All the beauty and the bloodshed

All the beauty and the bloodshed (2022) is a biographical film (biopic) about the photographer and activist Nan Goldin (US). In this film, the politically engaged director Laura Poitras shows the multilayered, traumatic, activistic and famous life of Goldin, now 69. The adage ‘The personal is the political’ characterizes both Poitras and Goldin, neither of whom ever hesitates to show the raw reality of existence as it is.

The film has two alternating storylines. ((1)) The first is Goldin’s own account, based on photos, of traumatic experiences in her youth, of her turbulent life in the New York underground scene and of her photo activism in the 1980s. The second focuses on Goldin as a celebrated artist and activist who is willing to put her own position on the line.

Through her advocacy group P.A.I.N., she is taking on the hugely wealthy and powerful Sackler family, whose company produces the painkiller Oxycontin/Oxycodon, which is playing a major role in the opioid crisis that is currently plaguing the US (and the rest of the world). ((2))
I will review this impressive documentary film from a care ethical perspective on reality.

All the Beauty and the Bloodshed

As she looks again at old pictures, Goldin remarks that there is a difference between creating a narrative of your life and becoming aware of flashes of memory. The former is composition, and that is easy. The second is fragmentary and entails painful confrontation with things that seemed forgotten. ‘But it is somewhere in my body, it takes me by surprise and it is difficult to face.’ She adds: ‘Could you stop the camera for a minute…?’

She grew up in the 1950s in a well-off bourgeois family in the suburbs of Washington DC. Photos from that time all show people smiling; the facade of a happy family. But Goldin emphasizes that this family was not what it seemed. She describes her parents as conformist, distant and emotionally unavailable. ((3))

Her sister Barbara, seven years her senior, took care of her. When Barbara turned against the oppressive environment, her parents regarded this as a symptom of illness. Barbara was crushed by the years she was forced to spend in various clinics; she committed suicide when she was eighteen.

Nan, then eleven, was told that her beloved sister had been involved in ‘an accident’. The secret was closely guarded and Barbara’s name was erased from history. The title of the documentary, All the beauty and the bloodshed, is derived from words spoken by Barbara, as quoted in a medical report on her mental state, which was in fact judged to be normal.

Goldin says: ‘We were adolescents, that’s all. No one loved us unconditionally, or helped us make sense of all the confusion.’ As a traumatized teenager, she decided to dedicate herself to unmasking secrets, bringing the naked truth to light, showing reality as it is.

She fled the parental home and began to record flashes of reality using her 35 mm camera: the urgency, the truth of life as it presents itself, not fictionalized, not ‘performed’, penetrating to the bottom of existence together with other survivors.

Respectable society, demi-monde?

Whenever outsiders disparage this hidden life of the 1970s and 1980s from a superior standpoint, Goldin snaps back, ‘This is my life, our life, we exist’. No one who has not been down there themselves in that life, has the right to pass judgement. She does; it has a dark, ugly, seedy side and it has another side. Beauty and bloodshed.

She lived in various communities of ‘alternative’ people who could not safely enter the public sphere: hidden queer communities of lesbians, drag queens, and the New York art underground scene. Goldin took art classes during her time among ‘the queens’ (as she calls them), and photographed herself and her friends openly and shockingly as they partied raucously, used drugs (heroin, cocaine, crack) or had sex.

Like real life, the much-vaunted freedom that the scene brought turned out to be ambiguous and full of tension. Friendship, love, and belonging were interlaced with destruction resulting from rejection, abuse, violence and horrible addictions.

Current views on dichotomies between ‘respectable society’ and the demi-monde, with corresponding judgements about successful lives vs. disgusting, failed lives, are incompatible with the truth. Neither world is what it seems, and they are ambiguously intertwined with each other. This is evident partly in the jobs Goldin did to fund her photography: as a waitress in a hotdog joint, a barkeeper, a street vendor of self-made photo badges showing happy families, in a well-kept brothel and as a sex worker.

Nobody photographs their own life

After art school, Goldin took her portfolio to the male-dominated world of galleries and art connoisseurs. The criteria for ‘real’ photographic art were more or less as follows: black and white landscape-format pictures, with sharp focus and perfect compositions. Goldin’s photos are brightly colored, are often out of focus and blurry, and look at first sight like snapshots. But the final assessment is: ‘nobody photographs their own life’.

One art expert took a different view. He recognized the importance of this unvarnished, new perspective on reality. He speaks in the film about the shock that the encounter with Goldin’s work represented for him and the transformative effect it has had on the art world. It was the beginning of Goldin’s path to the highest goal artists can achieve: exhibitions of her work (photos, slideshows and films) in world-renowned museums.

It’s incredibly political

When the as-yet-unknown disease AIDS hit the New York gay scene in the 1980s, Goldin was the first to organize a photo exhibition on the unfolding catastrophe. Her pictures show the reality of her sick, emaciated friends, of the people who looked after them, and of their bitter end. And of the bereaved and their grief.

The government at the time regarded AIDS as a gay disease that was none of its concern. In her exhibition, Goldin politicized this issue. How could there not be political action? No public debate, no research, no interest in the dreadful suffering of the victims, no care for them? AIDS expanded into a worldwide pandemic that is still ongoing.

Goldin’s breakthrough in the art world was due to an exhibition and a book called The Ballad of Sexual Dependency, on male violence against and power over women. Her pictures of her own badly damaged face were, once more, ‘incredibly political’ (according to one of Goldin’s female friends).

She openly displayed the violence perpetrated by her former lover, and thus shattered the taboo on domestic violence and inequality. Both her ex and her father tried to prevent the book and the exhibition (!). Following the example set by Goldin, women began to overcome their fears and tell their own stories of abuse. Domestic violence became an acknowledged social issue.

Profiting from people’s pain

In 2014, Goldin, then a famous photographer, underwent a simple operation and was subsequently prescribed the strong painkiller oxycontin/oxycodon. Within a matter of days, she became addicted to this drug, and she barely survived her growing dependency. She is far from alone in having this experience. There is a deadly wave of opioid addiction occurring in the US that is wreaking humanitarian havoc.

The official number of deaths in the US stood at more than half a million in 2022 and the figure is continuing to rise. The crisis can be traced back to the wealthy Sackler family, which owns Purdue Pharma, the company that produces oxycontin. The Sacklers tick all the boxes for success in American respectable society: they are enterprising, have acquired/are preserving wealth, power and status, and they contribute to society.

Oxycontin came on the market legally in 1996 upon receiving FDA approval. The medicine is intended for short-term use after heavy operations, or for pain relief for seriously ill and terminal patients. But from the start, the manufacturer used aggressive marketing techniques and bribery to get doctors to prescribe it much more widely. ((4)) ‘It works’ (i.e., the patient doesn’t feel pain) is viewed as a sufficient criterion.

Yet also the question should always be asked whether a drug serves the patient’s good (rather than other interests such as the producer’s profits). Soon after the launch, disturbing reports began to emerge of addiction and deaths. Goldin calls this trade ‘a diabolical way of earning money’. One investigative journalist in 2017 described the ‘oxycodon family’ as an ‘empire of pain’ in the New Yorker.

P.A.I.N. activism

Goldin has aimed her criticisms at the Sacklers’ ‘contribution to society’. The family name is displayed on the walls and facades of many museums that exhibit her work. Due to the millions that the Sacklers have given in donations, they have gained the reputation of being philanthropists who value the arts (museums) and sciences (university research centers). This ‘arts washing’, a term coined by Goldin, has been described in the New York Times as ‘toxic philanthropy’.

Goldin and the advocacy group P.A.I.N. (Prescription Addiction Intervention Now) which she founded are exposing the double life of the ruthless Sackler family. She is playing a dangerous game as she uses her renown as an artist to force prestigious museums to refuse the Sacklers’ blood money and take this family’s name off their walls.

P.A.I.N. activists organize museum die-ins that have attracted a lot of public and media attention due to their creativity and artistic value, as well as the seriousness of the opioid crisis. (see trailer). Goldin has formulated their motivation as follows, ‘The wrong things are kept secret in society and that destroys people’.

Sacklers lie, people die

The activists shout ‘Sacklers lie, people die’, and let bright orange Oxycontin pillboxes, Oxycontin prescription notes or blood-stained ‘banknotes’ rain down in the museums they visit. They recount their own bitter experiences of loss – a son, daughter, friend, or parent – due to these lethal tablets.

One museum after another is ending its ties with the Sacklers, including the Louvre in Paris, the Tate Modern and the British Museum in London, and the Metropolitan and Guggenheim in New York. The activists’ joy at this societal change that is underway is indescribable.

The Sackler family is embroiled in thousands of law suits which it keeps settling. This avoids creating precedent and ensures its lucrative business is not disrupted. The advocacy group P.A.I.N. is suing them for being partly responsible for the American opioid crisis. P.A.I.N. has a single pro bono attorney, the Sacklers have about eighty well-paid lawyers. ((5)).

The group’s realistic, viable objective is to ensure that the budget reserved for these settlements is used in its entirety to help victims kick their Oxycontin habit and for the victims and the bereaved. There are almost no funds for this at the moment, while health insurers are covering Oxycontin.

This will not end well

Film maker Laura Poitras’s expert montage of this documentary manages to keep viewers engrossed in Goldin’s unmasking of ambiguous reality. Unfolding reality as it is, with all the beauty and the bloodshed, revealing dangerous secrets and taboos; this concerns society as a whole. These are eminently political issues, but the government barely responds. ((6)) As Goldin says, this will not end well. ((7))

All images featuring in this article are stills from the trailer All the beauty and the bloodshed



((1)) The documentary film, released in 2022, was awarded the Venice Film Festival’s highest prize, the Golden Lion.
((2)) Oxycontin/oxycodon is a painkiller whose chemical effects are practically identical to those of morphine, fentanyl and heroin: it is strongly sedative, strongly addictive and ultimately lethal. The latter three drugs are illegal, but oxycontin has been legal for decades.
((3)) The film does not explicitly address the background of the revolutions of the 1960s. This was the era in which the children of the bourgeoisie turned against the rigid regime of their parents and claimed ‘freedom’. This resulted in an unprecedented cultural revolution. In the 1990s, cultural and economic transformations saw the onset of late modernity, which necessitates the recasting of care ethics, but this has so far happened only in piecemeal fashion.
((4)) This gives rise to questions concerning the healthcare system. To what extent can patients trust doctors if some doctors prove to be vulnerable to corruption by the industry? For further reflection, see the doctor and researcher Nortin Hadler’s The Citizen Patient: Reforming Health Care for the Sake of the Patient, not the System (2013).
((5)) This gives rise to questions concerning the judicial system that permits settlements with Big Pharma capitalists such as this company. And concerning the legal profession, which profits from serving the rich while access to justice for the non-affluent is impeded. The outcome of the legal process is astonishing. Citizens in the US (and across the world) are not protected from this clearly dangerous, lethal ‘medicine’. For a thorough study of the pharmaceutical industry and the legal system, see the Danish doctor and researcher Peter Gotzsche’s Deadly Medicines and Organised Crime: How Big Pharma has Corrupted Healthcare (2014).
((6)) This gives rise to questions concerning liberal democracy in the US and other countries in the Anglo-Saxon world, concerning the polis (politically organized society) and the content of citizenship as a political category.
((7)) Expected: retrospective exhibition Nan Goldin: This will not end well, September 2023-January 2024, Stedelijk Museum Amsterdam (The Netherlands)


About the author: Jeannet van de Kamp

Jeannet van de Kamp

Jeannet van de Kamp (1957) has master’s degrees in both Theology and Ethics of Care and is currently a PhD-candidate at the VU-University of Amsterdam. In her thesis she examines, from a care-ethical perspective, how citizen-patients are seen in the context of the upcoming experience economy. More specifically, she examines how ‘patient-experience-central’ market models deal with the concepts of vulnerability and suffering. She works as a freelance pastor.

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