Hi, Paste’s Something Rotten in Denmark (and by Denmark I Mean the U.S.) Correspondent here with a Disaster Documentary Bulletin. Are you concerned that you don’t have enough things to be disgusted by, frightened of or worried about? I’ve got your six! And so does HBO.
I’ve always said it: If you don’t want to die, avoid the hospital. There is this thing called “Iatrogenesis,” an ancient Greek word for “illness you got because you went to the doctor.” A long time has passed since Athens was the center of the intellectual universe, so you would think at some point in the last couple millennia we would have sophisticated ourselves out of the “hospital more likely to kill you than illness or injury” zone, but nah. We haven’t.
Enter Bleed Out, a raw and infuriating hour and a half documenting what happens to one man’s mother after she goes into the hospital for a hip replacement (a procedure we have honed to a pretty exact science, theoretically) and ends up brain damaged, incapacitated and suicidal. And broke. That last one’s significant, because the title isn’t just a reference to dying from blood loss. It’s also about a dirty system that lets you (indeed, depends on you) hemorrhaging money.
I will say at the outset that, artistically, this film is not a magnificent achievement. It doesn’t suck. But it’s scattered. It’s not searingly intelligent. It’s not cinematically groundbreaking. (It does have spy-pen footage, though!) It’s seriously middling on all artistic fronts. There, I said it. Sometimes that’s enough for me to gently suggest not burdening your queue with a documentary, but not in this case. This is something you urgently need to be aware of, because the odds that you will be affected by it at some time in your life are unfortunately huge. So buckle up.
Wisconsin-raised comedian Steve Burrows loves his mom, Judie, a globetrotting, independent-minded retired schoolteacher whose joints aren’t keeping up with her any more. So he’s obviously stressed out when he gets a call from his sister saying Judie has done that thing aging folks do, where you fall and end up with a hip fracture. (Or your hip fractures and that’s why you fall; they both happen: Yay, aging!). Judie goes into the hospital and has surgery to fix the joint. The surgeon is a trusted family friend. Everything seems fine, except she isn’t healing. That’s concerning, but it happens. Then she reinjures the hip. And all hell breaks loose.
Judie Burrows spends eight days in the hospital knocked out on painkillers, then, suddenly, there’s a rush to operate, despite the contraindication that she’s on blood thinners. She almost bleeds to death in surgery. They put her in an ICU with “electronic” doctors because yes, that is a thing. No one seems to notice that she’s in a coma. Records are flagrantly falsified. Everyone tells Steve to lawyer up. He does, and then things get really fun. Ten years later, everyone is broke, the insurance company blames the surgeon, the surgeon blames the hospital staff, the hospital staff blames the insurer, family members start checking out and saying they refuse to be involved any more, the lawyers won’t defend their client at all, the nursing home has eaten Judie’s retirement savings, and she is permanently disabled physically and mentally. No one is OK anymore, and no one has any incentive to take responsibility for the situation because the laws are stacked against patients like Judie.
Bleed Out is a bleak little film. It’s incredibly depressing, even in (no, especially in) its smallest details: Close shots of doctors in depositions looking blankly at the attorneys and lying though their teeth, deadpan voiceover remarks about key witnesses suddenly being dropped from the list because… reasons; tight shots of people in cluttered rooms making phone calls and being endlessly put on hold; repeated shots of Judie unconscious and of index cards reading “year one… two… ten” being tacked to a corkboard. No one helps. All the energy that gets poured into trying to get some kind of assistance, if not actual justice—it just evaporates. Honestly, for all my references to TV thermodynamics, I have to say Bleed Out mounts a pretty serious challenged to Law #1; they say energy cannot be created or destroyed, but in Steve Burrows’ world, it certainly appears that it can be destroyed.
After heart disease and cancer, “medical screw-up” is the third-commonest cause of death in the United States, claiming at least 250,000 lives a year and probably (because doctors refuse to take responsibility and they get away with it) many more (closer to half a million by some accountings). Sit with that for a sec. Between a quarter and a half million deaths per year. Elderly people. Children. Independent, educated, privileged adults in the prime of life. No one is protected. No: The system is protected. Doctors do not have to testify to wrongdoing by other doctors. Caps on what you can recover in a malpractice suit make it financially impossible to sue a hospital—and hey, it’s not like a lawsuit can get you back the kidney you lost because someone had the wrong chart, or give you back the family member who was poisoned because there was a “miscommunication” about meds. But these numbers don’t even count people like Judie who didn’t die but wish they had, people who are literally made to bear the financial burdens that accumulate in the wake of the doctor’s screw-up. An entire succubus-network of insurers, drug companies, rehab and nursing facilities make jaw-dropping amounts of money off these sad situations, and patients have no recourse because what is working is the bureaucratic rat-maze of CYA infrastructure. Yes, we are unfortunately a “litigious society,” and yes, there are situations where people see lawsuits as viable options for retaliating out of spite or ruining an adversary’s public standing or lining their own pockets. And doctors are not gods. They’re human and capable of error like everyone, and that needs to be respected. I am the first one to say it. Hell, I’ve been injured in a surgery. And while it was technically my surgeon’s “fault,” I genuinely don’t believe she acted irresponsibly. Bodies are complicated, and occasionally respond to procedures in ways you can’t foresee. Unexpected outcomes sometimes occur. Luckily, I received a very gnarly scar and not irreversible loss of cognitive function.
Meanwhile, cases like Judie Burrows’ are, unfortunately, not wild outliers. Doctors do make both good faith and bad faith errors. Sometimes they are inconvenient. Sometimes they are utterly devastating. And at this point in our history, in a culture with a seemingly unprecedented level of insistent focus on blame and victimization and intolerance, the United States continues to tolerate a mind-bending degree of willful deflection when lives are lost or hopelessly damaged by people we trust to protect our health. The ripple effect is massive. In Steve Burrows’ case, his mother’s incapacitation and increasing suicidality are in many ways hardest on Judie herself, but one of the silver linings of brain damage is that it can make you less aware of how bad the situation truly is. Steve has no such buffer, except the cold comfort of knowing that if Judie’s cognitive function were better she’d be even more painfully aware of how screwed she is.
Bleed Out premieres tonight at 8 p.m. on HBO.
Amy Glynn is a poet, essayist and fiction writer who really likes that you can multi-task by reviewing television and glasses of Cabernet simultaneously. She lives in the San Francisco Bay Area.