After being tipped off by his wife, Peter Nicks spent much of the last decade figuring out how to properly tackle a film about America’s health care crisis, though he always suspected it would be through the lens of one place: Highland Hospital in Oakland, California where the missus worked.
“Initially, we scouted the whole hospital,” says Nicks, who shot the film in 2010. “It was ostensibly a film about the uninsured and then we were all over the hospital — the clinics, the ICU, the emergency department and the waiting room, trying to figure out how to tell the story and I would pass through the waiting room to go visit doctors and talk to staff members in the executive wing. Then I’d come back often hours later after having these interviews and pre-interviews and see some of these same people sitting in the waiting room.”
While those long waits have been debated far beyond the walls of Highland in recent years, Nicks finally felt the charge towards a wholly unique take on the subject by placing the focus not on the doctors and administrators he had been talking to, but rather allowing the patients talk to him. The result is “The Waiting Room,” which recently was shortlisted for an Academy Award for Best Documentary and takes the sadly all-too-typical example of a emergency room short on resources and staff and vivisects it from the perspective of the diverse group of largely uninsured people who file in for treatment, illustrating the needs of the public and putting a human face on what often is reduced to dispassionate data.
Earlier this year, I had the opportunity to speak with Nicks for an article at TakePart, but like “The Waiting Room,” of which the film is only the beginning of a larger multimedia project, I felt our larger conversation about the origins of the project and the filmmaker’s future plans were worthy of publication, especially now that the film is back in theaters and primed for a spring debut on public television.
How did you get interested in this subject?
I’ve had an intimate view of Highland for many years because I went to Berkeley’s graduate school of journalism where I studied documentary film. I came out at the same time my wife came out of graduate school and her first job was at Highland Hospital. She’s a speech pathologist and I began hearing stories from her about the patient population and what the hospital was dealing with in trying to care for this community. My antenna as a storyteller immediately went up and I started thinking it would be a great place to tell a great story about a community and about an institution.
I never approached the hospital because it’s a very complicated process getting access to a large public institution like that. But over the years, I just couldn’t get it out of my head and the issue of health care just kept rising in terms of it dominating the public discourse. The issue becomes so political that the uninsured, a large swath of the population, were being misrepresented, so I just saw an opportunity to make an apolitical film that simply allowed people to become familiar with what the uninsured were going through day-to-day.
You’ve said you had the idea in 1999, so did it evolve by the time you eventually shot the film over a decade later? I heard you were working with “The Life and Times of Harvey Milk” and “Howl” filmmakers Rob Epstein and Jeffrey Friedman for a time.
The interesting thing is that the idea I initially had in ’99 is exactly the film that I made. What happened in the intervening years is a lot of things. Jeffrey Friedman edited my first film [“The Wolf”], which was a personal film of my own recovery from addiction and my time in prison. Then I moved to New York and [when] we moved back to the Bay Area, she returned to her job at Highland, she heard someone were making a documentary film about Highland and I was like “Oh crap! They got my idea!”
It turned out it was Rob and Jeffrey and when I called them up, they needed a producer, so I came onboard. Their film was a different kind of idea, but I was like okay, I’ll work on this and then for a variety of complicated reasons, it fell apart in 2007. I had done so much work and test shooting for Rob and Jeffrey, so I approached everybody — Rob and Jeffrey, the investors, these lawyers who are now the executive producers on the film, the hospital and said, “I’m not Rob Epstein and Jeffrey Friedman, but I’d like to take over this project and here’s what I’d like to do.”
Also, there was this whole paradigm shift in how media was being created that was happening and my pitch was it wasn’t just going to be a film, it would have a digital component that would self-sustain through the release of the film and that we would be doing community engagement. I basically regained access on all levels to both the story and the hospital, but on my terms. I went out and raised all the money whereas before it was privately financed. That was in 2009 and then in 2010 we started shooting.
If I’ve got my timing correct, the debate around the affordable care act must’ve been happening at the end of filming and the beginning of post-production. Did it have any influence on what the film ultimately became as you were editing it?
Not at all actually. I’m not going to say that there were not discussions in the edit room and with our co-producer, ITVS about the policy backdrop of health care reform, but my primary focus was on capturing in as intimate a way as I could the reality of what people were dealing with on the ground at this one public hospital. I felt that it was relevant not just because I saw the potential for good storytelling, but because Highland and Oakland represents a lot of communities all over this country.
The project actually began as a storytelling project where we just went into the waiting room and sat down with people and asked, what would eventually become the tagline, “What are you waiting for?” It’s an open-ended question. We didn’t say, “What do you think about Obamacare?” We just wanted to know who these people were and what they wanted to talk about and we just put these little moments up on the Web. That’s really what evolved into what became the film. And the film is kind of a spoke on a wheel of a larger community engagement project that preceded the film and is also going to continue long after the film comes and goes. But we didn’t want to create the film in such a way that it would be used in a specific way. The film is open to interpretation.
After months of shooting, you must’ve had a lot of footage. How did you decide on which stories would make it into the film?
It’s such a diverse place where people come in that you ordinarily would never meet or talk [with] that cut across race and class and ethnicity. I saw all these interesting interactions between people that I knew would never happen outside of that environment, so I started thinking if you could capture that in some way, that would be profound and illuminating. That’s where we started to focus on just the waiting room. Ultimately, we only shot for about eight weeks in the waiting room. A good chunk of the film came from one particular day of shooting that was one of those days where we just got a lot of material, but we didn’t spend more than one day with any one patient.
Every day, we queued up in line with them in the morning and introduced ourselves and spent about seven weeks doing this with the idea that eventually we’d get a cross-section of people that could be pieced together to produce the final film. We had some ideas of archetypes that we wanted. It wasn’t completely random, the way we edited the film and some of the best scenes that we shot aren’t even in the film for that very reason because for instance, we couldn’t have a film with all African-American characters or we couldn’t have a film with all men. It was really created in the edit room.
I always say the film is a spoke on the wheel of a larger community engagement and media initiative that I’ve undertaken. The genesis of it may have been the idea of making a film of the hospital, but what happened in the intervening years between 1999 and 2009, which is when I began really raising money for it was the way that we create, share and use media for a variety of purposes, from personal use to activism to journalism, completely changed. And I recognized that not only was it an opportunity to make a really great film, but we could dive into this new world of transmedia and really exploit these new ways of telling and sharing stories. What really sparked everything was when I applied to the Bay Area Video Coalition Producers Institute, who has been at the forefront of trying to activate new media projects and get producers and directors thinking in new ways for how you can engage an audience.
I workshopped this idea for interactive storytelling platform in “The Waiting Room,” and that’s where the sort of video storytelling project came from with the idea that we would create this platform to put in Highland Hospital and then potentially in other public hospitals around the country at a moment where there’s lots of questions about how the healthcare system is working for people. How is it going to work now? How is it going to work in 2014 when the new law is supposed to be fully implemented? Is it working for these communities?
Once the film got rolling, we kind of put the storytelling project on the back burner. It’s been kind of simmering and a film in a theater is still the most impactful thing you can do. But I think things are changing and that formula or that construct will maybe shift fairly soon or there’ll be more opportunities for different ways of making an impact. We are going to continue the interactive storytelling project on the heels of the theatrical release our PBS broadcast in the spring of 2013.
What would you like audiences to take away from the film?
I’m a big believer that when you tell a story really well, absent of any kind of specific context or agenda that cultural forces that create social change will come around the film. That was my belief going into this film and I believe it’s being bored out just by what’s happening on the festival circuit and what’s happening around the theatrical release, that people are coming around it and I think they’re coming around it because it tells…it takes away the political baggage that has come with the health care reform discussion and it just presents the story in simple human terms.
Our goal is to create empathy because you can’t have a civil discussion about a major public policy issue if you can’t have empathy across the aisle and the best way to build empathy is to know your neighbor. The goal for the film is to bring the audience in a very intimate way into the lives of these people without scaring them away with a political agenda. Maybe I’m naïve, but we’re hoping that this can cut across ideological boundaries, that people from all angles on the health care question can weigh in and use this film in a constructive way.