Extremis, a Netflix documentary directed by
Dan Krauss, follows Dr. Jessica Zitter a palliative care ICU physician at
Highland Hospital in Oakland, California. The documentary begins with an exasperated
Dr. Zitter trying to communicate with a patient on a ventilator: “Is this about
the breathing tube? You want it out?” she asks. When the patient nods in
affirmation, Dr. Zitter replies, “What if you die if I take it out?” The
questions confronting the physicians, patients and their loved ones get no
easier over the course of the film. The
documentary is propelled by a dramatic tension between its protagonists: on one
side Dr. Zitter, who is compassionate but dogmatically pragmatic, on the other
side the family members of patients who are driven above all by hope and faith.
This tension manifests itself in palpable ways. In one particularly powerful
scene, a patient’s daughter says to Dr. Zitter: “it would feel like murder to
pull that life support. That’s what it would feel like to me…I feel like maybe
as a doctor, you know, being as smart, and being as knowledgeable, and being
inside medical journals, it can dwindle your optimism a little bit.” Dr. Zitter
replies simply, “I’m just trying to help you make a decision that’s right for
your Mom.”
Of course,
for Dr. Zitter there does appear to be a categorically appropriate decisionin all of these cases. In most of her conversations, she is transparently trying to get
family members to see that there is no realistic chance of meaningful recovery for
their loved ones. That is not to say that she is insensitive to the family’s
wishes or the complex bioethical conundrums which arise around her. In fact,
her bravery and deftness in broaching these serious and difficult topics is on
full display throughout the film.