the more lofty the purpose of thesencollaborations, the more they are likelynto arrogate to themselves a wide rangenof powers and perquisites, which theyninevitably abuse. Wiseman seems notnto be so much shocked by these perversionsnand betrayals as. amused. There isnalso the dolorous satisfaction in seeingnthe confirmation, yet again, of his morenor less dismal expectations. NearnDeath is one of his most ambitiousnundertakings, running as it does to justnunder six hours. It was shot in thenMICU (Medical Intensive Care Unit)nof Beth Israel Hospital in Boston, andnit shows the progress or, more often,ndeterioration of four patients, uponnwhom the doctors and nurses andntechnicians lavish their expensive attentions.nThe work is a powerful one, as clear,nsimple, dramatic, and eloquent as anyndocumentary in the history of film.nEven at this epic length, it goes quickly,nand one is amazed that so muchntime has elapsed. But for all its powernand simplicity, it seems to have puzzlednsome of the professionals. SusannWolf, a jurisprudent from the HastingsnCenter in Briarcliff Manor who re­nLIBERAL ARTSnviewed it for The New England Journalnof Medicine, remarked that “It performsna great service, revealing a realitynmany laypeople and doctors are sure tonface. The film provides no overarchingncommentary, however, to put into perspectiventhe practices it depicts.”nWell, what it doesn’t have is one ofnthose great narrative voices lecturing usnin a voice-over about the urgent neednfor action if the Amazon rain forestsnare to be saved. It doesn’t proposenanything. But it asks some fundamental,neven radical questions, the first onenof which is whether these heroic measuresnof ICU care, including intubationnand cardiopulmonary resuscitation,nmake any sense. Is there a benefit,neither to the patients, or to their families,nthat justifies the enormous expensenand the exquisite prolongation ofnsuffering? Of the four patients wenfollow, two die in the unit, one makes itnout of the unit and back to the wardnand dies there, and one actually makesnit out of the hospital and goes home.nBut is this enough of a benefit tonwarrant the enormous distortion ofnresources that these units represent? Asnone discouraged senior doctor remarksnTHE PARTY OF THE COMMON MANnA transsexual convicted of murder inn1961 said in March that she planned tonstay in the race for the Harris Countyn(Texas) Democratic Party chairmanship.nLeslie Elaine Perez, age 52, finishednsecond in a four-person race, receivingn27 percent of the vote to 42 percent fornKen Bentsen Jr., a nephew of SenatornLloyd Bentsen. A mnofF between thentwo was set for April 10.nPerez, president of Houston’s chapternof Gay and Lesbian Democrats ofnAmerica, says she was born LeslienDouglas Ashley but became LeslienElaine Green when she underwent sexchangensurgery after her release fromnprison in 1971. When questioned aboutnher Hispanic surname, she said itn”comes from a boyfriend of mine.”nPerez and a codefendant were con­n52/CHRONICLESnvicted of capital murder in the shootingand-torchingnslaying of a Houston man,nfor which both received the death penalty.nTheir convictions, however, werenoverturned, and after a second trial Pereznwas sentenced to 15 years in prison, onlynfive of which he ended up serving.nOutgoing party chairman Jack Carternsaid a lengthy runoff campaign wouldnbenefit neither Ms. Perez nor the localnDemocratic Party, which was shaken inn1988 by the election to the party chairmanshipnof Claude Jones, a supporter ofnfringe presidential candidate LyndonnLaRouche. Carter has encouraged Pereznto drop out of the race.n”I didn’t think [the murder conviction]nwas going to come up again,” saidnPerez. “I just want to help get Democratsnelected.”nnnin the course of the film, two-thirds ofnthe medical care costs of an entirenlifetime will be incurred during the lastnthree weeks of a person’s life. “It fallsnto the viewer,” Wolf writes in The NewnEngland Journal, “to deduce thenstrengths and weaknesses of thosenpractices and to glean the lessons ofn’Near Death.'” The first lesson is thatnthere ought to be some considerationnabout these MICU’s, some discussionnof whether they ought not to be justnshut down tomorrow.nThere are several shots in the film ofnjanitors who come around to sweep thenfloors and to empty the wastebaskets.nThese are not just background eventsnor devices to allow for cutaways; Wisemannrepeats them so that there is nonquestion but that he is making a particularnpoint of them. They intrude, atnfirst simply as punctuation and then, asnthey continue to recur, as metonymicncommentary. We come to see that thenMICU is like a giant organism with thendoctors and nurses as its attendants,ntaking care of the garbage just as thenblack janitor is doing. He pushes hisnmop and empties the trash, trying notnto get too involved in his depressingnsurroundings and the interminability ofnhis own tasks. The doctors and nursesnare doing more or less the same thing,nbut their efforts to keep uninvolved arenless successful. Their patients fail andndie and they can’t help feeling failurenand grieving for these inevitable losses.nWe see these people extending themselvesnnot only as scientists but asnhumane sources of comfort andnstrength to the patients and their families.nBut highly trained health carenprofessionals though they may be, theyndon’t seem to have any control of thendirection in which they are going. Thenhospital and the unit might as well benrunning on automatic pilot. The questionsnthese doctors and nurses face arennot strategic, but only tactical andnlogistic.nThe direction of medicine, after all,nhas been taken from physicians by ansociety that recognizes how these arenquestions in which we all ought to havensome say. Medical care changes outcomesn(which it didn’t use to do), andnit is no longer a luxury, but is perceivednas a social or civil right. The allocationnof resources is something we all have anstake in. And we don’t trust the doctorsnany longer to do the right thing by eachn