Ekiyokere Ekiye explores the use of documentary filmmaking for medical humanities research practice.
The act of documenting tends to be a general activity of daily life, particularly because we are constantly placed in contexts that require the classification of information and problem-solving. This activity may include putting down information about something like groceries, accessing a guide to cooking Italian pasta or as mundane as how to identify moisturisers to suit different skin types. Outside this traditional perspective of documenting events through writing, there exists the notion that documenting can be enacted as visual performance. While we engage, normatively, with information documentation through writing, documentary filming may be viewed as an extension of that practice to include virtual presentations.
For instance, the renowned FilmMedicine director, Amy Hardie, documents lived experiences using the visual technique of documentary filming in The Edge of Dreaming which enacts the story of life and death within the family context. This is a good example of how we can extend existing knowledge about methods of recording events we find captivating. Documentary practice entails the skilful engagement with knowledge based on encounters of lived or real-life experiences. This encounter can either be with the self (through autobiographical filmmaking), with the Other (a research participant) or with the world around us, that can bring about a new awareness which might be beneficial to an audience. The aim of this article is to explore ways to extend existing research skills such as looking and listening in documenting lived experiences and, the ethics of the practice.
A significant component of documentary filming is lived experiences. This is because lived experiences tend to highlight the personal knowledge and its effect on the individual who accesses health and care services, for instance, a person living with a prolonged condition, family carers or disabled persons (NHS England, 2023). Documentaries that capture lived experiences about cancer, for example, can offer therapeutic benefits such as the reduction of stigma, isolation or ignorance that may form popular responses to the condition. Documentary filming can be a useful approach to address such issues by creating an alternative representation of cancer that focuses on an individual’s experience in contrast to a physical portrayal of a health emergency. This can encourage “… a different route to be sought …” (Trott, 2012, p. 190) to shape the practice of research into cancer. In attempting to understand the individual’s view about how they experience the condition in everyday life, it is important that we assume the position of an imitator, because our role is to narrate and bring alive the unseen aspects of cancer as ongoing event, an experiential journey unfolding on the screen. Bunuel describes such visual representations about encounters which tend to be invisible to others as an “… imitation of a dream … On the screen” (cited in Fredericksen, 2021, p. 32). This implies that documentary filming is beneficial if the aim of research is to provide an unbiased information about a condition or any other phenomena (e.g. language behaviour). This also enables a dialogue between what was previously known and the new knowledge.
Since documentary filming lies in transformational reflections and the creative narration of individual lived experiences, how might this method work in practice? Apart from lived experiences, other key components to documentary filming include reflective listening and observational looking. This, however, suggests moving beyond the normative perceptions of mere seeing with the eyes or hearing with the ears. As a researcher on the field, listening is vital to understanding the participant’s interpretation of their experiences. Within the context of an interview, it becomes necessary to extend your looking beyond sensory awareness of sounds to reflectively listening with rapt attention to what the participant says and with the intent of reiterating what was heard in our own words. While we engage in the activity of reflective listening, we can add nothing new, or add follow-up questions. By doing so, we encourage the speaker to reach deeper into their story. We even demonstrate understanding of the pieces of information shared with us when those words are repeated to the participant. This, in turn, helps to build trust. Practicing reflective listening can promote both individual and interpersonal wellbeing. Here, wellbeing includes care and empathy in the sense of creating emotional connectedness with participants; self-determination and participation as well as respect for diversity and value toward the individual (Pauwels and Mannay, 2020). In this way, the participant feels their voice is valued and heard.
Looking, on the other hand, deals with observation. This means using the camera to record reality, and converting aspects of what is observed into editable shots as opposed to simply noticing something with our eyes. Observational looking is the key language of storytelling in documentary filming. While in the field, we try to observe how the research subject interacts with the surrounding context or environment. Extending our looking skills beyond the traditional idea of seeing would enable us to uncover how the explored condition or situation mediates other aspects of the participant’s life. This allows the individual, as a filmmaker, to interact with the participant’s context with the aim of modifying it into scenes that can visually impact the stories about the condition they want to unfold before an audience. Interaction with participants’ contexts requires us to become familiar with different shot types (examples include metaphor, hook, landscape, colour pallet, pacing, scale of view or when and what is revealed) to cut between them to create a backstory that can strengthen our interpretation. Observational looking is beneficial for refocusing attention away from illness or condition to the individual. As such, the shots applied can deepen what is revealed by the camera position and frame. This helps to engage with the tension between mortality (e.g. the unconscious state of epilepsy) and consciousness (e.g. the experience of epilepsy). Extending our looking at a condition or situation using the camera can also be effective for making judgements about what elements are metaphorical, the right colour palette or the role of landscape that can best capture an audience. This also allows the filmmaker to consider the story structure while the participant enacts their experiences in front of the camera.
Both observational looking and reflective listening as aspects of the ‘how’ of documentary filming entail going beyond our perceptual reach (timelapse, hidden areas like ICU, and cameras inside the body) to reveal the complex inter-relationships between diagnoses, social and physical issues, and personality. In this sense, documentary filming as research is useful to gradually uncover the events surrounding a situation −and what constitutes an existential question− with nothing left to our speculation and imagination. This visual approach presents the positive impact of allowing the research to justify itself as a contribution to furthering the human response to illness or even language behaviour, for instance. The creative transformation of embodied experiences into a visual story, nonetheless, is not without ethical considerations. The individual who adopts a documentary approach to research must identify ways in which their practices are ethical.
One way they can do this is to examine the ethics of their practice through understanding that “… documentary does not produce a universal argument that subsumes the individual but rather provides a space in which the viewer can engage with the experiences of the Other” (Nash, 2011, pp. 224-239). We could document descriptions and meanings of the researched phenomena as an ongoing event and not absolute. This will enable both the researcher and the audience to anticipate potential complications before they become apparent and to visualise alternative possibilities. The ethical relationship enables both the researcher, as a filmmaker, and the viewer to accept the peculiarity and exclusivity of the participant. Levinas summarises this ethical relationship as ‘everything that takes place between us concerns everyone; and not a question of one foetus only, one Other solely, but incorporates otherness in its entirety’ (1969, p. 212). This implies that ethics, in relation to documentary practice, represents a dialogue around the intention, trust, representation, and agenda (Renov, 2004); and these form components of well-being (that is, for the participant, the audience, and the film-making crew).
Trust relates to flexibility and an ongoing commitment to being sensitive to the views and opinions of the research participants. It is the ability to restrain oneself from forcing personal biases or beliefs about the condition as understood by the participant. Agenda, as Levinas (1969) suggests, does not include violence. He emphasises that violence does not only involve murder or fatal assault of participants, but the act also includes disrupting the participant’s daily life and compelling them to perform parts in which they become unrecognisable. Intention deals with the irreducibility of the participant. Again, Levinas suggests that the filmmaker could ask reflexive questions about personal desires to know their participant. Through deep reflexivity, our assumptions about the participant and the probability of understanding are regularly examined. The final component of well-being is Representation. The filmmaker who adopts a documentary approach to qualitatively relate with participants’ lived experiences must recognise their role as an imitator. This deals with researcher positionality and situating oneself as an imitator implies resisting the urge for total exposure without proper participant consent. We can avoid displaying a complete version of the participant’s narrative and instead, protects their integrity by depicting truth as transient and incomplete (Renov, 2014).
Documentary practice, however, is not without shortcomings. For one thing, it may be time-consuming especially if one is new to this research approach (although, this holds true for other traditional methods). This challenge extends to recruiting the necessary expertise for the film production. Another challenge may be the high cost involved in the production of documentary films; particularly with funds needed to purchase quality equipment for the right voice over as well as picture quality. There is also the cost for funding the crew involved in the production. Despite these shortcomings, documentary practice represents an alternative qualitative participatory approach to share knowledge acquired from participants’ lived experiences and through the lens of those who live with the condition. As has been mentioned above, it can be beneficial to tackle issues of misrepresentation about a condition or observed phenomena to deconstruct stereotyped responses such as fear or stigma.
About the author
Ekiyokere Ekiye is a doctoral student supervised by Professor Robert McColl Millar within the Department of Linguistics at the University of Aberdeen. Her dissertation project, “Performativity and Contact Language Use: A Social Constructionist Approach to Reappropriations in Nigerian Pidgin”, focuses on the significance of contextualisation and meanings of language behaviours at momentary junctures of social engagement. Her co-authored book chapter, “An Endless Supply of Audio and Video … spoken by Native Speakers’: Analysing Sociolinguistic Attitudes in Metalinguistic Videos on YouTube” was recently published in the edited collection, Revisiting Second Language Sociolinguistics: Case Studies from Across the Globe (Cambridge Scholars Publishing, 2003).
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