How We Gonna Pay For That?
“Rahamid has a fear of plants,” explains his teacher, Janet Mino. “We’re trying to desensitize him. Outside, he won’t go by the trees.” She holds a potted plant in front of Rahamid, asking whether he might take it from her and put it back on the classroom shelf where she found it. “Ouch!” he murmurs. Mino presses on. “You want to put it back for me or no?” she asks. No. “You want me to do it?” Yes. “Okay, I’ll do it.”
Rahamid has been able to say what he wants, and that’s the point for Janet, rather than the fear of plants. Mino seeks engagement and communication, asking for each student, “How to take care of yourself, how to express yourself or just get some type of language out of you?” Throughout the documentary Best Kept Secret, she patiently coaxes just such self-expression from her students at John F. Kennedy High School in Newark. These students have a range of special needs, met by JFK staff members with attention to detail, innovative strategies, and remarkable dedication. As Mino puts it, laughing through her visible exhaustion, “I should get paid overtime, always… weekends, I’m always thinking about them.”
So far, so familiar: during its first moments, Best Kept Secret looks like another documentary about great work at a great school. But Samantha Buck’s film—which screened at this month’s AFI Docs this month and will be airing on PBS’ POV on 23 September—takes a next step, looking at what happens after school. Specifically, it shows what’s happening as, for the first time in her 20 years of working with autistic spectrum children, Mino’s entire class is graduating.
The film follows this transition in 2011, as it affects Mino and several of her students. Outside of school, they won’t have the same sort of attention or time devoted to them, and so, in the months before graduation, she sets to work with parents, guardians, and area agencies in hopes of finding situations for each graduate. As Mino confronts the difficulty of finding ways for each student to feel as stimulated and special as he—and they are all hes in this film—can feel at JFK. Social worker Cynthia Pullen Thompson cautions Mino that their lives are about to change radically, as the state now sees them not as students but as consumers (“Instead of a person,” interjects Mino). “That’s the language they use, the agencies,” underlines Thompson, language designating new costs and payments to be made.
As Mino notes, her students are all “inner city,” which is to say, poor. Their parents and guardians can’t afford the private services of a place like the West Orange’s WAE (Wellness, Arts & Enrichment) Center, a nonprofit alternative learning center where she sees students in a group situation, painting, sharing their work, encouraging each other, and engaged in the kind of self-expression she values. But even as a counselor assures Mino that “The only criteria is [sic] that you like to be here,” either the state or families have to cover costs. More often, the options for Mino’s graduates are “work-oriented,” janitorial activities or piecework they take on as individuals, where supervisors don’t have time or training to attend to what Thompson calls “social recreation,” and what Mino calls “life.”
Mino’s efforts to find rewarding situations for her graduates seem heroic in the film, and you’re invited to share in her frustrations, as caretakers and children are left with non-choices. Individual stories speak to broader constraints: Erik is thrilled to see his mother when she can make it to see him, as they’ve been separated owing in part to her addiction; Quran’s father admits that it was difficult for “accept him for him being who he is,” but still, he wants to have him tested, despite Mino’s advice against such standardized assessments (Bradley, Quran’s dad, sighs when he learns the results, which suggest his son has “regressed [in] some of the things that I know that he’s able to do”). Another graduate, Erik, finds brief joy in the job he’s “always wanted,” cleaning up once a week at a Burger King, but an epigraph at film’s end reveals that when his family is unable to secure a regular monitor for him, he loses the position.
Mino sees that such disappointments have more to do with her graduates’ economic situations than with their abilities, or their many achievements at JFK, a point she makes during a public panel discussion with Senator Robert Menendez. But identifying that particular difficulty doesn’t begin to improve it, as funding remains largely unavailable. That’s not to say Best Kept Secret focuses on the disappointments, or that it doesn’t return, in its final moments, to Mino’s classroom, where she has a new class of energetic students who are learning to express what they want.
Self-expression is at the center of another film at AFI Docs, Remote Area Medical. Here again, communication is limited by economic conditions, and again, consequences can be brutal. The film focuses on Remote Area Medical, founded in 1985 by Stan Brock and currently operating out of Knoxville, Tennessee. Brock explains briefly that this original idea was to provide medical care for communities in faraway places, for instance, South America or Africa, inspired when he was injured as a young man in Brazil and learned that the nearest doctor was 26 days away by foot. But the locus of operations has since turned to the US. “The thing that weighs on me the most,” says Brock, “is we have people who need help right inside our borders. Remote area medicine, it’s not too remote.”
Jeff Reichert and Farihah Zaman’s movie tracks the group’s work over one weekend at Bristol Motor Speedway. They bring in a huge semi-truck full of supplies and equipment, as well as volunteer doctors from all over the country, and service patients on a first come, first serve basis for three days. The undertaking is huge, complicated, and by now, too often practiced. The caregivers participating assert the rewards of the experience, and patients are grateful to get care—from dentists, opthamologists, and physicians, as well as veterinarians—they can’t begin to afford otherwise, the film makes clear that even these returns only expose and reemphasize the cruel limits facing everyone involved.
Such limits are made visible immediately, even before the clinic opens for business, as patients arrive by the hundreds in the parking lot, angling for position, waiting for Theresa, the extraordinarily serene person in charge of handing out tickets. Bundled in her jacket and making her way from car to car, she assigns tickets for each day, 500 for the first and 800, for the next, a process that is as efficient as it might be but also leaves hundreds of people without a chance to get care. Those waiting have to contend with all manner of troubles, the distance they’ve driven, the need to be back home with kids or back at work. They’ve started lining up long hours before for the opening at 5:30am ,and some find ways around, pretending a car is theirs when it’s not. But for all the understandable disappointment and anxiety, the RAM team maintains order and calm, even as they look forward to the escalating activity of the following days.
Throughout these days, the film makes clear enough its argument with the current state of health care, the woeful lack of delivery and efficiency. One of the staffers observes, “I wish all of the people who make decisions would come down and be at the racetrack this weekend and see what the consequences of some of their decisions have been.” The film’s portrait of these consequences is acute, evoking the many costs of the system as it stands. It does so by conjuring a compelling mix of emotional effects, a sense of urgency and good humor, fear and trust, desperation and hope. Most often, these effects are rendered in close-up, handheld images: dentists bent over open mouths, pulling tooth after tooth, doctors gently pointing out spots in lung x-rays or encouraging patients who’ve had minor but still painful surgery done on the spot, and a pair of eyeglasses makers, one a jeweler by trade who’s happy to serve as an “apprentice” today.
The film also offers interviews with patients: one woman looks forward to having her teeth fixed, she says, because the discomfort “takes a little bit out of me, I’m trying to see on the other side, that my self-esteem is gonna be a lot better (He husband adds that’s it been difficult not being able to “kiss my wife for a year”). A man reveals that he’s been desperate enough to pull a couple of his teeth, a woman with a cyst under her eye feels unable to leave her home, and another woman explains that she’s been unable to have insurance because she can’t find work, being over 50, overweight, and without a college degree. “I have a lifetime of experience and I ain’t stupid,” she says, but I can’t get a job.”
Remote Area Medical (2013)
Stories like hers are familiar but still, rarely examined. Remote Area Medical uses such stories to show stress and tension, as well as courage and joy, as patients leave with glasses, able to see clearly for the first time in years, or with a contact for follow up on a chronic condition. One fellow is pleased to have his teeth pulled, but now faces more problems. “I’m a criminal now,” he says, “because I can’t afford to go to the dentist, but can afford five or 10 dollars to get something for the pain.” Leaning over the plate where he’s crushed a couple of pills so he can snort them, he insists, “I don’t use a lot of these drugs like that really.”
Set within the ongoing context of the patients’ daunting needs and RAM’s substantial efforts, this scene seems straightforward, another practical attempt to deal with an alarming lack of options. No one—not the patients, not the doctors, not the volunteer assistants—sees RAM as the best solution to what’s wrong. But for now, the film shows, vibrantly and compassionately, it is one of the only ones.
Best Kept Secret
Remote Area Medical