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Nurse Betty
(Comedy, 2000) Review written December, 2001

Nurse Betty is an irreverent comedy about a woman's Post-Traumatic Stress Disorder (PTSD). In the Story, a humble Kansas waitress named Betty Sizemore (Renee Zellweger) witnesses the murder of her husband. She instantly goes into a state of shock, called dissociation, that distorts her reality into a comforting fantasy. This fantasy is based on her obsession with a popular soap opera, called "A Reason to Love," which regards the romantic affairs of a hospital. Consequently, Betty's memory of the murder is now replaced with the delusion that she is really a nurse who is simply leaving her unpleasant husband for the soap's fictional heart surgeon named Dr. David Ravell (Greg Kinnear).

As I often say about comedies, it's important not to take such films too seriously. In fact, very little of the story focuses on PTSD or dissociation beyond simply setting the stage for comical situations. Personally, I enjoyed the ironic plot twists and frustrated characters. However, as someone who has had PTSD, I also felt that the film trivialized the condition. Generally, the film does create some impressions about PTSD that deserve comment.

    "I think most women would have screamed, don't you?" says Charlie (Morgan Freeman).
Charlie, the murderer, is reflecting on the murder with some confusion. At the time of the murder, he had no idea that Betty had witnessed the crime because she had been silent. This detail of the film is fairly accurate. People do not necessarily scream when traumatized. In Betty's case, she instead feels a helpless sense of near paralysis, reduction of awareness and derealization; emphasized in the film by sounds growing muffled and echoed.
    "Post-traumatic reaction with possible dissociative symptoms." a man, presumably a psychologist, comments about Betty shortly after the murder.
This diagnosis, made early in the film, clearly places emphasis on PTSD. Though PTSD is certainly involved, acute dissociation seems the only symptom featured in the film. This can easily be misleading to a general audience; creating the false impression that dissociation is the main symptom of PTSD. In fact, the contemporary version of the DSM (DSM-IV-TR, 2000, a reference used to diagnose such disorders) does not include dissociation as a symptom of PTSD proper, but rather a symptom of Acute Stress Disorder (the more severe form of PTSD). The more common symptoms of PTSD are barely, if at all, addressed in the film.

As Betty follows her fantasy life, she plunges into Los Angeles society and is actually hired as a hospital nurse. A new found friend named Rosa (Tia Texada) is touched by Betty's efforts to find her lost love, Dr. Ravell. Rosa then goes to great lengths trying to track down this doctor for Betty. When Rosa suddenly discovers that Ravell is simply a fictional soap character, she understandably feels victimized by a cruel prank. Furious, Rosa confronts a confused Betty about this.

    Amusingly, Betty responds, "Are you having a nervous breakdown?"
Betty's ironic comment attests to the popular and traditional stereotype of what a nervous breakdown is supposed to look like. Traditionally, the term "nervous breakdown" has referred to the whole spectrum of anxiety disorders; including PTSD. Rosa's hysterical behavior fits the age-old stereotype. To some degree, this moment challenges the audience to question their notions of what a nervous breakdown actually is. Furthermore, it hints at the real life fact that people with anxiety disorders can often appear and behave in a perfectly normal manner; completely hiding the turmoil within. Though the film does not devote much time to such issues, it deserves some credit for touching upon them.

Towards the end of the film, Betty's dissociation suddenly unravels and she is soon completely in touch with reality again. There is some emotional upset, along with some further violence and death. However, she is quickly her carefree self again and goes on to live a successful life uncomplicated by PTSD. This was a nice happy ending. However, I felt this happy ending produced the most misleading impressions of the film.

First, the film suggests that the loss of Betty's dissociation also meant an end to her PTSD. This wrongly confuses the recovery from a single symptom with recovery from the disorder in general. Combined with the earlier false impression of dissociation being the main symptom of PTSD, the film nearly implies that dissociation and PTSD are one and the same.

Second, the film suggests that Betty promptly recovers. This is rarely true of PTSD, especially in acute cases. The loss of her dissociation and return of her memory would still leave her with a difficult trauma to overcome. She would likely spend months or years in counseling while trying to cope with triggers, flashbacks or related symptoms. Yet, the film suggests that she quickly embraces a happy life.

Overall, the film mainly uses dissociation as a catalyst for comic situations. The film does not pretend to address clinical issues with any real depth. As a comedy, the film is not intended to be taken too seriously. The story's intent is clearly entertainment, not education.


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