Abstract
The Fundamentals of Caring is the story of Ben, played by Paul Rudd, who is hired to be a caregiver for Trevor, played by Craig Roberts, an 18-year-old teenager, mostly home bound, with Duchenne muscular dystrophy (DMD). The film opens with Ben completing a six-week caregiving course and the instructor reviewing the Caregiver Commandments: “The fundamentals of caregiving are ‘give care…but not care too much.’”
Their relationship initially involves Trevor putting Ben through frightful pranks with a twisted sense of humor. Ben passes each test presented by Trevor, leading to the formation of a unique friendship. Ben eventually convinces Trevor's mother to let them take a road trip to “The World's Deepest Pit” and they begin their journey of many “firsts” for Trevor, making friends along the way. Besides the story including a protagonist who is living with a serious illness, this film beautifully depicts many themes we encounter in the practice of palliative medicine. While Ben and Trevor take their road trip, the viewers also take a journey experiencing the impact of human connection, loss, resiliency, and the evolution of a caregiver.
Early in the film, Trevor shares with Ben a map that he has marked with the “lamest roadside attractions” with “The World's Deepest Pit” being his favorite because it sounds “so depressing.” This becomes the final destination of the road trip. The colors early in the film are gray, dull, and dampened, and as the two begin their road trip, the scenes also start to brighten, showing glimpses of the sun and the open road as Trevor breaks free from his home. Ben explores with Trevor “if you woke up and you were totally fine, what's the thing you would want to do most?” Trevor replies “I'd really like to take a pee standing up.”
Throughout the journey Ben tries to fulfill Trevor's wish without success. When the two finally make it to the pit, it is shown as a beautiful lake in a deep valley, glistening in the bright sun. This is in striking contrast to what Trevor expected would be “depressing” and the reason he thought he loved it, but he shares his change of heart to say “it's actually pretty cool.” With the help of Emergency Medical Services (EMS), Ben straps Trevor onto a board to succeed in helping him do what he wanted to the most. In a comedic way, the movie reminds us that what is most important varies on the individual. Based on Trevor's wishes, Ben tailored his care to ensure his individual needs were met. The cinematic qualities, including the progression from dull to bright, enhance the viewers' experience of the story being told.
Along the journey, Trevor and Ben meet Dot, played by Selena Gomez, who is hitchhiking her way to Denver. The three form an unlikely friendship and it is hard not to notice that the three are also bonded by their experience of loss: Ben experiencing the death of his son years ago; Dot losing her mother to “a random blood disease” close to the time Ben lost his son; Trevor losing his autonomy to the disease and his relationship with his father who abandoned him when he was three years old, shortly after being diagnosed. The film delves into the complexity of grief and shows us that meaningful connections can thrive even in the face of illness.
The viewer witnesses the evolution of a caregiver as the film unfolds. It depicts the experience of a caregiver who is often untrained, inexperienced, and must learn about the recipient's care over time. Ben begins his caregiving duties with a tour of Trevor's home provided by his mother, Elsa. As the tour is given, Elsa asks Ben what he knows about DMD to which he replies “Uhh.” The following scene shows many different medical devices, including a continuous positive airway pressure (CPAP) machine in Trevor's room, as Elsa goes on listing Trevor's strict regimen. This is followed by a list of Trevor's many medications and supplements shared in rapid individual images of the vast array of bottles.
Elsa shares “Statistically Trevor probably has another 7–10 years, so let's do everything right, ok?” This scene shows Ben's overwhelm as he learns of the many tasks, medical devices, medications, and diagnosis for which he must become familiar in a short period of time, as this is his first caregiving experience. Elsa's final comment leads to the realization that how well Ben carries out his duties will directly affect Trevor's life and possibly his prognosis. Many can feel the burden a mistake may have for the care recipient during their caregiving duties.
As the film progresses and Ben and Trevor make their journey to “The World's Deepest Pit,” you see Ben become more confident as a caregiver with his hands-on duties, familiarity with Trevor's routine, and the medical devices. You also see him feel comfortable enough to pull some of the same frightening pranks that Trevor would pull on him early in their relationship. In the last few scenes of the film, one of the characters asks Ben, “What's wrong with [Trevor]?” Ben goes on to share specific statistics regarding prognosis and incidence of DMD in a direct and calm manner, showcasing how much expertise he has gained, both as a paid caregiver and as one who cares deeply for another.
“The Fundamentals of Caring” is a tragic-comedy that balances a heavy subject matter with humor. It reminds me that finding joy and laughter is possible even in challenging situations. Although a few themes are highlighted in this review, the film provides a good platform for more to be explored by individuals in the field of palliative medicine. It is a heart-warming film that could be enjoyed several times to spark meaningful conversations about compassion and care. “The fundamentals of caregiving are ‘give care…but not care too much’” reminds us of the professional boundary we practice with the empathy shared in palliative medicine.
Seeing Ben find his purpose enlightened me on the burden and beauty of caregiving. Trevor's many “firsts” throughout the film made me realize the experiences in life some of us take for granted. The film end-credits open to a song by Ryan Miller made for the soundtrack of the film called “This is the Only Time We Have.”
This is the only time we have
There are no more lives left
Take the good and take the bad
This is the only time we have.