Often in nonfiction filmmaking, credit is given to the the films that take the longest to make, but the ones made in condensed periods of time can be equally challenging if not more so. For Jeff Reichert and Farihah Zaman, the filmmakers behind “Remote Area Medical,” only a week of their time was necessary in Bristol, Tennessee to prepare and film the three-day clinic in which locals who can’t afford health care line up to receive free treatment for their general medical, dental and visual impairments, which might sound easy enough until you realize the line is great enough to fill up the Bristol Motor Speedway, a stadium ordinarily used for NASCAR events.
Although the event presented a complex logistical challenge for Reichert and Zaman, who cleverly stationed seven different camera crews along the route for care with filmmakers in constant contact with one another about who to keep track of and what to shoot, the end result summons an unusually nuanced and moving consideration of the great toll of income inequality and the lack of a just health care system in America. Told with great intimacy as it follows a number of patients through the process of getting care, “Remote Area Medical,” takes its title from the organization founded by Stan Brock to initially provide care in far-flung regions of Africa and South America but has increasingly pulled resources out of such countries as Honduras and Guatemala to deal with the great need in the States.
The program first came to the attention of Reichert and Zaman, two filmmakers who met while working together for a time at Magnolia Pictures as well as on Reverse Shot, the great online film journal that Reichert co-founded, when Reichert’s aunt, a retired nurse, suggest they volunteer at a clinic and after serving the residents of Pikesville, Kentucky, the two quickly realized there was a compelling film to be made. Though it took nearly eight months to convince Brock, who wasn’t looking for the attention, to let their cameras in, the directing duo have created a refreshingly candid, engaging and apolitical look at a subject too often defined by financial terms rather than human ones and as the film makes its own journey across the country, Reichert and Zaman took the time to discuss working together for the first time, how the film evolved from covering those who volunteered at the clinic to those who received care from it, and the unexpected influence of Robert Altman.
This is your first collaboration, but Jeff had already made one film (“Gerrymandering”) while this was Farihah’s first time. Did that mix of experience and inexperience actually prove useful here?
Jeff Reichert: I learned a lot while making “Gerrymandering,” and I’ve joked that I wish it was my fourth movie as opposed to my first movie because I think I would have done better knowing a bit more. Going to interview politicians and [dealing with] animation and music and archival [footage], it was just a lot to deal with and personally thinking about filmmaking, I wanted to do something very different than that. I was hungry to make a film that was a little bit more observational, just people with cameras interacting with folks that didn’t have all the apparatus that we needed to bring to bear to make “Gerrymandering” happen. We didn’t find Remote Area Medical because we were looking for that type of movie, but it definitely personally dovetailed with an interest that I’ve had in trying to do something very different than the thing that I’d done before and if nothing else, explore possibilities, keep myself interested, and test the limits a little bit.
Farihah Zaman: It’s funny. Even though Jeff had made a film before, it was so different that in approaching this and how big [the issue of health care] was statistically, we would talk about it and come up with a solution for something that seemed problematic and never consider if should we ask somebody if that’s how you conventionally deal with those problems. I think we both brought a fresh perspective that could have not worked at all, but actually, we just didn’t see it as impossible or crazy. We just thought, here’s the thing. How do we want to approach that? Bringing together a crew of 20, the way that we set up a communication system [between them in the Bristol Motor Speedway] and all staying in one house together? In hindsight, that stuff is pretty nuts.
Jeff Reichert: We didn’t know. The whole thing was bonkers. We piled the equipment in a van and drove down, three of us [including associate producer Dan O’Meara], from New York to Tennessee.
Farihah Zaman: Jeff also has a really good sense of how to see an eventual structure of a film even in the early stages, and I think that what I brought was a good sense of having a production work. I have a passion for organizing in that way, so approaching it together — seeing both the end result and also the nitty-gritty details of the day-to-day — is what helped us. What we shared in common was knowing that we wanted to ask people about their lives. We wanted to go into something different than a very polemical conversation about healthcare.
You’ve said initially you planned to focus on the volunteers who help the patients at the free clinic, but the final film tends to focus on the patients. How did that shift occur?
Farihah Zaman: It was a debate that we would have, and particularly now, when people are mostly shooting and editing on digital, a good solution to unsolvable debates is, “Okay, well, let’s just try it.” We have these seven different crews. We can ask [them] to focus on patients as well as volunteers. A lot of times we would focus on volunteers before the patients came in, because there’s this sort of lag. Then once the patients were in, it became a logistical thing where the doctors were constantly working, so the patients would have a lot of time where we could actually get to know them before they were going in and having a procedure done.
But it was more when we started hearing [the patients’] stories and getting a grasp on the fact that the people who are volunteering could go and talk to a camera — they have a platform to discuss their lives, but these people [who are patients] absolutely don’t and commented on it all the time. When we conversed with them, they would say, “I can’t believe you’re asking me about my life or that I’ll get to talk about this.” Some people said, “I have a lot of pride. It’s hard for me to talk, but I just keep thinking how else is anybody going to hear this kind of story?”
Jeff Reichert: I was a little worried. It’s a movie that’s made in essentially three or four days and I worried we were going to have a really hard time getting intimate with patients as they were coming in trying to get procedures that they need. Obviously, they had a lot on their minds, but for whatever reason, as Farihah talked about, [there was] a feeling of relief that somebody out there actually cared to hear their stories. We ended up getting so much more amazing material from the patients than I anticipated us being able to access to. Some of it is the way we made the movie. Some of it is the culture of the area and openness that people have.
It was interesting to hear that you went in a few days early to get background interviews with some of the people in the film, but hadn’t actually planned to use them until you discovered they had a use in the edit. Did you actually have a good idea going in of what this event was going to be like or did you really figure out what this film was going to be after you shot it?
Farihah Zaman: Because we volunteered [at another RAM clinic], we had some idea of what the event itself would be like. However, this was on a much bigger scale, both in terms of the place and numbers of patients they see. What the [early] conversations afforded us was opening that window into what is it actually like to live here [in Bristol]? What are the things that are tied in to health care, the main subject of this film, in a way that we hadn’t anticipated? The film became much more about a sense of place and a sense of community than we had intended going in, and that would not have happened if we hadn’t spent that extra time there and talked to people and been open to hearing other kinds of stories from them.
It seems so obvious, but you’ve said that the way you set up crews was to have two of your most congenial members at registration so that they could get to know which patients had the most interesting stories and would be open to being followed as they made their way through the clinic. In general, how much consideration went into putting people in the right places to make this film?
Jeff Reichert: A lot really. Everybody would gather at registration in the morning and we wanted Steve Bognar and Julia Reichert, my aunt and uncle [and the fine filmmakers behind “The Last Truck: Closing of a GM Plant”], there because they make these very extraordinarily intimate, empathetic documentaries about middle and working class people. They’re able to go into a room with anybody, strike up a conversation and within minutes, people would be telling their most intimate secrets. They did it when they first met Farihah actually.
Farihah Zaman: [laughs] It was very unnerving.
Jeff Reichert: So we knew we wanted to play to their strengths. [In] dental, we knew it was going to be a big, vast room with lots and lots of things happening, so we put our most seasoned camera person [Gary Keith Griffin] there because he has such a great eye for stuff — he’d get really amazing shots but also be able to navigate that space. I’m not very good [at shooting], so we put me in Vision because people aren’t moving around a lot when they’re doing vision tests.
Farihah Zaman: Jeff’s being a little hard on himself. It was also about putting somebody who had a bigger vision of the film [there] being able to meet people there and have conversations with them.
Jeff Reichert: We did have an overnight crew, and we picked the youngest folks, because we just thought they really hadn’t worked on a feature film before, and they’d be the most eager and willing to go and just get to a parking lot at 10 pm and shoot until 6 am the next morning. I think most of our choices worked out well.
As a vérité piece, there isn’t much specific reference to the national issue of health care, but you do seem to be able to say so much with a simple title card at the beginning, which explains how Remote Area Medical began in the Amazon rainforest and now 60% of its operations are in America. What went into the few pieces of information you wanted to give to the audience before the film begins?
Farihah Zaman: We went in with this idea of having a very rigidly vérité film. We don’t use any cards. We don’t use any titles. I’m actually glad that we pushed so hard to do that, because it forced us to consider that when we did use words, it was absolutely necessary. Is this something that we can’t convey in the film without it being on the nose or explanatory as opposed to emotional? We tried so many different iterations.
The first card talks about the fact that Remote Area Medical used to work overseas and now has pulled back and does most of their work in the US was something that we learned through conversation was one of the most shocking things to people because when you’re talking about the work that [Remote Area Medical] does, [you think], “Okay they do clinics [around the world], that’s really great,” and then you explain, “No, no, no. they’re seeing the same kinds of patients within the borders of the wealthiest country in the world that they see when they go to third world countries. That comparison is really crucial to understand.
Then the title about Bristol being the birthplace of country music seems like such an odd twist, but again, it speaks again to the fact that the film became much more about place than we expected. We needed to give some sort of context and say this isn’t just some poor town somewhere. It’s a specific place with its own history and cultural traditions. That’s how we ended up doing an entire sequence outside of the clinic, because we wanted that moment where you see people have lives because the extent of their lives isn’t their problems.
You’ve already made a film after this called “This Time Next Year” about the recovery from Hurricane Sandy in Long Beach Island, New Jersey. Since that also speaks to a community in need and the goodness that comes out of people helping each other, is there actually a connection between these two films for you?
Jeff Reichert: There is a connection for us, but it’s by accident.
Farihah Zaman: It’s organic.
Jeff Reichert: “This Time Next Year” is where I’m from essentially, and obviously, I have a strong pull to that place because it’s home. But we started making the film, we thought this is going to be a movie about local politics and about environmental issues that the community is facing and the push-pull between the working middle class and the wealthier people, who have certain kinds of needs, and how that all plays out. Then we met Joe Mangino, who started a grassroots organization [Stafford Teachers and Residents Together, otherwise known as S.T.A.R.T.] that went around helping his neighbors gut their homes and rebuild in the wake of the storm. We connected with him instantly just as a person, and in the end, we made another movie about place where people ended up helping each other.
But I think we both feel pretty good about that because documentaries can be pretty doom and gloom sometimes, and there’s a lot of good stuff out in the world. Just because good things are happening doesn’t mean they’re boring. It doesn’t mean they’re not interesting. It doesn’t mean they’re not worthy of being in films.
Farihah Zaman: Conversely, just because you show the good that comes out of it doesn’t mean you have to blunt the complications and that it has to be an entirely rosy picture. In both of these films, we saw a moment of crisis [where] there are people working within the community are filling in the gap, specifically where government can’t step in fast enough, and even though we had very different goals going into “This Time Next Year,” the experience of including so much of the landscape and sense of place in “Remote Area Medical” meant that we built our production schedule differently. We stopped looking at that as B roll that we would get when we had time and built in time in the case of “This Time Next Year” to be at the beach to film the ocean and to show what makes these people tick. If you spend your whole life on an island, obviously the ocean is an important part of your life, just like if you grow up in Appalachia, the mountains are important. We approached that a little differently and were still surprised by how much it became a part of the film.
As a longtime fan of Reverse Shot, I can’t help but ask has engaging with films critically as writers informed your filmmaking?
Jeff Reichert: Of course. When you spend a lot of time breaking down films into their constituent parts, thinking about the intention of this thing that I’ve seen in front of me on the screen, and how does the artifact meet or let down that intention, you can’t help but apply that sort of thinking to when you actually make films yourself. For both of us, we’re not interested in making things that are informational in a way. We want to make films that are aesthetic and are cinematic experiences and that move the way movies move and have beginnings that draw you in and endings that are consequential and that it feels like something has happened to you when you finish watching the movie. In documentary, obviously you are shooting things that are happening in real time, so you can’t always get the perfect shot and you’re not always going to have the perfect sound. It’s not going to be seamless. We had seven different cameras rolling on this, so just figuring out how to make all of that work as one thing was a challenge. But it’s something that’s important for us.
Farihah Zaman: We sometimes read interviews of other filmmakers who talk about how, “Oh, I don’t really watch a lot of other films [because] I hesitate to be somebody who solely deals in illusion and make references to other kinds of work.” I find that so perplexing because we just both love watching movies. If you love cinema, it’s not just about making it. It’s about experiencing it for yourself or how do you understand how other people experience what you see. It doesn’t have to be as simple as, “I saw this in a movie so I’m going to take it and do the exact same thing.” It’s that idea of just understanding the breadth of what’s possible, and those ideas that you see in other films can trigger new ideas. It’s not solely about homage.
It’s so wonderful when you watch a film and there’s some technique that’s unexpected, particularly in something like a doc, which can be a pedantic or more informational way of conveying a story, and there’s something a little bit rebellious. It’s such a delight. I want to be able to think about that outside of when we’re making the film so that we can bring that to the movie when we are.
Jeff Reichert: When we were making and editing [“Remote Area Medical”], we were talking about how [Frederick] Wiseman is someone who is called on a lot these days as a reference for documentaries that are working in an observational mode, but as much as Wiseman, we were talking with the editor [Sam Pollard] about Robert Altman and the way he can take you into big space and move you through characters.
For the ending of the film, we had our editor and composer [David Wingo] watch the end of Terrence Malick’s film “The New World,” because we had this material that wasn’t quite jelling. It was moving between different spaces and different times and we couldn’t quite figure out exactly how to piece it together until we looked at that and said, “Oh, Terrence Malick pieces these things together because he doesn’t really care about the chronology and he doesn’t care about keeping the space coherent. He just moves you to these places and he does it with confidence.” That’s how the last six or seven minutes of [our] film came about, throwing out the idea that the clinic ends. You see people after the clinic. The idea was just combining all the stuff into one space, tying it together a bit with the music, but really pulling back and giving this big picture.
Farihah Zaman: We still talk about Altman a lot. It’s a little unpopular right now in documentary to have an ensemble, but to us having multiple stories or vignettes is better at conveying a sense of community as opposed to only looking through the perspectives of two or three people very rigorously and to bring that reference from a different kind of genre was really exciting.
Jeff Reichert: People talk a lot about documentary characters, which is a word that we really hate because “character” has implications that come from narrative film, and when you meet a character in a narrative film, you’re expecting to see them on some sort of a journey and they’re going to have certain beats that they hit. If you start applying that to your life, you end up taking people and forcing them into these boxes and try to create these moments that actually fit. As you’ve seen in [“Remote Area Medical”], we’re a lot looser about that. We feel like if somebody has one really amazing interaction that we like watching, that’s worth being in the film, and that may be all that you need. For instance, [there’s a scene where] an older gentleman is getting his hearing checked by a young Eastern European woman and their interaction is whole unto itself. You don’t need to see where he came from. You don’t need to see what happened after. That is the thing that says what we wanted to say about that.
“Remote Area Medical” is now open at the IFC Center in New York and will open in Los Angeles at the Music Hall 3, among other cities, on December 5th. A full list of theaters and dates is here.