The Belly of an Architect (1987)

The American architect Stourley Kracklite arrives in Rome with his younger wife, Louisa. He is there to mount an exhibition devoted to Etienne-Louis Boullee, an eighteenth-century architect whose buildings were mostly never built.

From the first scene the film watches Kracklite's body. He eats. He photographs the stomachs of classical statues. And he keeps getting abdominal pain that comes back.

His Italian collaborators quietly strip him of authority and siphon off the money. He becomes fixated on the story that the emperor Augustus was poisoned by his wife, and starts to suspect Louisa of the same. She tells him she is pregnant. She also begins an affair with the exhibition's co-organiser. Then she leaves.

Doctors tell him he has stomach cancer and months to live. At the opening ceremony, replaced as director, he watches from a high window as Louisa cuts the ribbon and goes into labour. He jumps.

Spoilers throughout. Kracklite's diagnosis and his final scene are both discussed here.

Greenaway made an allegory, not a case study, but the slow, vague start is true to how stomach cancer can present.

Kracklite has pain that comes back, and an extra explanation available to him, poison, which he takes. Real people may put early symptoms down to ordinary causes, and the National Cancer Institute says those symptoms can result from many conditions other than cancer.

NCI puts it plainly. Early on, stomach cancer usually has no symptoms, which makes it hard to detect, and symptoms often begin only after the cancer has spread.

When early symptoms do occur, NCI lists these:

• Indigestion and stomach discomfort.
• A bloated feeling after eating.
• Mild nausea.
• Loss of appetite.
• Heartburn.

NCI notes these signs can result from many conditions other than cancer. If they persist, ask your doctor.

More advanced disease adds signs that are harder to explain away. Blood in the stool. Vomiting. Weight loss for no known reason. Stomach pain. Jaundice, meaning yellowing of the eyes and skin. Fluid building in the abdomen. Trouble swallowing.

In the United States there are no standard or routine screening tests for stomach cancer in people at average risk. NCI says so directly.

But NCI also names groups who may benefit from screening with upper endoscopy, which is a thin camera passed through the mouth into the stomach:

• Older people with chronic gastric atrophy, meaning a thinned stomach lining, or with pernicious anaemia.
• People who have had part of the stomach removed, or who have a family history of stomach cancer.
• People with certain genetic syndromes.
• People from countries where stomach cancer is more common.

Endoscopy is not free of risk. NCI lists false results and serious complications including a puncture of the oesophagus or stomach, severe bleeding, and reactions to medicines. NCI recommends talking with your doctor about whether screening suits your own risk.

There is no endoscopy. No staging. No conversation about surgery, chemotherapy or palliative care. The diagnosis arrives as a single verdict, delivered once, and then the film moves on.

Kracklite also stays physically imposing. He shows none of the unexplained weight loss, vomiting or trouble swallowing that NCI lists among signs of more advanced stomach cancer.

His belief that he is being poisoned is dramatically rich and clinically dangerous as a message. It edges towards the idea that symptoms like his are a state of mind. Persistent symptoms deserve a medical check. And the ending swaps suicide for death from disease, so the film never has to show dying at all.

It is very good on what an unexplained illness does to a person. The obsessive self-monitoring. The paranoia. The humiliation of losing physical and professional authority at the same time.

It is also honest that serious illness speeds up the collapse of a marriage and a career that were already unsteady. And that a diagnosis, when it finally lands, changes nothing about the momentum of a life falling apart. That is bleak and true.

Nothing on this page is advertising and nothing is for sale. If the list of easily dismissed stomach symptoms was useful, you can help keep it free to read. Support our work.

The Belly of an Architect is a film about a man losing everything, with a cancer used as the clock. As a medical account it is nearly empty.

Its one useful insight is worth keeping. Early stomach cancer usually has no symptoms, and early signs such as indigestion can have many causes. For most people there is no test to catch it in advance, so the thing that matters is whether indigestion, early fullness, difficulty swallowing or unplanned weight loss get investigated when they persist instead of being explained away.

• https://www.cancer.gov/types/stomach/symptoms
• https://www.cancer.gov/types/stomach/screening

This page discusses The Belly of an Architect for education. It is not medical advice, and nothing here is a judgement of anyone's real medical care. Spotted an error? Please email corrections@cancerexplained.org.