This article appeared in the April 28, 2022 edition of The Film Comment Letter, our free weekly newsletter featuring original film criticism and writingSign up for the Letter here.

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The grim reaper is at his grimmest when it comes to Alzheimer’s disease, at least for onlookers who must watch a loved one disappear mentally before the body finally gives out. Finally because it can take days, months, years—dementia’s refusal to consume the body distinguishes it in cruelty from other diseases. And as medical science has increasingly allowed us to bypass or survive killers like cancer and heart disease, Alzheimer’s has become ever more prevalent, as have the books and movies dedicated to it—it’s now a horror genre in its own right. In 2020, no fewer than three such movies appeared, each distinctive in its own way: Viggo Mortensen’s Falling; Florian Zeller’s adaptation of his play The Father, with Anthony Hopkins in an Oscar-winning lead performance; and Kirsten Johnson’s defiantly buoyant documentary about her father’s decline, Dick Johnson Is Dead. The latter two are especially imaginative in finding visual and spatial correlatives for their protagonists’ disorientation.

Of all the recent Alzheimer films, however, Gaspar Noé’s unsparing and claustrophobic Vortex might well be the bleakest. The story of one couple’s disintegration in a Paris apartment—hers from Alzheimer’s, his from a heart condition—is a far cry from the France-based Argentine director’s typical high-octane incitements (Irreversible, Climax), but Vortex is a provocation of another kind. For two and a half hours we are locked in a series of cluttered rooms along with an aging husband and wife—played by Françoise Lebrun (so memorable in Jean Eustache’s The Mother and the Whore) and the Italian horror master Dario Argento—as they wend their way to separate deaths.

Before the film opens, we hear a hum—is it Paris traffic? A waterway?— and see, over a black screen, a dedication: “To all those whose brains will decompose before their hearts.” As Françoise Hardy sings “Mon amie la rose,” the camera pans from an aerial view to rest on the couple’s sunlit balcony. Here we first see them together, enjoying a gloriously ordinary lunch with bread and wine. Then the camera moves inside… and pretty much stays there for the rest of the film. We keep expecting to return to that idyllic scene or another like it. That is what Alzheimer’s films do: allow us to remember what was while we endure what is. Films like Away from Her and Amour give us a past tense, scenes that implicitly or explicitly summon the couples’ earlier joys and mutual empathy. Noé’s radicalism lies in foregoing all the devices that provide relief: flashbacks to loving times, escapes from the present, the redeeming star radiance of the likes of Julie Christie in the former and Jean-Louis Trintignant and Emmanuelle Riva in the latter. Noé’s performers are a long way from movie-stardom: indeed, Argento is a director, not a star, and Lebrun is known mostly to cinephiles. Of the characters they play, we learn only that she was a psychiatrist, with a cabinet full of medications still at her disposal, and he is a film historian and critic, writing a book on cinema and the world of dreams. They are no longer even possessed of their names, but are, generically, “Elle” and “Lui.” 

Once inside, we first see the couple in bed, with Elle waking up gradually. Then a bold black square appears over the bed, turns into a vertical bar, and slides downward, cleaving a permanent space between them. Henceforth they will occupy split-screen compartments, as dual cameras follow each of them in restless movement, like animals in a zoo, prowling in adjacent cages. She tries to make coffee while compulsively tidying up; he gropes for papers and privacy. Even when they’re in the same room, the split screen tells us they’re not in the same mental space. Coupledom is itself a kind of compass whose needle has gone haywire.  It’s a masterly strategy for visualizing their parallel lives, a device that also provides a measure of theatrical distancing. 

After the morning routine, there are a few exterior shots: she makes a befuddled visit to a pharmacy, he goes to an editorial meeting for a cinema magazine. We see their loving and formerly drug-addicted son (a superb Alex Lutz) volunteering at a needle exchange. As these dark times unfold, we keep waiting for another glimpse backward in time, another meal alfresco, and then, realizing it isn’t going to happen, we wish we’d paid more attention to the one we saw, trying desperately to recall it. Noé makes us feel with increasing intensity the heart-piercing meaning of that brief glimpse: how the mundane joys and sorrows of a marriage, how the very identities carved out by coupledom, shrink to a pinpoint in the enveloping darkness of slow death. This realization is in some ways the most terrible moment: we’re never again going to see them as they were. What did they say to each other? How were their smiles? What exactly were they eating? Why didn’t we appreciate it all at the time? Too late. They’ve lost it and so have we. That opening scene, in its very brevity, casts a shadow far more haunting than a dozen flashbacks.

The ways in which Lebrun and Argento inhabit their differently declining characters verge on the uncanny. Her eyes are sometimes bright with confusion and a wordless pleading, sometimes dead with blinds drawn. He is baffled and angry, his command of his emotions and intellect not that much greater than hers. He rages at her (is she trying to kill him?), at his own helplessness, at his inability to reach her.  There are touches of dark humor: in a devastating, groan-inducing scene that certifies this as a horror film for writers, she tears up his manuscript and flushes it down the toilet. (The monitor in his office is apparently for movie viewing rather than word processing; neither does he seem to have made any carbons.) 

In a wrenching council, the family of three discuss the future, the urgency of moving to a facility or hiring a caretaker. Or rather, the two men discuss it, while Elle, in a rare spark of lucidity, wishes she were dead. Ultimately, he can’t move—all those books—and can’t bring himself to call a caretaker. His terror of change blinds him to what might better serve his wife and son. We follow them through death to memorial service, and then finally back to that apartment, now serenely empty, a ghostly space, every trace of its former occupants gone. 

The one whiff of sentimentality is the dedication, the notion of the heart outlasting the mind. If Noé means the physical heart, well and good; often, the brain fails before the heart. But he doesn’t. He means the heart as the seat of love and compassion, but in fact, wherever empathy is located, whether in the diaphragm or the cerebrum, that is precisely what is dead. This touches on the curious stigma that makes Alzheimer’s particularly difficult to confront. We know the disease has respect for neither IQ nor EQ, yet astonishingly, given its ubiquity, people will still express amazement that some brilliant acquaintance—often a writer, teacher, or psychiatrist—has succumbed. The brain is just another organ, but we don’t see it as such: it is mind, it is intelligence, it is identity, it is who we are. 

Just prior to filming, the director had a stroke, a close brush with death. Although the idea had already taken root, surely this had a profound effect on his perspective. In this bracing confrontation with dying, Noé somehow removes the special onus of Alzheimer’s. We are all some version of He and She: dignity is stripped away, yet we stubbornly persist. Like some of Bergman’s most despairing films, Noé’s meditation on the transience of life is both humbling and exhilarating.

Molly Haskell has written for many publications, including The Village VoiceThe New York TimesMs.Saturday Review, and Vogue. She is the author of Steven Spielberg: A Life in Films and From Reverence to Rape: The Treatment of Women in the Movies