Life Matters Media
Start the most difficult conversation American isn’t having- the conversation about our end of life preferences

An ‘Accidental Activist’: One ICU Doctor’s Work To Change Death Through Print And Film


Jessica Zitter calls herself an “accidental activist.”

After decades working in intensive care units, the California-based physician is now focusing on making end of life care better for her patients – and millions of others.

In today’s medical culture, the dying are often put on what Zitter calls the “End of Life Conveyor Belt.”

It’s a concept she explores in her first book, Extreme Measures: Finding a Better Path to the End of Life. Extreme Measures is due for release Feb. 21 and charts Zitter’s two-decade journey “in the trenches” through intensive care units across the country.

No matter where she has worked, Zitter has watched as some of the most vulnerable patients die intubated, catheterized and attached to machines. Many don’t even know they are fast approaching death, because they’re never explicitly told they are dying.

The result: millions of people suffering cold, painful deaths in hospitals instead of at home with their loved ones and with proper pain management.

Fortunately, when end-stage patients are told about their condition in clear, compassionate language by doctors, research shows that they are far more willing to opt for palliative medicine and make their end of life care wishes known.

The key: empowering patients with the truth.

“I am really an aggressive ICU doctor – I am all about saving lives, I love the ICU – but the reality is that my patients do die,” Zitter told Life Matters Media.

“My priority is always to do what the patient wants me to do. What you want me to do given the reality,” she said. “I’m about empowering people to do what their choices and preferences and values dictate.”

However, when patients are informed, they have been shown time and time again to choose less.

Zitter’s patient-centered approach to medicine is the subject of Extremis – a documentary short streaming on Netflix. The 2016 film is nominated for the Best Documentary Short Oscar, which will be awarded during the highest- rated awards show later this month.

Directed by Academy Award and Emmy Award-nominated filmmaker Dan Krauss, Extremis focuses on the “harrowing decisions” that doctors, families and seriously ill patients often face at the end of life.

“I’m thrilled – it’s beyond my wildest dreams,” Zitter said. “(Krauss) was somehow able to see into this world and make meaning of it. I never expected it would do so well, or that he would capture this world in such an emotional way.”

Producers were granted extraordinary access to the intensive care unit of Highland Hospital, the public hospital in Oakland, Calif. where Zitter practices.

“I am really an aggressive ICU doctor – I am all about saving lives, I love the ICU – but the reality is that my patients do die”

She hopes the film reaches people beyond the medical community.

“Yes, death is a taboo and it’s very difficult to talk about, but once you break the barrier and you either say the words – death or dying – to a patient or family, or bring the concept up with your own grandparents, then there is a certain type of power that comes into the relationship,” Zitter said.

“You can take control over your own life.”