To Protect Us from Ourselves

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When the AIDS epidemic began in the late 1970s, contracting the virus was a virtual death sentence. No one had a cure. In fact, at first, there wasn't even a diagnosis. People just weakened and wasted away until they died, usually of pneumonia. I don't know anyone who didn't know someone who died from the mysterious illness during the 1980s.

Once it was diagnosed, finding a cure became a top priority, and pharmaceutical researchers who had promising results in lab experiments were fast-tracked to human trials in an effort to out-pace the death toll. But people were dying faster than the cure could be found. Moreover, only half the people participating in the tests were given the medications that might cure them; the other half were given a placebo, and even their doctors did not know who was getting the real thing. The FDA controlled the game, and while they were fast-tracking the research, they weren't fast enough for the patients who were dying at alarming rates, and alarmingly fast.

Meanwhile, researchers in other countries were working just as hard to find a cure. AIDS sufferers desperate for medicine went abroad for treatment. Many treatments consisted of high doses of vitamin and mineral supplements that would boost the compromised immune system, giving the body the strength to fight the virus. These supplements and medications were not illegal, but they were not approved either. Consequently, individuals could use them, but they could not sell them. To circumvent this technicality, "buyers clubs" were born. By purchasing a monthly membership, people could have all the supplements they needed for free. The FDA didn't like these buyers clubs, but they couldn't stop them unless the specific supplements were declared illegal to use. Buyers clubs flourished around the country as thousands of terminally ill patients lined up for treatment.

He shouts at his doctor, "Screw the FDA! I'm going to be DOA!" Then he drives to Mexico to find his own treatment.

Dallas Buyers Club tells the story of Ron Woodroof (Matthew McConaughey), an electrical engineer and rodeo rider who contracted the AIDS virus in 1985. Given just 30 days to live, he begs to get into the clinical trials or to buy AZT, the only drug that was showing any promise. When he can't get into the clinical trials or buy the drug outright, he shouts at his doctor (Jennifer Garner), "Screw the FDA! I'm going to be DOA!" Then he drives to Mexico to find his own treatment from Dr. Vass (Griffin Dunne), an American who has lost his license to practice medicine in the US. The Dallas Buyers Club is born, and Woodroof lives another seven years, along with hundreds of other survivors who purchase memberships from him. The film documents his fight with the FDA as he struggles to keep his supplements from being actively banned instead of simply "not approved."

Ron Woodroof is about as unlikely a hero as you will ever find in a film. A disgusting man with disgusting habits, he's a foul-mouthed, homophobic, alcoholic, coke-snorting, porn-viewing womanizer without an ounce of the milk of human kindness. Both F words — “fuckin'” and “faggot” — regularly spew from his mouth. "Fifty bucks?" he says incredulously to a desperate young man who has come to join the buyers club. Then he strides to the door of his motel-room-turned-"club"-office and shouts to the men lined up in the parking lot, "Membership is four hundred bucks. You got that? Four hundred bucks. I'm not running no goddam charity!" He turns to the frightened young man: "Don't you come back here till you got $350 more." He's in it for the money. Saving lives is just a byproduct.

Ron learns what prejudice feels like when his friends turn against him. They call him "faggot" because they assume that's how he acquired the disease, yet they avoid him because they are afraid of catching it by standing too close. In anger Woodroof spits at them, knowing that his body fluids have become a deadly weapon. Early research demonstrated that AIDS mostly occurred among the "4H" group: homosexuals, heroin users, Haitians, and hemophiliacs. I remember the dark joke that used to circulate in the 80s: "What's the worst thing about getting AIDS? Convincing your parents that you're Haitian." But it was also a danger among promiscuous heterosexuals who engaged in indiscriminate, unprotected sex. And that was the way Ron Woodroof lived his life. He practically shouts "Hallelujah" when a woman who is HIV-positive joins the Buyers Club, because now he can have sex again without worrying about transmitting the disease.

The film portrays the FDA as the bad guys, in cahoots with the pharmaceutical companies and preventing sick people from getting the treatment they want and need. Like most libertarians, I am convinced that the FDA does as much harm in delaying the approval of effective treatments or approving the use of harmful treatments as it does good in its stated purpose of protecting the public. Dr. Vass tells Woodroof that the high dose of AZT used in the FDA-approved trials was toxic, poisoning the body along with the virus. Woodroof gets better when he stops taking his black-market AZT and starts taking Vass' supplements (as well as experimental Interferon he eventually buys in Japan).

However, I have to suggest that the patients involved in the clinical trials bear some of the blame for the skewed results of the early tests of AZT. Many of them were sharing or selling their meds in order to help friends who were also infected but could not get into the trials. For example, Rayon (Jared Leto) a transvestite whom Ron reluctantly befriends in the hospital, is selling half his AZT to his partner, who also has AIDS. This would have skewed Rayon's results. When Rayon got better, researchers naturally assumed that the dosage they prescribed was correct, when actually he was taking half as much as they thought he was taking. Future patients would be prescribed more than they needed, and they would not get better. These trials were flawed, because the patients were not being honest.

Of course, the whole system was flawed because the market was not allowed to operate in the open. As one almost-wise judge says in the movie, "Someone who is terminally ill ought to be allowed to take whatever he wants. But that is not the law." I would go one step further: we are all terminal. We are all going to die. We ought to be able to decide what we put into our bodies, as long as we accept the consequences of our actions — which includes getting sick and having to pay for treatment from our own pockets or the private insurance we pay for (which might not be available to us if our willful actions have caused the problem.) We don't need government watchdogs. Private organizations such as Consumer Reports, the Better Business Bureau, PCGS (Professional Coin Grading Service), and even Good Housekeeping, with its Seal of Approval, work just fine, thank you very much. But if someone agrees to participate in a clinical trial, whether publicly or privately funded, that person is obligated to be honest and diligent in maintaining the integrity of the tests.

We are all terminal. We are all going to die. We ought to be able to decide what we put into our bodies, as long as we accept the consequences of our actions.

Matthew McConaughey lost 38 pounds for this role, and he looks terrible. His cheeks are sunken, his eyes dull, his skin sallow. Other actors have undergone massive weight loss for particular roles; Christian Bale and Tom Hanks come immediately to mind, as well as Jared Leto, who lost 30 pounds for his role as Rayon in this film. But McConaughey does not seem to be bouncing back from this extreme weight loss as well as others have. In more recent roles this year his skin still looks sallow, and his eyes still have that dark, almost vacant brightness. While I admire his dedication to his craft, and I'm not surprised that so many critics are predicting Oscar nominations for McConaughey and Leto, I hope that this fine actor has not inflicted permanent damage on his liver or other organs in order to make this film, especially because it is not a great film. It's an important topic, but the movie drags in places, and I caught myself looking at my watch several times.

Moreover, it is borderline pornographic, from the opening scene when Woodroof is having a threesome at a rodeo and continuing through his voyeuristic visits to strip clubs, to the porn adorning his walls, to additional threesomes — or maybe it was foursomes; I had to stop looking — even after he finds out he has AIDS. I realize that director Jean-Marc Vallee was developing Woodroof's seedy character with these scenes, but I think the audience could have gotten the point without the scenes being so graphic. As a result, this important movie with its strong libertarian theme is making the rounds of the art houses instead of the major theaters, where it could (and should) have been seen by hundreds of thousands more viewers, viewers whose minds might have been changed about the FDA and other government agencies created to "protect us from ourselves." These scenes might not bother you, but I will be recommending that my friends read the article written by Bill Minutaglio for the Dallas Morning News on which this story is based. Here is a link: http://www.buyersclubdallas.com/.


Editor's Note: Review of "Dallas Buyers Club," directed by Jean-Marc Vallée. Voltage Pictures, 2013, 117 minutes.



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Comments

Johnimo

This is a great movie. Not only does the director develop a full picture of Ron Woodroof's wild lifestyle, but more importantly the movie slowly and skillfully shows his gradual acceptance of his transvestite friend Rayon, who becomes his business partner and confidant. Without the gritty, nasty, realistic background of Ron's lifestyle, the move would lose its authenticity. Freedom is not always pretty, but this movie's vulgar argument on its behalf is effective and convincing.

Jon Harrison

This movie will not get distributed up my way; I'd have to drive 200 miles to NYC to see it. I'm not going to do that, but perhaps I can get it for home viewing some day.

I was amused by the reviewer's squeamishness ("I had to stop looking"). It's a movie about wild sex and its consequences. Surely much of the flick's force would be lost if the director drew a veil over Woodruff's actions.

Do I remember correctly that some of the FDA's excesses were curbed by legislation passed by the Gingrich Congress in the 1990s? There's no question that the FDA by that time had become something of a bureaucratic monster, intent on letting incurables die rather than try experimental drugs. I remember feeling quite angry about this when it became news.

On the other hand, the FDA goes back to 1906, and its creation was necessary given the widespread corruption in meat packing and other private enterprises at that time. It's rather foolish to think that things have changed all that much since then. The consumer can hardly rely on Consumer Reports or the BBB to get it right all the time, in time. Remember thalidomide? It was the FDA that resisted pressure from one of the drug companies to get the drug on the market. Without the FDA, the damage caused by thalidomide would've been far more widespread. And there was absolutely no way for an "educated consumer" to know in advance that the drug was dangerous. It's one thing to say that we should take responsibility for what we put in our bodies -- that's quite true when it comes to using tobacco, alcohol, heroin, etc., the effects of which are well known. It's quite another thing to expect Consumer Reports to keep us abreast of the dangers from all the new drugs, chemicals, additives, etc. that come on the market. Not that the FDA gets it right all the time, but on balance it performs a necessary job, and one that is generally supported by the public. Once again we have an example of a libertarian refusing to recognize all the gray areas in life. If only the market could rule, all would be well -- a remarkably simplistic and, indeed, childish view. This is one of the reasons why doctrinaire libertarianism is so unpopular.

I was also struck by the reviewer's concern that McConaughey may have damaged his health by losing so much weight for the role. Surely, as a good libertarian, she acknowledges that McConaughey knew the risks and made an free, informed choice to do what he did. The consequences are squarely on his shoulders. Why then worry about him?

Overall a good review of what looks to be a very interesting movie. Maybe I can find something else to do in New York, and drive down anyway.

Jo Ann

Thanks for you thoughtful background on the FDA, Jon. You make a good argument for the necessity of government agencies to protect us from bad drugs. You could make a similar case for the necessity of government to protect us from bad meat, bad education, bad investment advisors, and bad art, for that matter. But I do think private watchdog organizations do a good job as well, and without giving us that false sense of security that nothing can go wrong simply because the government is behind it. As one who contracted polio from the original vaccine back in 1957, I am a bit wary of the government telling me what's good for me and what isn't.

As for my "squeamishness" regarding pornography: It isn't squeamishness; it's a deliberate choice. I'm cautious about what I put into my body, and I'm also cautious about what I put into my mind and my soul. There are certain memories I'd rather not have. Moreover, the movie is not about "wild sex," as you suggest; it's about the aftermath of wild sex. I appreciate that the film did not portray Woodroof as a saintly hero, but I think a skillful director can create the impression of decadence without forcing the audience to wallow in it. Horror is created by the anticipation of what's hiding behind the door, not by seeing it directly.

I also don't think there is anything anti-libertarian about being concerned about McConaughey's health, whether he knew the risks or not. He didn't really lose that much weight--only 38 pounds--so it's possible that his body reacted in ways that he did not expect. I hope I am wrong--I hope he's fine--but it would be shame if he is permanently damaged by making this film.

Jon Harrison

Can't argue with most of your reply, Jo Ann. I do think there's a big difference between bad drugs and bad art, though. The former, after all, can be lethal. To my knowledge no one has ever died from bad art.

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