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 decision in 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. 


Extremis is intimate to the point of being almost voyeuristic. It is a gut-wrenching portrayal of the end of life and a dizzying introduction into the complexities of end of life care. Where Extremis  thrives is in its equanimity. A lot is presented both explicitly and implicitly throughout the documentary: bioethical dilemmas; religion and faith in juxtaposition to science and reason; family dynamics; and physician-patient trust just to name a few. Extremis does not attempt to resolve everything, but it does lay bare what’s at issue for patients, physicians and family members. It is exceedingly fair to both “sides”—i.e. the physicians and the family members. But even more importantly—and perhaps a testament to Dr. Zitter’s abilities—the film does a good job of not setting these two groups in opposition to each other. Central to the film is a deeply held feeling that physician, family and patient are together grappling with the same unanswerable question--simply put—what is the right way to die?

Primary Source





f/8 Filmworks

Running Time (in minutes)