Psoriasis Advance
"The Singing Detective" exposes filmgoers and the media to psoriasis

From November/December 2003 Psoriasis Advance

First posted Nov. 3, 2003

"The Singing Detective," a film that has the most extensive portrayal of psoriasis and psoriatic arthritis ever on screen, is now showing at theaters around the country. It premiered on Oct. 9 in New York, then opened in New York and Los Angeles on Oct. 24, followed by wider distribution starting Nov. 7.

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The film has been getting a lot of press coverage because it features the first leading role for Robert Downey Jr. since his well-known addiction and legal problems, including a year in jail. He has garnered very good reviews for his performance as Dan Dark, a crime novelist hospitalized with severe, debilitating psoriasis and psoriatic arthritis.

Keith Gordon directed the film version of the highly regarded 1986 BBC television series, written by Dennis Potter, a well-known British writer who himself had psoriasis and psoriatic arthritis. Before he died in 1994 from pancreatic cancer, Potter wrote a screenplay based on his original TV series, updating it and setting it in the 1950s in the United States.

How the movie handles psoriasis and psoriatic arthritis is somewhat contradictory. On the one hand, the word "psoriasis" is never mentioned, and a brief reference to "psoriatic arthropathy" will probably be missed or not understood by most in the public. However, the diseases are very prominent and very graphically portrayed, and the physical and emotional toll they take on Downey's character is clear.

In addition, the visible aspects of psoriasis are tied back to Dan Dark's internal turmoil in several places.

• Dark is sent to a psychotherapist because, as one doctor notes, "You will never get on top of your condition until you get on top of your bitterness. Reassemble yourself."

• The therapist Dr. Gibbon, played by a nearly unrecognizable Mel Gibson, strikes a similar chord: "Chronic illness is a shelter...a cave in the rocks."

• Dr. Gibbon further alludes to the psychological aspects of psoriasis when he tells Dark, "The skin is a very personal thing. It is tempting to believe that the poisons of the mind have erupted on the surface of the skin."

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The therapist helps Dark work through the painful, guilt-ridden memories of his childhood. In the process, Dark's skin improves and the pain and stiffness of his arthritis diminishes. The film clearly associates the improvement with Dark's confrontation of his own inner demons, guilt and painful memories—not directly with successful medical treatment.

The parallel between the psychological aspects of the plot and Downey's personal history can easily be drawn. "The idea of someone who has a disease that's so humiliating, because it's worn right on the surface of his skin&38212;in my own way, I can relate to that," Downey said in an article published in The New York Times Sunday magazine on Oct. 19.

The extensive media coverage is encouraging in that it is raising awareness of psoriasis, but there have also been some negative reactions to the graphic depictions of the disease.

The Foundation, which assisted Gordon and his staff during production with information about psoriasis and psoriatic arthritis, has released a statement about "The Singing Detective." It says, in part, "We hope the film sparks a dialogue about psoriasis and psoriatic arthritis and the serious impact these incurable diseases can have on people's lives. The film breaks new ground by portraying psoriasis and psoriatic arthritis as the physically and emotionally debilitating diseases they can be."