Near Death is a truly great film. I think I already said something similar about Hospital, and maybe it’s these films about doctors and patients and serious medical issues that really get to me, but by any standard I can imagine, Near Death is a towering achievement. That it is six hours long (Wiseman’s longest) seems of negligible concern. It is full of riveting drama, portraits of amazingly selfless doctors and nurses, engaging and smart discussions of serious issues, and is so well structured and photographed - it’s an incredible film. I think all I can do with it is suggest some of the things I particularly admire and maybe consider some ways it is brave and bold.
Maybe we should consider length, as it pops up as a Wiseman issue with some of the later films too, as if anything over a couple of hours is really pushing it. I’d say especially in this age of streaming, when it’s nothing to binge watch multiple seasons of shows we’ve seen already, I think we should appreciate when a film gives us a lot. What should matter is if a film’s length is justified by what it offers, and especially with Wiseman, it’s usually a greater richness of incident, and likely scenes that play out at a duration their complexity warrant. When I feel bored, I’ll let you know. If it’s any easier, Near Death is shorter than the Deaf and Blind series by a couple of hours, so we shouldn’t feel like that’s such a big deal. And since we’re likely watching these days at home, nothing stops you from taking a break, although Near Death flows from start to finish and doesn’t require any intermission. And he felt these places were worth a month or so of his time and then a year of turning it into a finished film, so let’s trust him on this. In this case, it’s probably the combination of length and subject matter that sounds off-putting, but believe me, it’s the bravery of the subject matter that’s part of what makes the film such a wonder.
This time around, for some reason I occasionally had in mind Michael Haneke’s 2012 Amour, a fictional examination of a married couple where the wife is dying. It’s a moving film, but thinking of it in relation to Near Death it feels like a lesser experience, because especially where death is involved, there’s such a gulf between an actor portraying the experience and being in an actual hospital watching it happen. No matter what Wiseman does to select and edit, there’s still the raw material he starts with, the places he has chosen to go, that can have a visceral power unmatched by entirely fictional works. Say what you will about the shortcomings of terms like cinema verite and direct cinema, taking a camera someplace and filming what happens there produces results with their own unique effect. What’s stunning about Near Death is a simplicity of style - except for some very occasional moments I’ll mention, the camera just watches in a basic way - you could call it classical if it weren’t otherwise so rare. A doctor and a family member of someone dying will sit and talk, and we just watch and listen - no showy effects or fancy movements. It’s respectful of them and also of us as viewers. We’re witnesses to experiences viewed straight on and seemingly without artifice. I marvel at the talent and persistence this requires, and the modesty involved in just filming things straight on and steady. There’s a mention made of a medical procedure that we’ve already seen having taken place at five a.m., and you wonder if the filmmakers ever slept. So many scenes seem the result of sheer endurance - waiting for things and filming for very long periods to see all that transpires. And I have to admire again Wiseman’s frequent cinematographer John Davey, for this talent just to film so straightforwardly and patiently. It’s not as easy as it looks.
For a six-hour film, it’s surprising how relatively few cases the film covers. I was too involved to notice the clock and I won’t try to summarize the key sections revolving around certain patients, but that’s the general approach. We see the situation of a patient brought into intensive care, and we stick with them to see what happens, even if that sticking will take at least an hour’s time. So much of the film involves doctors speaking with family members of the patients, but we always see the patients they’re talking about and we become very familiar with the couple of doctors who are most directly involved in these cases. It’s unusual in a Wiseman film to hear so much from relatively few people, but I’d consider this adjusting to circumstances. It’s just not a circumstance suited to a more mosaic structure in this case. We still get a good number of Wiseman meetings, but even these are often about cases we’re following. He seems properly governed by his material, not forcing it into a preconceived template. If someone is talking at length and he deems it important, he’s absolutely not stopping.
One fascination in the film and one reason it is so involving is that we see difficult situations which require a lot of explanation and decision making. As these stories evolve, we see family members and occasionally patients offered options by doctors with great care, and in these times of crisis they can seem so bewildered and distraught that it’s hard to imagine they can make choices at all. This was my second viewing of the film, and this time I was struck by how the doctors often seemed to subtly persuade family members of what they thought was the best course of action, but in ways that never forced decisions upon them. Sometimes we can hear, through persistence and repetition, what it takes for the doctors to get family members to understand and then agree to difficult choices. Their patience is amazing to watch, and if we didn’t get such extensive chunks of discussions, we just would have no feel for this process. As always with Wiseman, he’s attracted to situations with no easy answers, as is acknowledged by the people themselves repeatedly. Rather than recount the situations, here’s a few quick quotes mostly by doctors to suggest how often this sense of uncertainty is expressed.
"It's a tough choice. It's a pretty tough choice. You're right. It's not a good choice."
"There's not a lot of good answers here."
"If that was me in bed, I don't know what the hell I'd say."
"I'm going to use the phrase 'raise the question' a lot . . . There is never an absolute in these situations.”
"Your decision is not necessarily a bad one. It's a hard one, but it's not a bad one."
"We're doing everything we can do. It's just not working."
"God decides. We don't decide.”
“I just don’t know how these things happen.”
The drama of Near Death is often the drama of breathing tubes and tracheotomies, how certain procedures are so invasive that they may not be worth trying, either because they will make patients worse or will leave them only artificially alive. We hear these procedures discussed a lot and see them performed several times, yet by the time the film is over, I don’t think we feel we know whether their use is effective or not. This isn’t a film that will answer many questions, but it will certainly thoroughly air the complexities of the problems. What does it mean to be “brain dead”? As one meeting puts it: "When does a terminal illness really become terminal?" A doctor asks: "Is five good months better than eight months of hell? That's what it boils down to a lot of the time." When to stop medical procedures attempting to save a life and move just to make their small remaining time more comfortable is a regular question too. The technologies and techniques available, like cardioverting - the paddles to shock a patient back to life so loved by television medical shows - are shown but rarely celebrated. “More technology for unclear benefit” is a doctor’s assessment at one point, and it’s another unresolved issue. The film courageously offers us doctors and families confronting these problems, without ever suggesting the options are clear cut or easily understood. A shorter film would never be able to achieve this.
A narrative strategy of the film unusual for Wiseman is to give large amounts of screen time to two doctors with somewhat contrasting approaches. One is named Dr. Taylor, and I think the other is Dr. Scott, although I’ll admit that might be his first name, as I don’t think it’s ever clearly stated. They are both in their ways incredible and dedicated people, but the differences between them bring out the dilemmas of these terrible situations. Dr. Taylor is the one who will sit forever with family members, answering their questions, attempting to explain the unexplainable, trying to get them to accept decisions that must be made, or the inevitability of what is taking place, that their loved one is dying. The film shows him at length, as it must, for to shorten his scenes would be to overly simplify what he does. We need to hear the same questions being asked as he takes a wife from “do everything you can” to acknowledging that it may be time to allow treatment to ease up in order to appreciate how understanding and helpful Dr. Taylor is. And you need to see him do this more than once in order also to understand the great contribution he makes in case after case. Dr. Scott, on the other hand, is the brilliant guy who can come right out and smartly assess the issues involved - maybe even too honestly sometimes. He might enjoy a little too much being cynical and straight to the point, but he’s so articulate at raising issues that you can easily see why he gets so much screen time. A few greatest hits of his assessments:
"These are the options. Life in an institution with a tube in your throat on a machine or you can die tomorrow."
“It might be something we could fix, but it might just be the end-stage of everything that's gone on.”
"It's a tragedy, but I mean that's the way it goes."
"I'm glad I only do this one month a year."
"Incredible kind of nightmare scenarios that get played out."
“Two thirds of all your health care costs are incurred in the final 21 days of life.”
“The problem is, we can't tell who's gonna make it and who's not."
“Some of this stuff is heavy flail for relatively small or no gain.”
“We know that everybody who rolls through that door looks bad.”
There are probably half a dozen scenes in the film where Scott talks through problems with nurses or other doctors, so the film isn’t always endorsing his view of things, but he’s naturally in the middle of a lot of the kicking around of ideas or approaches to take, and Wiseman is again very smart in including him so much, both for how he contrasts with Taylor and for having wrestled with these problems himself so extensively. Going between the straightforward drama of people dying and hearing the issues involved in how to deal with their situations makes Near Death both a wrenching experience and an intellectual challenge at the same time, no small feat.
I’ve praised the film’s directness, but there are a few arty touches that I can’t ignore either. Wiseman has always seemed big on signs - our last film, Missile, for example, seemed to love all the crazy signs outside buildings with arrows directing to weird unintelligible acronyms - there has to be at least a dozen of them. Ironic movie marquees have also popped up in a few films. (I don’t think I mentioned the one in Manoeuvre announcing “Invasion USA”, which is a real Chuck Norris film.) The sign Wiseman takes notice of in Near Death so caught his eye that he affords it a large close-up, in a basement morgue room in the hospital where bodies are stored. Over one of the body drawers is this:
REMOVE OLD TAGS
PLACE BODY FEET FIRST
USE MIDDLE COMPARTMENTS WHEN AVAILABLE
Funny-sad-bureaucratic doesn’t get much better than that. Another notable but extremely rare close-up is far more serious. When Dr. Taylor is speaking with the wife of a dying man, after about twenty minutes of speaking with her, he puts one hand on hers and they sit for a time in silence as she breaks down in tears. It’s so moving because it’s so earned - we had to have seen their discussion before this moment to experience this not as cheap drama. And as one last example of a shot that I’m not sure how they pulled off, there’s an amazing scene during an intubation procedure, where the camera moves to a high overhead position to show there's about ten doctors and nurses in the room working on the patient - an incredible image of dedication and effort. How Davey, though, would have gotten high enough for this angle is difficult to figure.
It’s artiness of a different order, but there’s a visual poetry to the regular exterior shots showing the sign for the hospital, patients being brought in, and usually a repeated shot of the windows at all hours. Film scholars have marveled at the transition shots in films by the great Japanese filmmaker Yasujiro Ozu, and these are along the same lines. Rather than just a method of getting us from one scene to the next, they express a timelessness both in terms of the events we’re watching going on all day and night but a sense too of the universality of what we’re watching - struggles that go on and on and that repeat and repeat. Maybe we won’t all wind up facing the decisions forced on patients and doctors in this film, but we’ll all be near death in one way or another. Until Wiseman does a companion film about the IRS, it doesn’t get any more universal than this.
And a last bit of attention must be given to final moments in the film, moments that repeat the end of Meat or the furs going out the door in The Store - the way to show that a process is complete. It might give a feeling of an ending, but I think it also shows Wiseman expressing a sense that now we understand the complexities of a process and that what looks so simple is worth the attention that we’ve just seen it accorded. Here, we are back with those drawers in the basement again, as a couple of men, one from the hospital and one dressed like an undertaker, take a body out and place her on a rolling table. They check her tag, zip her into a plastic bag, then strap it down, and then put another bag around that. They roll the body outside and into the back of a car, and as it pulls away, we see “hearse” on the license plate. Out onto the highway it goes, leaving behind an institution that is full of brave people performing difficult tasks. Watching Near Death more than thirty years after it was made, it’s impossible now not to think of these Intensive Care Units with their ventilators and first responders as having to deal with these same kinds of problems in a covid context. Not a single Wiseman film feels dated, because the issues and institutions he chooses to explore are ones that never go away. Near Death sadly feels all too topical and current.