Near Death

I planned in late spring that I was going to devote part of the first week of September to watching Frederick Wiseman's Near Death, a six-hour documentary epic about family members responding to the final moments of a loved ones' life while hooked up to machinery in crowded hospitals, as well as a detailed account of the work put in by hospital staff and personnel. Little did I know, at the end of August, I would witness my own display of "near death."

My grandmother was admitted to the hospital after suffering a massive stroke and became so uncontrollable, in a tizzy of psychotic rage, she had to be detained to the bed and given dosages of a sleep drug. Turns out, my grandmother turned unconscious and, while she was able to breath on her own, she didn't seem to have much control over her movements. She couldn't speak, and all we could do as her family was stand by her and witness what could very well be her last moments. I spent hours in a hospital, alongside my unbelievably distraught grandfather, my restless, sleepless aunt, my own stressed father, who was left to make the decisions on what to do with my grandmother, my devastated cousins, my nurse mother, who'd come to the rescue of breaking down difficult information, and additional family members express grief and devastation to such a fit of heartbreak.

I'd like to say I'm digressing from the actual film at hand, but I believe Wiseman wants us to somewhat reflect on how we'd respond in this particular quandary, as well as try and relate an experience we've had where it was like staring death or "near death" in the face. Wiseman takes us inside Boston's Beth Israel Hospital, specifically in the intensive care unit, where dozens of competent and qualified medical personnel work to diagnose, treat, and console patients and their family members. These patients are admitted in the particular unit for the obvious concern - they need intense, uncompromising care, for these could, fearfully, be their last moments alive. Some have cancer, some have heart issues, some have poor lungs, and some are just coming to terms with their age. Whatever the case may be, this is a difficult time, and the news usually brought forth is negative or faintly positive.

Wiseman unsurprisingly doesn't examine medical debates such as universal healthcare, or even really dig deep into the concept of the afterlife, heaven vs. hell, and so forth. There's no place for that kind of debate at this moment in time. Wiseman wants to focus on the immediate present: what we can see, what we can hear, what we can observe, monitor, and digest about a loved one and what can we do to assure their health is maintained and their current state comfortable? Wiseman, in addition, captures everything through a black and white lens, as bleak as possible, complimenting much of the information we hear from doctors and loved ones throughout the course of six hours.

While few scenes in Near Death aren't sad, one of the most soul-crushing is seeing a doctor telling an elderly man that his lungs are in such poor condition that, while they'd like to put him in intubation (a process using a machine to restore competent breathing before being slowly weened off a patient so he can breath on his own), the staff feels that doing so would only confine him to the machine and make him dependent on it. The man sits there, lying in bed, with a blank look on his face. There is no emotion in this scene other than the emotions shed by the viewers. One could view this as a simple slice of life: we're born, we live, we get older, we shutdown, and we die. Others will view this as a depressingly human state of affairs. I say it's an inevitable tragedy that still nonetheless strikes an emotional chord.

The final hour and a half is mostly dedicated to examining a man, who has been admitted for similar reasons in that he is beginning to lose strength in his organs, mainly his heart, liver, and kidneys, and that is making his vitals - blood pressure, blood sugar, heart-rate - all operate in a poorer state. We see his long-devoted, ostensibly long-suffering wife, sob in front of a careful and compassionate doctor by the name of Dr. Taylor, as he sits by her side, quick to answer, or respond, to her many questions and concerns and offer additional options. Dr. Taylor and the woman speak for sometimes twenty minutes at a given time, frequently through the final hour and a half of this documentary, and they are some of the most human dialogs I've ever seen exchanged on film.

This is one of the many scenes that shows the true compassion and skill of the medical personnel all across America. These men and women, some old, some fresh out of medical school, some with the title of a 'doctor,' others playing assistant to the man/woman with the title, but their daily activities range from changing fluids, observing vitals, writing reports, or scratching backs of patients not equipped with the strength or energy to do it themselves. Not to mention, these doctors engage in some of the hardest conversations imaginable, arguably some of the hardest and rawest ever committed to film. Their compassion and soul shouldn't go unnoticed, albeit the incredible amount of information existing in this film.

Near Death is, admittedly, exhaustive and sometimes tedious, as expected with almost every film spanning one-forth of a day. Because of this, it is best digested over the course of two, or in my case three days, for emotions to be digested and to prevent information overload of any kind. Furthermore, it should be stated that Wiseman, as repetitive as it is getting to say, has made another masterpiece of documentary filmmaking.

A sprawling 6 hour documentary on the ethical issues that doctors and family members of palliative care patients face when it comes down to the time of pulling the plug, so to say. The daunting length of the movie is a testament to the daunting passage of life to death, in that it you spend so much time connecting with the doctors, patients and family members that the tone of the movie transcends from frightening to strikingly terrifying. While Dying at Grace, which may be my favourite movie of all time, focuses more on the awe of dying, Near Death focuses on the struggle to save and rehabilitate, and this notion does not let up for the entire runtime. Near Death is an exhausting experience, and my heart goes out to the families who volunteered to have their last moments filmed for such an extraordinary film.

My review was written in October 1989 after a New York Film Festival screening.

"Near Death" is a tedious, repetitious documentary made at a Boston hospital critical care unit that sheds little light on the issues affecting terminally ill patients, their families and healthcare workers.

Frederick Wiseman, whose 1970 docu "Hospital" was an insightful, wider-ranging work in the same genre, has fallen in love with his footage this time. The nearly 6-hour opus debuted at the New York Film Festival will hold some interest via public tv for devotees of Wiseman's cinema verite approach.

Four case studies form the core of pic's content, plus endless, repetitive discussions by doctors and nurses about these cases and the ethical issues involved, mainly when to "pull the plug" on these terminal patients. Because of the medical jargon and unfortunately inarticulate physicians focused on at Beth Israel Hospital in Boston, pic is boring and unable to educate the viewer the way a researched docu with experts' interviews might do.

Instead, Wiseman with his no narration, no music, no facts/titles approach bears down in almost real-time sequences with the hope that lightning will strike and something moving or novel will be recorded. Only in the final segment, nearly two hours devoted to the hopeless case of Charlie Sperazza, does anything of that sort happen, as Sperazza's wife is very real and very empathetic. Sperazza makes an unexpected comeback and it is genuinely inspiring when he wiggles his toes after being all but given up on.

Pi'cs logical finish is the scene of Charlie being successfully taken out of intensive care, but Wiseman chooses to then end the film with footage of a corpse being removed from the hospital morgue to a waiting hearse, before bookending pic with a shot of the Charles River. Sperazza's doctor, with a boring monotone and endlessly reiterated (almost verbatim) cliches, unfortunately resembles most of the doctors and nurses shown before.

Main protagonist is a Dr. Weiss who seemingly presides over the unit and disconcertingly talks about heavy issues more like a basketball coach than philosopher. He confesses to being a nihilist, comparing the health care for terminal cases to the Greek myth of Sisyphus, i.e., endlessly rolling a rock up a hill only to have it roll back again. Near the end of the pic he recites virtually the only fact or datum imparted during its duration: that an average two-thirds of a person's lifetime healthcare costs are incurred in the final 212 days of one's life.

Most of the film's thrust deals with the issue of the team decision of physicians/nurses/patient/family as to what measures should be taken to prolong life during the end game of this medical chess match with Death. Once the parameters of this painful process are laid on the table, Wiseman unwisely pours over the topic dozens of times more, presumably for the benefit of slow-witted viewers.

The other key deficiency of his approach is that while patients (mostly unconscious, however) and families pour their hearts out, the health-care workers are obviously (and inevitably) aware of the camera's presence and therefore are on their best behavior. Intramural criticism is kept to a minimum and all concerned are portrayed as saintly, if hardly all that brainy, technicians.

A hard-nosed film editor could usefully cut this pic down to feature length by retaining only one or two of the case studies, while further removal of repetitious discussions during individual segments could reduce it to a tight, half-hour rtv special.

As it stands, "Near Death" is surprisingly bland. Even exploitational elements such as an autopsy review segment (with organs displayed on camera) and two scenes of corpses being removed come off as remote and clinical. End credits reveal that all but one patient died soon after the events depicted.

Grueling in both subject matter and running time, _Near Death_ nonetheless poses questions that most of us will have to answer, at some point in our lives, for either ourselves or a loved one. Do what extent should measures be taken to preserve a life that might be full of pain and sustained by a machine? Should the goal for terminally ill patients with little hope of recovery be life support, or comfort? At what point do we give up hope of recovery? While expressing ample skepticism about the function of much of our society's expensive, intrusive life-support technology, _Near Death_ also gives us little glimmers of hope - if only regarding the degree to which we can support each other in coming to terms with death, pain, and degeneration. The warmth and patience of one Dr. Taylor in this film is especially heartening, and very istructive in understanding, in human terms, the medical and philosophical issues at play. An unforgettable viewing experience

It's quite depressing because people are constantly down in this movie energies presented as a real-life sing so why would anybody want to see people that I know these sick individuals with like this and yes it is interesting to see how the doctor's deal with these things like life and death for the rest it's not so interesting one of the lesser great documentaries of the wonderful documentary maker Frederick Wiseman.