I would be hard-pressed to name another documentary as gripping, brilliantly executed, or intriguing as Under Our Skin that has come out in 2009. The film, about one of the world’s most mystifying infectious diseases, is a true landmark of the genre. Lyme disease is the focus of director Andy Abrahams Wilson's feature-length debut. Considering that the filmmaker's previous works include only two short films and a half-hour documentary (1996's Bubbeh Lee and Me, about a visit he made to his grandmother), Wilson is surprisingly deft in his treatment of such a misunderstood and controversial illness.
Wilson, whose laudable restraint and astoundingly labor-intensive legwork permeates nearly every scene, chose several people to focus on in order to offer up a broad spectrum of Lyme disease’s virtually infinite manifestations. Jordan, a former park ranger in Nevada; Mandy, a young wife in Orlando; and Dana, a production manager on tour with U2(!), are given the lion’s share of screen time. The brief snippets of four years in their lives are distilled into the clearest possible picture of their frustration and courage in the face of a disease that many people have asserted is psychosomatic.
During the four years he spent following Lyme disease sufferers, Wilson amassed over 375 hours of raw footage. With one of his producers (science writer Kris Newby), the director has created as complete a picture as imaginable of this potentially gruesome illness. The problem with Lyme disease is the unpredictability which it manifests itself in each victim. Wilson’s subjects run the gambit from those whose symptoms are akin to exhaustion to those who can no longer speak or move. Rather than inciting blind fear of a disease that is spread by the bite of a common deer tick, Wilson’s documentary encourages his viewers to explore the possibilities of creating a vaccine and eventually curing this bacterial infection whose closest relative is syphilis.
The crux of Under Our Skin is the fact that the Infectious Diseases Society of America refuses to recognize Lyme disease as a chronic infectious disease. Wilson interviews Merrill Goozner, Director of the Center for Science in the Public Interest, who insists that conflicts of interest surrounding a whopping nine doctors on the 14-doctor panel that made the decision against recognizing Lyme disease as chronic renders the opinions of the IDSA baseless. According to Goozner, the nine in question are on the take from big pharma or health insurance companies, or both. He insists these doctors have skewed the Society’s opinions on Lyme disease and the sense of urgency it should rightfully inspire among medical professionals.
The IDSA controversy serves as a legal basis for health insurance companies to refuse coverage to people diagnosed with Lyme disease, which is notoriously costly to treat. In fact, the accepted medical wisdom of the age holds that the only way to combat this vicious disease is through an intensive regimen of antibiotics for the rest of the patient’s life. This, of course, is hella expensive. To Wilson’s credit, he interviews doctors from the IDSA’s infamous panel, giving them virtually equal time to explain their views on Lyme and why it should not be considered chronic. Of course, the evidence against the panel still makes its members look like criminals -- but that can hardly be blamed on the creative team behind Under Our Skin.
Wilson’s film is an attempt to impart the gravity of Lyme disease through being as unobtrusive as possible, eschewing any type of narration in favor of displaying the candid thoughts and expressions of people afflicted with this impossibly nebulous disease. The technique calls to mind an almost verité sensibility, leaving us to interpret for ourselves the true weight of the words of people actually dealing with Lyme disease. Ultimately, this approach launches Under Our Skin light years beyond the pretense and pandering of Sicko and other such overtly sentimental and sensational public health documentaries. Where Michael Moore's film and others like it faltered under the weight of their own sentiment, Under Our Skin triumphs, laying bare the almost necessarily banal truth of this devastating and often misdiagnosed illness.