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Film Review

The Waiting Room

How can it be that the United States, the richest nation on the planet, is the only major developed country without universal healthcare coverage? Nearly every other first world country has long had universal healthcare, including countries that are far poorer than ours: Italy, Spain, and Greece, to name a few. Of course every Northern European country, plus Great Britain, Canada, Australia, and New Zealand have universal coverage that is praised by everyone that I have ever spoken to in or from those countries. Some are irritated that elective procedures may take months on a waiting list, but all are very clear that necessary and/or urgent medical needs are taken care of quickly, without worrying about coverage or costs. They simply can't imagine what life would be like without their systems of healthcare. The idea that private enterprise, rather than their government, would be the principal source of healthcare insurance seems totally alien to them. Well most of us know what our private system of healthcare is like, especially if you have lost or changed a job, have a serious illness, or even get married. Or they or a child have a pre-existing condition. An astonishing 48 million Americans, including children, about 16% of our population, have no healthcare coverage whatsoever. And many millions more have just the barest of coverage with many exclusions. Most without coverage go to the emergency room for urgent care, when regular healthcare, if available, would likely have prevented many of those visits. Very few of these ER patients can afford to pay more than a fraction of the costs, if any. Studies have repeatedly shown that the second most common cause of personal bankruptcies in this country is due to medical expenses, and confirmed with conversations that I have had with a number of bankruptcy attorneys. Little wonder that the United States is 39th in the ranking of life expectancy. Cuba is 38th. The only appropriate response should be a sense of shame and a determination to do more for the most vulnerable among us.

Nothing could better illustrate the stark reality of our healthcare crisis than "The Waiting Room", a documentary showing a typical day in the emergency room at Highland Hospital, the Alameda County hospital in Oakland, California. Conceived and shot by Peter Nicks, a former producer for PBS documentaries and a former drug addict as a very young man, this is his first full length documentary film. He filmed for one month in 2010, following the staff and the patients. Highland Hospital is the safety net for the poor, the working class, and often those who once had good jobs, but are now out of work. As one doctor says: "We are the last resort for so many people". Nicks opens at the beginning of the day, as the sick and hurting begin to come in. The admitting nurse, Cynthia Johnson, interviews each person, and tries to reassure them that although they will have to wait (no appointments here), they will ultimately be seen. She must triage everyone, and those with truly urgent needs such as the man with a suspected stroke, are seen first. Trauma victims have priority, as when the medics bring in a 15 year old boy who has been shot. The entire team rushes to help resuscitate, with each trying chest compressions, then being replaced when tired. He doesn't make it, and the staff returns to caring for the walking sick. Nicks shows a sea of sad, anxious faces, each with their own often sad story. He follows six patients, including a young man with probable testicular cancer, who walks in after being refused care at another hospital because he couldn't pay. His anxious girlfriend, who just had a miscarriage, comforts him. An older carpet layer, who has very painful bone spurs, describes a career with his company that has kept his wages the same for 30 years, threatening to let him go to cut costs. An out of work father, with his young daughter with a bad strep throat, describes his sense of guilt at being out of work and being unable to take care of his family. An alcoholic, who is very familiar to the staff, gets the same caring attention. His pastor now wants no part of him and will probably not let him return to his supervised housing.

The pace is incredible. People continue to pour into the waiting room while the staff desperately try to find beds for some of the acutely ill. Some are in gurneys in the halls. Most wait patiently for hours, but some not so patiently. Nurse Johnson deals with a large unruly man who has been cursing; she is firm, kind, but insistent that he respect other people. He quiets down. By the end of their shift, the entire staff looks exhausted, much of the waiting room has been cleared, but more pour in for the next shift to deal with. The room is like the seashore, where each wave of people breaks, then subsides, and is never ending. If we are looking for heroes, here they are, tough but compassionate, giving their all every day. This is the front lines of healthcare, a reality that few of the readers of this review will ever experience, God willing.

"The Waiting Room" is classic cinema verite in the tradition of Frederick Wiseman. There is no narration, only the interactions of patients and staff with voiceovers. Nicks uses very little music and no talking heads. The camera watches and listens, sometimes at floor level, sometimes seated, and sometimes roaming the halls. Often we want to know what happened to each patient. Did the diabetic older woman who can barely walk get on the bus and go home? Did the young man ever get his operation? Where did the alcoholic patient go? Nick's film is apolitical, but his sympathies are clearly with these patients, doctors, and nurses. His images will haunt you, as well they should. Its brief 82 minutes are packed with power and humanity. There are few films that should be required viewing for all Americans, but "The Waiting Room" is one of those films. Just opened at the Kabuki and the Grand Lake (Oakland).

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