It is fair to suggest that many carry with them recognition of their own mortality on a daily basis, but most do not possess the level of keen awareness that artist Bob Flanagan did. Born with cystic fibrosis, he was not supposed to live past six or seven (the eldest of five children, Flanagan lost two sisters to cystic fibrosis, aged six months and twenty-one years). That Flanagan managed to survive into his forties was a considerable achievement in and of itself; that he happened to do so while subjecting his body and mind to brutal degrees of self-inflicted "punishment" (as well as by the hands of others, though still dictated by him) renders the accomplishment all the more compelling. Though many will undoubtedly note the now infamous penis-nailing scene and other physical insults as the film's raison d'être, Kirby Dick's Sick: the Life and Death of Bob Flanagan, Supermasochist has so much more on its mind that the only polite way to respond to such a claim is to dismiss it as not seeing the forest for the trees.

From the outset, Dick wisely and deftly introduces many of the salient thematic concerns being explored: Flanagan's cognizance of his ever-looming death, his truly inspirational sense of humor regarding it, and the rules of engagement that his body has already set forth. Beginning with Bob reading his own premature obituary, he is soon seen singing his customized version of "Supercali-fragalistic..." ("Supermasochistic Bob Has Cystic Fibrosis") on stage. (When he notes that the Disney people will probably ask him to cease and desist, he wryly notes that he will. Just "not yet.") Interviewed while tinkering with a Visible Man, the old toy that illustrates some of the body's internal systems, Dick highlights Flanagan's hyper-awareness of his biology. Modifying this seemingly benign toy to mirror his particular physical existence, Flanagan creates viscous liquids for a pump system. The result is a Visible Man that constantly emits phlegm, semen and shit.

Both basely funny and defiant, these initial passages well encapsulate Flanagan's trajectory and Dick's fascination: the dialectic of the physical and the psychological/spiritual, of inspiration and the artistic process, of the sacred and the profane. And, at this point, they are both just getting started.

Returning to Flanagan's upbringing for information and insight, Dick interviews Bob's parents and his brother Tim. These interviews are used sporadically throughout the film, but always to superb effect – whether it's Tim noting that he viewed Bob as a "moral cop" who would bust him for masturbating, or his father commenting that for someone they tried desperately to keep alive, many of his actions jeopardized his physical being, Dick's selections perfectly suit the selected moments. Through footage shot on amateur video at various S/M clubs, Bob recounts his conception of his early Catholicism and his fascination with hanging and self-flagellation in high school. Bob's parents theorize (convincingly) that such dynamics represented Bob's way of controlling and contextualizing his own physicality and existence in the face of his failing body and his creator.

Sick then commences to different thematic concerns with the introduction of Sheree Rose, Bob's great love and mistress with whom he spent the remainder of his life as a slave to, sometime artistic collaborator with, and ultimately - and most touchingly - as a life partner coping with the changing dynamics of their relationship as Bob's health deteriorated.

Flanagan's increasingly complex relationship with Sheree and his own body become more prominent as Sick progresses, and Dick refuses to blink at the various - and at times troubling - implications of either. Again utilizing footage from other sources (mostly from Bob's own artwork and video recordings), the film ventures into decidedly tough, confrontational territory that is both entirely appropriate given Flanagan's concerns and respectful to his life choices. "Bob and Sheree's Contract" is included, wherein Bob pledges complete control to his mistress, as is "The Autopsy," in which Sheree is viewed ruminating about their relationship before piercing his scrotum and inserting a metal ball the size of an orange into his reluctantly accommodating anus. (It should be noted again that, as made obvious with the preceding sentence, Sick's gaze is unflinching. The squeamish will find little solace here, but I adamantly maintain that Sick is not the freak show some will undoubtedly make it out to be; Flanagan and Dick both scratch well below the surface, and if adventurous viewers employ an open mind and heart, much is to be found within.)

As director Dick has maintained, the conceived ending to Sick was Bob's final succumbing to cystic fibrosis, and the weeks, days and hours leading to his demise are captured in all their heartbreaking agony. Through blistering montages of Bob's adventures in pain thresholds and his brutal bouts of coughing, Dick and editor Dody Dorn never let Bob's humor completely disarm the viewer into forgetting exactly what is at stake. Moreover, Bob's seemingly outrageous behavior is nicely counterbalanced with footage of him counseling kids with CF (something he had done for decades and with his penchant for amusingly awful punning and wordplay) and his interaction with Sarah, a young woman also suffering with CF who met Bob through the Make-a-Wish foundation. As Flanagan's health waned his relationship with Sheree was similarly transformed, and sexual role playing had to take a backseat to his overall well being. Here too, Sick achieves a remarkably intimate and wholly recognizable portrait of the fragile nature of human relationships. If we always hurt the ones we love, Sick is savvy enough to note that the dynamic is often more far reaching than we sometimes care to acknowledge.

In short, Sick is a remarkable work. Brave, perversely funny, and as insightful and idiosyncratic as its subject, it is highly recommended with the above caveats.

the DVD

Video: Presented in its original full frame ratio, Sick looks as good - I suspect - as it possibly can. Unfortunately, that is not necessarily great news, as Sick was created on an incredibly tight budget that did not allow for much polishing. Moreover, since it includes so much footage from various sources, the quality varies from decent to mediocre to the flat-out awful. Many of the usual hobgoblins can be found here: uneven color, excessive grain, washed out portions, uneven blacks, etc. However, I did not see any of this as especially problematic at all: for one, it somehow suits the roughness and humanity of the piece; second, I become so engaged with Sick every time I watch it that I find myself not particularly concerned with presentation. It's good enough to watch, and it certainly deserves to be seen.

Audio: Sick has been given a DD 2.0 mix that essentially meets the parameters noted above. It is decent enough to hear easily throughout and remains consistently even - and Blake Leyh's Looney Tunes-inspired soundtrack is decently rendered - but overall the audio matches the rough-hewn quality of the video. Again, I did not find any of this particularly problematic.

Extras: Lion's Gate is to be heartily commended for assembling a bounty of additional features for the documentary. Included is the following:

An interview with director / producer / co-editor Kirby Dick (7:50), wherein he speaks to - among other things - the film's history, its reception at Sundance and the Los Angeles Independent Film Festivals (it took top prizes at both), and the fact that Bob and Sheree enjoyed Seinfeld and X-Files;

Sarah's Sick Too (14:35), a follow up short film that catches up with Sarah, the young woman who met Bob through the Make-a-Wish foundation. She is found to be doing quite well in native Canada, now married and living with four horses and two cats. Here, as in Sick, Sarah shares Bob's forthrightness and bravery in discussing her CF, as well as a laudable lack of vanity in letting Dick's camera capture its toll. She also notes that Bob discussed her potential for breaking the record for the longest living survivor with CF, and based upon the onscreen evidence, if will goes a long way I suspect she has quite the shot at it;

Four performance videos, all introduced by Dick: Body (3:50); In My Tomb (1:59); Rear Window (4:15) (again denoting his particular fondness for punning - you'll know it when you see it, provided you can withstand watching Bob give himself a wine enema); and the uproariously funny Poster Child (3:51);

Eight Deleted Scenes, also introduced by Dick: Toy Box (5:48), which Dick wishes he had included in the film, and for good reason; Needles (1:46); Autoeroticism (5:49); Original Opening (1:54), that shows Bob having sutures removed from his scrotum, which has enclosed his genitalia; Answering Unasked Questions (2:19); Pain in the Ass (1:59); Dr. Bob (2:10); and Repair the Visible Man (4:19), which is, essentially, just that;

19 isolated musical selections from Blake Leyh's soundtrack;

A DVD-ROM game that appears to be very much in the spirit of Bob (I did not actually play it, but it has something to do with "playing doctor" with Bob);

Trailers for Sick (1:54), Secretary (2:20), and Swimming With Sharks (2:10);

Lastly, Sick includes a feature-length commentary with Kirby Dick and producer / co-editor Dody Dorn. This track is informal and informative, as Dick recounts experiences and Dorn responds to what is on screen (she came on late into the project). The two have the easy rapport of old friends and constantly crack up during Bob's antics. Their respect and admiration for Bob the person is readily apparent, as is their respect for Bob the artist.

Final Thoughts: Sick is a deeply disquieting work, but not for the reasons those who have not seen it might expect. Moreover, it is both savagely and warmly funny, wise enough to acknowledge - and revel in - the many contradictory impulses found in all. In many ways Sick is an intellectual dark night of the soul, but the ideas being explored by director Kirby Dick never usurp the aching humanity and defiant humor at the core of the film. This is an extraordinary, compassionate documentary that accomplishes what many aspire to but precious few accomplish: it not only engages the heart and mind, it rewards both in equal measure.

The DVD Talk interview with producer/director Kirby Dick regarding Sick: the Life and Death of Bob Flanagan, Supermasochist, can be found here.