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Rural Health and the American Dream in 'If Dreams Were Lightning' [1]
['Liz Carey', 'The Daily Yonder']
Date: 2023-12-01
An abandoned hospital that serves paranormal investigators instead of patients. A green bus that has lines of people waiting for medical treatment when it comes to town. A coal miner struggling to breathe fighting with the coal mine that made him sick.
These are the realities of healthcare in rural Appalachia as illustrated by the new film by Ramin Bahrani, “If Dreams Were Lightning.”
As a child, filmmaker Bahrani traveled to rural areas in North Carolina and Virginia with his father, a doctor, as he treated patients who wouldn’t otherwise have access to healthcare. Now, he has trained his camera lens on the realities facing people in rural communities.
Drawn to the issue by the increase in rural hospital closures in recent years, Bahrani wanted to illustrate the rural healthcare landscape in a human way. Focusing on Appalachia, the film looks beyond talking heads and experts citing facts and figures.
“The rapid closure of hospitals in rural America and specifically in this region of Appalachia are so ingrained in (Ramin) and important to him,” Pamela Ryan, one of the film’s producers said in an interview with the Daily Yonder. “He is a director who integrates a lot of humanism into his work… We knew from the start that this was going to be something where you learned about the issues at hand by the people who were living it day-to-day.”
Originally, said Jason Orans, another of the film’s producers, the focus was just on rural hospital closures and how that affects the communities around them.
“If a company buys up five factories and closes one, some jobs go away,” Orans said in an interview with the Daily Yonder. “ But when the same thing happens with a hospital, it’s not just jobs that are lost… what happens to all those people that had counted on the hospital as a center not only for health care but for the health of their community in some ways. What is a community if it doesn’t have something as essential as a place to go when you’re sick?”
As shooting continued, however, the filmmakers realized there was a story to tell that centered more on the rural vision of the American Dream. Subjects in the movie say the life they are living now is not what they envisioned their future to be and doesn’t resemble their vision of the American Dream.
“Everybody we interviewed just kept on talking about this unshakeable idea that America is the greatest country on earth,” Orans said. “It’s this lovely idea that we all grew up with. But sometimes you have to take a really hard look and say, ‘Well…what about this part of it?’ [Lack of rural healthcare access] is just this terrible thing that we all take for granted.”
The film follows two women, lifelong friends, who travel the backroads of Appalachia in a mobile healthcare clinic bus, The Health Wagon. When they arrive in a town, they face long lines of people hoping to get access to the services they provide.
“They’re really fighting the good fight for these communities in Southwest Virginia that without them would just have such tremendous barriers to basic care,” Ryan said. “I think that to many audiences, it’s clear, the Health Wagon is incredibly noble and the work they’re doing is tremendous… But it’s also still a band-aid fix compared to the comprehensive change that’s really needed in our country.”
That fix is illustrated in some of the stories the film tells – a veteran who is diagnosed with cancer after a trip to the Health Wagon but doesn’t have access to continued care. A woman who admits she never goes to the doctor as she waits at a clinic for tooth extraction. A man caring for his bed-ridden wife who knows any medical issue for him would be more than they could financially survive.
But instead of anger or resentment, most of the subjects seem resigned to their situation, Ryan said.
“I think there are people who have seen multiple generations of their family struggle in the same way,” she said. “So while it may not be what they expected, I think it’s maybe also not unexpected… This is not a community of people who by and large are railing at the world. They get through day to day. They take care of their family and friends as best they can. They did not spend a lot of time expressing rage.”
The film debuted earlier this year at the Telluride Film Festival and has been shown at several other film festivals this year. In January of next year, the film will be shown on PBS channels, Ryan said. Working with PBS, she said, gives the participants in the film more access to view it as opposed to something like Netflix or Max.
“We’re particularly excited that this one will find a home on PBS,” she said. “With PBS, if you’ve got a pair of rabbit ears, you can tune into it.”
Liz Carey covers healthcare and related issues for the Daily Yonder.
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https://dailyyonder.com/movie-examines-american-dream-through-the-lens-of-diminishing-rural-healthcare/2023/12/01/
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