临终

''Yourlungsareaboutasbadastheycanget,''thenurseexplainstothe83-year-oldman.''Yourlungsaren'tgoingtogetbetter,andsotheactofputtingyouonthemachineisalmostafutileeffort.''Inalongconversation,thenurseletsthispatientknowwhathisoptionsareandtriestodeterminehiswishes,askindlyaspossiblebutwiththesuggestionthatshehasdonethismanytimesbefore.''Iwanttohelpyou,butIonlywanttohelpyouinthemannerinwhichyouwanttobehelped,''shesays.''Idon'twanttokeepyoualiveunlessyoulikeliving.''<br/>　　Ahalf-dozenyoungmedicalprofessionalsgatheraroundthebedofanoldwoman,astrokevictimwhocannotspeakandcancommunicateonlybymeansofthefaintestmovements.Theywanttodiscussthepossibilityofremovingherbreathingtubeandthemachinetowhichitisconnected.Doessheunderstandwhattheconsequencesofthismaybe?Isshepreparedfortheworst?Issheworriedaboutthewayherdeathmayaffectherdevotedhusband?Thewomanattemptstoanswerthisbarrageofdifficultquestionsbyweaklysignalingyesorno,butsheissoonexhausted.Sheindicatesthatshewouldliketheconversationtostop.<br/>　　Asemiconsciousmanwhowilldiewithinamatterofdaysisbeinggroomedbyaslightlyimpatientyoungnurse.Helooksmomentarilystartledassheadjustshisheadsothathecanbeshaved.Itlooksasifmovingthetubesattachedtohisfaceisslightlypainful.It'shardtotell.Themangivesthenurseonemorestartledlookassheperfunctorilyrunsacombthroughhishair.<br/>　　Inaroomfilledwithmedicalmachinery,thelineonamonitorgoesflat.Anursestandsby,stillholdingthepatient'shand.Adoctortouchesthepatientefficiently,thenchecksforbreathfromheropenmouth.''Okay,she'sdead,''hesays.''7:53.''<br/>　　Thesearetheunforgettablysoberingsightsandsoundsof''NearDeath,''FrederickWiseman'sgreat,fearlessandmonumentalsix-hourdocumentarychroniclingtheworkingsofthemedicalintensivecareunitatBoston'sBethIsraelHospital.Theyarethesortsofimagesthatbecomegrimlycommonplaceduringthecourseofafilmthatislessaviewingexperiencethanatotalimmersion.Itisn'ttherunningtimethatmakes''NearDeath''sooverwhelming;it'sthesubjectitself.Butatthislength,thefilmhastimetocarryitsaudiencefromaninitiallyrawemotionalresponsetoacalmerconsiderationofthedifficultissuesraisedhere,andfinallyontosomesortofresolution.<br/>　　ItisMr.Wiseman'smethodtomakehimselfanextremelyattentiveflyonthewall,observinglongexchangesbetweendoctorsandpatients,doctorsandfamilymembers,andamongthevariousmembersoftheunit'smedicalstaff.Thisparticularintensivecareunitisnotaplaceforemergencysurgeryorfortreatingsuddenillnesses;it'saplaceofferingmedicallysophisticatedtreatmenttopeoplewhosefinaldaysmarkthelaststageofslow,agonizingdecline.Everyonethecameraobserveshasspenttimewatchinglifeerodeandhashadextensiveexperiencewithdebilitatingpain.<br/>　　Oneofthedoctorshasasisterwhopracticesmedicineatanotherhospital.''Shedoesn'tsay'Whatdoyouthink?'-shesays'You'refather'sdying,'''hetellsacolleague.Butatthisparticularward,greatcareistakentotalkmorehumanelyandlessabrubtlyaboutwhattheterminallyillpatient'sprospectsreallyare,andtotrytoinvolvepatientsandfamilymembersinmakinglife-or-deathdecisions.Thisisevenharderthanitsounds.Patientswhothoughttheywouldneverwantheroicmeasurescansometimesfeeldifferentlywhentheirworstfearsbecomereality;relativeswhowanteverythingpossibledonefortheirlovedonesreachapointwheretheymayfeelthedyingpatienthasbeenthroughenough.<br/>　　Thedoctorshavetheirownperspective.Experiencehasinevitablytouchedsomeofthemwithcynicism,howeverhardtheyfightagainsttheirownpessimism.''Ireallybelievethatfromthemomentthatdiagnosiswasmade-likein'TreasureIsland,'whenthatoldcaptaingothandedablackspot?Shegothandedablackspot,''adoctortellsacolleagueaboutonepatient.''It'snotclearwehaveanythingtooffer,''thissamedoctorsubsequentlyacknowledges.''Butinthisdayandage,we'reextremelyreluctanttosay'Wecan'tdoanythingforthat.'''Thedoctorsarealwaysfirsttorecognizehopelesssituations,andtheyfindthemselvesgentlytryingtosteerpatientstowardtherecognitionthathigh-techlife-prolongingeffortsmaybefutileandself-defeating.Phraseslike''Weneverknowthefutureforsure,but....''and''aborderlinesituationbetweensurvivingandnotsurviving''havebecomedelicatestaplesoftheirconversation.<br/>　　Amongthemselves,thedoctorstalkdifferently;theymayuselessgentleeuphemisms,like''justcallitaday.''('''Qualityoflife'isforfurnituresalesmen,''onesays.)Forthemostpart,thedoctorsinthefilmareasyoungandenergeticastheirpatientsareweakandold,andattimesitisdifficultnottoregardascavaliertheveryhardinessthatallowsthemtodothisworkatall.Oneofthethingsthatemergesoversixhoursisanenormousappreciationofthedoctors'staminaandtact.<br/>　　As''NearDeath''focusesattentiononquestionsofjustwherelifeendsandhowitsendingcanbestbehandled,itflinchesatnothing.It'snotforthetimid.Thoughthereisnofullautopsysequencedepictedhere,doctorsareseenstudyingdiseasedorgansinapost-autopsyevaluationsession;anothersectionofthefilmshowsexactlyhownursesremovethedeadfromtheirroomsandtransporttheminconspicuouslytothemorgue.Thenurses'casualnessaboutthisisatleastaschillingastheprocessitself.<br/>　　Andifsqueamishnessisnotspared,neitherispureemotion.Therearescenesofheartbreakingtendernessinwhichlongtimespouses,soontobeleftalone,trytocomfortthepeopletheylove.ThefamilieswhoallowedMr.Wisemantofilmlong,uninterruptedtakeschroniclingsuchprivateandpainfulmomentshavemadeaninvaluablecontribution.<br/>　　''NearDeath''willbeshowntodayat11:30aspartoftheNewYorkFilmFestival.Thosewhoseeitwillfindthemselvesirrevocablyalteredbytheexperience.<br/>　　'WeNeverKnow'<br/>　　NEARDEATH,directed,producedandeditedbyFrederickWiseman;photographybyJohnDavey;productioncompany,ExitFilms;aZipporahFilmsRelease.AtAliceTullyHall,aspartofthe27thNewYorkFilmFestival.Runningtime:350minutes.Thisfilmhasnorating.