The Left Atrium The scenes filmed at night have a No quick fix nightmarish quality, while the daytime FIX: the story of an addicted city street scenes are a waking nightmare. A documentary film Mayor Owen tells the camera that the Nettie Wild, director city spends half a million dollars a year Vancouver: Canada Wild Productions; 2002 just on ambulance service reponses to Feature length: 93 min; television version: 45 min drug-related incidents in downtown Vancouver. o you have any idea what porter, will at least give drug addicts the But the documentary is also a profile “D you’re talking about?” Ann message that people care enough to of Livingston, who is a remarkable ad- Livingston, co-founder of the Vancou- keep them alive. “You can’t get off vocate. The very idea that junkies could ver Area Network of Drug Users drugs if you’re not alive,” she observes. be organized — she co-founded (VANDU), puts that question to a re- The feature-length documentary by VANDU in 1998 — is astonishing. At porter in the documentary Fix: The director Nettie Wild, whose previous the beginning of the AIDS epidemic, Story of An Addicted City. credits include an award-winning docu- when gay men and heroin users were The reporter, spiral notepad in mentary about the peasant uprising in the primary victims of the disease, the hand, has just asked why injection drug Chiapas, Mexico, was filmed over a pe- truism was that gay men could (and did) users shouldn’t just be put into treat- riod of almost two years, starting in organize around the epidemic because ment programs, the implication being 2000. It is a major accomplishment in they were members of a politicized, that such a move would solve the prob- that it manages to be a work of advocacy connected community, while no one lems of the city’s Downtown Eastside. that is, at the same time, fairly even- could expect junkies to get it together to Livingstone’s response is not mean- handed in its treatment of the range of form an organized lobby group. spirited, but instead conveys mild dis- players, including the police and the lo- VANDU puts the lie to that. FIX in- belief that anyone would think that cal business community. No one is de- cludes a few scenes of raucous meetings there are easy answers. Treatment isn’t monized by the filmmaker, although it and also captures a poignant moment particularly effective for heroine users: is startling to hear one local opponent of when a roomful of men and women only 3 out of 100 who’ve gone through safe injection sites tell the camera, “We stand and silently remember two of treatment are abstinent after one year, have compassion and goodwill for those their recently deceased fellow addicts. she explains. drug addict monsters.” FIX is a compelling documentary At one level, the documentary about the problems of Vancouver’s chronicles the struggle to establish safe Downtown Eastside, the activist group injection sites, a move that VANDU VANDU and its fight for safe injection and others hope will cut down on the sites, the politicization of (now former) obscenely high death rate among Van- mayor Philip Owen, and the charis- couver junkies. This struggle represents matic VANDU organizors Livingstone a disavowal of an American-style “war and Dean Wilson, a heroin addict. on drugs” approach to the problem and This downtown section of Vancou- move toward a more European-style ver entered an international spotlight in “harm reduction” model. In the late 1996, when it was declared to have the 1980s it became clear that what was VANDU president Dean Wilson in a highest rate of HIV infection in the de- happening in downtown Vancouver scene from FIX veloped world, a situation brought was a health issue, not just a law-and- about by shared needle use and exacer- order issue, Owen explains. bated by the availability of injectable A major reason for the high death Livingston, a single parent with cocaine (which addicts inject 10 to 15 rate — Wilson notes that in one year three children, is motivated by her faith times a day, compared to 2 or 3 times a there were 400 overdose deaths in Van- and her belief in Christ’s message that day for heroin). couver — is unsafe injection. Inter- you should reach out to people who But HIV/AIDS is mentioned only in spersed throughout the documentary have nothing and “stand in the most passing in this film, which is about are gritty street scenes of junkies in al- uncomfortable place.” “I hate this,” she “keeping people alive.” Safe injection leyways injecting themselves and their says at one point. “Any time someone DOI:10.1053/cmaj.1040736 sites, Livingston goes on to tell the re- fellow addicts with heroine and cocaine. can convince me there is something CMAJ • MAY 25, 2004; 170 (11) 1703 © 2004 Canadian Medical Association or its licensors Côté cœur more pressing and needs me more, then mentary he struggles with his addiction, the personal relationship are of a piece I’ll go do it.” She is neither sanctimo- trying to wean himself off heroin and, with this documentary’s other themes nious ( she swears regularly) nor stri- later, methadone, going to detox for of struggle. There are no easy answers dent, and she has a wry sense of hu- eight days and relapsing to heroin use. to the problems of Vancouver’s Down- mour. A local policeman, who is no fan (“It is,” as one unidentified woman town Eastside. But in this film, those of the idea of safe injection sites, de- states in the film, “a chronic relapsing more affected are allowed to voice their scribes her as “a rebel with a cause” and illness. That is what we have to recog- first priority: staying alive. a good advocate who takes not a bal- nize.”) Wilson talks about how often he anced but a passionate approach. has let Livingston down; she points out Ann Silversides Finally, the documentary is also the his evasions and lies and acknowledges Journalist story of the relationship between Liv- his drive to manipulate. Immediately Toronto, Ont. ingston and Wilson, who are clearly after seeing the documentary, I didn’t fascinated by each other. This focus in- like the steady shift away from the po- Ann Silversides is the author of AIDS tensifies as the documentary proceeds. litical story in favour of this personal Activist: Michael Lynch and the Politics FIX opens with Wilson and shows him one. But later, I came to think the ten- of Community. Toronto: Between the shooting up. Throughout the docu- sion, danger and mystery inherent in Lines; 2003. Lifeworks Regeneration ravelling through rural upstate New York in T 1986 and feeling like a misplaced tourist, pho- tographer Andrea Modica came across a farmhouse owned by a family with 14 children. Struck by this large number, she approached and asked if she could take some photographs. She was particularly capti- vated by an eight-year-old girl named Barbara. Their first meeting sparked a 15-year relationship that ended only with Barbara’s death in 2001 from complications of juvenile diabetes. These pho- tographs form the basis of Modica’s exhibition, Bar- bara, which was on view at the Edwynn Houk Gallery in New York City from March 4 to April 17, 2004. The 41 works in the show, displayed chronologi- cally, reflected only a small sample of the many pho- tographs produced during this long-term collabora- tion between artist and subject. Modica first documented Barbara as a young girl posed within her rundown environment, and followed her to her final illness, in which she appears as a shadowy pres- ence immobilized in a darkened room. The closely- cropped images are printed as 8” × 10” platinum contact prints. The breadth of detail and tone inher- ent in this process, as well as the small size of the prints, reinforce the powerful intimacy of Modica’s arresting images. In Modica’s first, pivotal image of Barbara in 1986, the young girl sits with her head turned to one side, a single hand held to her chest, projecting a maturity beyond her years. In her gaze and pos- ture there is the sense of someone who intuitively Courtesy Edwynn Houk Gallery, New York recognizes the burden of a world that she has not Andrea Modica. Treadwell, NY, 1987. Platinum contact print. DOI:10.1053/cmaj.1040742 yet experienced. During their periodic photo- 1704 JAMC • 25 MAI 2004; 170 (11).