POV: As a filmmaker with a background in journalism, tell us about your research process. Given the personal nature of this story, how did you fit it into a larger national context? How deeply did you have to familiarize yourself with the "right to die" debate, the issue of elder suicide, the history of rational suicide, etc?
Susan Stern: I chose to present "The Self-Made Man" as a personal drama, because I felt that was the best way to allow people to access their own feelings about dying, and escape the polarized intellectual debate over this issue.
But I have been a journalist, specializing in investigative reporting, for more than 20 years. So the dramatic face of the film is supported by my extensive research and reporting. Though the film contains no expert "talking heads" or statistics, every choice I made in the film and every line of narration is based on my reading and interviews with experts. Specifically, I kept abreast of "right-to-die" film, writing, controversy and law worldwide. I also studied the international and cross-cultural history of suicide, "rational suicide," "elder suicide," "assisted suicide" and "euthanasia" — again, looking at art, literature, law, politics, bioethics and religion.
Two books made me rethink religious views of suicide — bioethicist Margaret Pabst Battin's The Least Worst Death and The Savage God, a history of suicide by the British poet A. Alvarez. Both books point out that the Bible does not condemn suicide, and that, in fact, early Christian leaders saw Jesus' acquiescence to his own death as a kind of suicide. According to Alvarez, persecution of the early Christians, and the Christian emphasis on the primacy of spirit and afterlife, led to a "suicide mania which was, above all, the distinguishing mark of the early Christians." It was only in the sixth century, both writers report, that St. Augustine pushed for the Christian ban on suicide, largely to stem the excesses of the Christian martyrs.
Insights from suicide researchers also shaped "The Self-Made Man." It was from the National Institute of Health that I learned that my father was not alone — that white men over the age of 85 have a suicide rate nearly six times the national average. But the case studies published by Dr. Yeates Conwell, a leading authority on elder suicide, really shook me: here I found descriptions of men that matched my father almost exactly: elderly white men who had, or believed they had, cancer; who were highly authoritarian; who were WWII veterans; who had suffered the death of a loved one from cancer, and who had seen their own doctor a few weeks before killing themselves.
Dr. Conwell's work has convinced him that virtually all elder suicides suffer some form of mental illness — usually depression. His input forced me to take a hard look at the possibility that my father was depressed. So I examined my father's medical records, interviewed his physician and surgeon, had two outside physicians review his medical records, and pressed my family and my father's friends to re-consider our assessment that my father was not depressed. I also attempted, with only partial success, to talk to the survivors of others who seemed to be "rational suicides" — including the families of the writer Carolyn Heilbrun and the actor Richard Farnsworth.
I concluded that my father was not depressed, and that "rational suicide" does exist in some cases. But I also see that when we are trying to describe the grey areas of human life, one's perspective is everything. I think the mental health professional is predisposed to describe actions in terms of pathology, just as the religious person is predisposed to consider morality and the filmmaker is predisposed to describe actions in terms of character and story. And so I chose to express my point-of-view not as a polemic, but as a story. I suppose that expresses my attitude towards life as well: that our life is a story each of us writes, each with its particular meaning and its particular ending.