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Teacher’s notes

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This clip shows the effects of an acquired brain injury (ABI) on Billal Etter and his family. To the sound of haunting background music, a surgeon in a Sydney hospital describes Billal’s symptoms and his next operation. Billal then talks about what the operation will involve and says he wants to be able to go home. The rest of the clip focuses on Billal’s mother, Amal Etter, and the film’s interpreter, Alissar Gazal, as they wait for the operation to end and discuss Amal’s personal situation and the family’s difficulties. Subtitles are used.

Educational value points

• According to the Brain Injury Association of Queensland, symptoms such as aggression and inappropriate behaviour are not uncommon following an ABI and, as with Billal Etter, an ABI can lead to permanently impaired abilities and changes in cognition and behaviour. Etter’s ABI is of the traumatic type – when he was hit by a car, the soft tissue of his brain was propelled against the hard bone of his skull and bounced backward, causing major damage and leading to coma.

• Every year in Australia many thousands of people, like Etter, develop hydrocephalus, excessive cerebrospinal fluid accumulating in the brain, as a result of accidents, tumours, bleeding or infection. Without treatment, hydrocephalus results in compromised mental functioning, visual disturbances and other issues. For patients with a shunt draining the fluid, problems with their eyes such as Etter displays can be a sign that their shunt is malfunctioning.

• The effect on the carer and on the family unit as described by Amal Etter is relatively common following a violent crime or traumatic accident. Although Amal and Abdul Etter have been able to sustain a 'satisfactory’ relationship, Amal’s health has been affected and one of their three sons, Ahmed, has left home. The family 'no longer lives as a unit’.

• Billal was intended to be a documentary about the situation facing young Lebanese-Australians in south-west Sydney about to leave school and their highly uncertain job prospects but, as is often the case with Tom Zubrycki’s films, the focus sharpened onto a particular situation. Zubrycki believes that it is 'only when you engage at a really deep level with your subjects and with the story that you get those key revelatory moments’ (http://www.tomzubrycki.com).

• Because Zubrycki’s documentary style uses many of the dramatic storytelling techniques from fiction, it is hardly surprising that the crew’s community liaison officer and interpreter, Alissar Gazal, becomes a central character in her own right. In the film she is seen tackling the housing authorities on the family’s behalf and in this clip it can be seen that she has become a friend, able to be trusted with personal information about family relationships.

• A striking cinematic feature of the clip is the variety of shots used and this is particularly evident in the opening scenes with their use of ground-level and eye-level shots, and in the final sequence in the clip where long shots of Etter and Gazal in discussion alternate with close-ups. This juxtaposition is complex and subtle, with the close-ups eliciting an empathetic response but the long shots showing that the women are on their own, dependent on their own resources.

This clip starts approximately 1 hour 4 minutes into the documentary.

Shot tracks hospital staff as they wheel a bed down a corridor. The shot moves from behind the feet to full view in front. The doctor in full scrubs is interviewed in the corridor. Billal is interviewed sitting in his operating bed before surgery.

Doctor Bill was better for about a week after his last operation, then he deteriorated again. He’s got fundamentally disinhibited behaviour. He can be aggressive at times. He’s got an eating disorder. He weighs 20kg or 30kg more than he did last time we saw him and his behaviour is a problem, especially towards the female staff. We can see that there’s a problem in the brain but despite giving it our best shot with surgery, often we don’t seem to have any impact on it um, but with our simple reasoning and surgical measures, we will give it our best shot today.

Interviewer Do you know what they are going to do with you today?

Billal Yes, fix the (inaudible) that they put in last time because they’ve taken the water out of my brain which is not making me figure things a lot so they’re going to fix it up so I can get well and get out of hospital and get discharged. I want to go home. The best place is home.

Amal and Alissar are sitting in the hospital waiting room. There are shots of the busy operating room as Billal’s surgery takes place.

Amal, Billal’s mum (translated) Lately, he’s become uncontrollable. The other day I was so upset, I cried. He asked the neighbours to call an ambulance. He wanted to return to hospital. He didn’t want to stay with me anymore. Then Ahmed left home. I was sick for three days. I wasn’t as nervous with the first operation. The last few days have been too much. Our life is upside-down. Our family no longer lives as a unit like we did before.

Alissar, Interpreter How are you coping? Are you hanging in there?

Amal I have no choice. My back, my body, my head, my stomach are aching. They took me to hospital. I was feeling so ill. I can’t take it any more.

Alissar How’s Abdul?

Amal He’s all right.

Alissar Helping you?

Amal Sometimes. It depends.

Alissar How’s your relationship?

Amal It’s okay. No man can ever work as hard as a woman. He helps me a bit when I’m tired. Our life is not what it used to be.