Consider the Conversation 2: Stories about Cure, Relief, and Comfort
An Emmy Nominated Film by Michael Bernhagen and Terry Kaldhusdal
American medicine's success at fighting disease and extending life has created a new problem. That is, the vast majority of patients can now expect to die in a place (a hospital or nursing home) and in a way (with increased quantity, but reduced quality, of life) that most wouldn't choose if only asked. Talking about dying, which is as natural as birth, is now taboo. And, the reality is patients and families are suffering needlessly. It is a problem we never intended to create and one that must be solved, but how?
Twenty-one months in the making and entirely funded by private donations including the producers' labor, Consider the Conversation 2: Stories about Cure, Relief, and Comfort explores the effect of American medicine's success on the patient/doctor relationship and sheds light on the important role communication plays in helping both patient and doctor navigate the murky waters of severe chronic disease.
While in production, Michael Bernhagen and Terry Kaldhusdal interviewed physician experts from across the United States including Brigham and Women's Hospital in Boston; Coeur d'Alene, Idaho; Duke University Medical Center; the Fred Hutchinson Cancer Research Center in Seattle; Gundersen Health System in La Crosse, Wisconsin; Mt. Sinai School of Medicine in New York City; Providence Saint Joseph Medical Center in Burbank, California; the University of Arizona in Tucson; the University of Wisconsin in Madison; Wheaton Franciscan Healthcare in Milwaukee; Yale University School of Medicine; and Zumbrota, Minnesota.
In addition, the producers visited with residents of a Chicago nursing home and were embedded with palliative care teams at Duke University Medical Center and the University of Wisconsin Hospital and Clinics where they interviewed seriously ill patients from a variety of backgrounds and filmed actual patient/doctor conversations as they occurred in real time.
The documentary begins with Amanda Redig, M.D., a young internal medicine resident from Boston, sharing the beautiful story of her personal calling to medicine and ends with Robert Fulghum, author of All I Really Need to Know I Learned in Kindergarten, answering a question about what needs to change in order to move from "what is" to "what could be".
In between, the viewer bears witness to some of the most powerful perspectives ever captured on film about the universal human hope for cure, need for relief, and wish for comfort.
- Anthony Back, MD - Medical Oncologist, Fred Hutchinson Cancer Research Center, co-author of Mastering Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope, and facilitator of VitalTalk, a program that teaches doctors how to talk with patients about serious illness and end-of-life care.
- Joseph Bujak, MD - Author of Inside the Physician Mind: Finding Common Ground with Doctors.
- Toby Campbell, MD - Chief, Palliative Care, University of Wisconsin Hospital and Clinics, and facilitator of WeTALK, an interactive specialty-specific simulation that teaches effective ways of communicating with patients about serious illness.
- Kerry Case, MD - Hospice and Palliative Medicine, Wheaton Franciscan Healthcare.
- James Cleary, MD - Medical Oncology and Palliative Medicine, University of Wisconsin Hospital and Clinics.
- Anthony Galanos, MD* - Medical Director, Inpatient Palliative Care, Duke University Medical Center.
- Allan Hamilton, MD - Professor of Neurosurgery, University of Arizona College of Medicine, and author of The Scalpel and the Soul: Encounters with Surgery, the Supernatural, and the Healing Power of Hope.
- Arif Kamal, MD - Medical Oncology and Palliative Medicine, Duke University Medical Center.
- Kyla Lee, MD* - Internal Medicine and Palliative Medicine, Gundersen Health System, La Crosse, Wisconsin, and contributing author to Having Your Own Say: Getting the Right Care When It Matters Most.
- Diane Meier, MD - Director, Center to Advance Palliative Care, Mt. Sinai School of Medicine, New York City.
- Ken Murray, MD* - Family Practitioner and author of How Doctors Die: It's Not Like the Rest of Us, But It Should Be.
- Sherwin Nuland, MD - Professor of Surgery, Yale University School of Medicine, and author of How We Die: Reflections on Life's Final Chapter.
- Richard Payne, MD - Professor of Medicine and Divinity, Duke Divinity School.
- Amanda Redig, MD - Internal Medicine Resident, Brigham and Women's Hospital, and contributing author to At the End of Life: True Stories About How We Die.
- James Tulsky, MD - Chief, Duke Palliative Care, and co-author of Mastering Communication with Seriously Ill Patients: Balancing Honesty with Empathy and Hope, and facilitator of VitalTalk, a program that teaches doctors how to talk with patients about serious illness and end-of-life care.
- Therese Zink, MD* - Family Practitioner and author of The Country Doctor Revisited: A Twenty-First Century Reader.
* - indicates an appearance in the Director's Cut only.
Among the seriously ill patients featured in the film are Chuck Herro, George Poirier, Laura Schurman and Greg Singer from Wisconsin; Al Lewis and Dwight Whitley from North Carolina; and Paula Gerber, Deborah Glaser, Iris Khalid and Kenneth Kling from Chicago.
The goals for Consider the Conversation 2: Stories about Cure, Relief, and Comfort are simple: 1) demonstrate that communication is a skill on par with diagnosis, treatment, and prognosis - something that medical professionals can teach, learn, and use for therapeutic benefit, 2) help patients, families and doctors understand that talking about end-of-life wishes well in advance can help prevent unnecessary suffering at end-of-life, and 3) lend additional momentum to culture change movements seeking to inspire end-of-life care that is more person-centered and less system-centered.
Two versions of the film have been created: 1) a PBS cut (56:46) for television broadcast, and 2) a Director's cut (86:00) for DVD release. Important steps in the documentary's release trajectory include:
- The PBS cut premiered on Wisconsin Public Television on 5/27/14 and was released to public television stations nationwide via the National Educational Telecommunications Association (NETA) on 9/26/14. Beginning that date, PBS stations can show the film as many times as they want, whenever they want, until 12/31/16.
- The Director's cut was released on DVD via Amazon.com for personal use (private viewing in the home) on 10/20/14 and for educational use (public screenings in front of non-paying audiences) on 10/30/14.
- In addition, the theatrical premiere of the Director's cut of Consider the Conversation 2: Stories about Cure, Relief, and Comfort took place on Saturday, October 4, 2014 at 7 p.m. at the Oconomowoc Arts Center in Oconomowoc, Wisconsin.
Impact and Reach
To date, the PBS cut of Consider the Conversation 2: Stories about Cure, Relief, and Comfort has aired 1,588 times on 268 public television stations in 41 states (reaching 80.1% of the nation), received an Emmy nomination from the Chicago/Midwest Chapter of the National Academy of Television Arts and Sciences (NATAS), and won eleven awards including two Bronze Tellys and the 2014 Global Film Awards Humanitarian Award.