of Chablis, Director Barnz quickly ensures us that Jennifer Aniston has nice bare gams-- albeit ’scarred’ (the prosthetics team has done good work). To be fair, maybe Claire is so mentally and physically numb that this ‘afternoon delight’ does remind her in some cheap, hormonal way that she is alive-- that there is still a woman in there--although she remains completely without emotion during the three- minute adventure, and afterwards gives Arturo a plastic bin of boy’s toys for his little family waiting for him at his little crappy home somewhere in East L.A. Wam-bam-thank-you Mam-- not exactly what we are expecting in a film about Pain, but hey, that’s cool.

A problem with CAKE is that our leading character Claire is a snarky, unlikeable, self-proclaimed “bitch’ and we wonder if she was ever a kind person...maybe, but seems like she was probably always ungracious, rude, and lacking empathy. She was, after all, a ‘l-a w- y- e-r’.... When the film’s surrounding characters become more interesting than the lead-- we are headed the wrong direction. [HOWEVER, I am suspending disbelief and reserving judgement because I am ultimately heartened that there is a film out in the ether that remotely deals with chronic pain.]

Claire employs Silvana, a warm-hearted, generous Mexican housekeeper played by the wonderfully maternal and powerful Adriana Barraza who also cooks, drives and accompanies Claire everywhere---- even to Tijuana to buy more drugs since Claire has abused her prescriptions once too often. Silvana’s back story is compelling and we cheer for her when she finally tells Claire to stick it where the sun don’t shine.

No surprise that ‘snippy and hurting’ Claire is a loner, but she does befriend Roy Collins, the handsome but uninterested widower of Nina. (Roy is played by Australian actor Sam Worthington.) Roy just happens to have a five year-old son who in the end helps Claire begin her search for her long lost empathy, positive mindset and thus, desire to get better. This journey indirectly begins with her paying a hitchhiking-actress-wannabe one hundred dollars to make a homemade yellow cake with fudge frosting--(the kind that Claire NEVER made for her son!!) which Claire delivers with ‘Martha Stewart perfection’ to 5 year-old Casey Collins’ dining room table. (Apparently Claire does not need to work? as her free time and money appear more than ample.) A press article I read somewhere did refer to her as a non-practicing Lawyer. Plus, Claire probably got a hefty settlement from the ‘driver at fault’’ played generously and perfectly unhinged by William H. Macy.

I discovered the CAKE screener (dvd) in my mailbox only a few days before the SAG awards deadline. Ms. Aniston’s press team was doing some last minute aggressive campaigning in hopes that she might take home an award. And good for Jen. Really. She had boldly taken on a role unlike any she had ever played, it could be her tour de force--and maybe finally distance her from the bubbly, well-coiffed, 20-something, roomie Rachel on the TV sitcom FRIENDS. Playing a woman wracked by unrelenting pain would be a leap for her and hopefully a great boon for PAIN WARRIORS everywhere who are misunderstood, rarely healed, and often over medicated. We--(the ‘everyday people’ trying to separate ourselves from our pain)--and the movie stars--all might get our moments!

Pain Support communities are primarily virtual and certainly global. We support each other. We are kind to each other because we know kindness is reciprocal. We reach out to each other. We are not mean. We share information: new research on therapies, even off-color jokes and funny animal YouTubes; we have talked members ‘off the ledge’, and we cheer when a peer makes Progress. One ‘side benefit’ of Pain keeping you up at night is that there is always someone in the community awake and online in a time zone somewhere if you need a shoulder.

We share. We are not mean. We each have our own challenges. We survive. We will survive.

And we try everything. Some of us have open minds to a more holistic approach. Some of us are working on that. Pain signals can detour even the most positive attitude. But between thousands of us we have tried everything known to humankind to alleviate acute pain that has become chronic: from pharmaceuticals to alternative supplements; amino acids (my personal Rock Stars for healing), vitamins and minerals, enzymes, ice, heat, phytotherapy: herbs, to acupuncture, acupressure, mindful meditation, electric Stim units, physical therapy: external, internal, and aquatic; to mental health therapy, prolotherapy, neuro-lymphatic therapy to hyperbaric chambers, to MMJ aka medical marijuana and cannabis oil gel.

For every person with unending debilitating pain there is a unique cause for their pain. No two human bodies or minds are the same and no two human beings respond to pain or treatment in the same way. So to say we need to ‘find a cure for chronic pain’ is like saying we need to ‘find a cure for cancer’. There are many kinds of cancer each with its own cellular make-up that responds uniquely to a multitude of available treatments, so we patients spend vast amounts of time and resources to simply understand the specific source(s) of our Pain, why it may or may not stop, and what works for each of us. Only when we get answers or even just darn good clues, can we begin to more specifically plan our approach to healing or coping.

We are never told specifically what kind of pain imprisoned Claire, movie-goers will not care but this matters to us pain patients. There is a HUGE world of pain out there. A trillion miles separate a broken leg from trigeminal neuralgia. The majority of pain patients have endured mystery illnesses for months and often years, they have endured scores of doctor visits, very expensive tests, and shot-in-the dark incorrect diagnoses, so we patients DO ask a lot of questions, we want answers, and when we don’t get answers from our doctors we search-- unturning every stone until we find an acceptable cause and effect for our condition. We will cope with the pain and possibly heal the reason for the pain. We will out-DO that pain. We will (try to) be stronger than that pain. We will SURVIVE. So Claire Bennett has round- the-clock pain but the film does not deal with specifics of her pain so I will simply have to let that go OR, my pain levels will rise! Therefore, I decide to make myself stop looking for medical details in CAKE.

After seven years of visiting online medical organizations and social media private medical groups --like Yahoo, Facebook, and Inspire.com -- (there are many more), I have read hundreds of posts written by people searching for help because the Western Medical Community has generally agreed to medicate them but not to help them search for modes of HEALING. The number one topic is Pain , but the secondary is Financial Stability. Frequently voices with frantic despair ask advice: “Should I spend my last $20.00 this week on my Pain prescription? or on gas? to get to the doctor?”.

This is real. This is not a movie. This is real life with real pain, and Pain can be very expensive.

This is where Patrick Tobin makes a mistake. The film would work better if Claire didn’t live in such a rarified world. The majority of viewers will not find much in common with Claire’s luxurious world where money is abundant, there is help 24/7, plenty of peace and quiet, health insurance, and not any responsibilities that we can see. Yes, ‘pain’ is the challenge but no one I have ever met has such a path of least resistance. Mr.Tobin needed to dig up some reality for his script. Maybe it was the Executive Producer’s choice, who knows.

This winter another film was released about a woman experiencing a tremendous challenge. STILL ALICE, is based on Lisa Genova’s novel, written and directed by Richard Glatzer and Wash Westmoreland, and executive produced by Maria Shriver, Christine Vachon, and Declan Baldwin, and stars Julianne Moore. ‘Alice’, at age 50, is diagnosed with early-onset Alzheimers. Alice has a supportive husband (played by a genuine Alec Baldwin), they have thriving professional careers, grown children, and a comfortable lifestyle. This lovely picture slowly begins to fragment as Alice painfully loses grasp of her thoughts. We journey with her. We listen to the doctor deliver her prognosis. We hear her husband question the facts. We see the faces of her family. We are also lost when she suddenly can’t remember how to get home. We see her frantically try to hide her vulnerability. We instantly relate to Alice! Alice is real. Alice drops things. She loses things. She wets herself and is ashamed and apologetic. She is kind. She is likeable. Ultimately we see Alice’s irascible youngest daughter (Kristen Stewart) become her loving bridge to the cosmos.This beautifully written film sweeps us into the confused swirl of Alice’s thoughts exquisitely travelled by Julianne Moore. Watching STILL ALICE made me actually feel relieved that ‘all I have is nerve pain’. I could be kidding but I am not. Taking serious pain meds can surely cloud up one’s thoughts, but unlike having a quickly progressing form of alzheimer’s, one can always try an alternative form of treatment. There are times when pain patients imagine letting go of it all-- stepping off that ledge, veering the car into a tree, but that is different. We have a choice. We can begin again, tomorrow, but Alzheimers takes control of the most open of minds.

Real people with pain can be challenged by the simplest task, and because of this, many end up losing work hours, or leaving their job with only some receiving disability benefits.

Life does goes on.

Baby still needs shoes. The pot needs a chicken. We need income.

If our pain levels increase, we find ways to adapt. We downsize our homes. We wash our hair less often. We use a cane. We get rid of throw rugs. We become experts in Pain Management. We ask our kids and spouses to help us off the floor. We wear the same soft cotton sweatpants for days on end. Life goes on. Our power of concentration lessens because our brains are trying to makes sense of pain signals run amuk.

We have radio static in our thoughts, so forgive us when we lose our patience or cry inexplicably. To fend off depression and despair we need now more than ever: supportive relationships, economic stability, health insurance, exercise, good sleep, healthy meals, clean laundry, clean dishes, and humor--more silly YouTube videos and jokes that make us laugh out loud.

Life goes on.

We do find ways to help us continue. As Jon Kabbat-Zin, Ph.D., beautifully explores in his book, ‘Full Catastrophe’*, we find ‘mindful’ ways to carry on despite all of life’s ups and downs: we troubleshoot the computer crash, we want to make the 8 year-old’s birthday party, we must find the Lost Dog, we have to get the kids to the Dentist, we take time to play our music, we hug our families and our friends, we help with math homework even when our pain level is at an 8, we drag the garbage bin to the curb, we enjoy silly dance moves in the living room. Life goes on. We do what we can to try to embrace the ‘Full Catastrophe’.

We can choose to sit alone in a dark room-- be mean, and engage in self-destructive behavior as Claire does as she chomps, crunches and swallows her pain meds washing them down with Chablis (she surprisingly never staggers, drools, slurs, poops her pants, or even barfs), OR, we can continue to find ways to feed our bodies what they need to heal, keep our minds positive, open, and above all, hopeful for a painfree future. How we participate in the ‘Full Catastrophe’ is completely up to each one of us.

“Out of this shift in perspective comes an ability to act with greater balance and inner security in the world.” --Ben Kallene

The good news is that Claire has a moment of Awakening. She decides that she does in fact “want to get better” and the film ends on a positive note. I clicked off the film wishing that the film had also decided to get better, but once again I want to be fair. Soon after, I spoke with a friend on a Neuropathic pain site, and she confided that she and her husband went to the film, they related to Claire’s story, they cried, they hugged, they opened up about their real pain-related challenges more than ever before. This makes the movie worth it. (It may not be worth eleven bucks.--- ok kidding! sort of),

but CAKE is a good starting point for more public dialogue about how our society and medical groups can expand their knowledge to include holistic diagnosis, management, healing or managing of pain. I suspect Ms. Aniston chose to do CAKE essentially to stretch her acting chops. Perhaps her experience will inspire her to lend a hand and resources to the cause.

Note: In January, 2015, Ms. Aniston participated in a panel discussion on the issue of chronic pain and its effects at the Arthritis Foundation in Los Angeles. The Arthritis Foundation is expanding their pain management resources and tools, creating a new strategy to accelerate diagnostics and treatments, and building initiatives to give people stronger a voice.

Personally I want to see raised awareness of Integrative Medical Care done by our Doctors who are educated in ‘CAM’: Complementary and Alternative Medicine, and are part of the ‘NIH’, or ‘NCCIH’: National Center for Complementary and Integrative Health. We are an overmedicated society that is largely unaware of the many forms of holistic treatments that are ultimately healthier and more affordable. I remain hopeful as I continue on my journey.

END

Wendy Rolfe Evered is a freelance actress who is a self-educated Pudendal Neuralgia patient. She lives in Princeton, New Jersey with her husband Charles Evered (a writer/director), and their two wonderfully compassionate teens. Each have supported and encouraged her literally every step of her journey. After seeing 22 health practitioners, in four states, on two coasts, over three years, Wendy was finally correctly diagnosed and began treatment with

Michelle Dela Rosa, a Pelvic Floor Physical Therapist, owner of Connect Physical Therapy, in Hamilton, New Jersey.

*’full catastrophe’ is a line in ‘Zorba The Greek’ in which the title character refers to the ups and downs of family life as “the full catastrophe”. Jon Kabbat-Zinn, founder of the Stress Reduction Clinic at the University of MA Medical Center, is a well known proponent of using meditation to help patients deal with illness. The book goes into detail about how hospital patients have either improved their health or simply come to feel better despite their illness by using these techniques.These meditations can help anyone deal with stress and gain a calmer outlook on life.