20-Minute Health Talk
In this 20-Minute Health Talk, Matthew Heineman reflects on what is was like to document patients fighting for their lives, as well as the frontline heroes responding to the crisis. He is joined by two nurses featured in the film: Kellie Wunsch, RN, a critical care nurse at LIJ; and Brussels Jabon, LPN, who was pregnant with her second child when diagnosed with COVID-19.
Q&A Recorded from NYC Premiere at the Beacon Theater on November 18th
View the recording here.
FILMMAKER Q&A with Director/Producer Matthew Heineman and Producers Jenna Millman and Leslie Norville
Why did you decide to make the film?
Mathew Heineman, Director/Producer: In January of 2020, we started to hear about a mysterious and deadly virus raging through Wuhan province in China. At that point, the threat still seemed distant, but as the warnings of global spread grew louder, I felt like we were all going to become part of the story soon enough. So, my team and I started brainstorming ideas for a film.
We had no idea how the story would eventually unfold and ultimately change the very fabric of our daily lives, but I initially wanted to focus on the brave healthcare workers who found themselves on the frontlines fighting to keep the virus at bay.
Leslie Norville, Producer: As the virus made its way around the world, we became inundated with wall-to-wall news coverage, and, for most people who had not yet been personally affected, I think COVID-19 was just a dizzying array of numbers and statistics. As filmmakers, it was really important to bring a level of humanity to this invisible foe and the key to that was the access that Matt and the team were able to get.
How did you get access?
Heineman: In the early days, most hospitals were overwhelmed handling the flood of patients, with scarce resources and even less understanding about how to treat the virus, so we knew that gaining real access would be difficult. I reached out to Dr. Don Berwick, who had been an invaluable voice in my film “Escape Fire: The Fight to Rescue American Healthcare.” Dr. Berwick was the head of Medicare/Medicaid under President Obama and has remained an influential leader in the movement to reform U.S. healthcare. He also felt that the crisis unfolding inside the hospitals needed to be documented so he helped open the door for conversations with Northwell Health, who ultimately gave us access to their largest hospital — Long Island Jewish Medical Center (LIJ), in Queens.
Jenna Millman, Producer: Of course, Northwell’s top priority was always their patients, but after very careful consideration, they felt that they had the bandwidth to safely accommodate our team without impeding patient care or placing unnecessary burdens on their staff. The leadership team also felt it was imperative to document the crisis and their response to it, in real time, so that we could learn from it in the future, and to ensure that the everyday heroism of their staff would be recognized and remembered.
Heineman: By the third week of March, New York City had become the epicenter of the outbreak in the U.S. We were not only in the hardest-hit city, but we were in the hardest-hit hospital within the state’s largest healthcare system. LIJ was getting the most patients of any hospital in New York at that point.
How did you decide to focus on the film participants you followed?
Heineman: People don’t like to talk about it but casting for a documentary is extraordinarily important. Ultimately our film participants are the storytellers, not us, and they provide an organic perspective through which we can explore the issues of our time. In the past, a particular person or organization is what inspired me to make a film. In this case, we were starting with a topic that had global implications, but we needed to find those charismatic and empathetic people who could take us with them through their unique experience of the pandemic. There are no shortcuts to this “casting” process—you have to be there on the ground. Dr. Dougé was one of the first people I met, and I knew right away she would play an integral role in the film. She was incredibly gracious, bold, and open in letting us document her life in the most extreme of times.
Millman: I specifically remember the very first phone call we had with Dr. Dougé. She said, “I’m a doctor who spends too much time getting to know my patients. And now it’s so hard for me because I feel like I can’t connect with them. I want to touch them, and I want to show them my face.” It brought tears to my eyes. I don’t think the danger to her life was a primary concern and that said a lot to us about her dedication as a caregiver.
Norville: Ahmed Ellis and Brussels Jabon struck a chord for all of us. Ahmed works for the NYPD and Brussels is a nurse so they were both considered “essential workers” and may have contracted the virus on the job. Back then, we also thought that COVID-19 primarily affected the elderly, but they were both so young and had young children at home. In Brussels’s case, she had literally just given birth. So, to see the impact of COVID on these young people and their families and their spouses was, I think, very powerful.
Heineman: We filmed dozens of patients, but there was something quite unique about both Brussels and Ahmed. Despite being sedated for so long, Ahmed especially, had this glimmer in his eye. There was something very inviting about his gaze, something gentle. Everyone who came into contact with him during his time in the hospital could feel his strength and determination to survive.
Why do you think people wanted to share their stories with you?
Heineman: I think people who decide to take part in documentaries often share the same motivation–– they want to be heard, they want to be listened to, they want the world to understand what they are really going through. Repeatedly, I talked to families who felt we had to tell their stories. They told us that people had to know what the disease looked like and what it felt like so that the deaths of their loved ones were not in vain; that hopefully their deaths will help others understand what this was like.
Norville: Under these circumstances, where the stakes are so, so high, it was even more difficult than usual to gain the trust of our film participants. The honesty and intimacy that we see onscreen is an outgrowth of the relationships that Matt and the field team worked so hard to build during their time at LIJ.
Millman: It is important to note that in Matt’s films, access doesn’t just mean getting in the room. It means many things, but one crucial aspect is being present not just for the action, but for the in-between moments. There’s a shot of Kellie Wunsch, RN, looking at Ahmed Ellis. She’s just checking on him and the way her eyes look down at him and back up again. It blows me away every time I see it. That’s the kind of moment you only get when you are incredibly patient and attentive. You’re not trying to control the narrative at all but letting it unfold.
What were the biggest challenges/difficulties in making a film like this?
Heineman: I have spent a lot of time working in conflict zones around the world, but this was particularly terrifying because we were living through the same threat that we were documenting. There were no boundaries, there was no safe place to take cover, you could never “turn off.”
In the beginning, we knew so little about how COVID was transmitted, and personal protective equipment was in desperately short supply throughout the country. We were able to get one N95 mask each for two weeks from the hospital. Within the hospital itself, safety protocols were developing and changing very quickly, and they didn’t yet exist for production teams! So, we essentially had to create our own protocol by mirroring everything the medical staff did, from the way they wore their surgical masks over their N95s to how they stripped off their PPE at the end of a shift. I’m proud to say that, despite the hundreds of hours we spent inside the ICU/ER, nobody on our team got COVID.
Millman: Filming in a hospital under normal circumstances is incredibly difficult, but then COVID increases the complexity tenfold. Matt’s signature style is very tight, close shots. There’s nothing wide and distant in this film. To achieve this intimacy, Matt and the field team had to carefully choreograph their movements around crazy amounts of action, never getting in the way, always being acutely aware of the sensitive circumstances while keeping themselves safe. It was a logistical feat that took true creative thinking and incredible teamwork.
Norville: In post-production, I think the biggest challenge for me was making something that was palatable. The material, while it was intimate and beautifully lensed, was very harrowing. The struggle was how to convey to the audience the feeling of helplessness, the frantic pace and the confusion while also conveying the resilience of the medical workers and the families. We were lucky to have some of the best editors working on the film, and I think we were able to find the right balance between the devastating reality in the hospital and moments of pathos and levity. For example, Ahmed and Brussels both have young children, so there are moments of respite while you’re at home with the families, and there’s an incredibly sweet and unexpected relationship that developed between Ellis and his physical therapist Karl.
Did the film evolve or change through the production process?
Heineman: I’ve mentioned this multiple times in my career, but when I was in my early 20s, I heard Al Maysles say, “If you end up with the story you started with, you weren’t listening along the way.” Good advice for life, but very good advice for filmmaking. And with THE FIRST WAVE, this couldn’t have been truer. Right as New York was starting to open back up again in late spring/early summer, George Floyd’s murder at the hands of police led to protests around the country. People were calling out the two epidemics—police brutality/systemic racism and COVID 19—which disproportionately affect communities of color. For Dr. Dougé, “it was the final straw.” Although she had never considered herself an activist before, she felt compelled to join the protests, and we followed where her story led us. For me, it was very important that, through Dr. Dougé, we saw and came to understand how COVID brought to the foreground long-standing systemic inequities within the healthcare system and our greater society.
Norville: Not only was Dr. Dougé struggling to provide exemplary care to her patients, but as a Black doctor, she had the added burden of struggling through the epidemic of police killings of Black men and women that was brought, again, into stark relief after the killing of George Floyd. Her story really allowed for us to address George Floyd’s murder and uprisings that followed and subtly touch on the U.S.’s checkered racial history in a way that was true to what was going on in that moment.
What do you hope audiences will take away from the film?
Millman: In its intimacy and particularity, I hope the film captures something essential and eternal about the human experience. To me, the film is not just about COVID but about love, loss, and the ineffable value of human connection. Ahmed Ellis’ recovery is what kept his nurse, Kellie Wunsch, going back to the hospital. Ahmed’s wife Alexis found strength and comfort in the FaceTime with her husband’s medical team, and Ahmed leaned on his relationship with physical therapist Karl Arabian to keep fighting. This is just one of the many series of connections that the movie highlights.
In this moment where physical distancing is still necessary, the irony is that the way we move forward is by not living in our own little bubbles. We must connect with each other.
Norville: With this film, there was an opportunity to make COVID real for a lot of people. Also, I think there was a level of selfishness on my part. In those first few months, I had been living with a level of helplessness and resignation, like a lot of people. Being able to work on this film allowed me to kind of do my part to help fight COVID and, frankly, the misinformation that had begun circulating.
Heineman: There are many reasons why we make films, and there are many things that I hope people take away from this film. But I think, at its core, I felt a deep responsibility to document this moment in history, these four months that changed our lives forever. We are and have been inundated with news stories about COVID -19. I feel like it was my job, it was our job, to put people in the shoes of those who lived it on the front lines and to create a historical document of this time. We had the luxury of being able to live with this story and document this story so intimately, and for such a long period of time. I felt such a weight to get it right, to find meaning in it all.