Chris Knipp Writing: Movies, Politics, Art


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PostPosted: Wed Apr 11, 2012 5:52 pm 
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CYNTHIA JOHNSON IN THE WAITING ROOM

Life and death and the long wait in a big city emergency room

The title, The Waiting Room, is a little misleading. This documentary was made in the large anteroom to a big city ER, Highland Hospital, in Oakland, California, a place seething with suffering and need. It was also made in the hospital rooms and trauma units inside, where the people are waiting to be admitted. The film only lasts 81 minutes, but it's an emotionally exhausting watch, and it feels like six hours, as it should: the staff work long days and the patients often wait all day to be seen. The Emmy Award winning Bay Area director Peter Nicks' film is simple but selfless and tireless. The result is a tough experience and a vital one. The Waiting Room is an TV documentary film and social media project. The latter designation pertains to its use as part of "The Storytelling Project," "a "community engagement initiative that aims to improve the patient experience," and this comprises much information and oral testimony that goes beyond the film's contents. In the film, which has no narration, patients and some staff in voiceover talk about what was going on when we watch the close ambulatory coverage here of many who came into or worked in the Highland ER, the busiest in Alameda County during a 24-hour period.

This is first of all a raw slice of life, an intense look at human experience. The film depicts social and economic problems, but as Nicks writes, it primarily shows "how our common vulnerability to illness binds us together as humans." We see a young girl with a serious strep throat whose mother is afraid it's a cyst. She and her estranged husband have lost a small child two years ago, and the father is terrified just to be in a hospital again. An aging carpet layer who has spinal bone spurs that are giving him such intense pain he can't sleep, but he must go on working to pay his mortgage. He has nothing in the bank and $80 in his pocket. A man who needs dialysis but who hates the process so much he would rather (expletive) die. A drug addict who comes in twice a month, but is really okay; he's just overtaxed his damaged lungs. Another man who has a bullet in his leg that may be causing delayed damage. A forty-ish man who's recently had a stroke, and keeps falling down. A fifteen-year-old in a trauma case who can't be saved and apparently dies of a bullet wound. (There are so many around him trying to save him it's hard to see.) We also repeatedly observe the efforts of the staff to get people in need of the most care to doctors or into beds; but there are not enough. Everyone has a story, but there is one story that emerges from all of them. We know this, but here it is in knowing, specific terms. The American medical system cannot and does not adequately provide for the poor, the out of work, for those who cannot pay for medical insurance and do not have Medicaid or Medicare. If you're American living in America and you're not rich, this could some day be you.

Or course anyone in a serious accident -- or a gun battle -- has to come here, and this is the best place to treat such traumatic injuries. But many patients are here because they could not afford the regular care of a physician or clinic that could much more economically detect illness early or provide treatment and medication for chronic problems. Most of us know this too: that ER's are overburdened because so many go to them as their only source of medical care. They even go there for dental problems, because they have not been able to pay for a dentist, so they have an abscess or an infected jaw, that, with regular dental care, would hardly ever happen. They are diabetic, and they have run out of insulin. Or they were not referred for surgery through the proper channels. A young man without enough money for medical insurance has gone through the private Kaiser system to get urgent surgery for a testicular tumor. Somehow he got all the tests and was set up for surgery before the staff realized he was not a member of Kaiser and abruptly cancelled his surgery the day before it was scheduled. Luckily, he has all the data on a disc, and eventually seems set up for surgery again via public medicine before the film is over. But in many of these cases, from the girl with the strep throat to the twenty-something with the tumor, the patients' problem has worsened because due to lack of funds or insurance they didn't have access to regular outpatient care. This is the big waste of the privatized American system. But the film also is a minute-to-minute picture of America's economic crisis, because the waiting room is full not just of the indigent and the chronically poor but of the newly poor and newly unemployed, who have only recently lost health insurance or the ability to pay for it.

The Waiting Room doesn't make these generalizations. It provides a lot of live dialogue, along with occasional voiceovers from patients and staff. Besides providing pictures of many individual cases, Nicks gives us a good picture of the problems of the ER -- all the ways it isn't able to get people through fast enough, because it's overloaded -- and the staff's best efforts to deal with them. He need not generalize. This is the best kind of documentary: one that speaks through very specific and very human details. Life in the raw. An essential companion piece to Michael Moore's Sicko. Nicks does not point fingers. The hospital staff members we see, the most prominent ones, are models of compassion and efficiency -- not an easy or obvious combination, by the way.

The Waiting Room, which is Nicks' feature documentary debut, obviously benefits from full access to the ER and most of the people in it. It features some time-lapse photography from above to show the constant ebb and flow of waiting room occupants. It clearly is well served by the editing staff headed by Lawrence Leres, aided by David O. Weissman and Michael Godier. Nicks is the chief photographer. The film has been likened to Frederick Wiseman's Hospital, but it seems warmer and more "character driven" (Nicks' word) than Wiseman's work. There is a Waiting Room Project Flickr photostream of the film, richly supplied with stills, that tells us who the compassionate lady is who logs in most of the patients during the time of the film. She was Certified Nurse Assistant Cynthia Johnson, and the chief physician on view is Resident Dr. Doug White. The patients we get to meet are also identified. The film was shown at the CUNY School of Public Health in November 2011, and at the documentary True/False Film Fest in Columbia, Missouri in early March 2012. The film is scheduled to air on PBS' Independent Lens in the Fall of 2012. It is a contender for the Best Documentary Feature Prize at the San Francisco International Film Festival, where it will be shown at the following times and places:

PFA
Sat, Apr 21, 2012 3:50 pm
Kabuki
Mon, Apr 30 1:00 pm
Tue, May 1 6:30 pm


The film's website provides access to the Storytelling Project element of the Highland ER project.

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┬ęChris Knipp. Blog: http://chrisknipp.blogspot.com/.


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