Abstract
Objective: To analyze the manifestations of neurosyphilis portrayed in the film “Florence Foster Jenkins”.
Background: The biographical comedy film “Florence Foster Jenkins” was released in 2016. Set in 1944, it tells the story of the New York City socialite and amateur soprano, Mrs. Jenkins, who suffers from long-term syphilis. Throughout the film she exhibits behaviors that could be attributed to neurosyphilis.
Design/Methods: Review of the film and selected literature on neurosyphilis.
Results: Mrs. Jenkins contracted syphilis at age 18 and has had the disease for nearly 60 years. The chancre appeared in her left hand, an unusual location as extragenital chancres occur in less than 2% of patients. She has alopecia, a common sign of secondary syphilis; and occasional seizures, which may be provoked by cerebral gummas, characteristic of tertiary syphilis. She takes mercury and arsenic, two common therapies at the time. The most striking feature shown in the film is Mrs. Jenkins’ poor singing ability, which she does not seem to be aware of and, on the contrary, she considers herself a talented singer. Neurosyphilis can cause hearing loss and cranial neuropathies, which may have impaired her ability to hear herself and sing, respectively. Heavy metal toxicity could have contributed too. This perceived talent may also represent a delusion of grandeur, a classic feature of general paresis, a form of parenchymal neurosyphilis. She also displays emotional lability and manic symptoms. Memory seems to be unaffected. Motor function and equilibrium are preserved and there is no indication of her having tabes dorsalis.
Conclusions: The film “Florence Foster Jenkins” illustrates multiple signs of late neurosyphilis and its management in the pre-penicillin era. As this is a rare condition nowadays, portions of the film have educational value. It is also an entertaining movie for those who enjoy the portrayal of neurologic disorders in cinema.
Disclosure: Dr. Avila has nothing to disclose.
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