Interview: Rob Epstein and Jeffrey Friedman Highlight the Care of Hospice Workers in End Game

Rob Epstein and Jeffrey Friedman dive deep into the end of life issues in their Oscar-nominated End Game.  In this moving short documentary, Epstein and Friedman follow hospice and palliative care workers, highlighting their tireless work as patients near the end of their lives.

I caught up with both to talk about their moving and powerful work on the documentary now streaming on Netflix.

End Game

Rob/ Jeff

What made you want to tell this story?

Rob: We tackled this subject head on before, but then it was in the midst of the AIDS crisis and that was the focus of the film we did then. We became interested in exploring themes around end of life as it relates to every day and what we face every day.

We discovered this group of people whose job it is to alleviate suffering and not just by telling patients what to do or how to treat them, but by asking them and helping them to figure out what really matters. We were intrigued. We got access to the team at palliative care and this team at this hospice which we regarded as two model institutions that were dealing with this issue in a very innovative way. What we witnessed first hand was so inspiring and that’s when we committed to doing a film.

Within the context of terminal illness, we saw the opportunity to raise issues that involve emotional, psychological, and sociological issues at end of life and what we hoped would be something we could really explore in this microcosm.

When you’re going into these rooms was it easy to get people to be open?

Jeff: The people we approached were people who wanted to share their stories. They were very happy with the care that they were getting. I think they wanted the work that the hospice and palliative care teams were doing to be celebrated and broadcast.

I think when you find subjects for documentaries who want their stories to be told and who are willing to let you in, it’s a privilege and an honor and there’s a trust that you want to honor.

Rob: We also worked with a small team. There was a team of three and only two of us would be in the room with a patient at any one time. We came in as part of the palliative care team. We’d be in there with them.

Jeff: The medical professionals talked to the patients about participating before we entered the room. It wasn’t a matter of stalking people and trying to get them to participate. The team would talk to the people and explain what we were doing and they were open to us going in.

You have something like Meetra’s story. What does that do to you as a filmmaker to see that and be a part of her journey, as such?

Rob: That is our job as filmmakers to observe, be responsive, and to be attentive to what’s going on in the moment. That’s the joy of it all as well as the human challenges.

The actuality of filming this was that at times it was devastating and heartbreaking and the flipside was that there was something so beautiful and profound that we were witnessing.

When you’re there at the end of someone’s life and an 8-year-old is saying goodbye to his mother, it’s an exchange of love in it’s purest and distilled form. That’s the beauty. The flipside is the obvious. What we came to really feel is that at the end of life, in the best of circumstances, what we hope it all comes down to is love.

What was the editing process?

Jeff: We didn’t have many stories that we didn’t use. This is the closest of any of our films that is a pure observational film. We were just capturing what arose as it arose. We had a very limited amount of time that we spent in these institutions. We spent around 2 or 3 weeks in them. The editing challenge was finding a coherent narrative so all the stories could play out through and condensing it to a short running time and that made us make hard choices which I think made the film better.

What is it like to hear from hospice workers who give you the feedback and then to receive recognition?

Jeff: It’s been great to feel like we were able to capture moments that resonate with people. The subject is one of the last taboos and it’s something that people don’t really want to face. If we’re able to frame it in a way that makes it more accessible and the ideal outcome would be that people would start an outcome about what it means to make choices about how you’re going to live as the end approaches and to keep control of our own life story. Most of us put it aside and don’t want to look at it. It doesn’t serve us well. It’s heartening to think that we could be part of a conversation.