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Tribeca Review: 'TransFatty Lives' is Groundbreaking Documentary About Living With ALS

New York underground filmmaker Patrick O’Brien narrates “TransFatty Lives,” the documentary about his experience with amyotrophic lateral sclerosis — aka Lou Gherig’s Disease — in the mechanical voice that ultimately replaced his real one after a tracheotomy. The effect is immediate intimacy with O’Brien’s perspective as well as his condition, a remarkable feat that extends to the rest of the movie, which O’Brien himself directed over the course of the decade that has elapsed since his initial diagnosis.

The resulting project is a stirring blend of diary film and advocacy, chronicling the debilitating effects of ALS and various means of coping with it, with O’Brien’s perseverance conveyed in each scene by the movie’s very existence. 

But “TransFatty Lives” stands out less for its inherently emotional topic than the appealing personality at its center. The portly, bearded O’Brien’s spunky attitude, epitomized by his online identity as performance artist TransFatty, comes through in his rambunctious camera presence early in the movie, when he playfully teases a doctor about his diagnosis. O’Brien’s vibrant attitude continually gives the tragedy of his condition a unique context. Rather than inviting viewers to commiserate with him, he invites them in.

However, O’Brien makes it clear that he has only one real viewer in mind: In the movie’s opening sequence, he explains that the project has been conceived as a letter to his infant son, before segueing into complimentary descriptions of himself by his friends that he sarcastically rejects outright. The self-deprecating attitude provides the director with a sly means of developing his own personal revelations as he learns to accept his situation. An avant garde metalhead with a hard-partying streak, he’s a uniquely colorful guide to exploring the extremes of mortal struggles.

Several amusing early moments set the stage for the more profound expressions that follow as O’Brien’s physical shape worsens. Eventually, he turns to writing poetry for catharsis. The words frequently appear onscreen while O’Brien’s robotic narration delivers them bit by bit, and the creative means of conveying his experience leads to a continual source of enlightenment: From a series of sonnets about a “funeral for my arms” to another involving his inability to shoo insects from crawling up his nose, O’Brien conveys the precision of his evolving coping mechanisms.

Such inventiveness strengthens the revelatory nature of his assertion that, far from being trapped by a horrific disability, ALS becomes “a beautiful disease.” Realizing that his physical discomfort is “inversely proportionate to my inward journey,” O’Brien makes it possible to witness his progress from the inside out.

His funky, rebellious attitude is matched by the uplifting nature of his story, which finds him impregnating his girlfriend several years after his diagnosis and coming to grips with his limitations as both parent and religious partner. Yet it’s the degree to which O’Brien exposes every troubling facet of his experiences that allows “TransFatty Lives” to go beyond the inspiring nature of its events and transform into enthralling cinema.

With any other director behind the camera, certain scenes of the weakened figure facing each new chapter of his disease — in one case, battling to breath and begging to push back the tracheotomy that will rob him of his voice — the movie might seem voyeuristic. Instead, O’Brien offers a spectacular window into the marathon that defines his daily life, yielding a far more powerful depiction of ALS than any given moment in last year’s Stephen Hawking melodrama “The Theory of Everything.” While O’Brien clearly enjoys hamming it up for the camera, it’s that same attitude that enhances the poignancy of his journey.

Much like one of O’Brien’s funky pre-ALS creations, “TransFatty Lives” is far from perfect and very rough around the edges. Not every sequence works — one unsettling bit that cuts between a bedridden O’Brien moving his bowels and a televised healing session goes on way too long — but his personality sustains the project through these rockier moments, to the point where he even apologizes for a scene that starts to drag.

The flaws of “TransFatty Lives” bring it down to earth, just as O’Brien does for his disease. Notably, one might easily misread the title’s second word as a noun, as if it referred to multiple lives of TransFatty, but it’s actually a plural verb for good reason: By its end, “TransFatty Lives” leaves no doubt that its hero not only lives to accept his state, but thrives on it.

Grade: A-

“TransFatty Lives” premiered this week at the Tribeca Film Festival. It is currently seeking U.S. distribution.

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