Lori Felker’s “Patient” cleverly takes the viewer on a couple of unexpected turns. Cleverness isn’t the point, but its humanity is, or at least it might be. We start by eavesdropping in on a few discussions between patients and their doctors as they answer a series of questions designed to get at the heart of what ails them. We’ve all been here. Our doctors ask us questions about our health that eventually reveal something about ourselves we’d rather not admit out loud.
We listen to these people in white gowns anyway, identifying with their secrecy and perhaps even the sadness that exists in their lives. The doctors, all of them young and probably starting out, listen with great understanding as they take notes and repeat their patients’ answers back to them, free of judgment. In the end, they figure out a solution, and we hope, for the patient’s sake, that the medication or aid will be sufficient and affordable. End of discussion.
End of description as well, because this is a short film best watched without prior knowledge of some of what happens.
Director Felker is interested in both subjects on screen, even as we see multiple interviews. The doctors and their patients are given equal screen time and weight. We identify with the patients, but we also understand the doctors’ need to tread lightly and to form conclusions without appearing too vulnerable or judgmental. It’s a true balancing act.
Felker’s film will remind documentary students of the great Frederick Wiseman. The camera remains stationary the entire time, and we wonder: Is this a film about bedside manner? Or about the experience of seeing a doctor? The health system in America? Or all these things? The feeling of eavesdropping and of being grateful not to be in a doctor’s office or hospital at the moment will be palpable, but we also walk away from “Patient” wondering what we just watched. See for yourself.
Q&A with Lori Felker – SPOILERS AHEAD.
How did this come about?
“Patient” was born of research for a feature film also called “Patient,” in which the protagonist is a Standardized Patient. While I was writing that script, I visited a few simulation centers in the Midwest to incorporate the research into my writing. Shortly after I met the team at the University of Wisconsin Health Sciences Learning Center, I knew we had to make a short film together. Working with them gave me the opportunity to get to know this special process intimately, as well as to practice working with the architecture of this unique facility, improvise directly, and design the medical cases.
All of the SPs in this short film work there as SPs in real life. All the medical students are also played by SPs. For the most part, they are doing their job as they always do, except I wrote the cases and patient character descriptions, and there were film cameras in the room.
This may be too much, but if the question goes back further to how I became obsessed with Standardized Patients in the first place, it was from reading Leslie Jamison’s “The Empathy Exams,” in which she writes beautifully about her experience of being an SP in college.
What was the casting process like? And did that dovetail with the writing process in any way?
All the actors in this short film worked at the Madison simulation center, and they were so talented, generous, and caring. They really inspired me. I met most of them the day I went to conduct research and slotted them directly into the film as either SPs or Med Students. Kathleen Tissot, who plays the administrator in the film, is pretty much playing herself and is doing what she normally does at work. There isn’t really a script; I wrote an outline of the day, character backgrounds for three of the main characters, and I worked with Kathleen to write the medical cases the SPs could work with.
For the in-between and ending scenes, I had a narrative thread and knew how I wanted them to feel and how the day was going for them, but I would also ask, “Where do you normally sit when you do this?” Or what do you normally do at this point? And they would show me, and I would fold that in. There are shades of observation, reenactment, documentary, and fiction throughout the film. I was a little short on actors, so we sent out a casting call to their full SP pool to see if I could get a few more people I hadn’t met during my research trip—three roles were cast this way.
How did you and the cast approach this when shooting? Did you all treat it as an improv exercise? Were there multiple versions of scenarios?
They basically did their jobs, but also coached me through how they do theirs along the way. I wrote the medical cases (with guidance and examples, of course!), and then I met with the SPs and Kathleen over Zoom (as they normally do) to review the cases, answer their questions, and make sure they connect with them and can perform the learning objective. The cases are just a couple of pages and aren’t formatted like a script, but they do provide basic medical information, the learning objective, character trajectory, and a roadmap for answering the med student’s questions.
The SPs memorize/absorb those cases, then improvise on top of them in the room for about 15 minutes. Then, when it goes into feedback, they sort of turn back into themselves as educators and have an earnest conversation with the med student. We followed that format. I wrote two medical cases, and each med student/SP combo performed both with feedback, for 20 minutes straight. We shot the exams with two cameras, and I pretty much never said cut or asked them to redo anything. I was trying to capture the actual flow of a conversation, searching for questions and answers, and the progression of the actual interaction between these real people.
At first, I had wanted to work with actual Med Students to make it even more real, but that wasn’t possible for obvious reasons. The SPs were the first to speak up and say, “No one knows the Med Students better than we do!” and it’s true! They knew the procedures, the questions, and even the emotions of these students well enough to improvise in those characters.
In the end, I had 160 minutes of exam footage for a 20-minute film.
How many cuts or versions did you go through in the editing process before you decided on the best time to reveal what was happening here?
I knew from the start that I was interested in making viewers think that the first encounter in the film was “real”, even if just for a moment. I knew I had to establish Gayle (played by Ronna Trapanese) and Melanie (Rainy Armstrong) as people we felt we knew and could care about before we cut away from them, but I also had to find the right cut point.
Fairly early on, I tried the cut on the hands, demonstrating where the pain was as I jumped from one actor to the other. When I showed friends an early cut, it was such a clear winner and served as the building block for the pacing and structure of the rest of the film. It showed the repetition and standardization of what they do, but there was also no question that these two actors were not at all the same people.
After that, it’s gradual. Some people pick up on things right away because they’re familiar with this idea (from a relative in medicine or from Kramer on Seinfeld). Some viewers don’t exclaim “oh!” until the SPs are in the lounge, walking through with their gowns on in the middle of the film. I think the reveal starts early and slowly unwinds, allowing viewers to find the time that works for them.
Did you sit in on bedside manner sessions like this?
I did! At a few centers in IL and WI, I sat down at the observation computer with headphones and could switch between rooms or watch multiple exams at once. It was such a visually exciting way to see the similarities and variations between the performances and personalities in the room. I was also able to concentrate on the med students’ “performances” and how nervous or confident they were.
I know the feature version of “Patient” is in the works. Is there anything you want to tell us about it?
The feature version of “Patient” is a mix between the fascinating work of standardized patients and one of my own frustrating medical experiences. There’s a main character, Reggie, with family and a roommate, and there’s a whole script, but there are also scenes at Reggie’s job that look like I lifted them straight out of the short (because we planned and shot them in a similar way). The feature is in post, and I hope for a premiere later this year or at the beginning of 2027.
