A Pain/Addiction specialist’s review of the movie CAKE
January 24, 2015
I saw the movie CAKE tonight. I felt it was my duty. I am, after all, a pain specialist.
I’d read that it was gritty, honest, and accurate, and that Jennifer Aniston was very convincing. I found all that to be true.
It’s the show’s first weekend in Louisville theatres, and the crowd at this 5:30 pm showing was decidedly mature, reverently attentive, and noticeably equipped with more walkers and canes than I’m accustomed to seeing at the cinemas. I almost felt like I was in a pain support group. Perhaps in a way, I was.
I went in expecting to not like the movie. And if it had been a movie just about chronic pain, then I might not have been won over. However, CAKE is not so much a story about chronic pain as it is a story about dealing with loss.
Claire, played by Ms. Aniston, initially comes across as an angry, bitchy, sarcastic, and self-centered woman, who clearly has legitimate pain and the scars to prove it. But as the story unfolds and it is gradually revealed to us the degree to which Claire’s life has been altered by tragedy, a sad empathy takes root.
It’s not that Claire doesn’t have people in her life who care about her. On the contrary, is seems that everyone in her life is trying to help her. In fact, I wouldn’t say there is a real villain in the story. Claire is struggling to climb a mountain. And we, like the people in Claire’s life, feel powerless to help. So we just watch, hoping she can hang on and have some sort of epiphany.
Where the movie begins, Claire is several months removed from the tragic event that caused her life-changing pain and loss. She is clearly living the chronic pain existence: from her pleasant but over-booked doctor, to the impersonal waiting rooms where she winces as her number is called instead of her name, to the group therapy from which she is “fired,” to her continuous pre-occupation with obtaining pain pills – often times via demeaning and risky methods.
As a pain physician, I felt myself wanting to treat her – wanting to provide for her a regimen that was not insulting, dehumanizing, or uncaring. And I hope all health care providers who see this movie are moved in such a way that they see their patients as people who, more than pain, are grieving over what they have lost: autonomy, freedom, happiness, self.
And despite the script’s inclusion of so many themes common in the lives of patients with chronic pain, I hope that those people in the audience who were there with their canes and walkers understand that this movie is only about one person’s journey – not theirs. We all suffer loss. We all have pain. We all have a journey. And the journey is specific to the individual. There are no villains, but there are mountains to climb.
I thought CAKE was a very good movie for general audiences -and a great movie for pain patients and pain care providers. My advice: just make sure you allow yourself some time to process it afterwards. Then you might find it really was a pain support group after all.
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Confluential Truth 
I’m hoping this movie depicts a woman who is treated like a drug addict because of the medication she has to take for chronic pain. That same medication that gives her quality of life. I also hope that the movie explains that people who live with chronic pain have a physical dependence. And that there’s a difference between physical and mental dependency. We don’t get high off of our medication. And We would gladly give up the strong opioids for a life without pain.
Thank you for writing this review! I saw the movie yesterday. I really appreciate reading a review from a pain specialist. Your point about her having a solid support system, but still not dealing with things well is a good one. I am sad because I am in support groups, though, where people struggle on their own–no emotional or financial support. I have dystonia, among some other painful conditions, so I was anticipating the movie.
As a pain specialist, I am sure you see patients like Claire, who are suffering from really bad injuries and are going through rehabilitation, which is painful! I was a little sad that since it was being marketed as a general chronic pain movie, people may confuse some of her emotional pain from the physical pain with the circumstances surrounding her injury.
Also, there were the scenes asked her if she wanted to get better, implying that getting better from chronic pain is a choice. What do you think about that? I agree that in her case, she lacked motivation, which would have helped her. And in some cases of non-injury related pain there are definitely lifestyle adjustments that can be made for most conditions to avoid adding pain or minimizing pain, but I hope the general public doesn’t confuse an injury with an autoimmune disorder or neurological condition, etc. Confusing those would only reinforce the idea that people who will only be able to manage symptoms and pain are lazy because they can’t pull themselves up and out of the pain and depression.
I just hope that this movie will open the door for movies about the pain of searching for a diagnosis and treatment or what it’s like to be young and have to readjust all of your hopes and dreams when you become sick with something that is not a matter of recovery, but a matter of lifelong pain management.
The movie does seem to be opening the door for discussions on chronic pain–I saw mainstream media covering the topic a lot more leading up to the release!
**scenes where she was asked her if she wanted to get better
I like Jennifer’s pinpoint pupils in the movie poster….