"The Death of Mr. Lazarescu (Moartea domnului Lazarescu)" acidly crosses Frederick Wiseman's documentary "Hospital" with TV's melodramatic "E.R." for a brutally realistic yet blackly comic indictment of the intersection of bureaucracy and human nature at its most vulnerable.
Health care in post-Communist Romania is only the location of director/co-writer Cristi Puis's lacerating satire that cuts so close to the bone with Andrei Butica's hand-held camera it looks and feels like a docudrama of an actual 12+ hours. Ironically, we don't actually see the title expiration; rather, through a 360 degree familiarity with the titular, evocatively named, irascible, cantankerous, stubborn, elderly, lonely, cat-owning and yes ill "Dante Remus Lazarescu" we see step-by-step, hour by hour how his whole life led up to this final treatment by society, as he is uncompromisingly played by Ion Fiscuteanu.
A lengthy half-hour or so prologue sets the pacing as the cranky "Mr. Lazarescu" first starts to feel his symptoms, even as we see his isolated living habits and rude interaction with his estranged family and annoyed, patronizing, ineffectual neighbors who only very reluctantly get involved in this problem. Despite being surrounded by intellectual books (and being quite knowledgeable about medical issues around his ulcer), his communication is cryptic even before his condition makes explanations of his health situation more and more difficult to his neighbors and to the medic (Luminita Gheorghiu as a maturely cynical heroine) on the slow to arrive ambulance. A key narrative technique for the film's odyssey is to have her play a more and more important role in his life and in the film, and ultimately with the circles of hell that are several hospitals' hierarchy.
A prime recurring theme is how each person he comes into contact with demands to know if anyone is with him. Being alone is clearly the worst sin if you're old because then you lack an advocate and there is even a limit what a heroic medic can do outside her proscribed role up against issues of gender, class, age, personal relationships and professional gatekeepers (let alone miscommunication that's like an unfortunate game of telephone with no considerations of his body as a whole or in the context of his life). Well into the film is a wonderfully natural conversation between the medic and the driver about parenting that confirms her as a responsible adult compared to how the doctors have been treating her, but in general all the conversations sound natural.
Another intriguing theme is the system's blame the patient mentality if the real or perceived ailments are considered to be self-inflicted. And he doesn't even have, say, AIDS. This is a stark, abject lesson in how attitudes and assumptions affect how a patient is treated (I have a personal experience in how this affected the doctor's intended treatment for a family member if I hadn't insisted on correcting a false impression). It is fascinating to see how over the course of the night he gradually loses his individuality and just becomes a problem.
While the British TV series "Bodies" and Paddy Chayefsky's "The Hospital" focused on incompetence and power among medical professionals exacerbated by budget limits, "Bringing Out the Dead" focused on burn out, and "E.R." has only a couple of times given us the patients' point of view before they are heroically saved, let alone the cynicism of "House, M.D." that the patient is always at fault for lying (not that anyone is doing much of an expensive differential diagnosis here), this film is particularly droll at poking fun at the kind of romantic and other staff interactions that we usually find so entertaining in shows like "Grey's Anatomy" but are not so amusing when they interfere with patient care. This is the best examination I've seen of how Kafka-esquire bureaucracy is built up of the actions of individuals one-by-one since George Lucas's first sci fi film "THX 1138".
Though the subtitles are always legible, some of the translations are confusing so it is sometimes hard to tell what is a malapropism in the translation or errors by the characters, or perhaps Romanians use different medical terms than we're used to hearing on "E.R." The credits are not translated into English but there's a long list of doctors as advisers.
This film should be required viewing for anyone in the medical professions.
Health care in post-Communist Romania is only the location of director/co-writer Cristi Puis's lacerating satire that cuts so close to the bone with Andrei Butica's hand-held camera it looks and feels like a docudrama of an actual 12+ hours. Ironically, we don't actually see the title expiration; rather, through a 360 degree familiarity with the titular, evocatively named, irascible, cantankerous, stubborn, elderly, lonely, cat-owning and yes ill "Dante Remus Lazarescu" we see step-by-step, hour by hour how his whole life led up to this final treatment by society, as he is uncompromisingly played by Ion Fiscuteanu.
A lengthy half-hour or so prologue sets the pacing as the cranky "Mr. Lazarescu" first starts to feel his symptoms, even as we see his isolated living habits and rude interaction with his estranged family and annoyed, patronizing, ineffectual neighbors who only very reluctantly get involved in this problem. Despite being surrounded by intellectual books (and being quite knowledgeable about medical issues around his ulcer), his communication is cryptic even before his condition makes explanations of his health situation more and more difficult to his neighbors and to the medic (Luminita Gheorghiu as a maturely cynical heroine) on the slow to arrive ambulance. A key narrative technique for the film's odyssey is to have her play a more and more important role in his life and in the film, and ultimately with the circles of hell that are several hospitals' hierarchy.
A prime recurring theme is how each person he comes into contact with demands to know if anyone is with him. Being alone is clearly the worst sin if you're old because then you lack an advocate and there is even a limit what a heroic medic can do outside her proscribed role up against issues of gender, class, age, personal relationships and professional gatekeepers (let alone miscommunication that's like an unfortunate game of telephone with no considerations of his body as a whole or in the context of his life). Well into the film is a wonderfully natural conversation between the medic and the driver about parenting that confirms her as a responsible adult compared to how the doctors have been treating her, but in general all the conversations sound natural.
Another intriguing theme is the system's blame the patient mentality if the real or perceived ailments are considered to be self-inflicted. And he doesn't even have, say, AIDS. This is a stark, abject lesson in how attitudes and assumptions affect how a patient is treated (I have a personal experience in how this affected the doctor's intended treatment for a family member if I hadn't insisted on correcting a false impression). It is fascinating to see how over the course of the night he gradually loses his individuality and just becomes a problem.
While the British TV series "Bodies" and Paddy Chayefsky's "The Hospital" focused on incompetence and power among medical professionals exacerbated by budget limits, "Bringing Out the Dead" focused on burn out, and "E.R." has only a couple of times given us the patients' point of view before they are heroically saved, let alone the cynicism of "House, M.D." that the patient is always at fault for lying (not that anyone is doing much of an expensive differential diagnosis here), this film is particularly droll at poking fun at the kind of romantic and other staff interactions that we usually find so entertaining in shows like "Grey's Anatomy" but are not so amusing when they interfere with patient care. This is the best examination I've seen of how Kafka-esquire bureaucracy is built up of the actions of individuals one-by-one since George Lucas's first sci fi film "THX 1138".
Though the subtitles are always legible, some of the translations are confusing so it is sometimes hard to tell what is a malapropism in the translation or errors by the characters, or perhaps Romanians use different medical terms than we're used to hearing on "E.R." The credits are not translated into English but there's a long list of doctors as advisers.
This film should be required viewing for anyone in the medical professions.