A medical review of the documentary End Game
End Game is a 2018 Netflix Original documentary and an Academy Award-nominated short film about palliative care. At the University of California, San Francisco (UCSF) Medical Center, physician-led teams guide five hospice patients and their families through the end-of-life process. We watch these patients and their families struggle in real-time. As an internist with first-hand experience, I can attest that these are realistic, intimate moments, universal to all.
“Hospice means death … Do not talk about it with her.” – Vaji (Mitra’s mother)
The discussion of Mitra’s failing cancer treatment leads to recommendations of palliative care, and the family resists. Once the team determines that it is time to initiate the conversation, a heated exchange ensues.
“Still, we have (a) chance to fight, and I think we should fight.” – Hamid (Mitra’s husband)
The palliative team answers questions and allows the patients and families time to come to a consensus. As Mitra’s lucidity declines and her suffering worsens, the family is forced to confront questions no one ever wants to hear: How does she want to die (full code vs. natural death)? Where does she want to die (hospital vs. home)?
“The scary part is the unknown. And the lack of control.” – Thekla (hospice patient)
End Game is challenging, even grueling, but imperative. The more one is familiar with the process, the easier it is to cope when you are in this situation, whether as a patient or a family member.
My only criticism of the documentary is that these were all best-case scenarios. There is not one misspoken word or action. The doctors, nurses, chaplains, and social workers who make up the palliative teams express a dizzying level of empathy and skill. If I’m ever in this situation, I want all of them.
“I still believe in miracles … I don’t want to let her go.” – Hamid (Mitra’s husband)
He doesn’t want to, but ultimately, he has to; the inevitability of death demands it. What follows is a quiet but visceral moment: Mitra’s husband and 8-year-old son take turns kissing her hand while the boy slowly rubs his mother’s shaved head. We all have our demons, and mine was that I was that boy, over four decades ago and on the other side of the continent.
“There is nothing inherently medical about dying … It’s purely human.” – Dr. B.J. Miller (palliative care physician)
This documentary has no voice over. No one explains or describes anything. It just unfolds in front of you. I think this was a wise decision, and the result is a powerful documentary.
All five patients die. This is not a spoiler; it is the eventuality of hospice. After post-death discussions and funerals, the documentary ends, leaving you to grapple with your thoughts and emotions.
Conclusion
I vigorously recommend this documentary. While only 40 minutes long, End Game will stay with you for so much longer.
Visit the End Game website for more information and resources. Directed by Academy Award-winning filmmakers Rob Epstein and Jeffrey Friedman. Film by executive producer Dr. Shoshana Ungerleider, a hospice and palliative care physician.
End Game is available for streaming on Netflix.
About the Author
David Z Hirsch, MD is the pen name of the author of the award-winning novels Didn’t Get Frazzled and Jake, Lucid Dreamer, both available for purchase on Amazon or may be read for free with Kindle Unlimited. Didn’t Get Frazzled is also available on Audible.
He is an internal medicine physician with an active practice in Maryland.
Check out my other reviews:
A medical review of the documentary Cowspiracy
A medical review of the documentary Fed Up
A medical review of the documentary Feel Rich
A medical review of the documentary Forks Over Knives
A medical review of the documentary Heal
A medical review of the documentary In Defense of Food
A medical review of the documentary The C Word
A medical review of the documentary The Magic Pill
A medical review of the documentary Sugar Coated
A medical review of the documentary Super Size Me
A medical review of the documentary What the Heath
A Medical Review of the documentary Why Are We Getting So Fat?
And the video 5 Netflix Health Documentaries Worth Streaming
