''End Game'' is a 2018 American short documentary film by
Rob Epstein and
Jeffrey Friedman about
terminally ill
Terminal illness or end-stage disease is a disease that cannot be cured or adequately treated and is expected to result in the death of the patient. This term is more commonly used for progressive diseases such as cancer, dementia or advanced he ...
patients in a San Francisco hospital meeting medical practitioners seeking to change the perception around life and death. The film was executive produced by
Steven Ungerleider and
Shoshana R. Ungerleider. It was released by
Netflix
Netflix, Inc. is an American subscription video on-demand over-the-top streaming service and production company based in Los Gatos, California. Founded in 1997 by Reed Hastings and Marc Randolph in Scotts Valley, California, it offers a ...
.
Synopsis
The documentary begins with Dr. Pantilat, the palliative care doctor at the
University of California, San Francisco
The University of California, San Francisco (UCSF) is a public land-grant research university in San Francisco, California. It is part of the University of California system and is dedicated entirely to health science and life science. It co ...
, visiting terminally ill patients to speak with them about palliative care. The first patient he speaks about this with is Kym Anderson and her husband. Dr. Pantilat begins to describe palliative care as helping people live as well as possible for as long as possible; a care that focuses on not only the disease but the whole person, where there are people to help the patient with their symptoms, ensure the patient has the information they need to make complex decisions about their health, and have an extra layer of support for themselves and their family. Despite Dr. Pantilat’s attempt to bring light to palliative care, Kym and her husband do not side with palliative care as an option for Kym’s remaining time. The label the couple has associated with palliative care is “kissing it goodbye.”
The documentary then proceeds to the
Zen Caregiving Project, where there has been the acquisition of a new patient named Bruce. Bruce is 66 years old and has made the choice to stop
dialysis Dialysis may refer to:
*Dialysis (chemistry), a process of separating molecules in solution
**Electrodialysis, used to transport salt ions from one solution to another through an ion-exchange membrane under the influence of an applied electric pote ...
. Dr. BJ Miller, a palliative care physician, and his colleagues welcome Bruce into the home.
Within the Zen Caregiving Project is another patient named Pat Harris. Pat has been diagnosed with
fibroids and
uterus cancer
Uterine cancer, also known as womb cancer, includes two types of cancer that develop from the tissues of the uterus. Endometrial cancer forms from the lining of the uterus, and uterine sarcoma forms from the muscles or support tissue of the uter ...
. Despite the circumstances, Pat mentions she is doing well, as she has people in the Zen Caregiving Project who help her watch the symptoms she experiences and understand what is right or wrong with it, people that give her medicine and monitor it, so she does not have to do it alone. Pat then goes onto describe a possible treatment to prolong her life in chemotherapy. To assist Pat with her decision, registered nurses from the palliative care team help Pat weigh out her options. Ultimately, Pat decides to accept the chemotherapy treatment in an attempt to prolong her life.
Dr. Pantilat and his colleagues then meet with Mitra, a 45-year-old woman battling cancer, and her family. Dr. Pantilat and his team ask Mitra’s family whether or not they would prefer to provide treatment for Mitra or keep her at home and provide care from there. The decision of prolonging Mitra’s life is split between her mother, Vija, and her husband, Hamid. Dr. Pantilat and his team continue to talk through the situation with Mitra’s family to help answer their questions and ultimately choose what they feel is right. As part of the information being provided by Dr. Pantilat and his team, Dr. Bivona proposes the idea that Mitra becomes part of a research program where doctors try to understand what happened to the cancer via
autopsy
An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any dis ...
.
As the documentary progresses, Dr. Pantilat had his role as the palliative care doctor taken over by Giovanni Elia. Dr. Elia meets with Mitra and her family, where Mitra admits she is no longer doing well. Dr. Elia and his supporting cast then begin to speak with Mitra’s family about Mitra’s state; the doctors admit that Mitra is looking better from a short-term perspective, but she has a limited time to live. Dr. Elia asks Mitra’s family where she would like to be during these final moments of her life, where he mentions that inpatient hospice is a choice for Mitra. Mitra’s mother disagrees with the idea of inpatient hospice, as she would like to be with Mitra until her last breath; however, Mitra’s family is torn with the decision. As Mitra’s condition worsens, Azita, Mitra’s sister, explains to her mother that caring for Mitra at home would not serve as a just option for Mitra nor for Vaji.
Dr. Miller eventually meets with Thekla, who is experiencing shortness of breath, at the University of California, San Francisco, Symptom Management Service. Dr Miller does not necessarily dive into what Thekla’s shortness of breath may lead to, but rather he encourages Thekla to form a relationship with death, so that death is known and not as frightening. Dr. Miller attempts to change Thekla’s perspective on death, as he mentions that one cannot know what it is exactly like to be dead, so all that can be done is getting acclimated with the mystery that is called death.
As the documentary comes to a close, Dr. Miller explains that there is nothing medical about death, but it is something that is purely human and a time to celebrate and rejoice the deceased's life.
Cast
* Mitra: A 45 year old woman battling a devastating cancer.
* BJ Miller: A disabled speaker and physician practicing palliative care.
* Pat: A patient suffering from fibroids and uterus cancer.
* Kym: A patient suffering from an undisclosed disease.
* Thekla: A patient experiencing disease with shortness of breath as a symptom.
* Bruce: A patient who has discontinued his use of dialysis.
* Dr. Pantilat: The doctor on the palliative care team at the
University of California, San Francisco
The University of California, San Francisco (UCSF) is a public land-grant research university in San Francisco, California. It is part of the University of California system and is dedicated entirely to health science and life science. It co ...
.
* Hamid: Mitra's husband.
* Vaji: Mitra's mom.
* Trever Bivona: Another doctor a part of the palliative care team.
* Giovanni Elia: The palliative care doctor taking over the role of Dr. Pantilat.
* Azita: Mitra's sister.
Reception
Critical response
On
Rotten Tomatoes
Rotten Tomatoes is an American review-aggregation website for film and television. The company was launched in August 1998 by three undergraduate students at the University of California, Berkeley: Senh Duong, Patrick Y. Lee, and Stephen Wan ...
, the film has an approval rating of based on reviews from critics, with an average rating of .
Peter Debruge of
Variety wrote: "Miller's insights have been so useful as to have been featured by Oprah Winfrey, and one needn't be hospitalized or faced with losing relatives to benefit from his unique perspective."
Accolades
''End Game'' was nominated for the
Academy Award for Best Documentary (Short Subject)
This is a list of films by year that have received an Academy Award together with the other nominations for best documentary short film. Following the Academy's practice, the year listed for each film is the year of release: the awards are annou ...
at the
91st Academy Awards
The 91st Academy Awards ceremony, presented by the Academy of Motion Picture Arts and Sciences (AMPAS), honored the best films of 2018 and took place on February 24, 2019, at the Dolby Theatre in Hollywood, Los Angeles. During the ceremony, AM ...
. It was also nominated for the Short Film Grand Jury Prize at the
Sundance Film Festival
The Sundance Film Festival (formerly Utah/US Film Festival, then US Film and Video Festival) is an annual film festival organized by the Sundance Institute. It is the largest independent film festival in the United States, with more than 46,6 ...
.
Sundance Institute
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References
External links
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Zen Caregiving Project
{{Rob Epstein
Netflix original documentary films
2018 short films
Films about death
Films directed by Rob Epstein
Films directed by Jeffrey Friedman
Films set in San Francisco
American documentary films
Documentary films about health care
Healthcare in San Francisco
2010s English-language films
2010s American films