At this year’s Hot Docs, the film that undoubtedly had the biggest effect on me was Off Label. This erstwhile “issue doc” turned out to be so affecting that I literally could not write about it for months. You can read my very recently posted review of the film and maybe get a sense of why it seemed to difficult for me. My first viewing was a few weeks before the festival, but after seeing it a second time during the festival, I knew I wanted to talk to the filmmakers. I wasn’t exactly sure what I was going to say, but I knew that any film that left me so unsettled was doing something right. I’d been a big fan of the pair’s first feature documentary, 2009’s October Country (review) but that film’s intimacy didn’t seem to fit with what I thought would be a standard takedown of the pharmaceutical industry. So we sat down for breakfast at the Sutton Place Hotel while I threw some half-formed questions and observations their way.
James McNally (JM): OK. So I’ll start with just the stuff that you probably always answer. Tell me about how the film came about. I know you said that you were approached; it wasn’t something that came out of your own ideas. But how it came to you, let’s talk about that.
Micheal Palmieri (MP): Well the idea was proposed to us by our producers, who saw October Country in 2008. They saw a rough cut of it, and they approached us and asked us if we were interested in making a film about “human guinea pigs” because they had seen two articles, one of them being Carl Elliott’s “Guinea-Pigging” which was in The New Yorker. We said we would be interested. And we kind of explored it for a while, and we got back to them and said, “I think we can do something with this.”
As we started filming we kind of realized that on a dramatic level, we felt the way that you can tell the story – just about guinea pigs – was limited. It was like it was a first part of something, or a story unto itself that was more like a “60 Minutes” episode. So we started thinking along the lines of how we could expand upon it, and that’s how it kind of opened up to this sort of structure that we have. We’re just loosely following testing, marketing, and then end use, but seen through the prism of eight characters.
JM: What was it about your previous work that they wanted? Did they tell you, “We like the style; we want to do it in a certain way?”
Donal Mosher (DM): They saw October Country, and I think it was the stylistic approach. In that film there are very prevalent issues but they’re not the central focus; it’s more the impact of the issue on a person’s life.
JM: Yeah, it’s sort of implicit; the storytelling is front and centre. That’s part of what I love about the film and part of what I’m having an issue with…well, not an issue, it’s a challenge. It’s novel, let’s just say that to approach an issue film in this way. So I don’t know if anybody else is doing it or has done it.
MP: I haven’t seen anything personally.
DM: I haven’t seen anything that I think quite walks that line.
JM: Did you feel a little bit daunted taking on this material?
MP: Oh sure, the material is so daunting because it’s endless. It’s so complicated.
You could make a film that was completely balanced and showed the positives and the negatives. What was interesting to us were the ways in which it was corrupt and how human agency on all fronts is part of that so it’s not just the pharmaceutical companies that are corrupt, that they are engaged in corrupt things. I think they are in some cases, and it’s usually on the marketing side.
But the ways in which we as consumers buy into these ideas that are presented by pharmaceutical companies because we all want to be well.
JM: Yeah, and what that means, to be well.
DM: Not to be well, but not lonely. I think that’s the biggest illness we’re trying to hint at.
JM: Yeah. You’re jumping right to what I want to say which I’ll jump right into, then. The song “No Depression” is wonderful because I always thought of the double meaning of the Great Depression as this economic disaster. But also just depression, the feeling of being blue, down, and I wonder if the subjects are sort of financially strapped and there’s a sense that this medication is going to make them feel better about their lives. It’s almost as if there’s an epidemic of sadness or something, and instead of dealing with it the way that people used to deal with it, we’re letting companies tell us that we need to take medication.
DM: And it’s a consumer society, and before it was goods, then it was faith, so there’s been a long…
JM: The connections you make to it with faith are interesting because there’s Jusef [Anthony] trying to clean his body and I guess he’s drug free at this point. I mean what you’re saying is that faith used to fill that place and now people are using something that’s being prescribed to them by a different clergy.
MP: Yeah. It’s not just one or the other, either. I think when you look at it on just a basic level, the modes of belief in a god are similar to the ways in which we believe that certain medicine is going to work for us, or that we trust our doctors or whatever. Those are things that ought to be examined, not just taken.
JM: Moving on to the process of casting the film. I would say that must have been a really interesting process. How did you settle on the people that you found? Related to that, obviously you didn’t talk to any drug companies, but you didn’t talk to any doctors or any medical professionals?
MP: Well, we did. We talked to a lot of people.
JM: What was the process for making the cut?
DM: For a doctor, there’s a double challenge. One is just the nature of the film. You have to get into the doctor’s life, and into their practice.
A golden character would have been a doctor who is actually quite moral about his prescription, and fighting against the pressures. That’s stepping into the very private world of the doctor’s office, which you’re really not allowed. It would be morally questionable for us to step into this thing.
MP: It’s also dangerous for the doctor, because they’re worried about getting sued. It’s actually very, very hard to do something about.
Just maybe to step back a tiny bit, we did do a lot of interviewing of doctors, of people who write for the New England Journal of Medicine. Shannon Brownlee and all these people. Carl Elliot, we spent an enormous amount of time interviewing, filming. But they all weren’t characters. They were talking heads.
We were really interested in trying to do a film that didn’t have that, that somehow illustrated the issue without a talking head. The closest thing we get to it, obviously, is [Michael] Oldani, but on some half, he’s actively doing things he’s interested in. He’s trying. He’s pursuing the stuff at the zoo.
JM: Yeah, I was going to say, his character, there’s sort of an exposition function that he has to do. In that sense he doesn’t feel quite as connected to the story. Again, that’s a challenge in trying to make any kind of issue documentary, when you’re trying to give information to people.
The issue with him is, he’s very charismatic, but I suppose the issue is, do people trust him? He’s also a good salesman. He’s someone that used to do that for a living.
His function in the film is, you know why he’s there, but it doesn’t feel as organic. I guess that’s unavoidable when you’re trying to…like you said, if you put in a talking head, that would have stuck out, as well.
DM: The hardest thing about making the film was always wrestling with the need to inform. One of the reasons we have so many guinea pig characters is that each one of them is really unique and they’re compelling in their own way. The material we got from each of them spread a little picture of the possibilities of the lives on that segment of the population, so we had to have all those characters. There was a lot of balancing the real desire for the sort of lyrical film we wanted to make against the need to have some kind of foundation.
JM: Yeah. You don’t want to just throw up statistics and things like that.
MP: No, and that always throws me out of a movie. I mean I appreciate films that are more straightforward issue films, there’s nothing wrong with that, I just don’t have an interest in making one of them.
DM: I actually wish somebody had the strength, the legal protection, to make the big exposé on this subject.
JM: Another thing that you’ve talked about a few times, but it’s not in the film, is the fear of making that film. You said doctors don’t want to get sued. And you don’t want to get sued. It’s always looming, but it’s not really in the film. It would be interesting to let people know that really this is kind of insidious. That we can’t actually show you a lot of things because people are afraid to talk to us.
MP: But at the same time we have to be balanced. Honestly our interest is not on that level. I’m not going to go after a pharmaceutical company because that sounds to me like the dumbest thing in the world to do just for your own personal reasons. You’re going to be destroyed. We’re not here to do exposé, we’re here hopefully to help you to feel the ramifications [in a different way].
JM: That’s actually a good jumping off point. Most issue documentaries want you to think, want you to have a rational reaction. Or they manipulate in other ways, but they usually do it with facts. They blow you away with statistics or something like that. What I liked is that your film seeps into your consciousness. It’s not something you’re immediately going to react to, but it’s going to stay with you because of the stories. And also, I think I mentioned to you last night that I like the way you left space in the film for people to…
MP: I really appreciate you saying that.
JM: …absorb things. I didn’t notice it the first time, but I really noticed it with an audience. Because you’re going through some pretty harrowing stuff. There are lots of shocking things in the film, but there are also these little spaces where you just shoot birds or icicles. My first thought was, “Oh, what’s that?” But then I really realized you need this. You need a bit of, just take a breath.
JM: Don’t just jump into the next thing.
MP: It’s part of the strategy of the film, at least for us. We wanted you to feel the physical invasion, so things are filmed closely. The reason Donald offers his arm up.
JM: Wow. [laughs]
MP: It’s a tactic to get you to understand that, this is going inside your body.
And the reason that scene is there before you hear Mary’s story, is you feel invaded. When you hear her story, which is only a story that she’s telling, it’s connected. You’re feeling physical horror. That’s why you need these pauses, too.
DM: But it’s also just the nature of cinema. The thing you can do really well in cinema is, you can take any well filmed scene and infuse it. It works relieving the pressure. Also, in those interludes, or those prosaic moments, you’re relieved of the immediate pressure of the scene before, but you don’t lose it. It holds you.
JM: Yeah, you’re right.
DM: I think the narrative cinema works constantly on this. Documentaries can do it as well too, although they…
JM: They haven’t a lot of the time. Especially issue documentaries. They seem like they want to move on to the next point, which is very different.
JM: How long were you able to shoot with each subject? Because it really felt like you got very intimate with each of them. I wondered, does it take you a while? Were you just flying in, and shooting, and going home?
MP: We started filming in the beginning of 2009, and we finished in this last summer. We started editing in the beginning of the summer. There were some gaps we had to fill. Basically, each character in the film really represents only three visits.
Visits of, depending on the person, a couple of days to, let’s see… With Mary [Weiss], we would meet with her for a few hours. We met with her three times. We had an enormous amount of contact with her before, during, and after. We’re still in contact. We developed relationships with people before we go in, because we know that this is really…
JM: Kind of long term.
MP: Yeah. Andy [Duffy] became a friend. We met him at a very dark moment in his life. We filmed him twice, and then he came out to Portland because there happened to be an Iraq Veterans for Peace conference that was just set in Portland. It was the national conference. He asked to come stay with us. I said, “Yeah, of course. Come on, let’s go.”
DM: And that’s how we got the tattoo scene.
MP: More importantly, it’s like you’re developing a friendship with somebody who needs that connection, that the thing he’s missing in his life.
DM: On the practical side of it, too, even Mary, everyone in that film, their stories have been told. They were in a position where the basics of their story, they could put it out very easily. So, there was a feeling of intimacy already built in because they knew how to speak their story. We could go from personal to factual very, very fast, and that allowed for a richer intimacy.
JM: So somebody like Paul [Clough], it doesn’t sound like he was someone that was spoken to a lot, he’s not someone that would have been in the media or anything like that, he just sounds like a guy trying to get by.
MP: He’s a little bit higher up the food chain in the sense that he has a web site that operates in a similar way that Robert Helms used to do with Guinea Pig Zero. He had a zine that organized people who are doing this as a means for people to rally around and figure out which one of these has comfortable beds, which one of these studies has better food, that kind of thing. He’s doing that online with his web site called jalr.org, and that’s how we got in touch with him.
JM: That’s interesting because what I would get from the film is that each of the characters feels very isolated. The way you shoot them, I don’t think you even shoot Paula [Yarr] in the same shot as her husband, you do it separately. The whole effect is of these people being alone, but what you’re telling me is that they’re not, they’re creating their own networks.
MP: Oh yeah, but they are alone. Hopefully it comes across.
JM: Oh yeah, I don’t think it’s possible to miss it.
DM: Paul doing his web site, he works on it off and on and it is actually one of the most lonely things in his life.
JM: I think Robert [Helms] has a web site, too, doesn’t he?
DM: He writes and publishes small articles.
JM: He still does print stuff?
MP: Old school.
JM: It’s sort of like this lonely, tilting at windmills kind of stuff where it’s one person and he feels like he’s up against the whole world. They all feel it, a lot of them do. I would say the exception would be Jordan [Rieke]. Jordan is interesting, too, because you don’t get the sense that this is going to be a big part of his life for very much longer.
MP: They’re kids growing up, they don’t really understand what they’re dealing with, in a way. That’s part of the weird conundrum of this film is that it’s not all bad, this kid is using these studies to pay for his wedding. In a sense, you could see that as a positive.
JM: Although it’s a weird sort of thing to say that that’s the job that’s available.
MP: Yeah. And for him I think his is more of a choice issue and that’s why he’s in the movie. You know, Eddie (Jusef) Anthony in prison, it’s not a choice for him. It’s a system of coercion, which is why they banned it.
But the coercion, I think, runs into the same thing with people like Paul who are marginalized for systemic reasons in group homes and adoption and foster care.
JM: It’s not that different from the prisoner situation.
MP: That’s the point.
JM: Because it’s sort of like a captive audience where people have no other options.
MP: Right. They have no other options. That’s a large part of why Jordan is in the movie. He represents someone who actually does have options, in a way, but their lifestyle choice…
JM: Although, maybe not. I mean, I can’t see him going and working in an office or something.
MP: Well you’re right, that’s true. But all those things are choices that he’s made. You’re right.
JM: But it’s also great that you have him because you get to have the wedding scene which you really need at that point in the film. So that’s wonderful. The only other thing I would say is that I guess the film – and I think I mentioned this last night as well – there’s sort of a pervasive, it’s almost kind of gloomy in a way, mostly. What I’m not used to – and this is not good or bad, this is just unusual – is that most issue documentaries want you to feel like there’s something you can do, you know, there’s a call to action. There’s something. They want to sort of tie it up a little bit with a bow.
MP: Yeah, it’s not a call to action. It’s a call to reflection.
JM: Yeah, it’s different. There’s definitely a sadness. There’s isolation and you realize that the problem seems to be – it’s not about mental health. It’s not about drugs, it’s not even about corporations. It’s about how we don’t have any sense of community anymore. Are we just falling for the wrong solution to some of these problems? And when you see someone like Andrew finding this group of vets, that’s the way we used to do it and that’s the way it should be done. And it’s just weird that’s there’s…it’s just overwhelming. The marketing is so overwhelming. And nobody can make a buck out of that. Do you see it as a sort of a larger indictment of the way our economy works? Our society?
DM: For me it’s one of the symptoms of a capitalist society and the consumerism of that is a real isolation. It is definitely casting a light on that side of the American landscape, for sure. I feel that it’s great to have political anger. It’s great to have the facts on the website but those are also things that are easily shaken off.
JM: I think the reason why they like to do that, to sort of rally around a cause because in a way that’s how you get that sense of community. Because you get people together that share the same…
DM: And that’s completely necessary.
JM: And that may or may not change anything but it’s like you’re bringing people together that can support each other.
DM: But I think if you have that sort of action… I think anger and righteous action comes and goes very quickly but heartbreak stays with you. That’s the thing we want to…
JM: That’s the thing that you want to come out of it and go, “Wow, is that, is that…?” You don’t want to feel…
MP: But how you feel is. I mean it’s a success the way you feel. Whether or not you choose to like or not is not the point. The point is that you’re sitting here and you’re like, “I need to talk to you guys about this because I don’t really understand…” I think that is the type of thing that has more force than the “Here are three things you can do.” type of movie.
JM: And if you see a lot of documentaries, it’s just the same stuff.
MP: We also consume media. I mean, you go to a documentary they tell you dah dah dah. You feel like you’ve participated simply by watching. We don’t want you to feel like that. We want you to think about how you might also be implicated in that issue by breaking your heart and by making you feel conflicted and frustrated or whatever.
DM: This is something that can happen in novels and art even and certainly in narrative film. Somehow it’s become more and more that it’s not acceptable in documentary. I mean the films that we love are Chris Marker films. Every Chris Marker film is an elegy that communism didn’t work. It was such a beautiful idea, but it didn’t work. Or even Grey Gardens doesn’t tell you how to deal with crazy relatives, like “Here’s a website!” you know? [laughs]
JM: No, no. You’re right. Yeah. I know it’s refreshing but again the feeling that you come away with is… and it’s good. I guess that’s what I’m saying. It’s unusual. I don’t know if you are meaning for people to come away completely hopeless or completely feeling like, “Oh, this is just too big.”
MP: But how can you feel totally hopeless when you’ve got Andy. Because Andy’s positive, Jordan is incredibly positive.
JM: Yeah and these people are getting by. It’s a struggle but most of them seem like they’re going to be OK. But wow it’s just across the whole country. It’s this whole epic sort of loneliness everywhere. I don’t know. I don’t want to come out of it and say, “It’s just depressing.” But I guess the fact that it makes you think about it longer is probably the desired effect.
DM: I don’t think you want every film to be doing this. But I like that feeling. I like coming away from a piece of cinema or whatever it is and just be blasted by it. You’re uplifted or you’re destroyed or whatever. I think really that’s what cinema does better than anything else. I don’t mind.
JM: No. I guess I find the more that I reflect on it I can sort of understand that if you get people to saying, “I can’t get that film out of my head”, you know, “it just made me really sad”, that’s not a bad thing. It’s just that when you’re taking on something so big, I guess the idea here is you’re not making a film that’s trying to change anything.
MP: We’re laying out a complicated set of problems, how those things interconnect and we’re giving you the tools to think about it. You can’t cast judgement on something that’s that complicated. You know, part of the problem, at least with the culture of the United States at the moment is that everything is a black and white issue.
JM: Right, yeah, so you take sides.
MP: And you take sides. And there’s no one doing serious thinking about it anymore. The positions are rooted in the sand, you know. Rooted in the ground, and it’s not that easy.
DM: I think we differ slightly. I mean, I feel like you really can capture that, like, I am capturing that.
MP: Oh we are. But we’re leaving open this space for you to think about it.
JM: Now, I think one of the questions at the Q&A when I was there, there was actually an acquaintance of mine who asked you about putting two people from the film in a room and what two people that would be?
MP: Incredible question.
DM: Incredible question because she got to the heart of the problem with that question.
JM: Right. I just wondered have you shown the film to each person, have people interacted with each other’s stories at all, you know, the characters?
MP: Well [Michael] Oldani and Bob [Helms] and, you know, Carl [Elliott], they’ve all met. In Minnesota we’re going to show the film and we’re going to get Mary and Jordan and Andy and hopefully Oldani will all be there. Paula and Andy are going to be in San Francisco, they’ve all seen the film.
DM: But they’ve never met each other.
JM: I guess you would feel a little less alone when you realize that other people are struggling in different ways or the same way.
DM: You know to me it works like, I love to compare everything to country music, like good ole’ country music. That music soothes you because it knows your loneliness. You know, if we can get a hint of that kind of effect, you know.
JM: The blues.
MP: You know I was just thinking about this. I don’t know where this is going to go, but one of the things we were really concerned about, actually, you know, when you first put a film out and the first thing that is written is a catalogue with the description, right, and so Tribeca and Hot Docs wrote these catalogue descriptions that, you know, reduced the film to an issue film about pharmaceuticals, right? And one of the worries we had was if you do that the viewer goes in expecting issues and they feel thwarted by that in some cases or their mind is open and they watch the film. And I think you’re in the camp of your mind being open, certainly, but at the same time you are also…
JM: Oh I know, you’re right, my expectations are different for that and I think the interesting thing was that I had seen your previous film (October Country) and I sort of thought, wow this is interesting I wonder how they are going to do this? But not everybody has that luxury.
MP: But the previous film is also touching on these multiplicity of issues like foster care, the welfare system, spousal abuse, pharmaceutical drug prescriptions, and we are looking at all of those things in the context of this story under one house. We are doing similar things with this film but October Country was never viewed as an issues film. And this is a subject that we’re using as a jumping off point and it’s more of an issue.
DM: But like we said earlier, the issue kept forcing itself up.
MP: It kept forcing itself in.
DM: Like you had to adjust.
JM: Yeah and I guess because you had to choose different subjects there had to be something, a thread, and it was going to be this. One of the other things I would say is that there is sort of a trend in documentaries that you guys are part of which is toward more impressionistic stuff, like I saw the Ross Brothers’ film [Tchoupitoulas] last night. And even stuff like, you probably saw Billy the Kid a couple of years ago and, again it’s storytelling but there’s all kinds of stuff there. I just wanted to know if you would do another film if someone said we want you to make a film about gun control or something.
MP: We would really shy away from it I think probably at this point. We want to go back to something that is just completely personal.
JM: Yeah, so it is difficult in a way to meld those forms and I just want to know, from what you have experienced and learned is it something that you can’t really do again?
MP: No, I wouldn’t shy away from it, I just think that the type of stuff that we love to do is going to probably lead to a film that is very intimate in the way that October Country was and we also want to move in that direction again because we did get to do this.
JM: And those films, to be fair, are difficult to see in a festival context, I think.
MP: Which films?
JM: The kind of films that you are making because I think you don’t, and this is a sort of general thing about festivals, is that you don’t have as much time to really reflect on a film when it’s part of a packed schedule.
MP: Oh, now you’re talking about how you, like when you’re watching?
JM: Yeah. If the film gets out there and has its own release I think that’s different, but I think when you get press coverage at a festival, you get this sort of frenzy where people have to watch 20 films and write about them. I’m not going to be doing any other interviews because I can’t do that. I can’t just bang bang bang, and I don’t think that’s fair.
But I also think, for instance the Ross Brother’s first film , I was working at Hot Docs when that was submitted. I was an associate programmer for two years, and I didn’t have a lot of power, I was like the second viewer on films and I got that film and it had already been turned down and I watched it and that was the week I was watching 30 films or something.
Again, if something doesn’t grab you, it’s not fair but it’s the way the process is, if it doesn’t grab you, you kind of go wow, this is too languid…
MP: Yeah, that was the problem with October Country.
DM: So, when you saw the Ross Brothers’ film, did it grab you or not?
JM: It didn’t grab me and this was like three years ago or something and maybe this, for me it was a new development and I hadn’t been seeing films like this before.
Isolated examples. Billy the Kid was a Doc Soup as well, but when you’re in that hothouse of festival submissions you – I’m not sure everybody is like this, but I was sort of told “OK, you know there are certain things you’re looking for, you know is this going to grab people.” You are under a lot of time pressure where you’re like “OK, I’m going to give this 30 minutes or something and if it doesn’t seem like it’s going anywhere…” which is unfair to the film, no doubt. I wonder if it’s not conducive to festival type viewing, you know, whether from the programming perspective or the viewing.
MP: I would argue that it is conducive for festival type viewing. I think audiences are much more open than the programmers think they are, but at the same time the programmers are inundated with so many films that the function of actually getting through those films and doing due diligence, you’re going to cut the corners because you have to. I mean I used to live with somebody who did screeners for Sundance. You just watch them and Bam! Five minutes, out.
DM: But that’s why it’s not conducive. I actually think the shape of a lot of films has been reconfigured by the submission process.
JM: Yeah, I think that is what I was driving at and it’s unfortunate. It’s like certain festivals would be a better fit than other ones for you. I don’t know, did you show at True/False? Something that is highly curated by one or two people, audiences know what they are going to get.
MP: We had an amazing conversation at Tribeca with Geoffrey Gilmore on the opening night. And I just walked up to him and said thank you so much for having us it’s an honour to be here. Especially in that program. He was like, “Great, so you made Off Label?” and then he said, “Wait a minute, did you guys make October Country? You guys are doing something so different and it’s so hard to program that kind of stuff. I think he was intimating about how they didn’t take it at Sundance. I understand now what he was talking about after having gone through it a couple of times.
That film, it wouldn’t just get lost at Sundance, it would be trampled on at Sundance. They’re looking out for it in a way too where I think they actually are sometimes deeply reading…
JM: Yeah, you want to give it a bit of space. You need room to see a film like yours.
DM: He was talking about a lot of films that are not that standard documentary. Charlotte as well here, both of them are programmers who understand that non-fiction film is everything from Animal Planet to the Maysles; it is a huge spectrum and they’re really, I think at this point, people are fighting for a small but very solid window for films that don’t quite fit those standardized molds. I think it’s going to shift. I think Tribeca and Charlotte here are really strong champions of that non-standard non-fiction film.