People: Maren Monsen: caring through the end

Maren Monsen was in her late 20s when she was first confronted by death and discovered she didn't know how to cope with it. But it wasn't the death of someone close that left her feeling so helpless. It was the death of a patient. At the time, Monsen was a resident in Stanford University Medical Center's emergency room. She realized that medical school had not prepared her for facing death, nor given her the words to comfort the dying. Her inability to deal with the situation made her question whether she could continue as a physician.

Luckily for the medical profession, Monsen found a way to address her fears. An avid filmmaker, she decided to explore some of the issues of dying on film, and began work on "The Vanishing Line," which aired on PBS in July.

Monsen, 35, has always had twin interests in art and medicine. Although she majored in art history at Stanford, she already knew she wanted to be a doctor, and took pre-med classes. After graduating, she spent a year in Japan before returning to her native Seattle to attend the University of Washington Medical School. But she wasn't content with only concentrating on medicine.

"I started medical school, but at that point I was very interested in film," she explains.

For the next five years, Monsen managed to combine her medical training with filmmaking. She studied film at New York University summer school and took six months off after her second year to make a documentary on the crisis in rural health care in the United States. She also spent a year at the London International Film School, where she made two more films.

Back in the United States, Monsen completed her medical training, and began her residency at Stanford in 1991. She started work on "The Vanishing Line" in 1993. The film charts Monsen's journey as a doctor, as she accompanies Jim Brigham, spiritual care coordinator for the Midpeninsula Hospice, on his visits to terminally ill patients. The film also focuses on Brigham's own experience of loss: His first wife, Cay, died in 1986. Monsen was impressed by his compassionate and calm handling of such difficult work. "He was tremendous. He was very inspirational for me."

The film took five years to complete, during which time Monsen finished her residency and joined the emergency team at San Francisco General Hospital.

Before completing "The Vanishing Line," she released an educational film, "Grave Words," in 1996, which used Monty Python-style humor to help doctors talk about death.

She continued to use humor as a tool in "The Vanishing Line," but decided against it halfway through the filming. "I thought I was addressing death, but I was doing it through a lot of humor."

Monsen admits the film had a profound effect on her, leading her to question the practice of extreme medical intervention in cases where death is inevitable.

"The process of making 'The Vanishing Line' has really shifted my clinical interest from emergency medicine to hospice and palliative care," she said, referring to efforts to ease the suffering of terminally ill patients.

It is a change that her job duties reflect. No longer an emergency room doctor, Monsen develops educational films for the Stanford Center for Biomedical Ethics, where she is a senior research fellow.

Making the film also helped Monsen confront the fear of her own death, which she is now able to see as just another stage of life. She hopes it has also helped others come to terms with the inevitable.

"My goal in making the film was to give people the vocabulary to talk about death and dying and to change the way they think about death."

Monsen and her husband, attorney Jeff Grainger, live on Skyline Boulevard in Woodside and enjoy hiking in the hills. Monsen is also an avid cook and gardener.

--Jackie Sanders Maren Monsen will receive a "One From The Heart" Award for her innovative treatment of end of life issues through film at the Midpeninsula Hospice Foundation annual awards breakfast on Oct. 29 at the Hyatt Rickeys in Palo Alto. For reservations, call 949-3859, ext. 6103. Also, "The Vanishing Line" is playing at noon Nov. 8 at the Roxy Cinema in San Francisco.

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