GET OUT (2017): DIRECTOR JORDAN PEELE

©2019, by M. Keith Booker

Director Jordan Peele’s debut feature film Get Out was one of the most talked-about films of 2017, mostly because of its satirical critique of white liberal racism. But the film was also widely recognized as a technical triumph that deftly deployed references to previous films to reinforce its social message, while weaving together elements from different genres (including horror, science fiction, and comedy) to produce a smoothly-functioning hybrid. Get Out delivers a very serious message and resides primarily in the horror genre, but it is unusual enough that critics had a great deal of trouble categorizing it. For example, in a notorious example of categorical confusion, the film was nominated for a Golden Globe Award in the category of Best Motion Picture—Musical or Comedy. The film, though, received enough positive attention that it also garnered an Academy Award nomination for Best Motion Picture, a rare feat for a horror film. Peele received a similar nomination for Best Director, while star Daniel Kaluuya was nominated for an Oscar for Best Performance by an Actor in a Leading Role. And Peele actually won the Oscar for Best Original Screenplay, becoming the first black screenwriter to win in that category.[1]

That Get Out includes significant doses of humor should come as no surprise, given that, prior to this film, Peele was mostly known for his work writing and acting in sketch comedy. He appeared on the Fox network sketch show Mad TV from 2003 and 2008, garnering significant attention. Peele and another former Mad TV cast member, Keegan-Michael Key, then wrote and starred in their own sketch comedy series Key & Peele, which ran on the Comedy Central cable networkfrom 2012 to 2015. Key & Peele won a Peabody Award and two Primetime Emmy Awards and was nominated for numerous other awards, receiving generally positive reviews from critics.

Attentive viewers will notice from the very first scene that Get Out is something special. It begins at night, in good horror-movie fashion, though the setting at first seems relatively benign. We are shown a homey suburban street, with nice houses whose lawns are lined with hedges. Then a young black man (played by Lakeith Stanfield[2]) comes walking down the sidewalk talking on the cellphone. He clearly feels very ill at ease in this rather affluent, very white neighborhood, immediately suggesting a reversal of the scenes we have seen so many times in so many films of white people nervously walking through Harlem or some other seemingly dangerous black neighborhood.[3] The man on the phone helps to create the atmosphere for the scene by confessing to the person (apparently his girlfriend) on the other end that he finds it “creepy” here in this “confusing-ass suburb,” the latter word intoned in a mock “white” voice, which makes clear the reason he finds these surroundings uncomfortable. “I feel like a sore thumb out here,” he continues. After he hangs up the phone, he continues to walk, obviously searching for a particular address. “It’s like a fucking hedge maze out here,” he mumbles to himself.

To this point, this scene is a fairly clear social commentary that makes an obvious point: as opposed to the extensive legacy of rhetoric in which white Americans have expressed their fear of African Americans and other people of color, American history shows that, in general, it is nonwhite people who have had a reason to fear white people, rather than the other way around. This point is an important one and one that will be central to the rest of Get Out, which is crucially concerned with depicting the threatened and embattle position of African Americans—especially African American men—in contemporary American society. After all, Stanfield’s character (eventually identified as Andre Hayworth), looks clean-cut, well-dressed, and completely respectable, and yet he knows that he will be regarded with suspicion (and might even be in danger) in this neighborhood, purely because of the color of his skin.

The “hedge maze” line, however, adds a whole new dimension to this opening scene. Fans of horror films will immediately suspect that this line is a reference to the menacing hedge maze featured so prominently in Stanley Kubrick’s The Shining (1980), one of the central films in the canon of American horror.This horror-film reference immediately suggests that André’s fears are well-founded, a suggestion that is quickly substantiated when a white Porsche—meant, according to Peele on the Blu-Ray commentary, as an image of menace along the lines of the shark in Jaws (1975)—pulls up ominously beside him. “Run Rabbit Run” blares from the car’s sound system, in the original recording by Flanagan and Allen, a British singing and comedy duo popular during World War II. The song appropriately includes lyrics urging a rabbit to flee from a hunter, but it also sounds particularly eerie in this setting, helping to enhance the atmosphere of threat. It was actually used during the war, however, as a satirical dig at the German Luftwaffe, suggesting that their bombing raids on England were so ineffectual that at most they might have killed a few rabbits. Thus, the song is more than simply atmospheric: it also serves as a subtle announcement that we are watching a work of satire.[4]

This opening scene culminates when Andre is attacked by a mysterious man whom we fleetingly see to be wearing a black Templar helmet (one of the many little clues that are sprinkled throughout the film); Andre is rendered unconscious and dragged to the car, then stuffed into the trunk. The film then cuts to its opening title sequence, which shows a scenic wooded area as seen from a car that drives through the woods. If this opening scenic drive seems vaguely reminiscent of the famous scene of Jack Torrance driving through the mountains of Colorado toward the isolated Overlook Hotel, that is probably no accident. Indeed, the actual opening title of Get Out is clearly meant to echo that of The Shining, presented in a similar font and in the same color. By this time, we have been alerted that The Shining will serve as an important gloss on Get Out—but perhaps have also been alerted to look for possible references to other films as well, including the fact that the film’s title obviously derives from The Amityville Horror (1979).

Title frame from “The Shining.”
Title frame from :Get Out.”

As the opening sequence continues, the music morphs into the 2016 hit “Redbone,” by Childish Gambino (aka Donald Glover). Among other things, this musical shift places us in the context of African American music and culture (and in fact occurs as the visuals shift to a sequence of still shots of black urban scenes, but the song also includes lines that are highly relevant to this particular film. Indeed, the part of the song heard in the film here begins with what is actually the song’s third stanza:

But stay woke

Niggas creepin’

They gon’ find you

Gon’ catch you sleepin’ (oh)

Now stay woke

Niggas creepin’

Now don’t you close your eyes

Peele has said in an interview that the “stay woke” message in these lines is intended to suggest that the film’s black protagonist will be an alert, intelligent character, thus providing a positive image for the film’s black audience (Clark). At the same time, though, these lines can clearly be interpreted to link back to the opening scene to provide an ironic reference to the stereotypical notion of the dangers posed by “creeping” African Americans to law-abiding white people, who need to stay “woke,” or alert to this threat. This threat, of course, has traditionally been couched in terms of the dangers that black men pose to white women, as classically expressed in the early film The Birth of a Nation (1915). This latter aspect is then emphasized when the film cuts to a modest-but-nice apartment where a black man (Kaluuya’s Chris Washington) is shaving, rubbing white shaving cream on his face, symbolically going into “whiteface” in anticipation of the racial themes of the upcoming film. Shots of Washington are then interspersed with shots of an attractive white woman (Allison Williams as Rose Armitage), who is looking through the window of a bakeshop, apparently seeking something for breakfast, but with a sinister intent of which we are at this point unaware.

Rose, of course, is precisely the kind of wholesome, pretty white woman who might (at least in the lurid imaginations of overt white racists) be in danger at the hands of threatening black males, though we quickly realize that Rose and Chris are a couple as she brings goodies from the bakeshop back to the apartment they share. Meanwhile, the idea that Chris might represent a threat to Rose is completely undermined by our eventual discovery that it is Rose who poses a danger to Chris, just as Rose’s brother Jeremy (Caleb Landry Jones) will turn out to precisely be the kind of violent felon that racist lore expects young black men to be. (It is, we will eventually learn, Jeremy who attacked Andre in the opening scene.) Such reversals, in fact, run throughout Get Out. They are, for example, particularly prominent in the thinking of Chris’s friend, TSA agent Rod Williams (Lel Rel Howery), who seems completely paranoid about the threat posed by white people to black people. Williams’ “fantasies” about white plots to kidnap black people and use them as sex slaves constitute a comic highlight of the film, though the fact that they turn out to be well founded (and the fact that he ends up heroically saving the day) causes us to reassess just how exaggerated his fear of white people really is.[5]

Within the context of the film, Williams’ fantasies are triggered by the fact that Chris and Rose are planning a weekend visit to the posh suburban home of Rose’s wealthy parents, whom Chris has never met and who (or so Rose tells him) do not even know that Chris is black. She hasn’t told them, she explains, because they are so non-racist that his color is absolutely not an issue. In a variation of the “some of my best friends are black” cliché, she assures Chris that “my dad would have voted for Obama a third time if he could have.” But her reassurances that Chris will be welcome in her parents’ home seem sincere and convincing, and Rose herself certainly seems oblivious to Chris’s race. And why not? A gifted professional photographer, he seems to have good prospects in life, as well as being a really nice guy who genuinely cares about Rose and seems to have an excellent rapport with her. What could go wrong?

A lot, as it turns out. Chris suggests to Rose (not entirely jokingly) that he hopes he won’t be chased off her parents’ lawn with a shotgun, and—as we can imagine from such important cinematic predecessors as Guess Who’s Coming to Dinner? (1967—the tensions in this situation are innate. Indeed, the fact that they are still so half a century after that film is an important part of the message of Get Out, which provides a stark dose of reality to anyone who thinks that America is now a “post-racial” society.But Get Out is horror/satire, not social realism, so one might expect any innate problems to be exaggerated in this film. Toward that end (again in the mode of The Shining) almost everything that happens from this point forward adds to a growing sense that all is not right in the world of the film. For example, as Rose and Chris (with her at the wheel) drive through the beautiful scenery of the wooded countryside on the way to her parents’ estate-like home, this idyllic trip is suddenly interrupted when their car hits a deer, reminding us that violence and death can erupt at any moment. This reminder is, however, particularly strong for Chris himself, whom we will eventually learn has lived his life with the traumatic memory of his mother being struck by a hit-and-run driver, left by the roadside to die, while young Chris, age eleven, waited at home, suspecting that something was wrong, but calling no one. So now he insists on stopping to check on the deer—and even calling the police. The latter move, however, makes matters worse when a white cop who comes to the scene begins to hassle Chris, though he hadn’t even been driving. In America, racism can also erupt at any moment, and Rose’s seemingly righteous indignation at the cop’s attitude only makes things worse—though attentive viewers might realize later on that she has her own reasons for not wanting the cop to check Chris’s ID.

This particular situation blows over, but the tensions already associated with this sort of trip have clearly been heightened. When Chris and Rose finally arrive at the Armitage manor, the first thing Chris sees is the black groundskeeper, with the attendant implications (white family/black servants), especially as the groundskeeper seems to be observing Chris oddly. Rose’s parents are at least superficially welcoming, but there does seem to be something not quite right about their attitude as the film develops. For some time, though, we might even wonder if this sense merely arises from Chris’s own uneasiness with the situation. Chris is immediately given a tour of the house by Rose’s neurosurgeon father, Dr. Dean Armitage (Bradley Whitford), setting up more ominous expectations, somewhat in the mode of the initial tour of the Overlook Hotel given the Torrances in The Shining. On this tour, Dr. Armitage seems to be trying a bit too hard not to be racist, as when he shows Chris a photo of his own father, a sprinter who had had been beaten by Jesse Owens in the qualifying round for the 1936 Olympics in Berlin. Armitage then expresses great admiration for Owens and for the way his performance in the games undermined all of Hitler’s “perfect Aryan race bullshit.”

Armitage then takes Chris into the kitchen and delivers one of those cryptic lines in the film that seem like puzzles when they are delivered but that make perfect sense in retrospect, once the film’s secrets are revealed. “My mother loved her kitchen,” he tells Chris, “so we keep a piece of her in here.” Then, without explaining this line, the introduces the black “maid” Georgina (Betty Gabriel), who seems oddly affectless—and who, we will eventually discover, is the “piece” of Armitage’s mother than remains in the kitchen. Georgina is, in fact, Armitage’s mother, or at least she has the mother’s brain, transplanted into the body of a much younger black woman.

Similarly, when Chris, unable to sleep that night, wanders out onto the grounds of the estate, he encounters the groundskeeper, Walter (Marcus Henderson), sprinting furiously across the lawn, and nearly crashes into him. The scene again seems almost absurd but makes perfect sense after we realize that “Walter” is actually a young black man with the brain of Rose’s sprinter grandfather, who is just enjoying his new, young, athletic body. Indeed, one of the key strategies of Get Out is to drop in such strange moments that only make sense in retrospect. However, it is also the case that the film works extremely well on repeated viewings. In fact, one could even argue that these moments are more enjoyable when you already understand what they mean.

That same first night, Chris is tricked by Rose’s psychiatrist mother (played with delicious menace by the normally likeable Catherine Keener) into letting her hypnotize him—ostensibly to cure his smoking habit. He does, in fact, stop smoking as a result of the encounter, but the entire presentation of the encounter makes it seem so sinister that it comes as no big surprise to realize soon afterward that the hypnosis is just part of Chris’s preparation for his own brain transplant procedure. In fact, essentially everything that has happened in Chris’s life recently (including his whole relationship with Rose) turns out to be preparation for this procedure, adding to the paranoid, conspiratorial air of the film.

The exact nature of this transplant procedure (which leaves a small part of the hosts brain intact for the “nerve connections”) starts to become evident just short of midway through the film, when the Armitages’ social circle gathers for what is described to Chris as an annual “party,” which turns out in many ways to be the satirical center of the film. Here, a gathering of clueless rich white folks (and one Japanese guy) put on a spectacular display of what Rich Benjamin, writing in the New Yorker, has called “white racial innocence”—the tendency of white people to have no idea what race really means in America because they have always viewed race from a position of privilege in which being white is essentially to be regarded as being a normal human, with only nonwhites being regarded racially. The fundamental racial ignorance of white people allows white conservatives to believe that they, as white people, are someone being discriminated against and treated unfairly in America. More relevant to Get Out, racial innocence allows liberal white folks to believe that racism has been largely overcome in America and to be shocked when it nevertheless rears its ugly head.

The attendees at the Armitages’ party constantly regale Chris with admiring references to his superior physical attributes, while a paunchy, middle-aged white man announces to Chris that, after centuries of white being “in,” it has now become more fashionable to be black. One middle-aged woman even goes so far as to ask Rose, standing side-by-side with Chris, if it’s true what they say about “it” being better with black men. And the Japanese guy, without irony, asks Chris whether being black in America is an advantage or disadvantage. For his own part, Chris is simply astounded by it all, though he is even more astounded when he meets one white couple that consists of a white woman and her black husband, thirty years her junior. However, this husband—introduced as “Logan King”—dresses and acts like a sort of zombified white person and seems to have virtually no black personality traits whatsoever, though he looks oddly familiar to Chris.

Chris snaps a flash photo of the man, and the flash apparently activates a response that first causes the man to bleed from his nose, then leads him to rush toward Chris, frantically warning him to “get out.” The man is then quickly dragged away so that Rose’s mother can calm him down. Chris sends the photo of “King” to Rod, who is able to identify him as none other than Andre Hayworth. We realize, ultimately, that the flash had momentarily activated the remaining portion of Andre’s brain, which has otherwise been replaced by the brain of King. Meanwhile, we observe (though Chris does not) a silent auction in which attendees at the party bid for Chris’s body, in a scene clearly meant to evoke the legacy of slave auctions. The auction is won by Jim Hudson (Stephen Root) a blind art dealer and former aspiring photographer, who relishes the notion of having his brain transplanted into Chris’s body so that he can see through Chris’s gifted eyes.

Hudson is a crucial character in the film. His blindness is, of course, symbolic, though not necessarily in the way it first appears. Chris initially regards him as a potential ally: surely Hudson does care what color Chris is, because he can’t see color—or anything else. Audiences probably expect the same: surely, after all, there has to be at least one virtuous white character who will come to Chris’s aid. But what Hudson is really blind to is his own white privilege. He himself clearly believes that there is nothing racist about his desire to acquire Chris’s body—it is, in fact, a sign of respect for Chris as an artist. But, of course, there is something very racist about Hudson assumption that Chris would still have that talent with his brain replaced by Hudson’s—as if the talents of black people must always reside in their bodies, not in their brains. Moreover, there is something even more colossally racist about the shocking presumption by Hudson that he, as a rich white man, has the right to purchase the body of a black man and use it for his own purposes. And not to recognize the evil of this presumption is the biggest blindness of all.

There is, of course, an entire tradition of films about brain transplants, almost all of which are balefully bad, making the concept appear ridiculous. Indeed, the most successful brain transplant films are probably comic farces like The Man with Two Brains (1983) and Man with the Screaming Brain (2005), which employ this ridiculousness as an asset. It works so well in Get Out because there the motif is so clearly satirical and is never meant to be taken literally. Surely, no one is likely to interpret this film as suggesting that white people are literally transplanting their brains into black bodies. Instead, this motif is an allegorical stand-in for the entire history of the exploitation of black bodies by their white “masters,” the most spectacular example of which is slavery in the American South.[6] Of course, there are also relevant examples from American history, such as the notorious incidents in which African Americans have been used for medical experimentation.[7]

All in all, though, the cinematic tradition that Get Out fits in best is not brain transplant films, per se, but the tradition of films in which individuals lose control, or “ownership” of their own bodies, sometimes (but not always) by having those bodies replaced by duplicates commanded by sinister agencies. This motif is used to good effect in such science fiction films as Invasion of the Body Snatchers (1956, remade in 1978), The Matrix (1999), and (especially relevant here) The Stepford Wives (1975, remade as a comedy in 2004)—as well as in any number of horror films based on possession.

Indeed, Get Out, ultimately, is a sort of combination of the science fictional body exchange film with the horror-based possession film, something that becomes clear late in the film when we learn that the Armitages and their circle are members of a secret occult society that dates back to the original Knights Templar (thus the Templar helmet in the opening scene). This link, though, is made rather subtly in the film through the identification of the brain transplant process as the “Coagula” procedure. The reference, though a fairly obscure one, is to the pagan deity Baphomet, whom enemies of the Knights Templar accused of worshipping during the Middle Ages. Since the nineteenth century, Baphomet has been associated with the image of a “Sabbatic Goat,” with the Latin words “SOLVE” (“separate”) and “COAGULA” (“join together”) tattooed on his arms. The appellation “Coagula” thus suggests the joining together of a (presumably superior) white mind with a (presumably superior) black body to produce the perfect hybrid. In addition, the Knights Templar motif adds a touch of the occult and keeps Get Out situated more within the realm of horror than science fiction (and evokes a whole tradition of occult conspiracy films, from Rosemary’s Baby in 1968 to Hereditary in 2018), which is entirely appropriate, given the horrors that it addresses.

Apparently, the accusation that the Knights Templar worshipped Baphomet was false, as were many of the accusations levied against them for mystic practices by the medieval Catholic Church. For purposes of this film, however, the Knights Templar are used in a purely allegorical way, so historical accuracy is not as important as is the image of the Knights as a secret conspiratorial society that stands in for the web of subtle, submerged racism that has been in place for hundreds of years and that still haunts American society today. Moreover, the way in which membership in the secret society that has developed the Coagula procedure is clearly passed down from one generation to the next nicely captures the way in which American racism has been passed down through the generations.

The pagan god Baphomet as Sabbatic Goat. Note the tattoos on his arms, reading (in Latin) “SOLVE (“separate”) and “COAGULA” (“join together”).

Late in the film, Chris begins to realize the web of secret racism in which he himself has been ensnared. First, he discovers that Rose has dated a whole string of black guys (including Walter) before him (even though she had told him he had been her first black boyfriend). Indeed, it eventually becomes clear that Rose’s main purpose in life is to lure young, healthy black men to the Armitage estate so that their bodies can be stolen and used as hosts for the Armitages’ white cult. Chris’s growing realization that even Rose (who, up until this point, had seemed a sympathetic figure) is in on the conspiracy, begins the film’s harrowing last half-hour, in which Chris survives a number of close calls to escape to freedom—though not without an assist from Williams, who arrives, a more successful version of Dick Hallorann from The Shining, to take Chris away in his TSA vehicle just in the nick of time (and leaving a trail of bodies behind at the Armitage estate).

During this last half hour, the film shifts into action mode as Chris eventually kills the whole Armitage family. Along the way, though, Peele still takes time to drop in a number of deft touches. The action begins as Chris is strapped to a chair in the Armitage basement and begins to pick cotton out of the chair’s stuffing, just as slaves once picked cotton in the South. He then stuffs the cotton in his ears so that he cannot hear the signal he has been conditioned by Rose’s mother to be pacified by. The nod here to the legacy of black slaves (and, later, black sharecroppers) picking cotton in the South, is subtle but important. Later, Chris impales Dr. Armitage on the antlers of the mounted head of a buck, “buck” also being a label that was widely applied to black men in the slave era. Armitage has been hoist on his own petard, as it were.

The film’s ending is simply another of these carefully crafted signals. When Williams arrives in the vehicle, lights flashing, it at first appears to be a police car. Given that he comes upon Chris leaning over the dying Rose, this moment provides a final bit of tension for audiences who, given the recent history of shootings of black people by police, are clearly meant to feel that Chris is in serious jeopardy here. Indeed, in the original ending of the film, it was police who arrived, though Chris was arrested, rather than shot. Still, given the string of recent police shootings of black men, Peele felt that this moment of tension would be effective, though that it was also important to follow it with the happy ending that eventually made its way into the film. Chris survives, and it is even possible that his experiences with the Armitages have decreased his trauma over his mother. After all, this time he has acted strongly and effectively in a crisis, as opposed to his inaction on the night his mother died. We’ll never know, but there is certainly cathartic potential in the fact that he drives away, leaving Rose dying in the street, just as that earlier drive had left Chris’s mother. This happy ending, however, does nothing to diminish the message of the rest of the film—that American racism has in no way been happily ended.

WORKS CITED

Benjamin, Rich. “Get Out and the Death of White Racial Innocence.” The New Yorker (March 27, 2017). https://www.newyorker.com/culture/culture-desk/get-out-and-the-death-of-white-racial-innocence. Accessed November 12, 2018.

Clark, Trent. “Jordan Peele Explains Why Childish Gambino’s ‘Redbone’ Was Perfect for Get Out.HipHopDX (February 23, 2017). https://hiphopdx.com/news/id.42476/title.jordan-peele-explains-why-childish-gambinos-redbone-was-perfect-for-get-out#. Accessed November 12, 2018.

Weston, Kelli. “Get Out: Jordan Peele, That Sinking Feeling.” Sight & Sound 28.1 (January 2018): 37–39.

NOTES


[1] The Oscar recognition for Get Out was not unprecedented for horror films, of course. While The Shining struck out in terms of Oscar nominations and Rosemary’s Baby won only for Best Supporting Actress (Ruth Gordon), The Exorcist (1973) snared a Best Picture nomination, in addition to nine others, though it won only for Best Sound and Best Screenplay Based on Material from Another Medium. However, the horror/crime film hybrid The Silence of the Lambs (1991) was one of the few films in history to win all five of the most prestigious Oscar categories: Best Picture, Best Director, Best Adapted Screenplay, Best Actor, and Best Actress. It might be noted, though, that Peele was only the fifth black director to have been nominated for a Best Director Oscar, an award no black director has won to date.

[2] Stanfield would soon appear in a starring role in Boots Riley’s Sorry to Bother You (2018), which makes some of the same satirical points that Get Out makes with horror, though with a clearer emphasis on class. However, both films are really hybrids that contains stronge elements of science fiction, as well as horror. Of course, the most famous cinematic fusion of horror and science fiction in American history is James Whale’s Frankenstein (1931) and other films based on Mary Shelley’s original 1818 novel. Indeed, Peele has described Get Out as his version of the Frankenstein story. “In many ways,” Peele says on the film’s Blu-Ray commentary track, “the African-American experience is this country’s Frankenstein monster.”

[3] Of course, the idea of danger erupting in a seemingly ideal white suburb has appeared in horror film before. Peele himself has said that this first scene was partly inspired by the white suburban setting of John Carpenter’s Halloween (1978).

[4] For some viewers this song will also inevitably suggest a connection to John Updike’s classic 1960 novel Rabbit, Run, which (among other things) is a commentary on the search for a meaningful existence in suburban America. It is a book that essentially ignores the question of race, making American appear to be an all-white world, while suggesting that only white people have the kind of existential problems that Updike explores in the book. Within the context of horror film, however, some viewers might be reminded of the “Run, Rabbit, Run” sequence that occurs when the grisly Firefly family of Rob Zombie’s House of 1000 Corpses (2003) dresses one of their victims in a rabbit suit and then mocks her as she attempts to run away.

[5] As a sign of the densely allusive texture of this film, Rod at one point warns Chris that he might be getting into an “Eyes Wide Shut” situation, in reference to the 1999 Kubrick film Eyes Wide Shut, which involves a secret society engaged in sinister sexual rituals.

[6] Kelli Weston argues that “for all its contemporary trappings, Get Out may well be the most penetrating cinematic depiction of slavery, from the nature of the institution to its far-reaching psychic consequences” (38).

[7] Of these, perhaps the best-known example was the case involving studies of nearly 400 African American men with syphilis conducted by the public Health Service in conjunction with Tuskegee University between 1932 and 1972. The men were told they were receiving free treatment; in fact, they received no treatment at all so that researchers could track the progress of the untreated disease.