The understated but touching ‘Remote Area Medical’ shows America’s unmet health-care needs

April 11, 2013

By Matthew E. Milliken
April 11, 2013

At its most basic level, the new documentary Remote Area Medical is about a free three-day clinic that the organization of that name staged at Bristol Motor Speedway over an April 2012 weekend.

But just as sometimes a cigar is not just a cigar, this documentary about a free clinic in rural, mountainous Eastern Tennessee is not just a documentary about a free clinic. When Remote Area Medical was founded in 1985, its mission was to bring health care to inaccessible parts of the Brazilian rain forest. Today, 60 percent of the Nashville, Tenn., group’s work is done in the United States.

“We have people with desperate need within our borders,” one interviewee tells filmmakers Jeff Reichert and Farihah Zaman. (None of the speakers are explicitly identified in the movie.) “Remote Area Medical — we don’t have to go too remote.”

Another interviewee, a patient at the Bristol clinic, says she wishes America’s decision-makers could see the consequences of their choices. Indeed, this viewer couldn’t help but wish that hundreds of U.S. Senators and members of Congress and their key staffers would be forced to watch this film and then spend a few hours discussing possible remedies. (Whether they might choose, after doing so, to repeal, change or keep intact the reform program commonly called Obamacare is outside the scope of this review.)

Remote Area Medical — which had its world premier last weekend at the Full Frame Documentary Film Festival in Durham, N.C. — features interviews with the health care providers who volunteer for RAM. But it also tells several touching stories of the often desperate patients the group serves, many of whom lack health care insurance.

“I don’t make that much working, and I do the best I can,” one woman says on camera before being overcome by emotion.

“People want health care, but they don’t want to pay out the wazoo for it,” another woman says, perhaps referring to the extraordinarily expensive rates private health insurance companies charge individuals who try to obtain coverage but suffer from pre-existing conditions.

Another interviewee says she has gone without insurance for a decade. “You don’t go to the doctor,” she states flatly. “You don’t go to the ER, even in an emergency. It keeps you from getting the help you need.”

Asking for help, however badly needed, violates the rural code of conduct by which many of those seen in the movie live. “To allow somebody to step in, that goes against a lot of what I was taught,” one of the patients says.

As the film shows, relatively short and simple health care procedures can have transformative effects on the lives of uninsured or impoverished men and women.

One patient, Sheila, has a disfiguring cyst removed from the corner of her eye; she says its appearance was so hideous she skipped her daughter’s graduation ceremony. A man who has some teeth pulled on camera, in the second of two rather gruesome dental sequences, is given dentures gratis; he alternates between flashing his revamped smile and tearing up. We see multiple patients grinning giddily as they receive prescription eyeglasses for free, just like everything else provided at RAM clinics.

The lenses are made by a couple who are capable of producing 281 pairs of eyeglasses in a day. The man says he is often moved by patients who tell him what a difference his efforts make.

“I’m 14 years old,” the man says, recalling one testimony as his eyes fill with tears. “Till today, I didn’t know what a leaf looked like — that gets you. That gets you hard.”

Adds the optometrist, “It’s the best thing you can do.”

Of course, not everyone can be fully healed by a trip to the clinic, as helpful as its aid can be. A patient whose teeth have rotted away, and who hasn’t kissed her husband in a year, has teeth pulled but isn’t able to obtain dentures because there evidently aren’t enough dentists. “We take it day by day and then week by week,” she says with an air of resignation.

Rhonda, a heavy smoker, receives troubling news when a spot shows up on her lung X-ray. It may or may not be cancerous; an appointment for follow-up care is made. She lights up as she leaves the speedway.

One man who claims not to have seen a doctor in decades is found to have alarmingly high blood pressure. There will be no quick fix for him.

“The patients will always be there,” says Stan Brock, founder of Remote Area Medical. “The big question is how are you going to be able to see all of them.”

That very issue overhangs and underscores virtually every moment of Remote Area Medical. It goes unanswered.

Of course, it’s unfair to expect this quiet but beautifully shot movie, amplified by an original David Wingo score, to resolve a conundrum that has tied policy-makers in knots for decades. But due to its documenting some of the consequences of America’s failure to extend health care to millions of uninsured people, this film makes for worthwhile viewing. Simply by showing needy patients, and without any preaching whatsoever, Remote Area Medical provides its audience with an experience that manages by turns to be moving, educational and enjoyable.

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