Skeleton Key (2005)


We must have had a mishap crossing the Ole Miss, the Ole Man (Vacation, 1983), because I mistakenly substituted Skeleton Key for Interview with the Vampire. Nonetheless, in the former, Caroline Ellis takes a job as a live-in nurse to care for Benjamin, an elderly man suffering from the effects of a stroke. Through Luke, an estate lawyer, Violet Devereaux hires Caroline despite appearing put off by her Hoboken-esque appearance. Despite getting off to a rocky start, Violet entrusts Caroline with Benjamin’s health, and gives her a skeleton key that unlocks every door in the plantation house but one; she’ll unlock this door with the key of her imagination (Twilight Zone, 1963).


Skeleton Key is a film that depicts hoodoo (root work); a culturally sanctioned belief practiced in the southeast US.

It can’t hurt you if you don’t believe” to the final plot spin when Caroline enters the conjure room in the attic. This is the only room in the house that cannot be opened with the skeleton key, and can only be unlocked with faith.

The film also serves to review Benjamin’s portrayed affliction; cerebrovascular disease, likely subcortical vascular dementia (SCVD). SCVD, also called Binswanger’s disease, involves extensive microscopic damage to the small blood vessels in the white matter of the CNS. Benjamin’s character is accurate in that symptoms tend to begin after the age of 60 in individuals with history of stroke. The characteristic features of Binswanger’s demonstrated by Benjamin include lack of facial expression and speech difficulties. The latter is captured in the curative spell conjured by Caroline, “His words have gotten lost…lost and wandering in his mind…”

Last week’s movie: The Beast Within (1982)
Next week’s movie: Texas Chainsaw Massacre (1974)



The Beast Within is a horror film loosely based on Edward Levy’s 1981 novel of the same name. The film opens in 1964 Nioba, Mississippi with newlyweds, Caroline and Eli MacCleary, stranded on a deserted road. Caroline is knocked unconscious and raped by an unknown entity. The film then picks up 17 years later in Jackson, Mississippi, and depicts the trials of the MacCleary family as it deals with unexplained symptoms of their 17-year-old son, Michael.


The Beast Within may be viewed as a case study to review the signs of Neurofibromatosis type 2 (NF2), a hereditary condition most commonly associated with bilateral vestibular schwannomas, also known as acoustic neuromas. These benign tumors grow on the nerves of the inner ear and commonly cause tinnitus which is experienced by Michael throughout the movie as a cicada-like ringing. In the film, Eli and Caroline decide to confront their past and return to the small town of Nioba, Mississippi to hopefully discover some information about the man (Michael’s biological father) who sexually assaulted Caroline. The timing and nature of their search underscores 2 important facts; a) signs of NF2 usually develop in the late teenage years and b) NF2 is a hereditary condition.

Interestingly, Michael may also demonstrate mucosal neuromas (fattened lips of the beast), which along with his pituitary gland “going out of control” (adenoma), is consistent with Multiple Endocrine Neoplasia (MEN) syndrome type 1.

Last week’s movie: Laid to Rest (2009)
Next week’s movie: Skeleton Key (2005)



Laid to Rest is a 2009 slasher film depicting the “amnestic protagonist.” It follows a young woman who awakens in a casket with amnesia, and her attempts to recover her lost memories, the most disturbing of which is that she’s a victim of a serial killer who taunts the police by videotaping his victims.


An unnamed woman awakens to find herself in a casket, without any knowledge of where she is or how she got there. In fact, she demonstrates retrograde amnesia, unable to recall any long- term memory (episodic or semantic). She complains of a headache, and appears confused as she tries to escape the mortuary and its video-taping, sadistic inhabitant, ChromeSkull.

Locked in the embalming room, she is nearly rescued by an elderly mortician with a “lazy eye” (cranial nerve palsy) before ChromeSkull impales him. We later learn upon discovery of one of the video tapes that Mr. Jones was an accomplice, Chrome Skull’s Renfield, who regained compassion for the girl before being killed in an attempt to rescue her.

Upon her escape, the woman flags down a lone passer-byer, Tucker, who refers to her as “Princess.” As the story unfolds, Princess’s psychiatric symptoms (amnesia) combine with Tucker’s physical deficit (impaired gait) to derail their multiple attempts to reach safety.

Finally, we discover that ChromeSkull is a psychotic serial killer who has been abducting young women beginning in south Florida. He posed as a “john’ to abduct Princess, a prostitute who is seen on a video tape snorting cocaine just before being assaulted with a baseball bat (and ending up in a casket). While the details of Princess’s history explain her recent experiences including the headache, an alternative interpretation (scar notwithstanding) allows for an interesting psychiatric synopsis.

It may be reasonable to assume that Princess likely abused alcohol in addition to cocaine. Taken together, Laid to Rest may be interpreted as a case study of Alcohol Withdrawal, which can be reviewed in 3 phases. The first phase, uncomplicated withdrawal, results from cessation of alcohol thats use has been heavy and prolonged. Interestingly, the one criterion from the Clinical Institute Withdrawal Assessment (CIWA is the gold standard for symptom-triggered therapy) that is not included in the DSM-5 diagnostic criteria is headache.

The second phase, complicated withdrawal, is hallmarked by either seizures or hallucinations. The latter may be due to a) Alcoholic Hallucinosis or b) Alcohol Withdrawal Delirium (Delirium Tremens, DT’s). The third phase, Wernicke-Korsakov syndrome, may begin with a triad of confusion (Princess), ataxia (Tucker), and eye findings (Mr. Jones). If left untreated, Wernicke’s encephalopathy (confusion) may evolve into Korsakov psychosis (KP). KP is a likely irreversible neurologic syndrome characterized by amnesia (while Princess demonstrates retrograde amnesia, KP more commonly presents with anterograde amnesia/difficulty with encoding new memories), confabulation (the creation of false memories), and perceptual disturbances (psychosis). While ChromeSkull may represent “a psychotic serial killer,” he may only be a figment of Princess’s imagination; a product of her delusional belief system resulting from years of alcohol abuse and subsequent Wernicke-Korsakov syndrome. While the 3 forms of alcohol withdrawal are presented here as 3 distinct phases, they need not appear in any particular order. As confabulation is not depicted in the film, so too may alcohol withdrawal not include specific symptoms..

Last week’s movie: Jeepers Creepers (2001)
Next week’s movie: The Beast Within (1982)



Jeepers Creepers is inspired by actual events (Unsolved Mysteries). Since this blog was started on Easter Sunday 2015, exactly 25 years ago, Ray and Marie Thornton were terrorized by a motorist while playing “the license plate game” in Cold Water, Michigan. Also, like their counterparts in the movie, they later came across the van and discovered a bloody sheet. While the Thornton’s experience remains unsolved, the 2001 horror movie it inspired depicts the fate of siblings a 2001 horror film written and directed by Victor Salva that takes its name from the 1938 song first premiered by Louis Armstrong. The film is is Trish and Darry Jenner on their travels homefrom college during spring break in the Florida countryside.

On their way home, a mysterious driver attempts to run Trish and Darry off the road with his truck. After barely escaping a second time, Darry convinces Trish to double back to investigate
what they saw earlier at the “psycho version of the Sistine Chapel.” The two find an old woman (an oracle) who tells them of “The Creeper,” a demonic keeper of a “house of pain” who hunts
every twenty-third spring for twenty-three days by striking fear into its victims in order to smell if there’s something it likes. It then feasts on the terrified victims’ body parts to reconstitute and strengthen itself.

The eponymous “Creeper” is the reincarnation of Spring-heeled Jack, a supernatural entity of English folklore of the Victorian era (sightings were especially prevalent in London). The
cyclical nature of his hunting sprees parallels that of other geographically isolated mythical characters such as the Mothman (West Virginia) and It (Maine).


Beyond the role urban legends play in the psychology of a culture, Jeepers Creepers is useful in reviewing the harmful effects of two drugs: alcohol and phencyclidine (PCP). In the opening scene, Darry recounts the cautionary tale of Kenny and Darla (class of ’78), a prosocial warning of the dangers of drinking and driving on prom night (Weird New Jersey’s Annie’s Grave in Totowa and The White Lady Tree in Branch Brook Park).

Later in the movie, Darry and Trish are trapped in the police station when the Creeper’s rampage is reminiscent of the scene from The Terminator. Similar to the cyborg portrayed by Arnold
Schwarzenegger, the Creeper demonstrates the behavioral (belligerence and agitation) and physiologic (diminished pain response when it’s described as wearing body armor by police)
manifestations of PCP intoxication.

It’s only right that the final thought in this blog parallels the final scene in the film. Co- occurring use of alcohol and PCP may lead to suicidal behaviors and other symptoms including (ironically) rapid eye movements (nystagmus), eyes rolled to the back of the head, and a vacant stare.

Last week’s movie: Deliverance (1982)
Next week’s movie: Laid to Rest (2009)