Near Death

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.

It's good fly-on-the-wall documentary filmmaking, but I do wonder why it's so long. I don't think many of the scenes themselves should've been shorter- maybe just that there were too many scenes for one whole film. I wish it had been divided into parts so it wasn't just one big film that (likely) needs to be watched as a whole. Or at least it seems intended to be watched as a whole- I can't find any info regarding it being split into parts, or originally being a miniseries or anything.

There's some truly eye-opening stuff, and information that every human being would benefit from learning or experiencing. For that, there are essential scenes which usually would warrant a higher score than 3.5/5. But it's all thrown into one mammoth six-hour film that 99.99% of people would never touch with a 358-foot-long pole, even if most of them would get something out of this. And even those who do build up the courage to watch it may be a tad too exhausted by its end. Again, it's supposed to be emotionally exhausting and draining, I'm sure, but maybe not in this way or to this extent.

I've had some of my favourite people die the last year or two, and spent a fair bit of time skulking in hospitals where dozens of patients all lie in sight of each other, measuring who's the closest to dropping off, sometimes having to remain for several hours in the same room as a dead person with whom they'd previously spoken on many occasions. The curtain isn't even always closed on them and the body remains in plain sight. Jung said something along the lines of the only way to lie comfortably on your deathbed is to constantly make plans for tomorrow as if you will one day rise again. I didn't see much of that going on there. Just sallow faces too scared to look down at their own cancer- consumed legs.

The main focus over these six hours is trying to work out just how far you should go to stave off an inevitable death. If a relative wants, the medical staff will assemble a team of literally dozens of people on call wielding drips, interpreting machines measuring their vital signs, making incisions, shouting out assessments over each other. And very few of the relatives here wanted any of their loved ones to go gentle into that good night. They hold onto an invisible strand of hope as long as possible, and the doctors confer and confer about their own attitudes towards their patients. Continuously expending all this energy on keeping obvious write-offs alive, which would likely result in brain damage even if they did survive, which they won't, clearly gets to some of them, although most of them abide by the Hippocratic Oath to the point that doing everything they can to give dying patients a few extra hours comes automatically to them.

Wiseman's lens is different to that of other directors. It's hard to ascertain exactly how he does it, but he manages to show that behind every pulse in a temple, every slight arching of an eyebrow, timbre of a voice, hand gesture and body stance there's a thought and reasoning and these surface tics are data belying our underlying thought processes. His films are almost raw footage but they still manage to keep you captive because, though we sometimes forget it ourselves, every human has a complex that will never be untangled. Werner Herzog might say Wiseman's verité documentaries only capture "the truth of accountants", but that seems to be downplaying his subjects' ability to tell hundreds of stories in every frame simply by dint of existing. And dying.

A very long documentary, but you can't stop watching it even after the 4th hour. the footage was taken in an intensive unit care of a Boston hospital and it is simply about the world in there, a world made of medical doctors and nurses, near to death patients and their desperate relatives. A small world that lives constantly on the verge of a crucial boundary, the one between life and death, a world that is not meant to be inhabited for too long and in which everybody tries to find a self protective routine. The desperate relatives with their cries and tries of find an escape in the medical daily reports leading to an impossible recovery of their beloved ones. The hopeless and impotent patients with their silent pain and their belonging already to another world. The compassionate but always rational doctors that gained a sort of self powering attitude from living between life and death and are in fact just able to endless discussions. Wiseman is able to use these reality cuts and to make a novel out of them, still portraying the reality and in a beautifully 'dirty' black and white. Or better, in grey, this is how death is: and this is what this film is about, death and the poor means that every men and women of every status and education have to deal with it.