Film Review on Sparrowpost.net
Reviewed by Carla Blackmar
David Rosenthal’s new short film “Witnessing Death”
is a powerful, inquisitive film essay about the death of the filmmaker’s
Grandfather, Kurt Rosenthal from Alzheimer's. In contrast to our habitual,
perhaps even socially mandated tendency to sweep the details of death
under the rug until we must personally confront them in silence, “Witnessing
Death” addresses them with a lucid honesty that does justice not
only to the difficulty of dying, but also to the way the process defines
us as family, community and culture.
The film begins with footage of Rosenthal’s Grandfather about
four years after he has been diagnosed with the disease, at a time when
his more youthful personality is still visible in his quips and interactions
with Rosenthal and his camera. Over the course of the film, we see his
grandfather diminish, thinning physically and withdrawing cognitively
as he grows closer to death. The film centers on the way the progression
of Alzheimer’s confounds the social conventions associated with
“the good death.” How does one say goodbye during such a
prolonged period of departure?
In order to answer this question, Rosenthal seeks out different perspectives
on the role the living play in the life of the dying. Rosenthal has
a gift for conducting and filming interviews, and his discussions with
doctors, nurses and chaplains are woven into his personal narrative,
re-shaping his understanding as his grandfather moves towards death.
Some of the most remarkable interviews are those Rosenthal conducts
with CNAs (Certified Nurses Assistants) who attend to the most basic
needs of the dying in nursing home facilities. Following close on the
heels of a comment from a psychotherapist about the way our culture
doesn’t value “caring for the body of the dying,”
the CNAs frankly describe what it is like to do just that on a daily
basis. While the CNAs are open about the difficulty of their work, they
nonetheless assert that there is an element of closeness and sanctity
in serving those who can no longer serve themselves. It is surprising
to hear CNAs suggest that there is something tanscendent about work
so many of us imagine to be repugnant and dismal. It is remarkable to
hear that there can be something redemptive about dying: a process so
many of us would like to ignore, or even to euthanize our way out of.
The startling interviews with the CNAs mark a turning point in the film.
In contrast to our familiar way of talking about disease and dying in
martial terms “battle with cancer” or “struggle against
Alzheimers,” the interviewees suggest a different approach, not
fighting or curing, but instead “witnessing” death; to mark
someone’s departure from the world with the same attentions merited
by someone’s entry as an infant.
In the case of Kurt Rosenthal’s passing, this “witnessing”
is accomplished quite beautifully in his Grandson’s film. As sad
as it is to watch Alzheimer’s steady progression, the care Rosenthal
has taken in telling the story of his Grandfather’s end is a testament
to the life he led prior to the stage chronicled in the film.
Though we are told almost nothing of Kurt Rosenthal’s life from
the film; (there are no old black and white pictures, grainy 8mm footage,
or nostalgic reminiscing), we can’t help but feel as though we
know him through the process of watching his son and grandson witness
his death. The love evident in these last attentions tells us volumes
about the man Kurt Rosenthal was in life.
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Interview
with Sparrowpost.net
Sparrowpost:
One of the things I find most interesting about your movie is the
way we learn some important things about your Grandfather, but you
don’t tell us these things directly. For example, you tell us
he was an avid photographer, but we don’t see any pictures of
him as a young man. Did you intentionally exclude these pictures?
Dave Rosenthal: Good question. The decision to include and exclude
information about my grandfather was made intentionally and perhaps
slightly unintentionally. As much as I wanted to include personal
information about my grandfather, I decided to limit some of the footage
because the piece was focused on the end of his life and his care
at the nursing home. In a way, the piece uses the personal story of
my grandfather as a means to explore care at the end of life and the
meaning of death. I think that many of the important points can be
inferred from the way the story of the end of his life was told.
SP: Just out of curiosity, though, what did he think of your video
habit? Did you catch the photography disease from him?
DR: I think that by the time I had begun seriously filming, he was
already somewhat demented so it was difficult for me to understand
what he comprehended. In a way, you could say that I started filming
precisely because I recognized that he was losing something, that
every time I would film him, he would understand less and less, and
to me that necessitated capturing each encounter in some way. A video
camera was my medium, but it could just have easily been a diary,
a film camera, or a tape recorder.
As for the photography disease... I would like to think that I caught
it from him. It seems reassuring that there is a cycle of photography
in my family.
SP: At what point did you formalize the idea of editing the footage
into a film?
DR: Well, I guess that as I was filming initially, there was a compulsion
to capture each moment because it inherently seemed important. I didn't
know what, if anything, I would do with the footage. As a student
in Alfred Guzzetti's Experimental Video class at Harvard, I started
screening some of the interview footage cut together and realized
the power of the story and the images. I think after that point, a
few late night discussions with Andy Rice in Bar Harbor pointed me
in this line of thinking. A few years, two cities, a wife, and med
school later, I finally completed it.
SP: Do you have footage from a time earlier than the first footage
you show in the film?
DR: I know that I have footage of him at earlier times, in fact there
is quite a bit of footage of him from home movies, but I chose not
to use it a couple reasons. Firstly, I did not shoot the other footage
and didn't know how I felt about using that footage. Secondly, again,
I was making the film as part of the Summer Program in Geriatrics
at the Buehler Center on Aging, and part of the focus was trying to
expand this personal story to have more universal themes about end-of-life
care. The personal story, albeit necessary for the film to function,
was a delivery device for the voices of experts and caregivers.
SP: At what point in the process did you decide to interview the CNAs?
How did the things they had to say influence your experience of the
dying process?
DR: When I began discussing this project with my advisors at the Buehler
Center, it became clear that one of the most powerful parts of visiting
my grandfather was the care by the CNAs. When the CNA told me that
it was a "blessing" to care my grandfather, it was profoundly
moving. I felt that I needed to talk to other CNAs to try and extract
what it was that was so compelling. Ultimately, the CNAs taught me
a great deal about the dying process, and I was honored to be able
to interview them. Perhaps the nicest part of making this video was
that at a screening for the Nursing Home in Skokie, IL, after the
film ended, an impromptu standing applause was given to the CNAs in
the room.
They felt that I accurately depicted their stories and sentiments.
SP: Wow. That's so cool.
DR: Yeah no kidding. And supposedly the same thing happened when it
was screened for the executive board of the nursing home.
SP: Is there an existent body of work about CNAs already out there?
Would you consider making a second film more pointedly about them?
DR: As far as I know, there isn't much work on formal caregivers (i.e.
CNAs from institutions); however, there is a great deal of work done
on informal caregivers such as family members. I've watched a lot
of films dealing with the family care giving experience. You can check
out www.terranova.org and Fanlight Productions.
SP: At one point, I read “How We Die” by Dr. Sherman B.
Nuland. In that book I believe he suggests that our society has overly
sanitized the dying process... and that our culture suffers because
of the cloak of mystery we have built around it. Is this something
that you discuss in Medical school? Do you think that our tendency
to hide the facts of death in the back closet has something to do
with the problems our health care system faces in general?
DR: That is almost exactly one of the questions that I asked some
of the ethicists!
It is true that nursing homes are a place separated from the rest
of society where many people die at the end of their lives. Interestingly,
the vast majority of people never move into a nursing home and stay
at home with the care of a relative. That said, I do believe that
our society does have a tendency to sanitize the dying process and
in a way, quarantine those members of society who are old, infirm,
or disabled and keep them out of sight. In medical school, we do address
end of life issues, but not with regard to the social issues surrounding
end of life care. For the most part, physicians work closely with
social workers to address these issues.
SP: I guess along the lines of the last question, One of the most
disturbing articles I have read in recent history was an opinion piece
which I believe was penned by someone involved in the White House
Bioethics committee. His article argued against Doctor assisted suicide
and euthanasia, not on a religious basis per se, but on the basis
that the process of caring for the dying is one of the most humanizing,
and one of the things that defines us as a civilization. While I would
generally count myself as someone who believed physician-assisted
suicide should be an option, I found that this article deeply challenged
my beliefs on the subject. Did the experience of making this film
change your attitude towards these ethical dilemmas?
DR: Interesting question. Physician-assisted suicide is a complicated
issue. I do believe that if people want to die, and can clearly be
deemed of sound mind, that they should be given the right to humanely
end their lives with the aid of physicians and our medications. The
tricky part for me comes when someone with Alzheimer's or dementia
is then put in that same situation. How can we determine what the
wishes of that person should be? Should a loved one be able to decide
at what point his or her father should die? In making the film, I
did realize that life is a very complicated thing to define and qualify.
SP: I'm interested in books like Nuland's and movies like yours. I
know that Fred Weisman made a movie somewhat on this topic called
"near death." or something like that. Are there others you
would recommend?
DR: Yes. “Complaints of a Dutiful Daughter by Deborah Hoffman.”
“Grace” by William Whiteford, “Alzheimer's: My Mom,
Our Journey” by Julie Meisner Eagle. And a few by Jim Vanden
Bosch.
SP: So what’s next for you, Mr. Rosenthal?
DR: What's next for me? Step 1:Passing the USMLE (United States Medical
Licensing Exam) in June and Step 2: trying to implement a plan to
put video cameras in every hospital room around the country.
SP: Whoa! Videocameras?
DR: It's an idea I have for better analysis of doctor-patient interactions
and reducing malpractice costs.
SP: Pretty crazy stuff.
DR: Yes, it would be crazy! Gotta think outside the box!
SP: Maybe we'll hear about that one in some future Sparrowpost episode!
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