The film Astu is about an aging Sanskrit scholar who is gradually losing his memory to Alzheimer's dementia. It focuses on the changing relationship dynamics between the father and his daughter, who becomes his caretaker. Through their story, the film provides insight into the devastating impact of cognitive decline on individuals and families. It also conveys a message of compassion, as shown through the non-judgmental care provided to the father by strangers when he wanders away. Finally, the film appears to suggest there is more to a person than just their memories and personality, and this truth should make us more compassionate even as illnesses rob individuals of their cognition.

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doi:10.1016/j.ajp.2015.05.041
Asian Journal of Psychiatry 15 (2015) 90
Contents lists available at ScienceDirect
Asian Journal of Psychiatry
journal homepage: www.elsevier.com/locate/ajp
Film review
Astu: So be it
‘Astu’ (2013) is a marathi movie directed by Sumitra Bhave and
Sunil Sukhtankar with Dr. Mohan Agashe and Iravati Harshe as lead
actors. I had the opportunity to watch the movie at the Asia Center
at Harvard and participate in a discussion on April 29 2015 moder-
ated by Dr. Arthur Klineman, a renowned Harvard psychiatrist and
anthropologist. The panelists were Drs. Agashe and Ruth Barron,
both psychiatrists, and Dr Diana Eck a professor of Indian studies. It
was an honor to see and hear Dr Agashe, a well-known psychiatrist
whose interview by me has been previously featured in this journal
(Daiello and Keshavan 2013).The film is about Alzheimer’s dementia,
and its devastating consequences on the individual’s intellect as well
as every aspect of the life of family and care providers.
Astu, which in Sanskrit means “so be it”, focuses on the chang-
ing dynamics between a father (Agashe) who is gradually losing his
memory, and his daughter, who becomes his care taker. The aging
and retired Sanskrit scholar repeatedly invokes the upanishadic
teachings of ‘being in the moment’; ironically, he has to now live in
the moment as he beginning to lose memory of the past, as well as
any ability to plan his future. One day, while his daughter is away for
a few minutes from the car for an errand, he wanders away, like a
curious child, seeking to go near an elephant in a crowded street. The
caretakers of the elephant, who are a couple that speak a different
language, cannot figure out who he is, but take care of him with love
and care, till he is found by the police, and returned to his daughter
about 20 hours after his disappearance.
The film is elegant and engaging, as well as highly insightful.
First, the impact of the father’s cognitive decline on the relationship
dynamics between the care taking family members, as well as ques-
tions and doubts about the ailing father is something that resonates
with the many family members of people with dementing illnesses.
Second, the non-judgmental care and compassion by the travelling
couple with the elephant speaks volumes about the value of toler-
ance and acceptance when dealing with someone in the throes of
a devastating mental disease which is rather poorly understood by
the lay and medical community alike. Third, the desperate plight of
a person searching for his lost memory is illustrated symbolically by
his following the elephant, which is symbolized as the creature with
abundant memory.
Finally, the “elephant in the room” is the spiritual truth the film
appears to convey. The family members appear to question whether
the father, who has little memory of his closest relatives, is even alive
any more (I myself experienced such a grief when I encountered my
grandmother who stopped recognizing me a few years ago when she
developed dementia). The basic truth may be that there is more to
the person and the spirit than just memories and the personality.
Recognizing this makes us to be more compassionate. This is clearly
illustrated by the way Sanskrit scholar is treated by others such as
the wife of the elephant caretaker as if he were her father, and how,
despite his failing cognition, he reciprocates her emotional warmth.
Astu is a must see for people who care for, and treat people with
major brain illnesses, or any illnesses for that matter. This is all the
more important given that dementias such as Alzheimer’s disease
will be more prominent problems in the decades to come as we live
longer, and effective treatments still elude us.
Matcheri S Keshavan MD
Harvard Medical School
D’Aiello A, Keshavan MS. 2013. Mohan Agashe, M.D. eminent
psychiatrist and veteran actor. Asian J Psychiatr. 6(3):272-4.