EFL Movie Study Guides (for English learners)

EFL Movie Study Guide for: Patch Adams

Story: In a mental hospital, Patch learns (from fellow patients) that 'if you focus on the problem, you can't see the solution,' and this inspires him to apply his brilliant mind to the field of medicine. In medical school (1970s), fun-loving Patch tries to inject comedy and compassion into the medical profession, believing that patients need both medicine and friendship from their doctors. But can he face the problems and pain that come with actually caring for needy people? Based on a true story. (1998; Universal Pictures; Robin Williams; comedy, drama, US history; 115 minutes)

Setting: Starts in 1969, Fairfax Hospital Psychiatric Ward (mental hospital); moves two years ahead (I970s), Virginia Medical University, and nearby hospital and clinic

Characters:

Arthur Mendelson: a famous, wealthy patient in the mental hospital (see dialog 1)

Carin Fisher: one of the eight women in Patch's 163-member medical class

Dean Walcott (also spelled Wolcott in some subtitles): at the medical school, this is Patch's dean; also chief doctor at the university hospital (he doesn't like Patch, so he is the main protagonist/enemy in this film)

Hunter 'Patch' Adams: the central figure in this story ('Patch' is his nickname)

Larry (formal name is Lawrence Silver—this is important to the story): a depressed, self-mutilating patient (i.e., sb with mental problems who hurts himself)

Mitch Roman (in his first appearance, the subtitle says 'Vroman'): Patch's roommate in medical school

Nurse Joletta: a black nurse (probably the head nurse) at the university hospital

Dr. Prack: head of the psychiatric hospital

Rudy: Patch's roommate in the mental hospital. He is afraid of invisible squirrels ('one of the most amiable creatures on the planet')

Dr. Titan: an elderly doctor at the university hospital who likes Patch, and later helps him.

Truman Schiff: Patch's best friend at medical school

Note 1: After their first exam, you briefly see their grades: Carin 'Fisher, C' earned a 79%, Mitch 'Roman, M' got 94%, and Patch 'Adams, H' got 98% (second highest grade in the class).

Note 2: Comedians often rely on offensive sex jokes to get a quick laugh (creating clean humor takes more effort). For example, when Patch realizes that Dr. Prack is not listening to him, he says weird things about body parts to get a reaction (unsuccessfully). Patch also creates an 'ass' joke when telling Dr. Prack he didn't care about his professional opinion—Patch had decided to check out of the mental hospital. Thus, this movie features crudeness, comedy and tragedy, but so does real life.

Note 3: In the US, hospital patients often wear gowns that have no 'back' (for the convenience of examination and treatment). The last joke of the movie relates to Patch's decision to 'conform' and wear this kind of gown.
Language note: Some characters (e.g., a black nurse in the mental hospital) use non-standard English, so the subtitles might not help you understand what they mean. Example: 'You gon' love it here,' which means 'You are going to love it here.'

With medical students, I split this film into two parts, ending the first part after Patch appears dressed like an angel.

*A few terms (vocabulary):

Part 1:

*to adjourn: (formal) to end a meeting, class, etc.

*amputation: a medical operation to cut off someone's arm, leg, etc.

antics: strange, often humorous, behavior

catatonic: [medical] not able to move or talk because of an illness

to conform: to act like others, esp. because 'everyone' in your group or society acts this way

have a crush on sb: to feel like you are in love (especially as teenagers) and not sure that you want the other person to know (Patch says to Carin: 'I have a crush on you. Ha! I can't believe I just blurted that out.')

*to be dismissed: to be given permission to leave a meeting, or to be forced to leave a university, club, job, etc.

fantasy: in this film, 'what's your fantasy' means 'what is something you wish you could do before you die from this disease' (One patient dreams of 'one last safari' and another dreams of swimming in a pool of noodles!)

to flunk out: to fail, and therefore be dismissed from a school

*genius: a person with exceptional talent or abilities (or things such a person creates)

*the Golden Rule: 'Do unto others as you would have them do unto you' or 'treat other people the way you want others to treat you'; this is a quote from Jesus in the Bible, and for the first 200+ years of American history, every school child memorized this 'Golden Rule'

gynecologist (BrE: gynaecologist): a doctor specializing in women's medical conditions and who delivers babies (a big joke about this almost gets Patch dismissed from med school)

*infirmity: illness

meat packers: people who process meat to sell in grocery stores (Patch attends a 'meat packers convention'; that meeting is full of puns, such as 'Nice to meat you.')

narcolepsy: an illness where the patient can suddenly fall asleep

*nickname: a short name or alternate name for someone (e.g., Patch for Hunter) (绰号; 雅号?)

*to patch: to fix (especially sth with a hole or tear)

a prick: a very offensive term for a stupid, unpleasant male who 'isn't fun to be around'

*pun (to make a pun): [c] words that sound alike, in such a way that the result has two meanings and is often amusing; example: “Seven days without food makes one weak/week.” (“one” could mean “someone” or the number; orally, “weak” could mean “lacking strength” or “seven days”)

*to repel: opposite of attract; to forcefully push sb/sth away

self-committed mental patient: a person who decides that he needs emotional help, and checks into a mental hospital; self-committed patients can also check out whenever they wish, but those committed (put into the hospital) by a doctor, judge, etc., cannot just leave whenever they want to.

*to steer clear: to avoid sb/sth unpleasant ('You can stay at my university, but you WILL steer clear of Dean Walcott.')

transference: [technical] to unconsciously develop personal emotions for patients, which might prevent/hinder you from making difficult decisions regarding their treatment (In order to avoid transference, doctors say 'that cancer patient' instead of using the patient's name.)

Part 2:

adamant [adj]: with strong opinions

*backbone: the rows of bones down the middle of your back; something important that gives an organization strength and structure ('This is the backbone of our institution.')

bedpan: a pan used as a toilet by bed-ridden (confined to bed) patients

to disband: to stop existing as a club, school, organization, etc.

motif: theme, esp of decorations ('We should decorate with a western motif.')

mockery, to make a mockery of…: to cause sth important to be regarded as a joke or as useless ('You've made a mockery of our distinguished guests.')

*murdered: intentionally killed ('She was murdered. There was a shotgun involved. Then the murderer turned the gun on himself.')

pediatrics (BrE paediatrics): the field of medicine dealing with children

proctology: [medical] branch of medicine concerned with colon and anus (butt) disorders

*protocol: the official set of rules and practices ('Don't get me fired. Just observe rounds and stay within hospital protocol.')

*stature: literally 'height' but figuratively one's level of respect ('Treat them according to their stature as doctors.')

thorn: a sharp barb (point) on some plants, like rose stems; someone who annoys you like such a barb

Sentences or conversations from the movie:

Part 1:

1. Mental hospital nurse describes Patch: 'Hunter Adams. Self-committed. Suicidal. Slate him [for appointments] with Dr. Prack.'

Mental hospital nurse describes Arthur Mendelson: 'Brand Beaton Industries. [That] guy was one of the most innovative minds of our time. Look at him now. Self-committed. Genius syndrome. Constantly digging into the creative potential of the human mind. I guess he dug too deep.'

2. Arthur: How many fingers do you see?

Patch: There are four fingers, Arthur.

Arthur: [You are just] another idiot. No! Look at me. You're focusing on the problem. If you focus on the problem, you can't see the solution. Never focus on the problem! Look beyond the fingers. How many do you see?

Patch: Eight.

Arthur: Yes! See what no one else sees. See what everyone chooses not to see... out of fear, conformity or laziness. See the whole world anew each day. Ah, the truth is, you're well on the way. If you didn't see something here [in me] besides a crazy, bitter old man, you wouldn't have come in the first place.

Patch: What do you see when you look at me?

Arthur: You fixed my cup. I'll see you around… Patch.

3. Dean Walcott's opening speech to medical students: It is human nature to lie, take shortcuts, to lose your nerve, get tired, make mistakes. No rational patient would put his trust in a human being, and we're not gonna (going to) let him! It is our mission here to rigorously and ruthlessly train the humanity out of you and make you into something better. We're gonna make doctors out of you.

4. Carin: Please spread the word: I'm not here to date. I'm not here to flirt. I'm here to study.

Truman: I thought only I could repel women with that kind of raw efficiency.

Patch: Well, you just met your match. Patch Adams. (he extends his hand)

T: Truman Schiff. (he shakes Patch's hand)

P: Nice to meet you, Truman.

T: So, why do you want to be a doctor?

P: I want to help. I want to connect with people. A doctor interacts with people at their most vulnerable [time]. He offers treatment, but he also offers counsel and hope. We want to become doctors because we want to help people. We have to learn to treat the patient as well as the disease.

T: I've always been fascinated by the development of the human mind. We start out so open and spontaneous. We're real individuals. Then somewhere along the way we're drawn to conform. It's as if we're conditioned by programmed responses.

P: Well, that's true, but sometimes you can alter the programmed response, just by changing some of the conditions or altering the parameters.

5. Dean Walcott: Hunter, Dr. Prack [a former colleague] tells me that you have a brilliant mind, and, like many brilliant people, you don't necessarily think the rules apply to you. (explanation: intelligent people think they can do whatever they like, without obeying the social rules that 'lower' people must follow)

Patch: Not all the rules, sir, but the Golden Rule, I think that applies to everyone. Don't you sir?

6. Patch (when caught clowning around): The American Journal of Medicine has found that laughter increases secretion of catecholamines and endorphins, which in turn increases oxygenation of the blood, relaxes the arteries, speeds up the heart, & decreases blood pressure, which has a positive effect on all cardio­vascular and respiratory ailments, as well as increasing the immune system response.

Patient (to Dean Walcott, referring to Patch's comment): That's a smart clown.

7. Patch: You told Dean Walcott I cheated. Why?

Mitch: Look, cut the crap, Hunter. I live with you. I know how much you study, or don't study. And you do better than me? Give me a break.

P: You arrogant, pompous prick! Who appointed you custodian of the medical profession?

M: I'm from a family of doctors. I know what it takes to look in the eyes of dying people day after day, and [still be able to] come home for dinner at night. You don't have what it takes. (explanation: you don't have the emotional ability to become a doctor)

P: Why don't you like me? You're a prick and I like you.

M: Because you make my effort a joke! This isn't playtime; this is serious business! The more I learn, the more likely I will have the right answer at the crucial moment, and save a life. Maybe I am a prick, but when death comes knocking at the door, people want a prick on their side, not some kindergarten teacher.

Part 2:

8. Dean Anderson (university president?): Dean Walcott wants you dismissed, but I've decided that you can still be in my school. I have a source who informs me that your antics have improved the quality of life for the patients. But you WILL steer clear of Dean Walcott. Just don't screw up, huh?'

9. (this is rather condensed, not word-for-word)

Patch: What's going on here?

Nurse: Oh, drunk driver. She lost her husband and son. Her daughter's in Trauma One, but it doesn't look good (i.e., she will probably die). If she fills out the forms, she can see her daughter. It's hospital procedure. (walks away)

P: It isn't right that a woman has to spend the last moments of her dying child's life filling out forms.

Woman: Last year, I had to have my appendix out. I forgot my insurance card, so they sent me home. My appendix could have burst.

Man: My antibiotics cost 100 bucks (dollars) a month. I paid $250 for a sprained ankle.

Woman: You know what they need to do: the government needs to pay for health insurance.

Truman: It's complicated. Health insurance companies are why prices got so high in the first place.

Woman: So what do we do? What's the answer?

Patch: A free hospital! It will be the first fun hospital in the world. We'll use humor to heal pain and suffering. Doctors and patients will work side-by-side as peers. There will be no titles (like 'doctor'). They'll be a community where joy is a way of life, where learning is the highest aim, where love is the ultimate goal. We'll call it the Gesundheit ('Good Health') Institute. Arthur Mendelson is letting us borrow the land till we can purchase it. Carin, I need you to help me with this.

Carin: Look, I'm not like you, Patch. I want the white coat. I want people to call me doctor more than anything.

P: There is more to life than what Dean Walcott puts out there; that's about power and control.

C: You know, you sit here and you talk about life without limits and breaking the rules. But people get hurt that way. I have to go.

P: (as Carin walks away) I'm really starting to love the back of your head.

10. Dr. Titan: Patch, you remind me of myself when I first started out—on fire, wanting to save the world. But you lose a little of that after a while. The system is what it is. It's not perfect, but it's all we have.

Patch: Why can't it be changed?

T: You figure out how, and I'll be there for you.

11. Carin: It's amazing what you've done with this place. These people we are helping would have had no where to go. You're a good man.

Patch: What are we? (friends? lovers?) Are we just good friends who occasionally kiss? Is it me? (i.e., have I done something wrong?)

C: No…. Men have been attracted to me my entire life. (i.e., I was sexually abused as a child) When I was a little girl I would look out my bedroom window at the caterpillars. I envied them so much. No matter what they were before, no matter what happened to them, they could just hide away and turn into these beautiful creatures that could fly away completely untouched. I hated men so much… then I met you. The way that you help people… the changes I see in everybody that's around you… I've loved you for so long.

P (I think this is from Walt Whitman): I love you without knowing how, or when, or from where. I love you straightforwardly without complexities or pride. I love you because I know no other way than this. So close that your hand, on my chest, is my hand. So close, that when you close your eyes, I fall asleep.

12. Patch: So what now, huh? What do You [God] want from me? [he looks over a cliff, and thinks about jumping to his death] Yeah, I could do it. We both know you wouldn't stop me. So answer me please. Tell me what you're doing. Okay, let's look at the logic. You create man. Man suffers enormous amounts of pain. Man dies. Maybe You should have had a few more brainstorming sessions prior to creation. You rested on the seventh day. Maybe You should've spent that day on compassion. (As he turns away from the cliff, he sees a butterfly on his medical bag, which reminds him of something Carin said.)

13. Patch (puts a letter on Walcott's desk): Why?

Dean Walcott: Everything will be delineated (explained) in your letter of dismissal. You don't fit in. There are standards and codes. You make the patients and everyone else around you uncomfortable.

P: I make you uncomfortable. I wanna (want to) see my records.

W: They're confidential. Only the staff is permitted to see them.

(Patch steals his records, then finds Mitch)

Mitch: I like this. You need my help?

P: I prefer to think that I'm using you.

M: You have one shot (only one thing you can do). You'd have to appeal to the state medical board. You claim that a prejudice and injustice has occurred. They'll be worried about a law suit. They'll have to investigate. They'll review your grades—which is good—but mostly your behavior. Do you have any idea what Walcott has on you?

P: They can't prevent me from graduating because of a personality clash, can they?

M: Hunter, this is a medical institution you're dealing with. They draw their own law. You'll just have to get their focus on your high marks and off of this (your strange behavior).

P: I'm screwed, aren't I? [screwed is an offensive term, meaning 'cheated out of sth']

M: You're almost a doctor. They're a panel of doctors. Just think of them as your peers. And return these stolen papers… and get a suit.

14. (at Patch's hearing before the medical board)

Doctor: Hunter Adams. You've been accused of running a medical clinic without a license.

Patch: Is a home a clinic, sir?

Walcott: If you are admitting patients and treating them, physical location is irrelevant.

Doctor: Have you treated patients at your ranch?

P: Yes, everyone who comes to the ranch is in need of some form of physical or mental help, so they are patients. But each person also takes care of someone else—cooking, cleaning, listening—so that makes them doctors, too. At what point in history did a doctor become more than a trusted and learned friend who visited and treated the ill?

Doctor: Did you consider the ramifications (consequences) of your actions? What if one of your patients had died?

P: What's wrong with death sir? What are we so mortally afraid of? Why can't we treat death with a certain amount of humanity and dignity, and decency, and maybe even humor. Death is not the enemy gentlemen. If we're gonna fight a disease, let's fight one of the most terrible diseases of all: indifference. A doctor's mission should be not just to prevent death, but also to improve the quality of life. You treat a disease, [sometimes] you win, [sometimes] you lose. You treat a person, I guarantee you, you win, no matter what the outcome. Now here today, this room is full of medical students. Don't let them anesthetize you (numb you out) to the miracle of life. Always live in awe of the glorious mechanism of the human body. Let that be the focus of your studies and not a quest for grades. And start your interviewing skills now. Talk to everyone… And cultivate relationships with those amazing nurses that could teach you… they have a wealth of knowledge, and so do the professors you respect. Share their compassion. Let that be contagious….

Doctor: Mr. Adams! I demand that you turn and address the board.

P: Sir, I want to be a doctor with all my heart. I wanted to become a doctor so I could serve others, and because of that I've lost AND gained everything. I've shared the lives of hospital patients and staff members. We've laughed and cried. This is what I want to do with my life. And no matter what your decision today, I will still become the world's best doctor. Now you can prevent me from graduating and getting the white coat. But you can't keep me from learning. So you have a choice—you could have me as a passionate, professional colleague, or you can have me as an outspoken outsider, still adamant. Either way, I'll probably still be viewed as a thorn. But I am a thorn that will not go away.

Discussion:

Part 1:

1. Patch liked to ask patients: 'What's your fantasy?' Tell your partner the answer to this question.

2. Have you ever had a crush on someone? Tell your partner about it—did you ever let this person know? Why or why not?

3. Look at dialog 2. Do you think Arthur is right? Explain your answer.

4. Look at dialog 4. Tell your partner why you want to be a doctor.

5. Read dialog 6. Does humor have a role or function in the medical community? Explain your answer.

6. If you have stayed in a hospital, tell your partner how you felt. What did you like and not like about the experience? Would you have wanted someone like Patch to visit you? Explain.

7. Look at dialog 7. In what ways is Mitch correct, and in what ways is he wrong?

Part 2:

8. Dialog 9 raises questions about the medical system. Are medical/hospital forms (表格?) important? Should hospitals treat (i.e., give medical care to) people without insurance (cards)? Should medicines be cheap to help patients, or expensive so medicine companies can do research and find new medicines? Is health insurance good or bad, and who should pay for it? Would a 'free' hospital work—how would doctors get paid, and how would they pay for supplies? What do you think of Patch's dream? Work with the people in your group to answer these questions.

9. Read dialog 14 and tell your group what you liked most and least about Patch's speech.

10. People like Patch Adams are rare. They are brilliant, and can see possibilities no one else thought of. But in the real world, it takes time, money and effort to help all the people who need help, and 'the system' does it pretty well, considering the difficulties. As Dr. Titan said, 'The system is what it is. It's not perfect, but it's all we have.' What are the difficulties and advantages of 'working under the limitations of a broken system' and 'working to change or reform the system'?

11. Where do revolutionaries fit into society? What happens if there are too many revolutionaries, or if revolutions take place too often? History sometimes honors those who rebel (like Patch, national 'founding fathers,' Martin Luther King, Gandi), but it also sometimes kills them (think of all those in your country's history who were executed as traitors or assassinated by those who didn't want change). Discuss the difference between 'doing what you are told' and 'breaking the rules to make things better.' When and why should you do either?

The board's decision: We find your methods less than appealing. Your appearance and demeanor do not reflect what we believe is necessary to earn the patient's trust and respect. You openly accuse us of adhering to time-honored practices that for years have been the backbone of the entire medical institution. However, we find no fault in your attempts to improve the quality of life around you, nor in your desire to expand upon existing medical practices and theories. We applaud your love of the patient. Your grades are among the highest in your class and, therefore, we find no merit in the decision to block your graduation from medical school. Now, along with your crass and disdainful behavior, you carry with you a flame, which one could only hope would spread through the medical profession like a brushfire.

During the next 12 years (after Patch's graduation), Patch Adams opened a home-based family medical practice and treated more than 15,000 people without payment, malpractice insurance, or formal facilities. You can read more about the Gesundheit Institute (and the real Dr. Adams) at http://www.patchadams.org/home.htm.

Footnotes: These dialogs have been changed (but not much) for educational purposes. This isn’t a transcript of the show!

To understand some of the medical terms I looked at http://www2.merriam-webster.com/cgi-bin/mwmednlm

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