Living In Emergency
Four-Letter-Word-Inducing Intense

Imagine Sam Neill, Tilda Swinton, and Powers Booth starring in a reality-TV version of M*A*S*H—set in a Cuckoo’s Nest war-zone mental hospital.  There you have, in a nutshell, the feeling invoked by Living in Emergency, a documentary about real-life volunteers for Doctors Without Borders (Médecins Sans Frontières).  The doctors featured are both regular joes and larger-than-life, internationally-flavored rockstar personalities, driven and tortured personalities doing mind-boggling work in impossible places with inadequate resources.  When it doesn’t drive them crazy, it does drive them to extreme behaviors.

One thing is certain: this documentary does not try to depict these doctors as saints.  Doctors Without Borders (or MSF in most of the world, as the central headquarters is based in Paris) recruits qualified medical professionals for insertion into front-line medical missions in war- or natural disaster-ravaged areas.  The missions are by definition temporary, dangerous, and tenuously supported, as supply lines are easily disrupted, local services are unreliable at best, and the missions always represent, as the featured Dr. Chris Brasher puts it, “a tiny, tiny drop in a sea of oceans.”  The work tends to appeal to the already-disillusioned, renegades, and mavericks.  It’s a volatile mix in which “the division between what is professional and what is personal” completely evaporates.

Operating in Liberia in Living in EmergencyAs presented in this documentary—which focuses on specific missions in the Congo and Liberia—you can believe mission director Dr. Kiara Lepora when she says, “It’s not about being a good person.  It’s not about that at all.”  It is, as this Italian MSF-veteran puts it, about doing what you can when you run across the nation-sized equivalent of car crashes.  There are victims everywhere, and you do what you can to help as many people as possible, knowing that a lot of what you do will be inadequate and that a lot of your patients will die regardless.  According to Brasher, however, you do have the consolation of knowing you do “make a difference, life by life, person by person.”

The film is unflinching in depicting this anti-heroicism.  Dr. Davinder Gill manually reinserts a basketball-sized hernia into a woman’s abdomen without the resources to know if she’ll be dead the next morning anyway due to strangulated intestines; Dr. Brasher and his team devote hours to resuscitating a man after heart failure, only to find that the quietly-sleeping man passes away just minutes later; Dr. Tom Kruger and his team improvise a cranial drill to release pressure from the skull of a gunshot victim without knowing if the ad hoc brain surgery will be the least bit effective.  No wonder, we are led to think, these doctors make no apologies for a little bit of pot, a good bit of off-hours booze, and as Lepora puts it “a lot of sex.”  And aside from the nookie, we get to see it all.  This is not a film for the faint of heart at all.

Local medical professionals—who make up 95% of MSF volunteers—are perhaps the most frustrated participants in the missions.  While they are wildly grateful for the outside assistance, they know that when the mission folds, and the psychologically ravaged expatriates get to go home or move on to the next mission after a much-needed and less-than-restorative break(down), their boots will remain firmly planted on the ground ina  situation that may not be a crisis but certainly is not much better than one—and they don’t receive the kind of rock-star, godlike attention that their jet-setting, six-figure-salary-foregoing counterparts receive.  And it doesn’t seem at all like grandstanding or petty carping when the filmmakers capture moments of such frustration boiling over.

After seeing this film, in fact, you may be led to ask: Is all this extremity in circumstances and behavior warranted? 

Well, gosh, who am I to say?  My brother is a surgeon, and I roomed with him while he was in med school, so I have some relatively-first-hand knowledge of the wringer that medical professionals get put through at all levels of their careers.  I have spent a cumulative four or five months in the hospital (and literally days in the E.R.) with my wife over the last several years—and have been spontaneously on hand for two surgeries and numerous invasive medical procedures—so I’ve seen first hand the pressure-cooker environment that exists in even sanitary, first-world medical missions.  And still it’s tempting to think: MSF operates on a secular-humanist model that is bound to burn out its volunteers, all of whom are, by nature, already bereft of adequate spiritual sustenance.

And yet… I’ve also been an elder in my local church, I’ve served on the board of an international Christian relief organization, and I’ve been on staff at a small Christian college—and in almost all of such circumstances, I’ve seen the same kind of heated arguments, underfunded efforts, fractured personalities, compensatory indulgence, and flaming burnouts as depicted in Living in Emergency. 

It seems to me that the problem is not models of organization or modes of relief or belief: it’s extreme circumstances into which very imperfect, guilt-ridden, and idealistic people are inserted.  These are simply the forges which refine human beings, in which both the pure and the puerile become abundantly self-evident.

Both as a human document and as film, I can’t recommend Living In Emergency enough.  As a pleasant or entertaining experience, forget it.  There is no amount of sugar that will help this medicine go down.

One sidenote: Living in Emergency has been screened as part of an in-theater Fathom Entertainment event, including a post-screening panel discussion hosted by Elizabeth Vargas and including Drs. Brasher and Kruger, journalist Sebastian Junger, and others.  While I’ve been highly impressed by past Fathom events, I cannot at all recommend this one.  Vargas was an extremely poor choice for moderator, pitching brain-dead questions to which panelists were clearly thinking, “Didn’t you just see the movie?”—while fumbling their way through totally-inadequate deer-in-the-headlights responses.  Granted, Vargas may have been totally caught off guard by the film, and not known exactly what to make of its depiction of such off-the-wall practice of ad hoc medicine; but it sure seems that Junger would have made a better choice as moderator, or even Brasher or Kruger.  Still, if Fathom offers an encore presentation, you can feel good about taking advantage of the opportunity to see this Oscar-quality film from director Mark Hopkins… and skipping the blather after.

Living in Emergency is unrated—but trust me, this is very R-rated material.  It’s four-letter-word-inducing intense.

Courtesy of a national publicist, Greg attended a public screening of Living in Emergency.