Extremis

Extremis, a Netflix Original documentary from 2016, directed by Dan Krauss and featuring health-care professionals – Monica Bhargava, MD, and Jessica Zitter, MD, provides an intimate, urgent exploration of the intersection of life, death, medicine, and what it means to try to extend life at any cost.

Focusing on the complexities and ethical dilemmas of end-of-life care decisions, Extremis takes you inside the Highland Hospital Intensive Care Unit (ICU) in Oakland, California. The six-time Emmy award-winning director, Krauss grants audiences an insider view of the emotional, real-time decision-making process for physicians, patients, and their families. The title of the movie itself, derived from the Latin phrase In extremis, which translates to "at the point of death," aptly underlines the high stakes faced by the people whose stories unfold in this powerful film.

Dr. Jessica Zitter and Dr. Monica Bhargava, the physicians at the core of this documentary, are seen dealing with one of the toughest aspects of their job – guiding critically ill patients and their loved ones through the emotionally fraught, morally complex, decision-making process about the looming end of life, and the question of whether to continue aggressive, life-prolonging measures or to choose comfort-oriented care, letting nature take its course.

These choices deeply animate Extremis, forcing the audience to confront the reality that modern medicine offers us a range of options to prolong life but also forces us to wrestle with a more fundamental question: At what cost and within what quality of life does this extension come?

The film presents a largely unvarnished view of the ICU and the emotionally charged, often fraught conversations that unfold there. The camera gives us poignant moments - from the tears of family members struggling to comprehend that their loved ones may be at their final stages, to the charged meetings with the medical team, to quiet instances of empathy and connection that hush the sterile, busy hum of the hospital.

Dr. Zitter plays a prominent role in the documentary. A strong advocate for the transformation of how the medical community communicates with patients and their relatives regarding the end-of-life decisions, she ensures that patients' voices remain at the center of these discussions. Dr. Bhargava's compassion and more personal bedside manner offer a contrast, showcasing the diverse approaches in the high-threat world of critical care.

We also meet several patients throughout the film, offering not just theoretical insights into end-of-life care but richly humane portraits of people in the final stages of their lives. The film handles these intimate moments with restraint and respect, creating a space for us to reflect on our own mortality and that of our loved ones.

One of Extremis's most commendable aspects is its universality. By stripping away everything to focus on the raw human struggle of survival, it becomes a film that speaks to everyone. We all have or will confront these questions, for ourselves or our loved ones, and Extremis allows us to appreciate the gravity of end-of-life decisions from the safety of our homes, hopefully better preparing us to face them when the time comes.

Extremis is a short documentary, clocking in at approximately 24 minutes, but in its brief runtime, it manages to paint a profound picture. It's not an easy watch, but it is a necessary one, offering important reflections for anyone interested in health care, bioethics, and indeed, the human condition itself.

The film has received acclaim all around, praised for its delicate yet unflinching portrayal of a difficult subject. It went on to become a nominee for the 2017 Academy Award for Best Documentary (Short Subject), competed in the 2016 Tribeca Film Festival, and won in the Best Short category at the International Documentary Association Awards in 2016.

In conclusion, Extremis opens in the stark realm of the ICU but leaves viewers in a space of contemplation, encouraging hard conversations about end-of-life care. By taking a deep dive into the ethically charged waters of health care, Extremis sets a high bar for transparent communication, empathy, and resilience. It is a mesmerizing meditation on life, death, and the complexity of the choices we make – or don't make.