Dir: Dan Knauss
I’m glad this was a short documentary, it’s a tough thing to watch people suffering in this way, which gives us some idea of how hard it must be for their loved ones and doctors.
This is a documentary about patients in need of end-of-life care in a hospital, as the medical staff work with their families to decide what’s best for them and what the patient would want.
The focus of the film is very well-balanced between patients and the doctors, watching how they work together to make some horribly difficult decisions. The opening shows how difficult communicating directly with the patient can be in these cases and we regularly return to conversations between doctors and family, discussions in the hallways between medical staff of their options and differing ideas. Throughout, no clear consensus wins overall, there’s constant alternative views presented from a number of angles to show how complex an issue it is.
There are two main patients we see in detail in the film, Donna and Selena. Though they are unable to talk or communicate much, we see how their families handle the situations. While one is just able enough to show she doesn’t want to be on a machine, the other is unable to communicate at all while her family want to wait ‘for a miracle’. Ultimately they come to different decisions on how to proceed, the film doesn’t pass any judgement on which is better, showing that it has to be what the patient wants and what the family can cope with, guided by the medical staff giving as much explanation and support as they can.
There are a few other patients shown in part, some of whom are able to express themselves, most have their families around them. These moments are quite intense and emotional, so showing them just briefly is enough to see what we need without making the film just a cacophony of emotions.
While the setting is clinical, the film certainly isn’t. There’s a nice even-handedness in balancing emotional moments with families, matched by great tact and empathy on the part of the doctors. It handles matters in a very respectful way, possibly making a gentle point about the use of ventilation machines, though careful not to contradict the views of patients and their loved ones on the matter, clearly communicating the difficulty and complexity of providing good end-of-life-care.
‘Extremis’ is available to watch on Netflix and is currently nominated for the ‘Best Documentary Short’ Academy Award. It’s only 24 minutes long and quite upsetting but a very well-handled view of an interesting subject.