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Vital Signs in Vérité: 'A Lion in the House' Confronts Childhood Cancer

By Taylor Segrest

Mother and son, Regina and Al Fields, featured in 'A Lion in the House,' which airs on PBS' Independent Lens

A phone call from Dr. Robert Arceci can change lives for the better or for the worst. The one he placed to veteran filmmakers Julia Reichert and Steven Bognar in 1997 demonstrated that kind of power, but the news was not what one might expect from the head oncologist of the Cincinnati Children's Hospital.

"He had just seen Hoop Dreams," recalls Bognar. "He called us out of the blue and said he wanted to make a long-term, in-depth documentary about childhood cancer--little knowing that Julia's daughter, my step-daughter, had just finished her treatment for cancer. Just an amazing coincidence."

Nine years later, A Lion in the House, the unflinchingly intimate four-hour vérité opus initiated by that phone call, will air on PBS' Independent Lens series June 21 and 22.

A Lion in the House was the longest documentary to ever screen in competition at the Sundance Film Festival. Shortly after arriving in Park City in January, Reichert and Bognar received another call from an oncologist. This time the news was more typical: Reichert was diagnosed with late-stage lymphoma. Doctors advised her to return home immediately, but in the defiant spirit of the children their film celebrates, the couple stuck it out for a few days to attend the premiere. The film received standing ovations from capacity crowds.

Interviewed from a Columbus , Ohio hospital room, Reichert and Bognar took time between chemotherapy treatments to share their thoughts on the monumental process of making A Lion in the House. Reichert says that their own experiences with childhood cancer complicated their decision to make the film. "We thought, 'What gives us the right to walk into these rooms with our cameras?' But we were also thinking, 'Who else is really going to do this or would really devote however long it takes?' We realized that it was a fantastic opportunity, but it was also a responsibility."

A Lion in the House presents five families as they tirelessly wage war against an invisible enemy. The filmmakers lay bare the frontlines of that war, without apology. The camera holds steady on irrepressibly mischievous Tim as he vomits on himself after a feeding tube is inserted into his nose, on rebelliously optimistic Justin during his brain biopsy and on adorably intransigent Jen as she demands to finish her ritual of counting to "three" before the doctor taps her spine with a needle to "get the rain drops."

These children provide the audience with necessary reprieves from their grim situations. Whether it's the comic relief of mischievous Tim wisecracking with the hospital staff or Al's free-style rapping to the camera, the children in the film triumph by, as one nurse puts it, "simply being kids."

"We had never made a vérité film," Reichert admits, and their naïvité may have been one of their greatest assets.

"We had what we call 'breaker switches,'" Bognar explains. The first of which was "a hospital staff person who would bring up to the families the fact that this documentary was going on." The second was the assurance given to the interested families that they could, at any time, turn away the filmmakers or even drop out of the film completely.

With the trust those steps helped establish, the filmmakers arrived at their privileged vantage point, a place to which Reichert refers as the "crow's nest." He explains, "We could talk to the doctors, then go right over and talk to the parents, the social worker, the nurse...We had access to all sides."

With access came crises. Before long, the filmmakers found themselves in what they refer to as "the eye of the needle." Reichert describes "a big turning point in the film came when [two of the children] were clearly in danger. They were in the hospital at the same time. We couldn't leave. We would stay overnight, day after day after day. That was really, for us, the hardest part."

Bognar and Reichert sound like explorers recounting an expedition, and with good reason. Their virtually unrestricted hospital access over five years of filming is a monumental precedent in the documentary world. "The camera became a kind of confessor," says Bognar. "When it first started happening, we were a little thrown by it."

"[Kids] were telling us stuff they couldn't tell their parents," Reichert recalls. "It was kind of a heavy responsibility because there were times when we thought maybe we should say something. There were a lot of lines that documentarians are not supposed to cross that we walked right up to, and sometimes went a few feet over."

In spite of their sympathy, the two never intervened when confronted with ethical dilemmas. In one such instance, they witnessed Tim cheat on the scales to avoid getting a feeding tube. "Luckily, we were let off the hook when the doctor busted him," states Bognar. The two had countless ethical debates, in which Reichert maintained a staunch non-interventionist platform.

Confessions to the camera regularly expose the complex dynamics boiling beneath the surface. One mother confides that she made funeral arrangements for her child without telling anyone, including her husband. The two are often at odds about what's best for their child, and admit it more readily to the camera, it seems, than they do to each other.

Doctors speak their minds as well. In a "hallway interview," one doctor offers insight into the process of applying to use a new drug. "If there's a potentially bad outcome, even if it's not related to their med, it can be ascribed to their med and...unfortunately, it affects the stock market," he reluctantly admits.

"We had 525 hours of tape and our first rough cut was something like 20 hours long, which is ridiculous," Bognar ruminates. Leading a post-production team composed of veteran documentary editors and recent college graduates "with great instincts for storytelling," Bognar and Reichert began living with a rough cut. They would frequently consult other documentarians, among them Hoop Dreams director Steve James. They made sure to have a continual feedback loop and scheduled weekly screenings of documentaries they admired in search of effective narrative innovations. One of their most effective techniques involved overlapping sounds and layering the narratives. "We call them '[Robert] Altman moments,'" Bognar explains.

Of all the poignant moments in this tapestry of emotional rollercoasters, perhaps the most deeply affecting arrives, as it should, when it is least expected. At one of the daily morning staff meetings, the doctors calmly reach the consensus that an especially beloved patient has a failing immune system and can no longer fight. Dr. Arceci then pats a tattered paperback of Albert Camus' The Plague and begins to read:

"They had already seen children die, but they had never had to witness over so long a period the death throes of an innocent child..." Arceci chokes up. "...That sort of thing passes our human understanding, but perhaps we should love what we could not understand. Now the old doctor said, 'No, father. Until my dying day, I shall refuse to love a scheme of things in which children are put to torture.'"

Much like The Plague, A Lion in the House fearlessly refuses to love the scheme while unashamedly exposing the totality of its impact on these five families. The children are the soul of the film, and the film's greatest achievements are the indelible memories of their defiant innocence. These memories serve as reminders of what Bognar and Reichert refer to as "a very awake place."


Taylor Segrest is a writer based in Los Angeles.