From its Latin roots, Extremis which means “at the point of death”, this award-winning documentary was released on September 13 of 2016 which tackles a day in a life of those people working in the ICU.
The documentary opens with Dr. Jessica Zitter’s sharp, almost too loud voice, asking for the patient‘s wellbeing. For a person like me who have luckily not been exposed to death of a loved one, I find her way of talking to patients unpleasantly frank, crude and honestly left me reeling from shock.
Her calm, strong demeanor in face of death made it too much for me, I expected more kindness, more patience in the matter. But this is a woman you know who has seen death and mourn too many times to count. For Dr. Zitter, death was not something to shy away from. Death is a part of life and it’s her job to make sure that it would be as easy as possible for everyone.
The documentary focuses on two patients and their families. Donna, who is in the end stages of a myotonic dystrophy which is a form of muscular dystrophy, and Selena, who stopped breathing in the car on the way to the ER.
On one scene we saw how Gordon, Donna’s husband, was trying to show his love and affections through small acts like lovingly stroking her hair, saying soft words of encouragement and gazing on her as she tries to speak through her eyes. It was intimate; it felt almost like the viewers are intruding into something as important and private as this.
We see further on how Dr. Bhargava explains the situation to the family as to whether it would be for the best to take out the tube and let her pass naturally or to do the tracheostomy and keep her attached to a machine to help her breathe.
A million thoughts and emotions flickered on Gordon’s eyes with this information, to suddenly be put in charge on whether somebody would live or die? The overbearing weight of somebody’s life in the palm of your hand, the weight, the responsibility, the guilt… it’s all too much.
“Is it to just kinda… just to keep her in a limbo? Is… that… is that pretty much it?”
“You’re right, it’s a form of limbo.”
Time passes by and we see how Donna is not getting any better. Decisions have to be made soon but nobody is really ready for such things.
No matter how much we would like to delay it, we would still have to face reality soon. Decisions have to be made and for Donna, it seems that letting her pass naturally is the right way to go. We saw Gordon confirming the decision and the relief on Gordon’s face was enough to know that no matter what he would stand by on whatever decision Donna makes.
Vignettes of the other patients that are handled by the team are shown in the screen. We saw the day in a life of a physician in an ICU, having to deal with the difficult decisions of being in charge of people’s lives. Being in a position to where you have to make the decision for the patients themselves. It’s a tough environment to be in, but somebody has to do it.
The second patient, Selena, stopped breathing in the car and spent 16-26 minutes without oxygen before being put into a ventilator. We see Dr. Zitter trying to get some sort of response from Selena to no avail. But we see Selena’s daughter Tama, bright eyed and strong, being resolute on her opinions and would not take no for an answer.
To some extent, her will represent how people would normally react in this situation, we hold tight into things we don’t want to end. Letting go is a very difficult process but it is a necessary step to reach acceptance. We see how Tama and her uncles try to get a response from Selena, hoping from a sign, a squeeze, anything at all to make sure that they are making the right choice.
Contrary to what we always see in the movies, death seeps into our lives in a quiet, unbecoming way. We avoid thinking about it because nobody is really ready for something as absolute as death. Extremis showed us the raw emotions on what it looks like to be working side by side with death. Death is terrifying and absolute and a part of our life. It’s what makes us human and that’s okay.
Watch "Extremis", the 24-minutes documentary about end-of-life-care on Netflix.