The film’s public debut was at the Sundance Film Festival in January 2007, where it was one of 16 winners out of 856 candidates, and played at numerous regional festivals in the USA thereafter. Following Sundance, it was also selected as one of the top five American films to be presented at the prestigious Directors Fortnight sidebar at the 2007 Cannes Film Festival.
The film was made with co-operation of the two men who took Pinyan to the hospital, as well as other friends of his, in the attempt to explore the life and death of the man, as well as those who came to the farm near Enumclaw for similar reasons, beyond the public understanding of the media. It does contain explicit material of sexual activities, but only in the view of video footage shown on a small television screen.