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Radical 'Wisdom' for the Global AIDS Epidemic

In her new book, The Wisdom of Whores, epidemiologist Elizabeth Pisani interviews sex workers, drug users, health officials and bureaucrats in an effort to determine why 40 million people are living with HIV — and what can be done to curb the epidemic.

20:19

Other segments from the episode on June 10, 2008

Fresh Air with Terry Gross, June 10, 2008: Interview with Elizabeth Pisani; Interview with Julianne Moore.

Transcript

DATE June 10, 2008 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Epidemiologist Elizabeth Pisani, author of "The
Wisdom of Whores," on curbing the spread of HIV
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

When asked what she does for a living, Elizabeth Pisani sometimes answers `sex
and drugs.' The more precise answer is that she's an epidemiologist who has
spent years investigating the spread of the AIDS epidemic. She's provided
research analysis and policy advice to UN AIDS, the World Health Organization,
the World Bank and the Centers for Disease Control. Her new book is called
"The Wisdom of Whores: Bureaucrats, Brothels and the Business of AIDS." As
we'll hear later, one of the subjects she writes about is President Bush's
program PEPFAR, an acronym for the President's Emergency Plan for AIDS Relief.
President Bush described it as a work of mercy to help the people of Africa,
but the financial aid comes with strings attached that Pisani says reflect a
moral agenda, not an epidemiological one.

Elizabeth Pisani, welcome to FRESH AIR. Just give us a brief overview of the
work that you've done as an epidemiologist working on the AIDS epidemic around
the world.

Ms. ELIZABETH PISANI: Well, most of my work has been focussed on trying to
help governments understand how the HIV virus is spreading in their countries.
And in the countries that I've worked in, which are mostly in Asia--so
Indonesia and China, in East Timor and the Philippines and other
countries--that means spending a lot of time hanging out in brothels because
we work a lot with commercial sex workers and men who buy sex. Also with gay
men in nightclubs and injection drug users. So I spend a lot of time having
very late nights.

GROSS: Give us an example of something you learned about how AIDS was spread
by sex workers in one of the countries that you work in that you wouldn't have
know had you not really been there on the ground talking to people directly.

Ms. PISANI: We always have this assumption that sex workers have huge
numbers of partners. And when we were talking to some of the sex workers in
Jakarta, the capital of Indonesia, where I worked for many years, they
actually reported very low numbers of partners. And, in fact, that taught us
more about the science than it did about the sex work itself.

I was sitting around, in fact, one evening with one of the transgender sex
workers, and we were chatting and drinking, and she was knocking back my very
best whiskey. And I was like, `Ennis, you've got expensive tastes. How do
you support that on three clients a week?' She said, `What do you mean three
clients a week?' And I said, `Well, that's what you're telling us in your
surveys.' And she said, `Nah, you're talking to all the dogs.' And I said,
`No, we're not. We're doing random selection, very by the book, great
epidemiological surveys.' And she said, `Nah, you're talking to all the dogs.'
And I was like, `You're not listening to me, Ennis. We do these random'--and
she interrupts me again and says, `No. Any sex worker who's talking to a
research team is a sex worker who's not with a client. So you're talking to
all the dogs. You're talking with ones who are not with clients, and
therefore you're getting'--she didn't put it this way--`but you're biasing
your estimates downwards.'

And, in fact, as a result of that, we changed the way that we did our
samplings and we got much higher reports of clients later on. So you learn a
lot from being on the ground and chatting to the people that you're working
with.

GROSS: What did you change?

Ms. PISANI: What we did was we actually worked with the structures. The
transgender sex trade is very, very interesting. It's very well structured,
and it has a structure that almost exactly mirrors the government structures
of Indonesia. So you have a provincial head, a district head, and then a head
for each of the subdistricts. And they organize the girls. And all of the
girls--girls, I call them--transgender sex workers, and all of them are very
careful to work in a hierarchy and do what the district head says. So we
started working with the district heads in the transgender community. And
they gathered people during the daytime, when we weren't interrupting with
working hours, to their houses. And we were able to do the surveys there.

So not only did it make easier for the transgenders, because we weren't
interrupting their work, but it also made it easier for my research team
because we didn't have to be on the streets at 2:30 in the morning subject to
police raids, for example. It's very embarrassing when your whole survey team
gets taken away by the police because they're accused of being sex workers.

GROSS: Right. You write in your book that the AIDS epidemic in Africa is
different in how it's spread than the AIDS epidemic in most other countries.
What's different about Africa?

Ms. PISANI: Essentially there are two epidemics in the world. One is, as
you say, in east and southern Africa particularly. And one is in all of the
rest of the world. So the United States looks more like Indonesia, looks more
like Argentina, looks more like Kyrgyzstan than it does like any Africa
nation. The difference is this, that in most of the world HIV is spread
mostly in behaviors that are fairly well defined as high risk, and that is:
among people who buy and sell sex, among gay men who have many partners, and
among people who inject drugs.

In Africa, because of different patterns of sexual behavior, HIV spreads among
men and women in the general population. And the different pattern of sexual
behavior are this--it's not a volume question. It's not Africans have more
sex--it's that they have sex in different patterns, and that is they're more
likely to have two or three partners at any given time in any given six month
period then people in other parts of the world. People in other parts of the
world may have the same number of partners overall or probably more over the
course of a lifetime, but they tend to have them in a string, in a serial
monogamy pattern. So I call it "sex in nets" vs. "sex in strings."

Why is that important? Because HIV is actually not very infectious so it's a
virus that, once it gets into your body, replicates very, very, very quickly,
and there's lots of virus hanging around in your body. And for that period
you are highly infectious, but that period only lasts for a maximum of two or
three months; some would say up to six months, maximum. And then you start
making antibodies and it controls the amount of HIV that's in your body and
that can easily be passed on, and that phase can go on for a very long time.
But you're not, in that phase, not very infectious. So the likelihood that
you spread HIV essentially depends on how many partners you have in that first
very infectious period.

GROSS: You're of two minds when it comes to President Bush's AIDS funding
program in Africa. You're very supportive and upbeat about the treatment
aspects of the funding, the funding that's used for treatment programs; but
you're very critical of how the funding is used for prevention.

Ms. PISANI: The progress that has been made on treatment has been absolutely
astonishing worldwide, and it's really because the United States and President
Bush, through this PEPFAR program, as it's called, upped the ante. When we
first made the estimates of how much it would cost to beat this thing
worldwide, we didn't even put treatment into the equation because everyone
just thought, `Ah, you know, it's just never going to happen in Africa. We
can't even be dreaming of it.' And three or four years later, the United
States government said, `Why shouldn't we be thinking of it? Of course we can
think of it and put the money on the table.' And it changed everything. And
that's been absolutely wonderful and really made a dramatic difference to the
lives of now close to three million people who are living with the virus and
who are now able to access treatment.

But the more treatment you have, the more prevention you need because it
increases the size of the epidemic by keeping people alive for longer. So we
really need to re-focus on prevention. But the money that has been provided
through PEPFAR is peculiarly ineffective for prevention because of the
restrictions that have been placed on it, and those are the following: Of the
money that's earmarked for prevention, a third of it has in the past been
earmarked for abstinence-only programs. Now, abstinence-only programs have
been heavily funded in the United States and they've been shown not to work
even in the United States. Of the teenagers who take an abstinence pledge,
who actually stand up in public and say, `I will abstain from sex until I'm
married,' we have a failure rate of at least 72 percent. That's among the
people who actually take the pledge. Forget about those who don't. Why we
think that those programs would be any more effective in eastern southern
African than they are--or anywhere else in this world--than they are in the
United States, I've never been able to fathom.

The second restriction, which is a very important one, is on working,
effectively, in the commercial sex trade. The United States government in the
moment takes an abolitionist view to the sex trade: The only way to deal with
prostitution is to wipe it out entirely. Now, many of us believe that that's
not a feasible answer and that what we need to do is to increase health and
safety conditions for workers and for clients in the sex trade; but we can't
do that effectively with PEPFAR money. It's not allowed.

GROSS: In fact, in countries that take AIDS funding for prevention from the
United States, they have to sign a pledge. What does the pledge say?

Ms. PISANI: The pledge says that, `We will not, as an organization'--or if
it's a national government--`as a country recognize commercial sex as an
industry or a legitimate activity, and that we will not engage in anything
that promotes commercial sex or recognizes it in that way.' Now, that makes it
very, very difficult to work effectively with sex worker rights organizations.
It makes it every difficult to work with the structures of the sex industry.
I think I mentioned earlier that some of the most effective programs have been
when we work with brothels and when we work with sex workers directly; and you
can't do that.

GROSS: Now, you mentioned that in the Bush-funded program, when it comes to
prevention that the programs have to be abstinence only and countries and
organization that accept money have to sign an oath saying that they oppose
the practice of prostitution and that they have no intention of using any
American money for prevention programs related to sex work. How do those...

Ms. PISANI: Excuse me.

GROSS: Yeah.

Ms. PISANI: Of using any money, not even any American money.

GROSS: Oh, I didn't realize that.

Ms. PISANI: The government is currently being sued....

GROSS: Even their own money?

Ms. PISANI: Yes. The government of the United States is currently being
sued by two organizations who contend that it restricts their freedom of
speech because they're not allowed to use even their own money to do those
activities.

GROSS: Well, how do these...

Ms. PISANI: Unless they sign the pledge.

GROSS: How do these restrictions end up in AIDS funding from US money?

Ms. PISANI: They were part of a bill that was passed by Congress in 2003,
and the restrictions were written into the bill. Now, that bill was passed by
a Republican Congress. The bill is now being considered for re-authorization
under a Democrat-controlled Congress. Some of the restrictions have been
removed. The abstinence-only earmark has been removed. But some of have
stayed, including the anti-prostitution oath. I think that many people are
deeply disappointed by that and would like to see that change before the money
is actually re-allocated.

GROSS: My guest is Elizabeth Pisani. She's an epidemiologist and author of
the New book "The Wisdom of Whores: Bureaucrats, Brothels and the Business of
AIDS." Let's take a short break here and then we'll talk some more. This is
FRESH AIR.

(Announcements)

GROSS: My guest is Elizabeth Pisani. She's an epidemiologist who has
provided research analysis and policy advice to UN AIDS, the World Health
Organization, the World Bank and the CDC about HIV and the spread of HIV.
She's the author of the new book "The Wisdom of Whores: Bureaucrats, Brothels
and the Business of AIDS."

You know, you write in your book about how politics around the world has so
often interfered with the effective prevention of HIV, of the spread of HIV.
Give us a couple of what you consider to be the most frequent way that
politics that politics prevents what you would consider to be the best
epidemiological ways of preventing the spread of HIV.

Ms. PISANI: The most obvious example is drug injection. The United States
taxpayer has funded, at my last count, I think, 17 comprehensive reviews of
the evidence on harm reduction; and 17 out of 17 have concluded that it is
effective and that it is also cost effective. And yet we are still not
allowed to use any federal money to provide clean needles to drug injectors.
And this is, you know, that's a US thing but we see it in numerous other
countries.

We've been fighting very, very hard to get HIV prevention into prisons,
because we know that people in prisons both inject drugs and have unprotected
sex that's very risky. And people don't want to support that. And when you
talk to--and I remember talking to a friend in Indonesia who is from Bali, and
he's been living with HIV for many years now. And he's like, `Yeah, I
remember exactly when it happened. I was in jail and someone gave us a bunch
of--we got a bunch of heroin in through one of the guards, and we had one
syringe. And so we voted. We designated one guy the injector and we all
lined up. And there were 26 of us lined up, and I was number 23 in the line.
And he shot up the first person, and he shot up the second person, and there's
blood all over the place, and he rinsed the needle under a dirty tap. And
then he shot up the next person and the next person. And then it got to
number 12, and all I could think was, "Please let there be some drugs left.
Please let there be some drugs left."' He's not thinking, you know, `I'm going
to get infected with a disease, that needle is disgusting.' He's thinking,
`Please let there be some drugs left.' And my friend Frank, he said to me,
`You know, I can't believe now that I was so stupid, but, boy, does addiction
make you stupid.'

Yes, it makes you stupid, but does that mean that we should punish you for
being stupid or could we possibly try and keep you alive until you stop being
an addict? Those very, very pragmatic approaches to addiction and to risky
sex are things that are not necessarily supported by the majority of voters
and therefore are not supported by the majority of governments.

GROSS: A lot of people who have AIDS now--and I think is probably
particularly true in developed countries, you know, in countries like England,
where you live, and the United States--a lot of people who have HIV are on the
new drugs, and people with AIDS are living with it as a very difficult but
chronic condition as opposed to a life sentence. So how is that affecting, do
you think, the spread of HIV and how often people are actually following safe
sex practices? You know, now that AIDS isn't the death sentence that it once
was.

Ms. PISANI: The effect of this treatment is that we're decoupling the HIV
epidemic from the AIDS epidemic. You can live with HIV without ever seeing
AIDS. We are now seeing a whole generation of young people--and we're seeing
it most obviously in the gay communities in the United States--we're seeing a
whole generation of young gay men who have never seen AIDS. So for them HIV
is this sort of slightly mythical thing that they've heard about and they know
it's suppose to, you know, be horrible; but actually people are thinking of it
almost now as an inconvenience. You take your medicines, you'll be fine.

And when you look at the advertising that drug companies do directly to the
consumer, and you see the guys who are on AIDS meds and they're all, you know,
abseiling down canyons against a sunset, or whatever, you think, `Yeah, it
doesn't look so scary.' Now...

GROSS: So how is this affecting safe sex?

Ms. PISANI: Well, we've got quite a bit of evidence from gay communities in
industrial countries, including the United States, that condom use is falling
and that unprotected sex is rising. Now, people are getting a bit clever
about who they have sex with, so you're seeing a lot more unprotected sex
between people who are already infected. But we're also seeing a rise in
unprotected sex between people who don't know the other person's HIV status,
and that's really very, very worrying.

If we see that same effect in Africa now that this extremely generous program
from the United States and many other countries is increasing treatment
dramatically in Africa, then we're going to have a very, very big problem
because what we're doing is getting rid of AIDS through treatment without
getting rid if HIV. We're removing the fear. We're reducing the incentive to
stay safe, to adopt safer behaviors. That means more people infected with
HIV, and that means even more people who are going to be on these treatments.

The treatments are expensive. The price is coming down all the time, but they
remain expensive. And, because HIV is a virus that replicates very, very,
very quickly, it also develops resistance very quickly. We don't know how
long these drugs are going to be effective for. So it's really a very, very
big risk, both financially and in terms of the ongoing spread of the disease.

GROSS: So you're looking at a possible nightmare, the dimensions of which we
don't know yet?

Ms. PISANI: I would say so.

GROSS: A new form of the nightmare.

Ms. PISANI: That's right. And it's a form of the nightmare that no one is
talking about.

GROSS: Well, Elizabeth Pisani, thank you so much for talking with us.

Ms. PISANI: Thank you very much.

GROSS: Elizabeth Pisani is author of the new book "The Wisdom of Whores:
Bureaucrats, Brothels and the Business of AIDS." I'm Terry Gross, and this is
FRESH AIR.

(Announcements)

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

Interview: Actress Julianne Moore on her new film "Savage Grace"
and her career
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross. She got her start on the soap opera "As
The World Turns," but Julianne Moore is famous for her roles, often edgy
roles, in independent films like "Short Cuts," "Safe," "The Big Lebowski,"
"Boogie Nights," "Magnolia," "Far from Heaven" and "I'm Not There." She made
her film debut in the 1992 thriller "The Hand That Rocks the Cradle." In 2003
she received two Oscar nominations, one for her performance in "The Hours,"
the other for "Far from Heaven."

Now she's starring in the new film "Savage Grace," which was adapted from the
nonfiction book about Barbara Daly Baekeland. Baekeland entered the elite
social world when she married Brooks Baekeland, the heir to the Bakelite
plastics fortune. But when their marriage fell apart so did her life and her
son's life. This is a story of social climbing, jealousy, incest and madness.
Here's a scene from early in the film, set in Paris in 1959. The marriage has
soured and Barbara's social attentions are focused more on her son than her
husband. Barbara is having lunch in the park with her son, talking about
their privileged lives and comparing it to the life she was brought up in by
her mother, who she refers to as Ninny.

(Soundbite of "Savage Grace")

Ms. JULIANNE MOORE: (As Barbara Baekeland) Some people's fathers, some
people's mothers, they have to go to an office or a factory or a store, I
guess, every day. But we are fortunate because what we do is what we love.
What does Francois' father do?

Mr. EDDIE REDMAYNE (As Antony Baekeland) He works.

Ms. MOORE: (As Barbara Baekeland) Ah, well, we work. Father worked. Ninny
worked. There was no other way. I kind of had to raise myself. And then I
worked too, at Filene's. I mean, when I could have left, just left. Ninny
wanted what was best for me, only what was best for me. `Find the love,'
she'd say. Man, I guess she meant. And she meant money. The rich, they
don't have pet names for money.

(End of soundbite)

GROSS: Julianne Moore, welcome back to FRESH AIR.

Ms. MOORE: Thank you for having me.

GROSS: Let me ask you to describe Barbara Baekeland, the character that you
play, who was a real person. What's your take on her?

Ms. MOORE: Hm. Yeah. Well, she was from the wrong side of the tracks, so
to speak, you know, in terms of these society people. She came from Boston
with her mother. She came to New York City to kind of marry somebody, to find
a rich husband. And she kind of, you know, she dated lots of society people.
And then went to Hollywood for a screen test where, interestingly enough, she
discovered she didn't want to be an actress because it was too hard. She
didn't want to work. You know, she really wanted--somebody who definitely
wanted glamour and society and fame and attention without anything underneath
it, you know. And I think that was probably her greatest tragedy in her life,
was that it was all kind of, her pursuits were sort of, you know, hollow. But
it didn't make her any less human. She was also kind of passionate and alive
and engaged and narcissistic and difficult. And, I mean, you know, she was
sort of a--people would say about Barbara, like in one breath they'd say how
she was the life of the party but then they never wanted to have dinner with
her ever again. She's that type of person.

GROSS: I think one of the interesting things about your performance is,
Barbara Baekeland had gone to Hollywood, you know, wanting to be an actress
and then, as you've said, just didn't want to have to do the work.

Ms. MOORE: Mm-hmm. Yeah.

GROSS: But the way you play her, she's acting through her life.

Ms. MOORE: Constantly.

GROSS: Because she's not a person who grew up in society. She's not a person
born to money, but she acts like she was. And sometimes that veneer just kind
of falls away and you see the person who she really is.

Ms. MOORE: You see what's underneath.

GROSS: And underneath...

Ms. MOORE: And she also, she doesn't act well either. You know, I mean,
there are times, you know, she's kind of a sort of a poser. And I even tried,
in the performance, because the movie takes place in these little, these, kind
of these vignettes at the very beginning in the '40s, I wanted my speech to
have a quality more like old movies.

GROSS: Yes.

Ms. MOORE: You know, more like she was copying the way she thought she
should speak.

GROSS: Mm-hmm.

Ms. MOORE: By the time we get to the '70s her speech becomes much more
relaxed and more sort of of the time, or whatever.

GROSS: "Savage Grace" is an independent film.

Ms. MOORE: Mm-hmm.

GROSS: You've had--like a lot of people now, you've had a dual career in more
commercial films and more independent films.

Ms. MOORE: Yes.

GROSS: And in your independent films you've done some pretty risky material.
And you seem to, in fact, gravitate to movies about extreme characters or, you
know, movies that take risks with their subject matter. Let me play a great
scene that you're in in the movie "Magnolia." And this is one of Paul Thomas
Anderson's films. And in this film you're married to a character played by
Jason Robards. He's very sick and he's dying.

Ms. MOORE: Yeah, mm-hmm..

GROSS: And he has a prescription for a liquid morphine that you've been
getting for him. And in this scene you go into a pharmacy, you get a
prescription filled, and do you want to set the scene up for us?

Ms. MOORE: I'm going to get a prescription filled, and I attack the
pharmacist because I think he thinks that I'm, you know, that I'm a junkie,
that I'm a drug addict. And he doesn't treat me with the kind of respect that
I think I deserve as somebody who is taking care of a dying man. I'm saying
you don't know who--you know, it's basically, `You don't know who I am just by
looking at me. Don't think you know who I am.'

GROSS: So you're getting the morphine and other heavy duty drugs at the
pharmacy.

Ms. MOORE: Yes.

GROSS: And the pharmacist comments that this is strong, strong stuff.

Ms. MOORE: Yeah.

GROSS: And he says to you, `What exactly do you have wrong with you that you
need all this?'

Ms. MOORE: Mm-hmm.

GROSS: And that's when you really erupt. Here's the scene.

Ms. MOORE: That's--yeah.

(Soundbite of "Magnolia")

Ms. MOORE: (As Linda Partridge) I come in here, you don't know me. You
don't know who I am, what my life is and you have the balls...

Unidentified Actor #1: (In character) You don't have to...

Ms. MOORE: (As Linda Partridge) ...the indecency to ask me a question about
my life.

Actor #1: (In character) Ma'am. Ma'am. Listen to me.

Ms. MOORE: (As Linda Partridge) I don't care what you do! Don't you call me
lady. I come in here, I give these things to you, you check, you make your
phone calls, look suspicious, ask questions. I'm sick. I have sickness all
around me and you...(word censored by network)...ask me my life. What's
wrong? Have you seen death in your bed? In your house, where's your...(word
censored by network)...decency. And then I'm asked...(word censored by
network)...your questions. What's wrong?

(End of soundbite)

GROSS: That's a great scene. That's Julianne Moore in "Magnolia."

Ms. MOORE: Beep, beep, beep.

GROSS: Yeah, we had to bleep a lot there. Well, you're really unraveling at
this point, without getting too deep into the story explaining why.

Ms. MOORE: Yeah.

GROSS: But one of the interesting things about that scene is that you're
doing your lines in an almost musical way because your hysteria has kind of
like taken you out of regular conversation into this world...

Ms. MOORE: Right.

GROSS: ...of almost, you know, music. And at the same time you have this
very dramatic music behind you.

Ms. MOORE: Right. Uh-huh.

GROSS: Did you know what the music behind you would be, that that would be a
counterpoint to what you were saying?

Ms. MOORE: Unh-unh. You never know that. You never know how a movie is
going to be scored. That's one of the weird things about seeing a film when
it's completed, is that you don't know, you don't know how it's going to be
edited, you don't know how it's going to be scored, you don't know how the
color timing is going to work; it could be brighter, it could be darker than
what you thought. So, you know, it's not an actor's medium. You're really in
the hands of the director in terms of how the performance kind of is shaped.
There have been times when I felt like I've been in stuff that's been
overscored. And I'm like, oh, no, oh, gosh. You know? I didn't feel that
way with this. I think it was a beautifully scored movie. So I think I
really liked it.

GROSS: Over the years you've played a lot of characters who have their
moments of breakdown, hysteria, or they're just sobbing.

Ms. MOORE: Yeah.

GROSS: Have you developed different ways of sobbing, depending on who your
character is?

Ms. MOORE: Yeah, you have to because they're all different people. You
know, one of the questions that I get a lot is, you know, how do you make
yourself cry; you know, people say, `Do you think of something, do you'--and I
can't make myself cry. Only the character can make me cry. She has to cry.
So I have to be in the place where she is. And her circumstance bring me to
tears. And hopefully the character then is--then the crying is like her.
It's not going to be like me or like some other character that I did or, you
know, I think there's some characters--I've had some silent criers. I've had
some, you know, some wailers and some sobbers. And you know, but you know it
has to be--not to sound all touchy feely, but it has to be the character who
kind of presents it to me.

GROSS: Have you become an observer of the different ways in which people cry
or lose control?

Ms. MOORE: Oh, well, you know, the interesting thing about it is that it's
very, it's something you very rarely see because people don't like to do it.
I was just doing a movie recently where, as usual, I had some crying. And
every time I had to do it, I just go, I just kind of moan and complain. I was
like, oh, I don't want to, I don't want to. And the director said `Why? Why?
Because you can do it. You seem to do it so easily.' I said, `Well, no,' I
said because, I said, `the thing about crying is that's the one, that's one of
the things we don't like to show people. We don't usually show people that.
We usually try to hide it. We're always trying not to cry. So to get
yourself, even to get yourself, a character to a place where you are doing it
is a weird, you know, there's a sort of twist it.' You're in an emotional
place. You have to allow it to happen because it has to happen on screen.
But at the same time everything in your body is telling you not to do it.

(Announcements)

GROSS: Julianne Moore is my guest, and she stars in the new film "Savage
Grace."

Let me move on to a scene from another film. This is a film also directed by
Paul Thomas Anderson, "Boogie Nights."

Ms. MOORE: Mm-hmm.

GROSS: It's your first film with him.

Ms. MOORE: Yeah.

GROSS: In this your an actress in the porn industry.

Ms. MOORE: Right.

GROSS: And your lover and director is played by Burt Reynolds. And Mark
Wahlberg plays like the new actor who arrives on the scene.

Ms. MOORE: That's right.

GROSS: And is making movies with you.

Ms. MOORE: The big star.

GROSS: Yeah, the big star who's very well endowed.

Ms. MOORE: Yeah. Yeah.

GROSS: So in this scene you are a casting agent at a desk for a porn film.

Ms. MOORE: Mm-hmm.

GROSS: And Dirk Diggler, played by Mark Wahlberg, walks in to audition.

(Soundbite of "Boogie Nights")

Mr. BURT REYNOLDS: (In character) Action, Dirk.

Ms. MOORE: (As Amber Waves) Hello, are you John?

Mr. MARK WAHLBERG: (As Dirk Diggler) Yes, ma'am.

Ms. MOORE: (As Amber Waves) Your agency recommends you very highly.

Mr. WAHLBERG: (As Dirk Diggler) Well, I'm a really hard worker. And if you
give me a job, I won't disappoint you.

Ms. MOORE: (As Amber Waves) What special skills do you have?

Mr. WAHLBERG: (As Dirk Diggler) Well, I just got--I've been in the Marines
for three years. I just got back from a tour of duty.

Ms. MOORE: (As Amber Waves) You're kidding.

Mr. WAHLBERG: (As Dirk Diggler) No, I'm not. And it got really hard being
surrounded by all those guys all day.

Ms. MOORE: (As Amber Waves) How long has it been since you've had a woman?

Mr. WAHLBERG: (As Dirk Diggler) A long time.

Ms. MOORE: (As Amber Waves) That's terrible.

Mr. WAHLBERG: (As Dirk Diggler) And now I'm back and I'm ready to pursue my
acting career.

Ms. MOORE: (As Amber Waves) Well, as you may or may not know, this is an
important film for me. If it's not a hit I'm going to get kicked out of my
apartment. My landlord's a real jerk.

Ms. WAHLBERG: (As Dirk Diggler) Really?

(End of soundbite)

GROSS: A scene with Julianne Moore and Mark Wahlberg from "Boogie Nights." So
in this scene, like you're both intentionally being really...

Ms. MOORE: Yeah.

GROSS: ...you know, amateurish bad actors.

Ms. MOORE: Right. Right.

GROSS: So what did you do to...

Ms. MOORE: Well, when you're acting, the idea that is to make--you know,
basically it boils down to being as realistic as possible in a film. You want
to be behaving as people do in real life, which is difficult when you're being
observed. But we have, you know, we've learned how to do that. We've learned
how to do that by relaxing our bodies and our voices, and being connected and
being in the moment and looking at somebody. And there's a way that you train
yourself to be able to behave that way.

Now, if you're not trained, if you're not an actor, if you're not even an
instinctive actor, you're not going to know how to speak with inflection.
You're not going to know how to move your body and use your voice at the same
time. That's something that I do. I never move on a line. Like, I make a
movement and then I say the line, which is one of the things that young, you
know, inexperienced actors do all the time, and it's hysterical. So I loved
that Mark has that--he has a fumble in his line. He goes `I just got--I'm a
Marine and I just got back.' And, you know, he corrects himself midline. We
all do that. We start a line, stop it, start it, whatever. But in his case,
because they're just on this little porn movie they just leave all the
mistakes in.

GROSS: You seem to place your voice higher and in a more uncertain place in
that scene, too?

Ms. MOORE: Yeah, I did. I put it over, like above my, you know, larynx so
it's not so connected, either. Like when people are afraid they can't, you
know, they're on top, they're on top. You know, she's like on top of her
voice, she's not in her voice because she's not in her body. You know, she's
not really present in a way.

GROSS: Do you have a favorite story from the making of "Boogie Nights"?

Ms. MOORE: You know what was funny? I do remember the scene where I give
Mark coke for the first time. And at the end of the scene in the script it
said they embrace. So I'm supposed to, you know, do the coke, do the scene
and, my interpretation, give him a hug. And Paul's like, `OK, and then you
kiss him.' And I panicked. You know, I absolutely panicked. I had to do all
this stuff with him. You know, all this pulling out of the rubber appendage
and him laying on top of me and whatever. But I didn't think I had to kiss
him. So I remember thinking--I mean, I was absolutely terrified. It put me
in a cold sweat. I did it. It was all fine. I mean, I love Mark. But that
was what was so funny to me, is that after all that the thing that really
freaked me out, oh my gosh, now I've got to kiss him.

GROSS: Why did that freak you out?

Ms. MOORE: Well, you know, because kissing is pretty intimate. It's
probably--I mean, that's just a whole--that's a very intimate thing. It's
probably more intimate than taking your clothes off in front of somebody in a
weird sort of way.

GROSS: You'd be able to speak about that, because in an earlier film...

Ms. MOORE: I've done both.

GROSS: Well, like in Altman's film "Short Cuts," you were naked...

Ms. MOORE: Yeah. Uh-huh.

GROSS: ...from the waist down...

Ms. MOORE: Right. Right.

GROSS: ...in a very dramatic scene.

Ms. MOORE: Right.

GROSS: So did you have to overcome...

Ms. MOORE: Which created quite a furor. I wasn't--I was nervous. You know,
I was nervous about it. But Bob, oh my gosh, I love Bob so much and he was so
kind and so caring. And as far as Bob was concerned, you know, an actor
couldn't do anything wrong because he had hired them and therefore they were
right, you know. So he just gave you all this latitude. And so I felt very
taken care of, you know. I felt, you know, nervous about the scene because it
was such a dramatic scene. But he was trying to communicate something that
Raymond Carver had written, and in a cinematic way. And he did it by kind of
peeling off--that kind of intimacy, that's sort of, that's the way you are
physically with somebody in marriage. That's something that we see with our
partners all of the time. So he was doing that in that. So I didn't find it
all salacious, and certainly not sexual.

GROSS: So you were never self conscious about doing that?

Ms. MOORE: You know, yeah, obviously, you know, a little bit physically self
conscious. You always are. You're always like, `oh, OK.' But I didn't feel
frightened. I didn't feel--I felt like it was the appropriate thing in the
scene. It wasn't like one of those things where you see an actor having to
take their top off and walk across the room. I didn't feel like--it didn't
feel pointless to me. I understood why it was there and how it contributed to
the fabric of that scene. So, no, I didn't feel challenged by it. But, yeah,
normal kind of self consciousness like oh, gosh I hope I look OK. Yeah,
there's always that.

GROSS: How did it contribute to the fabric of the scene? Why was it
essential?

Ms. MOORE: Mm. Because I think, you know, this was a movie where a man was
trying to figure out whether or not his wife was having an affair. And in the
short story, in Raymond Carver's short story, he's thinking of her, like you
keeps flashing back to him seeing her with him, physically with him or with
another man or doing something, you know, he keeps flashing to these moments
of what she looks like, physically, her body while she's like doing this kind
of mundane stuff in the house. So Bob was trying to find a way to put that
element in there in a visceral kind of way, so this man is presented with his
wife's physicality and sexuality and her corporealness, I think. And so he
said, he was like, `This is what's going to happen.' And like I said, in a way
it's something that happens in a marriage all the time. You're in the
bedroom, your husband's out of the shower and he slowly starts to get dressed
and he's telling you what he's going to do that day. And you say `well, I
have to pick up the kids or I have to do' whatever. But you're confronted by
each other's bodies and our physicality all the time.

So that's what--you know, I think that's what Bob was doing in that. And in a
way I think that is why some people were so kind of inflamed by it because it
felt too intimate to them. Because it is. It's an extremely intimate moment.

(Announcements)

GROSS: My guest is Julianne Moore and she's starring in the new movie "Savage
Grace."

I want to play another scene from one of your shows. And this is from "Far
from Heaven," which was directed by Todd Haynes.

Ms. MOORE: Mm-hmm.

GROSS: Who more recently--who first directed you in "Safe."

Ms. MOORE: That's right.

GROSS: And more recently you were in his film about the many different Bob
Dylans, "I'm Not There."

Ms. MOORE: "I'm Not There." Yeah.

GROSS: And "Far from Heaven" is an homage to the 1950s melodramas of Douglas
Sirk movies like "All That Heaven Allows," "Imitation of Life," "Magnificent
Obsession."

Ms. MOORE: Yeah.

GROSS: And in a lot of those films there's personal secrets, dark secrets,
lovers kept apart by close-minded social mores of the day.

Ms. MOORE: Right, right.

GROSS: And this, "Far From Heaven" has all of that. And it's filmed in those
like saturated colors of the '50s melodramas.

Ms. MOORE: Yeah.

GROSS: And in this movie you're a suburban mother and homemaker in the 1950s
unaware that your husband is a closeted homosexual.

Ms. MOORE: Right.

GROSS: And you and your African-American gardener, who's played by Dennis
Haysbert, who is probably best known for his role as the president on "24,"
you start to develop feelings toward each other and slowly fall in love. But
of course it's pre-civil rights movement. You're married. This is a love
that cannot be.

Ms. MOORE: That's right.

GROSS: So here's a scene. Let me play a scene where you and the Dennis
Haysbert character are walking through the woods. You're looking at the
beautiful flowers and the leaves, and he's looking at a bruise on your face
that you got in a fight with your husband.

(Soundbite from "Far From Heaven")

Ms. MOORE: (As Cathy Whitaker) Oh, look. How lovely.

Mr. DENNIS HAYSBERT: (As Raymond Deagan) Did he cause that?

Ms. MOORE: (As Cathy Whitaker) He didn't mean to strike me.

Mr. HAYSBERT: (As Raymond Deagan) I'm so sorry.

Ms. MOORE: (As Cathy Whitaker) No. Heaven knows we all have our troubles.
I'm sure you yourself...

Mr. HAYSBERT: (As Raymond Deagan) What?

Ms. MOORE: (As Cathy Whitaker) I don't know. Ever since running into you at
the exhibition, I kept wondering what it must be like to be the only one in a
room colored, or whatever it was, how that might possibly feel. I'm sure I've
never...

Mr. HAYSBERT: (As Raymond Deagan) Well, I suppose you sort of grow
accustomed to it over time. I mean, don't get me wrong. There is a world,
even here in Hartford, where everybody does indeed look like me. The trouble
is, very few people ever leave that world.

(End of soundbite)

GROSS: That's a scene from "Far from Heaven" with my guest Julianne Moore and
Dennis Haysbert. Everything in this movie is so heightened. You know, the
colors, the birds in the background.

Ms. MOORE: Yeah.

GROSS: You're speaking like movie speech. It's not...

Ms. MOORE: Yes, exactly.

GROSS: It's intentionally not naturalistic.

Ms. MOORE: Right. Right.

GROSS: Did you go back and watch those '50s melodramas before making the
film?

Ms. MOORE: Oh, yeah. I mean, "All That Heaven Allows" particularly was
instrumental. I mean, because that's the movie that it most resembles. You
know, it's so wonderful sometimes to work in a specific style because there's
so much feeling it can hold. You know, you have these rules and these
conventions about, you know, what the--you know, all the colors are
meaningful. You know, the speech is meaningful. The way people move, you
know, there's intention in absolutely ever moment of it.

GROSS: So when you were watching the Douglas Sirk movies in preparation in
making "Far from Heaven," what else did you notice in the film in terms of the
style of acting of that genre from the period?

Ms. MOORE: Well, you know, it's interesting because, for us, it's easy to
make fun of it. It's easy to make fun of that kind of style and that kind of
sort of vocal choices and the, you know--but what makes it work and what makes
it beautiful in the Sirk films and hopefully in "Far from Heaven," too, is
that it's filled. It's that you might have this very stylized way of
speaking, but if the emotion is behind it, if it's meaningful, it's very
moving because you realize people are not saying what they want to say all the
time. They're just trying to kind of try to communicate in other ways. So
the trick was when you watched them--Rock Hudson and Jane Wyman, for
example--you realize it's all very deeply felt, even though the language seems
arch or weird. It's meaningful, and that's what makes it kind of beautiful.
Like I said, you've got all this content behind the style. I mean, you have
that. I think it's quite powerful.

GROSS: Now, I know you grew up in a military family. Did you move around a
lot as a kid?

Ms. MOORE: Oh, yeah. A lot. A lot, a lot. You know, I went to like nine
different schools growing up. But, you know, that's not uncommon for an
actor. And you find with a lot of actors if they're not military kids they're
embassy kids or traveling salesman kids or minister's kids. Any of those sort
of itinerant upbringings tend to produce actors.

GROSS: Why do you think that is?

Ms. MOORE: Behavior. You know, you learn very, very quickly how to change
behavior from place to place. You learn that it's malleable. You know, so
who you were was determined by how you were perceived. And as a consequence,
I thought--my my identity felt really, really fluid. It wasn't until I was an
adult, I think, and then I, you know--I mean, I think it takes a long time for
any of us to really try to figure out who you are. But I think mine was
delayed significantly by moving around.

GROSS: One more question. I know you have a couple of kids who are in
school.

Ms. MOORE: Yeah.

GROSS: I don't know if they're in school plays or not, but do you go to the
school plays? I think there's something...

Ms. MOORE: Oh, yeah.

GROSS: ...that's so endearing about watching kids act.

Ms. MOORE: My son--this is unbelievable because he's 10. He's in the fourth
grade. They did "Macbeth" the other day. Yeah. It was an abridged version.
It was, you know, it was completely abridged. But they all got a part. They
picked parts out of a hat. And they performed it. And the clarity was
astonishing. There was a line that I heard Lady Macbeth say that I had never
really heard before where she says, `I would have killed him myself but he
reminded me of my father.' And I went, huh? It's like, I didn't know that she
said that. And here's this little girl and I just like snapped to attention.
It was beautiful. It was really, really beautiful because--and especially
with that kind of language, when you see somebody communicate to each other
that way and try to tell a story it's quite moving and really authentic.

GROSS: Did you cry?

Ms. MOORE: Oh, did I? Yeah, I think I probably did. It doesn't take much
to make me cry when my kids do things.

GROSS: Julianne Moore, thank you so much for talking with us.

Ms. MOORE: Thank you for having me.

GROSS: Julianne Moore stars in the new film "Savage Grace."

You can download podcasts of our show on our Web site, freshair.npr.org.

(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.

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