Adrian Lyne's film meets madness, death, grief and trauma in one nightmarish symphony.

“It is better to burn than to disappear.” 
― Albert Camus, The Stranger

Adrian Lyne's Jacob's Ladder gives us the key to its mystery early in the film, as Jacob (Tim Robbins) flirts with a palm-reader on the staircase of a raucous party. She tells him, at first laughing and then growing serious: "And your life line...You have a very strange line, hon. No, it's not funny. See, according to this, you're already dead. You're out of here, baby." 

In any other film, particularly in the post-Sixth Sense world, we would all automatically accept that the ensuing events take place in Jacob's fevered subconscious as he lies on his deathbed in that Vietnam triage station. But Jacob's Ladder is so richly layered that we allow ourselves to forget this blinking signpost. Jacob's demons are attributed to PTSD, to the lingering effects of The Ladder, the chemical he and his fellow veterans were dosed with to increase their violent tendencies and make them more formidable soldiers. In Jacob's world, purgatory and PTSD are indistinguishable, a clever disguise for what would otherwise be a self-evident reveal.  

Jacob was traumatized before he even went to Vietnam. He lost his son Gabe, a cherubic Macaulay Culkin, and the tragedy created an impassable rift in his family, forever keeping him separate from the surviving members. We meet Jacob's other two sons, Eli and Jed, and we meet his estranged wife, Sarah (Patricia Kalember), but they are presented as warm but insubstantial memories, wispy things that drift through Jacob's fingers before he can grasp them. They are soft, hazily lit angels, with their beautiful biblical names. Sarah is the Israeli matriarch, the first mother. Jedidiah is beloved, Eli is God on High. And Gabriel? Gabriel is the messenger of God. 

So who was Jacob in the bible? He is the patriarch, the father of the Tribes of Israel. He heard the voice of God and envisioned a ladder reaching all the way into the heavens, the eventual passageway out of mortal life. Jacob meets with ladders and stairs throughout the entire film, not only in the fittingly named drug that he's told is ravaging his mind but in nearly every alley, hallway and room he encounters.

His wife and sons aren't Jacob's only seraphim. As Jacob looks up from the chiropractor's table of his friend Louis, played with great warmth by Danny Aiello, and sees Louis' head circled by fluorescent light, he tells him, "You know, you look like an angel, Louie. Like an overgrown cherub. Anyone ever tell you that?" Louis smiles his cherub's smile and replies, "Yeah. You. Every time I see you." There is no Louis in the bible, but with all the emphasis on names in Jacob's Ladder, we know the character wasn't baptized without meaning. Louis Segond is a theologian who translated the bible from Hebrew and Greek into French, and one of the final lines in Jacob's Ladder is spoken in Aiello's deep, rich voice, translating the entire film for us as we at last discover that Jacob's recent trials have all been a purgatory of his own making, as he fights to stay on earth rather than allow himself to ascend that ladder and out of his mortal existence - to disappear rather than to continue to burn. 

If you're frightened of dying and you're holding on, you'll see devils tearing your life away.

If you've made your peace, then the devils are really angels freeing you from the earth.

We've met Jacob's angels. But who are his devils? They're not only the twisted faces of the creatures that haunt New York's subways and streets, the writhing patients and barbarous doctors inhabiting the mental asylum of Jacob's mind. We have a more insidious devil in Jezzie, Jacob's long-suffering girlfriend played by Elizabeth Peña. In the bible, Jezebel is the temptress, the schemer, but here, she just seems put upon, a partner ill-equipped to assist Jacob through the increasing demands of his condition. She incinerates the photos of his wife and children, determined to make Jacob forget the first of his three lives - first Sarah, then Vietnam, now Jezzie. Casually topless for the first half of her appearances, she tempts Jacob to live in the earthly confines of his mind, to find contentment in this new reality he has created for himself instead of letting go and allowing himself to pass away into whatever's waiting for him at the top of the stairs. 

One scene in particular unlocks the strata of multiple meanings in Jacob's Ladder. After the party where Jacob learns that he's dead - learns it, forgets it, and then watches the bacchanalia around him transform into a hellish orgy - Jacob is stricken by a fever of 106. Jezzie (who really does seem to love him, making the temptation of their life together far more seductive) gathers ice from their neighbors and carries Jacob into an ice bath, watching over him all night, fearful for his life. In his fever, Jacob dreams, or remembers, that he is shivering in bed with Sarah, who insists on leaving the window open because she craves the fresh air. He tells her he had a dream that he lived with another woman: Jezzie, from work. "She was really good in bed...she had these great thighs." Sarah laughs and scolds him, and Jacob acknowledges the rest of it: 

God, what a nightmare.

There were all these demons, and I was on fire. 

I was burning from ice.

Gabe enters the room and says he can't sleep, and Jacob takes him to bed, tucking him in as he greets Jed and Eli, who've also awakened. It's a beautiful memory, or dream, and then Jacob is pulled from it back into his current reality, opening his eyes to find himself submerged in icy water as Jezzie and their doctor peer at him from above. 

So what's the dream, and what's the memory? As Jacob's Ladder presents it, the scene with Sarah is the falsity, a hallucination brought on by his fever and the ice, the result of his trauma and chemical abuse. But when the film ends with Jacob dead on that gurney in the middle of Vietnam ("He looks kind of peaceful, the guy. Put up a hell of a fight, though."), we realize the opposite is true. He once dreamt of his sexy coworker and admitted it to his wife. As he fights his impending death, trapped in memories both real and false, that dream becomes a reality. The fever is the hell around the corner, burning through Jacob as long as he holds on, the devils tearing his life away. The ice is both the cold from Sarah's open window and the quieting of his soul when he allows himself, for a moment, to remember his life as it was and to let it go - before the temptation to hold on, temptation in the form of Jezzie's solicitous vigil, brings him back into purgatory. Jacob reads Albert Camus' The Stranger throughout the film, and like the protagonist of that novel, a man waiting for his death at first unwillingly and finally with peace, he believes it is better to burn than to disappear.

The reason that Jacob's Ladder works so well is that its ending is no arbitrary twist, no "gotcha!" moment springing from left field and making questionable every event that came before it. We believe Jacob's purgatory is PTSD because Jacob's Ladder also has something to say about PTSD - it's not just camouflage, it's a very substantial part of the narrative Lyne and screenwriter Bruce Joel Rubin are trying to tell. When Jacob is searching for those who dosed him with The Ladder, he's told again and again to let it go - by doctors, his attorney, even the soldiers from his squadron. "The Army was part of another life. Let it lie." He's returned from the hell of war with a hell of a story, but no one wants to hear that story now that his heroic duty is finished. He's meant to stand aside and be quiet, to disappear. The film even ends - after the staircase, after the triage - with a title card stating that the Army allegedly used the drug BZ (3-quinuclidinyl benzilate) on unsuspecting soldiers in Vietnam. For Jacob, who never made it home from Vietnam, his purgatory was literal. For so many veterans, that purgatory is just a metaphor for the agonizing reality of life after war.

But before we're dosed with this bleak detail, Jacob's Ladder has something of a happy ending. Jacob sees Gabe standing at the foot of the stairs, waiting for him. Gabe holds his father's head in his arms and comforts him, before whispering to him, "Let's go up." Jacob has finally made peace with the end of his life; he's stopped burning his way through a fight he can never win. He takes Gabe's hand and, together, they climb the stairs toward the unknowable landing place that awaits them.