End Game

“People come here to die. But it’s also true that people come here to live.” -BJ Miller, M.D.

BJ Miller decided to become a doctor after surviving his own medical crisis: in a college prank gone haywire he was electrocuted and lost most of his left arm and both legs below the knees. This experience set him on his life’s professional mission, leading him to a relatively new branch of medicine devoted to the relief of suffering, called palliative care. Miller has a practice in San Francisco, at UCSF Medical Center. He and the founding director of the palliative care unit at UCSF, the visionary Dr. Steve Pantilat, work with chronically and terminally ill patients. Pantilat recalls taking care of a young woman with leukemia when he was just an intern. “She had a two year old daughter. I was just at the beginning of my training and I could see that we were going nowhere and she was going to die. The rest of my team, including the attending physician, did not acknowledge that at all. Maybe she doesn’t want to be in our hospital. Maybe she’d rather be home in her own bed reading a book to her two year old. We didn’t give her the choice.” As medical care has become more centered on treatments, cures, and fixes that can increase suffering, these doctors are often the first to have a direct conversation with their patients about their time remaining and quality of life.


END GAME will follow both doctors as they do their compassionate work, often lingering by bedsides of terminally ill patients while listening to their stories. They are empathetic and unafraid to be honest. Above all, they want their patients to make informed choices about their treatment and how they want to live in the time they have left. In fact, they are on a broader mission to change the way we all think about our last moments on this earth. Until recently, BJ Miller was also the face of the Zen Hospice Project, a 30-year-old residential facility in a classic San Francisco Victorian founded in the early years of the AIDS crisis. For many of those years, UCSF’s Palliative Care team has referred patients to the Zen Hospice Guest House.


Telling Pictures has been granted unprecedented access to these two institutions. We will follow these exceptional doctors and the dedicated staff they work with – nurses, social workers, chaplains – as they guide patients and their families through choices that will profoundly change the course of their lives in the time they have left. In the course of several research days at ZHP and UCSF we identified such potential subjects as a grandmother dying of lung cancer whose grandson was trying to convince her to try medical marijuana; a San Quentin prisoner who was shackled to his bed with two armed guards standing by, doubling as his medical proxies and companions; a 37-year-old chef with a brain tumor who finds joy in specially prepared meals and drumming sessions with his nursing aid. These are the sorts of patients we will follow from UCSF to the Zen Hospice Guest House, capturing their intimate conversations with families, doctors, and caregivers, as they make perhaps the last and most important choices of their lives.


Filmed and edited in intimate vérité style, this work follows visionary medical practitioners who are working on the cutting edge of life and death—and dedicated to changing our thinking about both.