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The Monkey on Our Back

In Off Label, the documentary team Michael Palmieri and Donal Mosher set off on a “medicalized road trip” to explore our country’s unhealthy reliance on pharmaceuticals.

Tribeca: Tell us about Off Label. How do you describe the movie in your own words?

Michael Palmieri and Donal Mosher: Off Label is a medicalized road trip across the United States and an associative essay on the pervasiveness of pharmaceuticals in our culture. This includes and extends past medicine and healing into social relations and belief systems.

The film is literally all over the map, because we are interested in examining mainstream social issues that are relevant to everyone through the viewpoints of those who live on social and economic margins. It’s at these margins where you begin to really see how extensive the problem is, and how it relates to other issues around it. Our hope was to bring the visual and metaphorical style we began exploring with October Country to an expanded set of themes and issues.

Tribeca: What inspired you to tell this story? Was there a catalyst from your own experiences? How long have you been working on this project?

Palmieri/Mosher: The film was actually proposed to us by our producers, Anish Savjani and Vincent Savino of filmscience. They saw a rough cut screening of October Country at Rooftop Films in October of 2008 and asked us if we would like to make a film about human lab rats, people who do drug testing for a living for money for the pharmaceutical companies. We said we’d think about it. And then they told us it was fully funded. Naturally, we said yes!

As we began filming, the abuses we uncovered in the human drug testing community led us to examine how these drugs get marketed, and ultimately, how they end up being consumed by the end user. The basic idea for us was that if the drug testing is faulty, what’s the impact of the whole system on personal lives? This was a much bigger story to tell, and took us four years to complete.

Tribeca: How did you hook up with the subjects in your film?

Palmieri/Mosher: The range of areas where we found our subjects really points to the pervasiveness of this issue. Some came from the essays and articles that inspired the initial idea of the film, others came from direct solicitations to websites, and others even came from casual conversations. A random stranger in an airport mentioned to Mike that his mother was intensely medicated and lived in a Bigfoot museum. Both the woman and the museum are now part of the film.

The work of Carl Elliott was also instrumental—some of the people who are in this film are the result of his journalistic investigations. But more importantly, Carl’s approach to this subject matter really gave us the key to explore things in a truly satisfying way, a way you might more typically encounter in a long form journalistic essay or book. We wanted to try an approach like that with this film, where the survey of the landscape and the journey through the ideas took precedence, perhaps because the ideas and subjects kept coming our way and the issue was so complex. The fact is, even after four years of working on the film, stories are still presenting themselves to us.

Off Label

Tribeca: You tackle some pretty hot topics in the film, not least of which is the power wielded by pharmaceutical companies in our everyday lives. What do you want audiences to take away from your film? Is there a course of action you want to effect?

Palmieri/Mosher: Like any pressing social issue, pharmaceutical medicine already has a great deal of public discourse, investigative journalism, and activism in place. While we drew from all of these elements for the basis of the film, we found that focusing on personal stories allowed us to explore the grey zones of the issue that aren’t usually addressed. We chose our characters from the margins of mainstream life because their lack of options make the crisis all the more evident, but in the end they have to navigate the same political contradictions, personal responsibilities, faith, grief, and love in the medicalized, industry-influenced culture we all live in.

Our goal was never to say that the medical system and the medical industry are simply corrupt. Medicine is far too necessary and full of too many moral practitioners to be that simplistic. But it’s a fact that many of our viewers will be on prescription medicines. If we can give the audience a glimpse at what makes each one of us personally and socially vulnerable to that corrupt side of medicine and the medical industry, then we feel the entire endeavor has been worth it.

Tribeca: What's the craziest thing (or "lightning strikes" moment) that happened during production?

Mosher: The craziest thing for me during the filming was volunteering my arm so that our character Andy (who was a young medic in Abu Ghraib and now suffers severe PTSD) could demonstrate how he tortured prisoners with large needles while treating them. The whole time we were filming, my mind was caught between the strangeness of Andy doing such a thing for the sake of a film, and the fact that he’d done this repeatedly, to the point of mental illness, for the supposed sake of country and freedom. I can’t think of any other career that creates such peculiar situations as documentary filmmaking.

Palmieri: In summer of 2011 we spent three days in Las Vegas with Paul Clough. He likes to gamble, so we tagged along and followed him around. It was a bad luck couple of days for Paul, and he lost a lot of money and it was really getting him down. Perhaps because of this, the emotional intensity of what he chose to share with us on that trip got really, really heavy. It was a very hard shoot, and I don’t typically like Las Vegas to begin with, as I don’t really like to gamble. But after three dark days of filming, I needed to turn my mind off a bit, so I went over to the penny slots to kill some time and have a drink. In about ten minutes I was up $20. I moved to the quarter slots and was suddenly up $120. I moved again to the dollar slots and I was up $1200. Donal was trailing behind me at this point, begging me, “Cash out, cash out!” but I simply couldn’t help myself.

We walked over to the $5 slot area—a place NO ONE ever goes into, because it’s a very dumb idea—and I put $100 into the machine. On the first pull I won a huge jackpot, just over $8000. I was just dumbstruck. It was like we’d just received an artist’s grant from God or something—we had a lot of bills to pay, and the film was running out of money. So this time I did take Donal’s advice and I cashed out.

Off Label

Tribeca: Good for you. That's not always easy to do. So you previously worked together on the heralded October Country. How do you divvy up the work?

Palmieri/Mosher: Mike is first and foremost the cinematographer, Donal does sound, and we both work with the subjects. Since there are only two of us though, Mike often handles sound going directly to the camera, and any lighting if it’s necessary, while Donal picks up a bit of b-roll, tries to keep extraneous noise to a minimum, and makes sure Mike isn’t hit by traffic or doesn’t injure himself while focusing on the monitor.

In the edit, we work closely on the scene structure and the visual texture of the film. Mike, however, is the editor, and the final success of any scene rests with him. We reach our final decisions by an often hard-won consensus. Collaboration is not an easy thing—when we both want to kill each other over a scene, then we know we have something worth fighting for. We really rely on each other’s strengths, so we’ve survived this life-endangering process thus far.

Tribeca: Did you bring any lessons from your first outing to the project? What was different this time around? What’s your advice for aspiring documentary filmmakers?

Palmieri/Mosher: On October Country we learned, as probably every documentary filmmaker learns, that you can go in with ideas and a basic framework, but you have to be open to what is happening in front of you. If your original idea still works with the material you’ve recorded at the end of the filming process, then you are a lucky person. If it doesn’t, then you have to be able to reassess the project and see what kind of film life has given you.

You have to be flexible. Knowing this kept us more fluid and more willing to take left turns with the initial ideas percolating around Off Label. For instance, we saw that, for some of our characters, religious faith was also a kind of psychiatric medicine. Following them into their beliefs allowed us to make a comparison between faith in deity and faith in a pill.

Esther Robinson once told us that in creating a documentary you are actually creating three films—the film you conceive, the film your material guides you into making, and the film that hits the public. In this last instance, your own view of your work is altered by audience reaction. This is such a good framework for any type of filmmaking. We certainly carried this with us the entire time of making Off Label.

Tribeca: What are you most looking forward to at the Tribeca Film Festival?

Palmieri/Mosher: We’ve attended screenings at the Festival in the past, but never really been part of the Festival itself, so that’s very exciting. It seems very energized this year with the addition of Frédéric Boyer, and the lineup of films looks incredibly strong, especially in the documentary competition section we are a part of.

Michael Palmieri

Tribeca: If you could have dinner with any filmmaker (alive or dead), who would it be?

Mosher: That’s not a fair question; can we make it a dinner party? If I have to choose one I’d say Chris Marker.

Palmieri: Chris Marker would most definitely be at my dinner party. But I’d also like to reserve a seat next to Jean Cocteau. His work and writing are pure magic.

Tribeca: What’s your favorite New York movie?

Mosher: I’ve wracked my brain but couldn’t find a single movie answer to this question. However, New York has engendered its own iconography through film for so long, that the city kind of exists in collective cinema space. Street signs and buildings bring a film to mind every few blocks—just walking in New York, watching its daily energy, is my favorite New York Movie.

Palmieri: Woody Allen’s Radio Days.

Donal MosherTribeca: What would your biopic be called?

Mosher: I think mine would have to be called Hey—How Do I Work This Thing?

Palmieri: It Will All Make Sense In the Edit.

Tribeca: Finally, what makes Off Label a Tribeca must-see?

Palmieri/Mosher: Bigfoot’s in it!

Michael Palmieri and Donal Mosher collaborated to direct the documentary feature October Country, which won a grand jury prize at Silverdocs and was nominated for an Independent Spirit Award. Palmieri has directed music videos for Beck, The Strokes, and many others. Mosher is a widely exhibited photographer and writer.


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