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Firstly, director Scorsese intertwines war-induced mental trauma of Teddy Daniels with personal tragedy of Andrew Laeddis. This compounds the confusion for the audience, but also adds a political dimension to what is an exposition on psychiatric illness. Toward the end of the film it is unveiled how the whole of the Shutter Island is a set up to play along the illusions of Andrew Laeddis. So, when we construct the film from backwards, it is obvious that Laeddis is the only ‘patient’ there is. The mysterious disappearance of Rachel Solando is a ploy designed to put Laeddis in situations of acute emotional tension, with the aim of correcting his aberrations. Perhaps, even all the ‘inmates’ of the wards A, B and C were part of the ploy, or perhaps not as mentally ill as is conveyed to Laeddis/Daniels. As the story unfolds, we see how only a porous line separates the dreams and realities of Laeddis. At first, Laeddis, in his persona of Teddy Daniels, is given a warm welcome by the hospital staff and their chief Dr. Cawley. But soon he becomes “increasingly suspicious of the doctor and his staff, and when he begins experiencing fierce migraines and vivid visions of tragedies in his own past, he begins to fear that he has become Cawley’s latest experiment.” (Thomson, 2010)
For nurses and therapists, one of the questions at the center of the film is the debate in the choice of lobotomy and drug therapy. During the 1950s when the film is being set, this was a dominant debating point in psychiatrist circles. Even Dr. John Cawley talks about this debate and his preference for non-interventionist methods. He suggests that he would first try humanitarian methods of talk-therapy, failing which the patient would be tried drug-therapy. It is only as a last resort that surgical procedure would be prescribed. This is a very sensible position to take, for today’s psychiatry suffers from ready resort to medication,
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