A look at The New York Times documentary "They Get Brave"

Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.

AMA Chief Experience Officer Todd Unger speaks with the team behind The New York Times documentary, "They Get Brave," which takes an inside look at the lives of front-line physicians and nurses in New York during the COVID-19 pandemic.

Learn more at the AMA COVID-19 resource center.

Speakers

• Samantha Stark, director/producer, New York Times
• John Pappas, director/producer, New York Times
• Alex Garcia, director/producer, New York Times

Unger: Hello, this is the American Medical Associations COVID-19 update. Today we're talking to the team behind The New York Times documentary, "They Get Brave," that takes an inside look at the lives of several front-line physicians and nurses in New York. We have a clip here, so let's start by taking a quick look.

Speaker 1: Trying to calm the knot in my stomach.

Speaker 2: People need to see what we're going through.

Speaker 3: I feel so guilty for not being stronger.

Speaker 4: I don't want to die.

Speaker 5: There are just seas of people on breathing tubes.

Speaker 6: It's hard to not feel anxious or upset because the cost of human life is too great.

Unger: To talk about the making of "They Get Brave," which debuted on FX and Hulu earlier this month, I'm joined by Samantha Stark, director/producer at The New York Times in Brooklyn, New York; Alex Garcia, director/producer at The New York Times in Cold Spring, New York; and John Pappas, director/producer at The New York Times in Brooklyn, New York.

I'm Todd Unger, AMA's chief experience officer in Chicago. Let's start by talking about the project and how the idea for it came about. Who'd like to start?

Stark: I'll start. So, we had just, just started this new documentary project from The New York Times called the "New York Times Presents," 10 standalone documentaries. We had just gotten the green light to start the series and the pandemic struck in New York and quarantine happened. And so we were so worried. I mean, we didn't know what to do. How are we going to film? It changed everything. And working for the "New York Times," when there's an emergency, any kind of huge thing that happens, we are there while it's happening to cover it to give people information that's happening. But this is so unique because we couldn't physically get ourselves inside the hospitals because it was so dangerous. And it was right when we were all told to quarantine ourselves and stay at home. So we needed to do that. It was so important for people to actually see what's happening in a big situation and connect it to real people.

Unger: When you had this idea, did you have any idea how bad it was going to get?

Garcia: I think we had some idea. I think what had been going on in Wuhan, in Italy and Iran, we were keeping up with all of that. And I remember there was some video footage from inside hospitals that came out of Italy. And I remember that had a huge impact on me and I felt like we all knew that there was a possibility that that could happen. And we knew that we were going to be in the epicenter if this thing was really going to happen because it's New York, and we live on top of each other.

Unger: So you mentioned being in the epicenter and not being able to obviously be able to shoot people in a normal environment. How did you pull this off then and get all of this footage?

Pappas: I can try to take this one. I mean, this was a total experiment in filmmaking. Alex actually did a great job figuring out how we could try to film people while not physically being there, came up with a little sort of a kit where the basic component of it is an iPhone, but then there was a little light, a little microphone. And also she and Sam wrote up this amazing PDF document about here's how to film yourself, basic cinematography 101. And then we just had to kind of send it out to these doctors and nurses and coach them along and teach them how to be their own cinematographer. So we actually did not even know if this was really going to work. It was all an experiment. And of course we had to edit it all remotely too, which means we couldn't be in the office together. We couldn't be sitting in the edit room together. So we were sort of pleasantly surprised that it worked.

Stark: We talked to dozens, I would say, of health care workers while trying to find people that would, first of all, have an emotional connection that they could express to us about what was going on. And also it's a really big ask. These people, as you know, are having one of the most profound experiences of their life and the most difficult experiences of their life, so we really needed, from all the people we talked to through video chats, which we got their information from reporters, from call-outs, from connecting to hospitals directly. We needed people who were really on board with this idea that they wanted people to know what it was like for them and that they understood that by sharing their personal experience and vulnerability, it would make people connect to what's happening more than just reading it or seeing numbers on a chart.

Unger: How did you actually pick the people that participated in this?

Garcia: We really did interview dozens and dozens of people. I mean, I think that there were two things. We definitely wanted to have a mix of emergency department doctors and ICU doctors, because we figured their experiences would be quite different. And we wanted to show the difference in what they were dealing with on a day-to-day basis, especially understanding that we needed to have ICU doctors because so much of what the story that was happening was happening, the devastating parts were, a lot of them were happening in the amount of time that people are going to stay in the ICU.

We also really struggled, and I think that this says something about what's happening in the countries. It's really hard to get inside hospitals and HIPAA rules. And plus it's a chaotic situation. Plus it's a dangerous situation. So Sam and John were able to work with two hospitals who basically allowed their subjects to film inside the hospitals, which was great. So we were looking for that. We were looking for some buy-in. We were looking for doctors and nurses whose institutions were on board with them joining us. And one of the things about the New York Times is that they don't get final sign-off of our piece. So it had to be places that were really open and trusted us.

Unger: Willing to take a risk, because some of the commentary that came from a particular nurse about lack of PPE, they're very vocal. So let me ask you, we've heard a lot in the news about the struggles of health care workers on the front lines, what do you think makes this documentary different and why do you think it's important to present the stories of these health care workers in this way? Mr. Pappas, why don't you start?

Pappas: Sure. And to piggyback off of what Alex said about emergency room and ICU, we also reached out to people in environmental services who are just in charge of emptying the trash cans and changing the bed linens. And there was an X-ray technician that Sam worked with for awhile as well. Not everybody we started out with made the final cut of the film, as is always sort of the sad reality of filmmaking.

But with each one of these people, no matter what department they're in or what position they were in, you got an intimate look at sort of the toll that it takes on health care workers. So what this sort of brings to the equation that a lot of stuff that's out there so far doesn't quite get is that really intimate like, "What is your psyche like?"

And I think as you watch the documentary, it's unfortunate but you begin to see these folks who are, almost to a tee, they all want to help people, that's why they got into this profession, they start to find themselves really questioning their ability to do that and questioning what's going on in their profession. And so I think it's really profound because I think there's going to be mental health consequences from this in the longterm. And this sort of stands as a bit of a record as to why exactly.

Unger: The pandemic, it's affected all physicians, at this point, in some way, although kind of on a rolling basis as the pandemic moves from different parts of the country. What do you hope physician viewers take away from your documentary? Ms. Garcia?

Garcia: Through talking to some of our subjects, I think that there's a bit of a stigma in asking for help as a medical professional and some people reading it as seeming not strong. And I hope that people realize that their colleagues are all going through something traumatic, and it is going to impact them. And I'm so thankful that the people who we interviewed were so open with us about that, especially knowing that there can be a stigma against seeming weak in the medical profession or seeming like you're asking for help or asking for mental health help. So that's what I hope.

Unger: Well, I love the title, "They Get Brave." And when you see the documentary, you'll understand where that title came from, which really adds to its emotional impact. What do you want the public to feel after watching this? Do you hope it will change people's outlook or behavior and response to the pandemic? Ms. Stark?

Stark: I think when you watch the emotional toll that it takes on these people we followed and also the risk that they're putting their families through by coming home, that people will think, "Wow. I don't want me not wearing a mask to cause pain, emotional pain to somebody else." That's the hope, that people really really understand why they need to protect themselves and others.

Pappas: Can I add to that too, that there was actually a patient whose family allowed us to film his journey. He was a rare case where he came to the ICU before being put on a ventilator. Most of the people come directly, they get intubated as soon as they get into the ICU. So he was able to communicate. Luckily his wife is actually a nurse, so she understood the importance of getting the message out there. But watching him struggle to breathe and watching what he goes through, he's a survivor, but it still, drives home for viewers that this isn't a walk in the park. And you think, "Oh, only 1% of people will pass away." And it's like, okay, maybe, but the other risks associated with it are not worth it. So I hope that, especially now with masks are becoming politicized and there's difficulty in getting people to wear masks, that this can be a reminder of: it's serious. You got to take it seriously.

Unger: The film amplified a lot of the issues that we're hearing about, especially lack of PPE, confusing guidance, physician wellness, which you mentioned. Was this an initial goal of the documentary or was it something that was kind of revealed as the filming progressed? Ms. Garcia?

Garcia: I would say at the beginning, by the time we really started filming with our doctors, which I think was March 24th, 22nd maybe, we knew that PPE was going to be an issue. I think for me, the other toll that this took on our doctors was a surprise to me. And I think for me, I learned to understand doctors' schedules during a pandemic in a way that's just unreal and the amount of work they're doing when they're not actually in the hospital and the amount of stuff they're doing, whether it's a nurse talking to her union, whether it's a doctor reading through papers, that was really surprising to me.

Unger: Ms. Stark, Mr. Pappas, was there anything else that surprised you or something that really resonated with you personally?

Stark: So Alex was talking about doctors because she followed doctors, but I had nurses. So giving a shout out to the nurses. Kelly who's an ER nurse, we follow at a public hospital. I was really surprised how the very first thing she told me was, "I don't think we should be martyrs." And she would get very offended when people called her a health care hero because she was saying like, "I don't want to risk my life and I shouldn't have to. I should have the proper equipment, but I know that I will and I know my fellow nurses will risk their lives. And I don't want to be a martyr in that way." And that was a very profound, real thing that I hadn't thought of that she said right away. So then her whole story ended up being about that.

Unger: Mr. Pappas?

Pappas: Yeah. I think for me, this is something that's probably obvious to any of the physicians listening or anybody who's spent a significant amount of time in the hospital, particularly in the ICU, but I was blown away by how emotionally connected the nurses and doctors in the ICU get with these patients and how they truly do live that emotional roller coaster that patients go through of, "Oh, their breathing is better today," or, "Things are getting worse this day." They are living that right along with the patients. And I commend them for having the sort of emotional strength to go through that day after day. And I just, I don't know, I guess I figured that maybe you get numb to that or maybe you find a way to kind of compartmentalize it in some way, but in our interviews with these subjects, it was so clear that they were riding this wave, emotional roller coaster right along with them. So that was really surprising to me.

Unger: Yeah. That dynamic is really clear, as is kind of the pain when the system becomes so overwhelmed that they can't really keep that connection even when a patient dies. So interestingly, we were talking before the segment about whether or not you still felt this would be relevant several months after the original pandemic wave hit in New York. Talk to me about, do these stories serve as a warning now for other parts of the country? How do you feel it's going to impact places where maybe they're just getting the first taste of this? Ms. Garcia, why don't you start?

Garcia: Sure. Yeah, we really worried that it wouldn't be relevant, because editing these things, putting these stories together ... I mean, we had hundreds and hundreds and hundreds of clips that, we provided these medical workers with phones, and then their clips would automatically upload into the Cloud. And so we would be kind of just waiting for their stuff to come in. And that was already sort of a process that was delayed. And then we had the editing, which was a delay. So we wondered whether it would still be relevant. I think that we didn't even necessarily think that the overall nation curve would go back up again. And I feel like now that it has, and now that the death curve is starting to also go back up again, I really think that I'm glad that this came out now and not actually earlier. I hope that people watch it while they're in the middle of thinking about the decisions that they make on a daily basis and think about whether they want to put these people whom they might call heroes in danger or their families in danger.

Unger: I think that's such an important point. There are not that many jobs where when you go to work you are really exposing yourself to that much danger and your family. It's really great that you have produced this film to showcase what life is really like on the front lines. That's something we try to do here at the AMA and channel those voices into action. So thank you very much Ms. Stark, Ms. Garcia, and Mr. Pappas for being here today. That's it for today's COVID-19 update. "They Get Brave" can be found on FX and streaming on Hulu. We'll be back tomorrow with another COVID-19 update. And for updated resources on COVID-19 go to ama-assn.org/COVID-19. Thanks for joining us and please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.