Near Death

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.

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.

This was an excellent breakdown of the complex relationships between hospital staff, patients, and their families and how their mannerisms change around and away from each other. One could call the film a tragedy, but as we gradually realize over the course of its nearly six-hour runtime, the tragedy at the heart of their jobs is just a regular part of everyday work.

I was mildly saddened by the fates and situations of a couple patients shown early on, but like the doctors, I realized the survival rate of the patients was low and adjusted myself to that fact. Thus making every minute of its runtime necessary. One doctor, for instance, explained how her first week was the hardest since none of her patients were pulling through but she quickly realized most of what she can do is simply delay the inevitable and minimize their pain as much as possible, as opposed to save them. Other doctors occasionally vent their frustrations about the patients and joke about their situations behind their back, but a lot of this could very well be a coping mechanism they use to deal with the stress of their jobs. Because whenever the doctors are around the families, they always display an utmost sense of honesty and respect. They need to walk a fine balancing act with being honest about the dire situation at hand and the odds of the patients pulling through, while remaining respectful to the agency of the patient and the family in being the ultimate deciding factor of what medical procedures they're comfortable undergoing, being careful not to offend in the process.

The patients' situations being unpredictable and subject to change at any given moment is on full display throughout but perhaps most achingly exemplified through an elderly female patient who's clearly not all there given her constant uncertainty and variable responses to the doctors' questions on how to proceed. With her mental decline influencing her contradictory responses and constant requests to keep "thinking about it", one can feel each agonizing minute of her time slowly running out. Even with the other patients, the doctors consistently specify that any procedure they do comes with potential consequences and the patient will need to be constantly monitored throughout them every step of the way. The unpredictability of the future makes the present situation of the patients so finite. There's no way for them to go but forward.

Like the other documentaries I've seen from Wiseman so far, he doesn't need to spell out the themes of his work or include any voiceovers/exposition which outline them. The fly on the wall look at his subjects speaks for itself and says all that's needed. That said, I think I prefer Titicut Follies.

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.

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.