Carol Levine, Championing The Caregiver's Cause

DATE July 21, 2008 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM
NETWORK NPR
PROGRAM Fresh Air

Interview: Carol Levine discusses her experience as a caregiver
to her quadriplegic husband and how she would reform the home
health care system
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

Carol Levine survived the car accident uninjured 18 years ago, but her husband
suffered a serious brain injury and was left with quadriplegia. Carol says
when he was released from the hospital, she became a caregiver and not a wife.
After 34 years of marriage and 17 years as a caregiver, Carol lost her husband
last year. She recently wrote an article for The New York Times magazine
about life after his death. She had joined us on FRESH AIR in 1999 to talk
about family caregiving. We've invited her back to update her life and her
thoughts about how to help family caregivers. Since 1996, she's directed the
Families and Health Care Project for the United Hospital Fund. She's
launching a new project, which will offer guides and materials for family
caregivers. Earlier in her career, she was awarded a MacArthur fellowship for
her work in AIDS policy and ethics.

Carol Levine, welcome back to FRESH AIR. You've described yourself as having
been widowed twice. What do you mean by that?

Ms. CAROL LEVINE: Well, the first time, Terry, I was widowed in a
metaphorical sense when my husband was devastatingly injured in an automobile
accident. And the second time, I was widowed in fact when he died, which was
January 1st, 2007. But it felt like being widowed twice.

GROSS: What parts of him or of your relationship did you feel died after the
accident?

Ms. LEVINE: Well, because he had a severe traumatic brain injury, the things
that died after the accident were his wit, his ability to have a good sense of
humor about almost anything that happened, his memory, his sociability. All
of those things that made him the dear man I loved. And what was left was a
very needy and very often angry man, which was part of what he was before;
these things don't come out of nowhere. But it certainly was heightened and
sort of the loss of those other things made the balance so hard to deal with.

GROSS: If you don't mind my asking, was the self that he became after the
accident a person who you still loved?

Ms. LEVINE: I did love him, even in that state. It was hard to deal with,
but I responded to his need, I saw his deep love for our children, our
grandchildren, even though he could not really express it in a way he would
have. And love never died, it just got moved over into a different part of my
life, and I had to find a new way to express my love for him, which was
through caring for him. Which I had never anticipated would be the case.

GROSS: What were some of the needs that you had to take care of?

Ms. LEVINE: I had to take care of everything. And when I say everything, I
mean everything. Now, I did not provide all of the direct hands on care. He
was essentially quadriplegic, in addition to the traumatic brain injury. So I
did have home care aides with him during the day when I was at work. But I
was the night nurse, as I called myself. So I was responsible for organizing
the home care, for paying them, for making sure that all of his needs were
met. I became his advocate and his spokesperson, which he had been quite able
to do that for himself before, and I had never seen myself in that role. And
I did have to learn to manage all of that. It was an all inclusive and very
intense relationship.

GROSS: I know people who have complained bitterly about how difficult life
is, taking care of their spouse or their parent, and how there's no time for
the things they want to do, and their routine is totally revolving around the
sick person. Then after the sick person dies, the person who had been the
resentful caregiver feels lost, feels lost and like, `What am I supposed to do
now?'

Ms. LEVINE: I think if you become that kind of intensely involved caregiver,
there's no way not to resent some of it. Anyone who says, well, it's a total
joy every minute of the day, I think is deluding themselves or deluding you.
I kept working and I believe that working saved my life, basically. Many
people would say, `Well, why are you still working?' Well, I had to earn
money, one, but I also had to have a life. And I think that is what saved me
from the kind of despair that many caregivers fall into.

GROSS: I remember the previous time when we talked, and this was in the late
'90s, you were saying that when your husband got out of the hospital and he
was helpless and they were just saying, `Take him home and deal with it.'

Ms. LEVINE: Right.

GROSS: You were basically told that if you wanted to qualify for home health
care, that you basically had to quit your job...

Ms. LEVINE: Yes.

GROSS: I mean, for funding for home health care, you had to quit your job,
stay home and do your best to become poor so that you'd qualify.

Ms. LEVINE: Right.

GROSS: And that you thought that that was a ridiculous way of doing things.
So why would you have had to quit your job, and why did you refuse to do it?

Ms. LEVINE: Well, Medicaid--the only publicly funded home care, and it's not
24-hour care, mostly, is only available to people who are indigent, and that
means really poor. And if you are married to someone, not just living with
but married, that your income counts as the spouse's income. And so the only
way I as a wife could have been able to have him eligible was to not earn
anything and to become eligible for Medicaid, where we would really not even
have the level of services that he needed. And I just thought that was not
fair, and I was willing to pay my share. I was willing to do something
reasonable in terms of--I didn't expect the government to pay for all of it,
but I certainly would have wanted a more equitable arrangement. And the
advice I was given was both, you know, `Quit your job, stay home, spend down
is the term, get eligible, or divorce him and then it won't count.' But that
would have been fraud. And so I said, `I don't like either option A or option
B. I like option C, which is I continue to work and I provide the home care
for him.'

GROSS: Were you able to at least deduct the home health care expenses on your
taxes?

Ms. LEVINE: Some of it, yes. Some of it you can deduct. Not all of it, but
some. And let me just say it's not a winning proposition here. And it's very
expensive, and it's getting more expensive. And also I think even now, and
this is, you know, 15--well, 17, 18 years after I started, the work force is
smaller. It's very hard to find competent people to do this job. So that's
one of the issues that I think has arisen in the time since we spoke. It's
not just your willingness to pay for it, it's finding people who are willing
to do the job.

GROSS: Carol, your husband survived his accident for 17 years.

Ms. LEVINE: Yes.

GROSS: And for 17 years, he lived with a traumatic brain injury and as a
quadriplegic. For most of those 17 years, your professional issue was home
health care policy. I mean, you've been directing for a long time now the
Families and Health Care Project of the United Hospital Fund. What would you
like to see done as somebody who's been advocating policies on this front for
many years? If you could write the policies yourself, what would you be
writing?

Ms. LEVINE: Oh, that would be nice. I would first start with changing the
so-called unit of care in Medicare and Medicaid from the individual to a
family unit. This is the way hospice is organized, and this is the way
palliative care is organized. Understanding that a patient or a beneficiary
of these regulatory benefits does not exist in a vacuum and that you have to
take account of the family member who is providing most of the care. That
means an assessment, not just of the patient, but of the family caregiver. Is
this person able to do this job? Nobody ever asked me could I do it, what
parts of it could I do, what parts of it couldn't I do.

GROSS: And for example, a part you couldn't do is like lift him.

Ms. LEVINE: Right. The parts I couldn't do were the heavy duty, literally
the heavy lifting and the constant personal care that he required. I could do
many of the things, but I couldn't do them all. Nobody ever asked, `Do you
have any health problems that may interfere with your being able to do this?
Do you have other people you're caring for? Do you have a job?' I mean, those
are things that were--sort of basic questions, were never asked. It was just
assumed that either I would do it or I would find somebody else to do it.

And I think caregiver assessment is becoming more common, but it's usually now
in the outpatient setting where caregiver comes in with so much stress and so
much burden that they are really paralyzed and unable to go forward. We've
done studies that show even when there is formal home care in the home, which
is usually a very short period, the family members are providing
three-quarters of the care anyway. So they need to be involved, they need to
be helped to find ways to do the job in their own way.

I remember that, you know, one of the few times I had a formal home services
after an operation or something like that, the nurse would say things like,
`Well, you have to turn him every two hours.' Well, that's not possible, you
know. No way is it going to happen. So we have to figure out a way to
prevent bedsores without having someone turn him every two hours. He wouldn't
talk...

GROSS: Two reasons why that couldn't happen. One is that you were going to
be at work and the other is you weren't strong enough to do it.

Ms. LEVINE: I wasn't strong enough to do it, and he wouldn't tolerate it.
Those was three reasons why it wouldn't work. So he didn't like that moving
around. So, you know, this was not good advice. It's standard nursing
advice, but it didn't work. So we had to find another way.

GROSS: Which was hiring somebody, huh?

Ms. LEVINE: Which partly was hiring somebody, but then I was there at home
at night, so I had to find ways to make sure that his skin was intact, to, you
know, I could look at that, I could make sure that there were lotions and all
of those other things, and I would say that I'm pretty proud, over the 17
years he was at home, he never had a skin breakdown. And, you know, that's
very rare. But it was just due to constant monitoring, and that was, you
know, it wasn't due to turning him every two hours.

GROSS: Anything else you'd like to change in the system?

Ms. LEVINE: Well, I would certainly like to change the funding so that
long-term care is not only going to nursing homes but is really going to
support families and patients in the community. Right now there's still an
imbalance in the institutional bias of Medicare and Medicaid, and to provide
some sort of financial support for family caregivers in the middle because in
the end, it saves the system money if the patient stays at home. So why not
help the family do that in a way that doesn't force them into poverty and
doesn't lose the productive contributions of so many family caregivers?

GROSS: If you're just joining us, my guest is Carol Levine. She directs the
Families and Health Care Project of the United Hospital Fund. She's a former
MacArthur fellow, and for 17 years she took care of her husband at home after
he was very seriously injured in a car accident, had traumatic brain injury
and was a quadriplegic after the accident. He died in 2007. We'll talk more
after we take a short break. This is FRESH AIR.

(Announcements)

GROSS: My guest is Carol Levine, and she directs the Families and Health Care
Project of the United Hospital Fund. She's also a former MacArthur fellow.
For 17 years, she took care of her husband at home after he was seriously
injured in a car accident that left him with traumatic brain injury and also
rendered him a quadriplegic. And home health care, how to help families who
are giving home health care, has become her professional life as well. Her
husband died in early 2007.

Carol, during the 17 years that your husband was transformed and living at
home and you were taking care of him, did you ever talk to him about his
death, about what he wanted? I mean, what his medical wishes were, how much
intervention he wanted, that kind of thing?

Ms. LEVINE: Yes. In fact, not only did I talk to him, he talked to me. He
would bring this up many, many times, and he would say in a very serious way,
`I want to talk about something.' I'd say, `OK. What is it?' `I want to talk
about dying.' I said, `OK. What do you want to talk about here?' And he was
very clear because he had had so many hospitalizations and was so unwilling to
undergo any kind of real intervention, that he did not want to be
hospitalized. He did not want anything of feeding tubes or any of those
things.

So he also talked to me about his funeral, or his memorial service, and he was
very clear about that, and he mentioned the people he wanted to speak, and I
was able to do that and able to get those people, and in his memorial service,
I felt as though he were there because this was what he wanted. And so it was
very--of course it was sad, it was very sad because he actually died very
suddenly. But it was gratifying to hear people talk about him in the way that
he knew they would.

GROSS: Did you ever talk about whether he ever wished he had died instead of
surviving with such a compromised mental and physical state?

Ms. LEVINE: No. My husband had a very realistic outlook on life, very
pragmatic. He never wished that he had died. He wished often that it hadn't
happened. But that he did try to find the enjoyment that he could. This did
not mean he was happy all the time. He certainly was not. But that the
things that made him happy did please him a lot, and those were, as I said,
the children and grandchildren, watching sports on television. He was a major
Giants fan. And having readers come and read to him, and I think that was one
of the wonderful things that I was able to do for him was to hire
underemployed actors in New York, and they would come for two hours a day and
read to him or talk to him and give him that connection to the outside world
that was not me and was not the home care aide, but was something else. And
so he took pleasure in little things, but then it was against a background of
sadness. So I think he tried to find the best ways that he could to cope.
And didn't work all the time, but when it did, he was OK.

GROSS: I know underemployed actors are not hard to find in New York, but how
did you find the people who would come and read to your husband?

Ms. LEVINE: Well, I had a first group from the Tisch School of the Arts
students, and then went to another setting where a lot of actors live and put
up a sign and, you know, from then one led to the other. And there were, you
know, a core group who stayed with him for many years, actually, and they
liked it because it was flexible for them, and if they had an audition, it
worked out for everyone.

GROSS: How did your husband die?

Ms. LEVINE: He died suddenly of congestive heart failure. And this is
something he had experienced before. But in each of those cases, we had been
able--"we" meaning the home care aide and I--had been able to--and then with
the doctor--been able to overcome. And so there were a certain number of
techniques that we used. And then this one time on New Year's Eve, it just
came very suddenly, very severely, and I was alone with him, and it just,
within a few hours he was dead. So he had had a very good weekend, and it was
just a shock. It sounds ironic to say after all these years, but I never
expected it to be that way. And so it was as big a shock as if it had
happened, you know, without any preparation. It was very traumatic for me and
for my family.

GROSS: During the 17 years that you took care of your husband at home, I'm
sure you wondered sometimes what it was going to be like when you came out the
other end of that experience. Your husband died a year and a half ago.
What's surprising you most about life without him?

Ms. LEVINE: How much I miss him and how much I miss the person he was. I
hadn't really been able to grieve the loss of that person. And so I'm kind...

GROSS: The loss of the person he was after the accident?

Ms. LEVINE: Exactly. Exactly. I had become so close to the person he
became that I had lost touch with the person he was. And so that's really
difficult.

GROSS: Is his absence allowing you now to become more in touch with the
person he was before the accident?

Ms. LEVINE: Yes, it is, and I find myself remembering things that I had
totally forgotten. And that's very gratifying, and one of the nice things
about the Times essay was that many people who knew him many years ago have
called me. And so that reminds me of this really wonderful person. But it's
also given me a chance to be myself again, which is a good thing.

GROSS: Carol Levine, thanks so much for talking with us and all best to you.

Ms. LEVINE: Thank you very much, Terry.

GROSS: Carol Levine is the director of the United Hospital Fund's Families
and Health Care Project. She's preparing to launch a new project, the next
step in care, which will offer guides and materials for family caregivers.
I'm Terry Gross, and this is FRESH AIR.

(Announcements)

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Interview: Christian Bale, the star of "The Dark Knight," and
Christopher Nolan, the director and co-writer on making the film
and Heath Ledger
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

(Soundbite of "The Dark Knight")

Mr. HEATH LEDGER: (As The Joker) A year ago these cops and lawyers wouldn't
dare cross any of you. I mean, what happened?

Unidentified Actor #1: (In character) So what are you proposing?

Mr. LEDGER: (As The Joker) It's simple. Kill the Batman.

(Soundbite of laughter)

(End of soundbite)

GROSS: That's the late Heath Ledger as The Joker in the new Batman movie "The
Dark Knight." The film broke box office records when it opened over the
weekend. "The Dark Knight" is the sequel to the 2005 film "Batman Begins," in
which a tormented Bruce Wayne learned to channel the rage over his parents'
murder by adopting the persona of Batman to clean up Gotham City. "The Dark
Knight" features extravagant sets and dramatic action, but it's the terrifying
villain in the movie, The Joker, that's getting the most attention. It was
Heath Ledger's final role. He died in January from an overdose of
prescription medications. The film is directed and co-written by Christopher
Nolan, who directed and co-wrote "Batman Begins." Christian Bale returns as
Batman.

FRESH AIR contributor Dave Davies spoke to Nolan and Bale. Dave asked Bale
how he was transformed by putting on the Batman suit.

Mr. CHRISTIAN BALE: You know, I must admit that I was never a Batman fan.
This was the first time, when I sat and met with Chris, that he presented a
Batman that I had an interest in playing. But also for me, with absolute
respect to, you know, anybody else who has played Batman in the past, I always
felt that I viewed them as a man standing in a rubber suit. And I never could
quite buy it. So what I felt was the only way that I personally could make it
work is if he truly becomes a beast when he is within the Batman costume. It
does make you feel quite invincible. It has such protection on it, you know,
you feel like you can achieve great violence very easily. You feel very
defended as well and protected by it. And so consequently you get very
aggressive once you're inside of the suit.

DAVE DAVIES, host:

You know, Christian Bale, there was--I read that there was a scene, and there
are a lot of memorable scenes in this film, and one of them is Batman standing
on top the Sears Tower in Chicago at night utterly erect looking across the
city while, you know, the camera shot I assume is done by a helicopter
circling you. Is that--that's really you there, right?

Mr. BALE: Yeah, that is me. You know, I think, you know, a lot of people
have suggested it was a dangerous thing to do. It really wasn't dangerous. I
look at it more as an experience rather than a stunt. You know, I know where
to draw the line. I have a very good stunt double, Buster Reeves, who I'm
very happy to let him smash into concrete pillars at 30 miles an hour and to
jump five stories onto cars. But when it came to the fighting, which I really
think is very much an acting job, everybody fights so very differently. So I
did that all of myself.

But something like the Sears Tower was more just an experience that I wanted
to have. I don't see in the future I'm going to have many opportunities to
stand 110 stories up on the edge of the Sears Tower in the Batsuit looking out
over Gotham. And so I wanted to take advantage of that. But, you know, the
truth is that they were never going to allow me to plummet 110 stories down to
the streets of Chicago. I would have fallen a couple of stories and banged
into a window and surprised some office workers below. So that's why I say it
was less of a stunt and more an experience that I didn't want to miss.

DAVIES: What did it feel like?

Mr. BALE: It felt wonderful, you know. I mean, there's initial slight
feelings of vertigo, but surprisingly within a couple of minutes I felt
absolutely comfortable up there. I was strolling up and down along the ledge.
I was kneeling down and looking over the side, and I felt very happy to be
there.

DAVIES: The villain here, The Joker, is one of the most memorable characters.
Christopher Nolan, it's interesting that we don't see any back story of The
Joker here. You know, in "Batman Begins" we see the origins of Batman. And
in some earlier versions of the Batman story, particularly the Tim Burton
film, you know, a lot of that was devoted to telling us where The Joker came
from. Why the choice here to simply present him to us as he is?

Mr. CHRISTOPHER NOLAN: Well, when we looked at what we wanted The Joker to
be in the film, the real question is who is this icon when seen through the
prism of "Batman Begins." We tried to present the world of Gotham as a more
realistic world, a grittier world. So when we thought, OK, who's The Joker
going to be in that world, he had to be terrifying. He has to be terrifying.
He has to be this extraordinary force of pure anarchy, really. And what Heath
and I talked about a lot is, when you look at characters, great sort of icons
of villainy like, you know, Darth Vader or Hannibal Lecter, these guys, really
the more you find out about who they are and where they came from the less
interesting they are and the less threatening they are. That was how we felt.
And so we decided, rather than addressing any origin for The Joker, we wanted
him to be an absolute--we didn't want to know, you know, who his parents were
or what happened to him as a kid and all the rest. And indeed, we sort of
riff on that in the film. The Joker kind of mocks the audience's actual
desire to know things about people that might explain why they're bad.

DAVIES: And he is a truly memorable, scary character as portrayed by Heath
Ledger. And, of course, it was after shooting completed for the film that
Heath Ledger died tragically in January of this year. And that's, of course,
going to be talked about a lot as the film is released.

Christopher Nolan, tell us about getting Heath Ledger in the role of The
Joker. Did you seek him for that role?

Mr. NOLAN: Well, it was one of those unusual things where I'd met Heath
three or four times over the years for different projects, and nothing had
come of it. But we kept in touch. And he heard we were doing The Joker in
the film and I heard that he might be interested, which was a huge surprise to
me. I sort of never had--I probably never would have thought about asking him
to do it. But he came to me and said he was interested before we even had a
script. So we sat and we talked about the touchstones of movies and
literature that would inform, you know, the type of character that we would
need to create. We talked about, you know, the character of Alex in "A
Clockwork Orange," for example, things like that. And it became clear to me
that he'd really just figured out a way to do this and had the confidence to
do it. So I jumped on it immediately. I mean, as I say, before we even had
the script finished, and signed him up for it. He just had that terrific
enthusiasm for it, that great confidence. So, you know, you looked into his
eyes and you knew he was going to do something very, very special.

DAVIES: Christopher Nolan, when you look at Heath Ledger's performance in
"Brokeback Mountain" and that deep voice and that sort of very controlled
character he played.

Mr. NOLAN: Hm.

DAVIES: And here the voice is completely different, and the character is
so...

Mr. NOLAN: The voice is--yeah, everything. I mean, but that--people sort of
asked me at the time when I cast him, `What did you see that he had done that
made you think he'd be right for The Joker?' And the answer was, well, nothing
that directly related to The Joker, but what you saw in "Brokeback Mountain"
was an incredibly, as you say, withdrawn performance. It's a performance
where nothing is done for the sake of vanity, and nothing is done to open the
character to the audience, which is a huge risk for an actor to take. You
know, you risk completely alienating the character from the audience. But
Heath pulled it off. And that for me was what told me that he would be able
to do anything, really. And so when he said he could do The Joker, when he
said he could find a way to create an iconic performance that would have its
own peculiar rhythm, it's own really visual and oral sort of sense, but there
would be a human being and a real character. There's no question in my mind
he'd be able to do it.

GROSS: We'll hear more of Dave Davies' interview about the new Batman film
with its star, Christian Bale, and its director and co-writer, Christopher
Nolan.

First let's hear Heath Ledger as The Joker. In this scene he's crashed a
party Bruce Wayne is giving for the new DA, Harvey Dent, who has promised to
clean up Gotham City.

(Soundbite of "The Dark Knight")

Mr. LEDGER: (As The Joker) Good evening, ladies and gentlemen.

(Soundbite of footsteps, clanking)

Mr. LEDGER: (As The Joker) We are tonight's entertainment.

(Soundbite of clanking and shoes hitting floor; feet shuffling)

Mr. LEDGER: (As The Joker) I only have one question. Where is Harvey Dent?

(Soundbite of coughing, footsteps, clanking)

Mr. LEDGER: (As The Joker) You know where Harvey is? Do you know who he is?

(Soundbite of music)

Mr. LEDGER: (As The Joker) Do you know where I can find Harvey? I need to
talk to him about something, just something little, huh?

Unidentified Actor #2: (In character) No.

(Soundbite of music)

Mr. LEDGER: (As The Joker) You know, I'll settle for his loved ones.

Unidentified Actor #3: (In character) We're not intimidated by thugs.

Mr. LEDGER: (As The Joker) You know...

(Soundbite of clanking)

Mr. LEDGER: (As The Joker) ...you remind me of my father. I hated my
father.

(End of soundbite)

GROSS: More about the making of "The Dark Knight" after a break. This is
FRESH AIR.

(Announcements)

GROSS: Let's get back to the interview FRESH AIR contributor Dave Davies
recorded with the star of the new Batman film, Christian Bale, and its
director and co-writer, Christopher Nolan.

DAVIES: Christopher Nolan, if you could just describe a little bit the look
of The Joker character as Heath Ledger plays it. I mean, it's not--well,
maybe just describe a little bit how the look came about and whether that's
something he developed or something you worked with him on and the
characterization?

Mr. NOLAN: Well, we developed the look very much as a collaboration between
myself and Heath and Lindy Hemming, our costume designer, and John Caglione,
as makeup artist. And we looked at a lot of different references. There was
always going to be some kind of punk influence on the guy. I always liked the
idea of a sort of grubbiness to him. So with his wardrobe we sort of made
everything dirty and aged down as if he'd slept in his clothes, that kind of
thing. We really wanted him to have that slightly, slightly smelly feel of
somebody who's been out on the town all night, you know, and a little ragged
around the edges. And I showed Heath a lot of Francis Bacon paintings as
reference for the makeup on the face because I wanted to get that sort of
streaky, corrupted feel into the makeup itself. So we realized early on that
we'd want actual physical scarring, you know, sort of three dimensional aspect
to what creates the idea of the grin. But then he would have, in some kind of
punk fashion, kind of painted on top of that, painted a smile on top of that.

And we started off, as far as the creation of the actual makeup look, Heath
started from a point of applying it himself to begin with just to see what it
really would be if he put it on with his hands, just dipping his hands in the
makeup and smearing it on and everything. And then his makeup artist, John
Caglione, would sort of work from that and define it and make it textured in
the way we wanted. And it sort of degrades through the film as well. And I
really wanted to get a tactile sense of that character so that when you go in,
you know, for a huge close-up, you really, you feel like you can smell his
breath.

DAVIES: Right. Right. Christian Bale, you know, The Joker here is such a
jarring and unsettling character to witness, do you think it affected your
performance at all? I mean, you don't share that many scenes with him, but
did it affect the way you played the character at all?

Mr. BALE: Yeah, definitely. He, you know, is a opponent that Batman has not
come across before. You know, if you can find what, you know, the criminal is
after then you have some leverage. And with The Joker there is nothing. That
man can find nothing. Even his usual kind of fallback, you know, resort to
violence, which Batman is, you know, very good at, doesn't work either.

Mr. NOLAN: I think The Joker really brings out the rage in the character,
too. I mean, it was something Christian and I talked about in the first film
was showing, exposing really the rage that drives the creature of Batman, you
know, that really elemental thing, that anger that drives him. And I think
it's really not until this film that, you know, The Joker is able to get under
Batman's skin the way he gets under everyone else's skin. And you see in the
interrogation scene between, you know, Christian and Heath, I mean, you see
this extraordinary anger from the character coming out. And I think Batman,
in that moment, is sort of very frightening and you're not really--at a
certain point you're not really sure that he's coming across as that heroic a
figure. I mean, he's quite terrifying in that scene, I think. And I think
only The Joker is able to bring that out in Batman.

DAVIES: You know, Heath Ledger delivers this amazing performance. And then,
of course, in January he died. It was an overdose of prescription
medications. And it was, of course, a terrible shock and a loss to you both,
I'm sure. But you're also in the middle of, I guess, production of this film,
which is, in addition to being a work of art, of course, a big expensive, high
stakes, commercial project. And it must have posed all kinds of difficult
questions that you knew you would have to face months hence. I mean, do you
limit his performance, do you change his performance, do you change the way
the film is marketed? I think it's probably hard to get perspective because
you're right in the middle of the film itself, and in this sort of emotional
vortex. And I'm wondering, Christopher Nolan, how you found perspective on
how you would deal with his death and the release of this film?

Mr. NOLAN: Well, all I can really say about that, to be honest, is that I
had a very specific task at the time when Heath died, and that was to finish
editing the film. And it was very obvious to me that what I had to do was to
finish the film in exactly the way we would have anyway. That's what Heath
would have insisted upon. And it's very important that his performance come
through in the film exactly the way he intended. So really that was my task,
that's what I've done. And I'm gratified to hear people reacting to the
performance in the way that I know he wanted them to.

DAVIES: Any thoughts about that, Christian Bale? I don't know how much you
got to know Heath Ledger on the set.

Mr. BALE: Yeah, I think that, you know, this is what he did. And he was a
wonderful talent. And this is not a personal journal. This is not a homemade
video which must and should remain private. This is his work, and he intended
for this to be seen. And he created an incredible portrayal. He immersed
himself into this role. I think contrary to what many people have said--and I
think there's been a lot of, frankly, quite rude amateur psychology been going
on by a number of journalists--Heath enjoyed playing The Joker immensely. He
immersed himself in it as any good actor does. But the minute the makeup came
off, he was Heath and he was wonderful company.

DAVIES: And the rude commentary you're referring to is this notion that
because he played such a tormented character that it might have affected him
psychologically in some way that contributed to his death.

Mr. BALE: I find that disrespectful to Heath's acting ability. He was far
beyond that.

DAVIES: You know, one more question about the story here. Christopher Nolan,
you know, it's interesting that in this film we see that Bruce Wayne has
adopted this character Batman in "Batman Begins" and has begun fighting crime
in Gotham. And then we see that, as he succeeds against the criminal element,
that they respond in kind and unintended consequences appear. Criminals are
replaced by ones that are even, you know, more cynical, more ruthless. And in
a way a chaos emerges which he didn't anticipate. And I wonder if that's not
unlike the experience of the American invasion in Iraq, and I wonder if there
was anything conscious in that?

Mr. NOLAN: Well, not insofar as, I think, we're all--in the world we live in
today, I think one of the biggest threats we feel, one of the most palpable
fears is the fear of anarchy, is the fear of the complete breakdown of the
systems we live by. And obviously, you know, Iraq is one of the places that
we're shown every night on the news. The truth is that myself and David Goyer
and my brother Jonah, when we're working on the story, working on the
screenplay, we try not to be too conscious of trying to put, you know,
political perils and things into the story because that sort of violates the
terms of the storytelling a little bit. It violates the terms of the genre.

We try and write from the point of view of writing about what genuinely moves
us. And we trust that, because we all live in the same world, that things
will arise from that. If we're really sincere about what genuinely moves us,
things will arise that do speak to other people and do speak to them in some
ways about the actual state of the world. But I think if we were ever trying
to be, you know, conscious with that, I think you'd feel it in the
storytelling and you'd react against it. So if those things are in there,
it's sort of about now when I'm sitting, talking to people like yourself
who've seen it, you know, objectively, that's when I start to sort of see
these kind of parallels and things that we've put in there. But hopefully
there's stuff in the movie that resonates. But we try and be a little
accidental with that.

DAVIES: Well, Christopher Nolan, Christian Bale, thanks so much for speaking
with us.

Mr. NOLAN: Thank you.

Mr. BALE: Thanks.

GROSS: Christian Bale plays Batman in "The Dark Knight." Christopher Nolan
directed and co-wrote the film. They spoke with FRESH AIR contributor Dave
Davies.

Coming up, jazz critic Kevin Whitehead reviews a new re-issue by one of the
first great jazz saxophonists, Coleman Hawkins. This is FRESH AIR.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Review: Kevin Whitehead reviews the new reissue of Coleman
Hawkins' 1957 album "The Hawk Flies High"
TERRY GROSS, host:

Coleman Hawkins, one of the first great jazz saxophonists, played in Fletcher
Henderson's big band in the 1920s, worked in Europe for a while in the '30s,
and mixed it up with young be-bop musicians in the 1940s. In the '50s he made
some big band and jam session records, and often appeared in informal
combinations on live TV.

Jazz critic Kevin Whitehead reviews a 1957 album where Hawkins got to pick his
own band.

(Soundbite of music)

Mr. KEVIN WHITEHEAD: Coleman Hawkins on tenor sax from the new reissue "The
Hawk Flies High" from 1957. By then he'd been recording for 36 years already,
since before King Oliver or Bessie Smith had ever cut a record, or Hawkins had
even heard of Louis Armstrong.

When Coleman Hawkins started out, he sounded straight out of vaudeville, with
a slap-tongue technique stiff as a starched collar. But he was into periodic
reinvention way before David Bowie or Madonna. By the 1930s he developed a
sumptuous ballad style, immortalized on his hit "Body and Soul." In the '50s
he changed up again. His tone became harder, more of a roar, to fend off
tough young tenors like Sonny Rollins and John Coltrane.

(Soundbite of music)

Mr. WHITEHEAD: Coleman Hawkins never really outran his past. His choice of
notes and ear for harmony were always state of the art, but his rhythms could
sound a little stodgy compared to his rival Lester Young. Plus, record
companies were always after him to record another ballad like "Body and Soul."
This exasperated Hawkins. `I've done hundreds of them.' The lush ballad here
is David Raxon's "Laura." As on "Body and Soul" Hawkins barely glances at the
melody.

(Soundbite of "Laura")

Mr. WHITEHEAD: Save for drummer Joe Jones, old enough to be Hawk's kid
brother, his hand-picked septet is roughly a generation younger, including top
be-bop trombonist J.J. Johnson and pianist Hank Jones.

(Soundbite of music)

Mr. WHITEHEAD: And then there's trumpeter Idrees Sulieman, who on "Juicy
Fruit" plays one of the truly weird recorded solos. It relies on the
technique of circular breathing, which lets wind players blow continuously
even while taking a breath. Later, it'd be put to good use by innovators like
Rahsaan Roland Kirk and Evan Parker. With Sulieman it's more of a one note
gimmick. But by shear perverse persistence, it creates a jazz solo so odd it
could have been dreamed up by Thomas Pynchon.

(Soundbite of "Juicy Fruit")

Mr. WHITEHEAD: Idrees Sulieman's trick trumpet solo harks back to vaudeville
routines, even if circular breathing later became a staple of the avant garde.
That makes him a perfect complement to Coleman Hawkins: one foot in the past,
one stepping toward the future.

(Soundbite of music)

GROSS: Kevin Whitehead teaches English and American Studies at the University
of Kansas, and he's a jazz columnist for emusic.com. He reviewed the reissue
of Coleman Hawkins' 1957 album "The Hawk Flies High" on the Riverside label.

(Credits)

GROSS: I'm Terry Gross.
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.