Extremis

There's probably no decision that's harder than the decision about the end of life - especially when you're in the position of having to make (or at least heavily influence) the decision. Most of us have probably at some point had to make that decision for a beloved pet, but we hope and we pray that we don't have to face the decision for a family member. But sometimes we do. People have a tendency not to just fall asleep and not wake up, or to simply die in an instant. People get sick - and then sicker, and sicker still. And somewhere along the way, the question comes up - how far should we go with this? If you've ever been in the position of having to face those questions (and I have been personally within my own family, and as a pastor I've stood with families who've been faced with this decision) then you'll certainly be moved by this short film, and by the situations depicted.

This is a 24 minute short film that depicts these decisions being made in what seems to be an ICU in a major city. Doctors, nurses, families and patients all struggle together with the decision. Machines or no machines? Tubes or no tubes? Just how far do we go to keep a person alive who has no reasonable prospect for any significant recovery and when the quality of life has disappeared? It's a heart-wrenching decision for everyone, and that's one thing that becomes clear. Even the doctors - who surely have to do this a lot - are sometimes uncertain, and it's emotionally draining on them as well. Everyone wants and hopes for and prays for a miracle, but usually they don't come. If you've never been through this kind of situation and you want to get a glimpse of the sorts of things you struggle with, this is worth watching.

The main weakness I saw here was that it was so short. We got no real depth into any of the patients. There was no chance to get to know them or their families. We could sympathize (and perhaps empathize, if you've been through this) with them, but although the situations are moving, there's no real emotional connection with the people involved. I almost had the sense that I was intruding into some place that I had no business being. I think if more of the backstories had been made known, that might not have been the case.

Still, this is sobering and thought-provoking. As one of the people in the movie said, "everyone in this room is going to die one day." It's true. Everyone reading this review is going to die one day, and so is the person writing it. This certainly does make you cognizant of your own mortality and it leaves you hoping that you have an easier end than the patients depicted here. (7/10)

So real and so viscerally hard yet compelling enough to make you feel immersed in what you're seeing. "Extremis" touches one of those hard topics we tend to avoid and hardly ever think about until it happens to us or to someone we know and care about and that is the decision one must do in order to save a family member who's dying or to pull the plug and let them go because there's nothing more that can be done. A short documentary following medical doctors, families and people at the saddening final moments.

"Extremis" makes you think about those choices and gets all those different points of view of what to do, how to react and all the doubts that comes with it. The sick person can't do much to what's happening to them, the ones here all got tubes, equipment and such to help them breathe and continue to live in a deficient way. It all boils down to the talk the doctors must have with the family members, an extremely hard talk that follows with a more difficult decision.

We follow three or four cases, and people with better understanding in medicine will get it better the patients conditions since the film doesn't establish all that much, already cutting to what's going on and what's need to be done. In a way, it was very good they did that because all we need to know is that the patients will live though not in proper conditions and their relatives are the ones who can understand all the pain that goes through, all the caring they do and if they find appropriate to continue treatment or relieve their loved ones from more suffering. As someone who've always seen through the sick/dying one perspective, this is was truly something new to me, it made me reflect to how certain I could be in making an important decision concerning a person I loved, things that, unfortunately, they won't respond or say anything unless stated in previous talks - and that's the one we tend to avoid while going on living...cause death is for the later.

A commendable work though very sad to watch. What concerns me about the project is the thin line between what is exactly real and what is staged (if there is something like that, I mean, there were times I thought it was all acting). With a longer time, it'd be interesting for us in the audience to get everyone involved, backgrounds from families and the concerned doctors, just little things that'd make this a lot better. 8/10

Had a real rough time with this one. I though about dying the entire time. Really jacked me up with a bad anxiety freak out. Solid watch though considering all things.

I had to create an account just to write a review for 1. To criticise american medicine and to 2. Criticise these brainless reviews.

It seemed like many of the patients in the show were terminal patients whose steady decline of long-term ilnesses had lead them to the ICU. The show based a lot around the questions wheter to put the patient on a ventilator or not. In many countries it is quite easy to determine this - if a patient has the possibility of recovery to a meaningful state, they can be hooked to a machine while the body fixes itself and administered medicine works its wonders. This means for example that patients whose breathing function has declined because of a progressive untreatable disease gain nothing with ventilators. They would simply be put under anesthesia and they would die on the machine - one cannot recover to a state better than in which the person was before the acute sickness that brought them in the hospital. Many of the patients depicted indeed seemed chronically ill and the respirator does not offer to them any form of hope - yet they were put there for even months and they then finally died - not very ethical i would say.

Second about these comments criticizing the doctor for not giving more hope and trying to talk family members out of putting their loved ones on a ventilator. In response to one of these comments about key part of recovery being "hope". Thats absolute BS, key part is being realistic and managing expectations and not prolonging suffering. While there still is hope for recovery, treatment is continued of course. The doctor knew that these patients had nothing to gain and they would die on the tubes. A doctors job is not to give false hope but to clearly communicate to the family that the end is near and to take the best of it.

In short: ventilators are only for those who can get better. Terminally ill people cannot. Ventilator does not fix a heart, lungs, kidneys etc that are shutting down because of a long term illness. It can only give time for the body to heal after a sudden onset disease that is curable. Ventilators should be reserved for these people only - for the chronically ill they are a long kiss of death.

It's an important and worthy topic - honestly, more people should be aware of what these conversations are like, both so they can express their wishes to their loved ones in advance, and because it would probably lead to interesting reflections on what one wants out of life.

However I feel the execution of this short film leaves too much out. We're not told much about the preceding circumstances of any of the patients, some of whom only get about 45 seconds of screen time. What happened to the patient who was 38 and just became a grandma? She seemed pretty "with it" but was being put on a long term ventilator - why?

That said, it was instructive to see how the doctors debate these decisions. A lot of people will probably second guess some of the doctors (especially the curly haired white woman), but I actually feel better seeing that it's a bit of a committee rather than just one doctor. And there honestly isn't one right answer, which is why it's a debate.