The Death of Mr. Lazarescu

Mr. Lazarescu (center) navigates through an uncaring medical system populated by caring paramedics, judgmental nurses and indifferent doctors.

(Tartan) Ion Fiscuteanu, Luminita, Gheorghiu, Gabriel Spahieu, Doru Ana, Dana Dogaru, Florin Zamfirescu, Clara Voda, Adrian Titieni, Mihai Bratila. Directed by Cristi Puiu

Nobody wants to get sick. After all, with illness comes discomfort but worse yet is being marched into the medical system, into hospitals. Some of these journeys leave lasting impressions of caring, competent medical professionals; others are much different.

Dante Remus Lazarescu (Fiscuteanu) is a retired 60-something engineer who is an alcoholic with a headache that hasn’t gone away for four days. He’s nauseous and is throwing up blood. He thinks it’s a symptom of a problem with his ulcer, which was operated on ten years before. The pain finally gets bad enough to the point where he calls for an ambulance.

In post-Communist Romania the ambulance service is spotty at best and Mr. Lazarescu is skeptical as to whether one will arrive at all. There has been a major bus crash and casualties are being driven to several area hospitals. He heads over to a neighboring apartment to borrow some painkillers from Sandu Sterian (Ana) and his wife Mihaela (Dogaru). They are willing to help, but don’t really have the pills that he needs. Alarmed, they call the ambulance once again and finally one arrives, driven by Leo (Spahieu) with a compassionate paramedic named Mioara Avram (Gheorghiu).

She manages to get past the well-meaning interference of the Sterians and the crusty personality of Mr. Lazarescu to discover a worrisome diagnosis – Mr. Lazarescu may have colon cancer.

The ambulance (really more of a converted mini-van) whisks Mr. Lazarescu away to the hospital which is presided over by a tyrannical doctor who is far more interested in lecturing the ill man about his alcohol intake than in treating his illness. In a recurring theme, the hospital staff is overworked to the point of apathy. They send Mr. Lazarescu to a different hospital to get some tests done.

That hospital is overwhelmed by casualties from the bus crash, but Mioara’s persistence, a nurse whose friendship with Mioara leads her to be an advocate for Mr. Lazarescu with a doctor who actually has a thread of decency (and a bit of a crush on the nurse) who gets the tests done. Once the tests are done, it is discovered that Mr. Lazarescu indeed has a tumor (in his liver) that is going to kill him slowly. He also has a blood clot on his brain that is going to kill him quickly if he isn’t operated on.

That immediate surgery is a bit of a problem; the hospital they are in is far too stacked up in the O.R. for the surgery to get done in a timely manner. Instead, they recommend Mr. Lazarescu be taken to a neighboring hospital which didn’t get as many bus crash casualties. As Mr. Lazarescu is transported from place to place his condition begins to deteriorate rapidly. Will he be given the life-saving surgery in time?

Strangely, this movie was marketed in Romania as a comedy and there are certainly some comedic elements to the film, but I found the tone grim, unrelentingly so but not in a way that makes the movie a downer. Director Puiu takes the tact of being a passionless observer, one without opinion or agenda who is merely presenting the facts.

In fact, this was based on an actual incident in Bucharest in which a 50 year old man was transported to five different hospitals before the paramedic dumped him at the side of the road, where the man died. In this movie, you don’t get a sense that Mioara would ever consider such an option; she’s doggedly determined to get the treatment Mr. Lazarescu desperately needs.

Despite the title, this isn’t Mr. Lazarescu’s story. It is the story of the system and the participants thereof. It is an indictment of the system (and is regarded as such by the Romanian press) on one level, which fails Mr. Lazarescu miserably but it also praises those who go above and beyond, trying to procure decent medical care despite the obstacles. Mioara is definitely the heroine here.

Gheorghiu does a tremendous job in the role. Sympathetic, she puts up with all the jibes and put-downs by the supercilious and arrogant staffs of the various hospitals, most of whom are less experienced than she. She does so with stoicism that is sad and heroic at once. Also of note is Fiscuteanu, who would pass away from cancer himself a year after the completion of the movie and plays the mostly unlikable Lazarescu with dignity and just enough pathos to make him sympathetic without going over-the-top.

While some might believe this is channeling “E.R.,” there is a more realistic feeling to this than that television show. In fact, medical professionals in Romania have praised the movie for its realism which comes by it honestly – the admittedly hypochondriac Puiu has a long list of physicians who acted as consultants on the film.

The drawback is that the movie, at a little over two and a half hours, does tend to drag in places. However, all of this can be overlooked considering the relevance to today’s healthcare debate. The Romanian film industry has been quietly putting out some really compelling movies (such as Four Months, Three Weeks and Two Days) but this is the best I’ve seen yet. It’s worth seeking out if for no other reason as a cautionary tale to take better care of yourself so that you don’t wind up taking the same journey that Mr. Lazarescu does.

WHY RENT THIS: Realistic performances make for an almost documentary-like feel. The subject matter is particularly relevant in today’s U.S. healthcare system debate.

WHY RENT SOMETHING ELSE: At two and a half hours, the movie drags on a bit too long. The tone may be too unrelentingly grim for some.

FAMILY VALUES: There is some foul language and scenes of hospital carnage as well as some brief nudity. The subject matter may be a trifle overwhelming for younger sorts.

TRIVIAL PURSUIT: This was intended to be the first of six feature films to be directed by Puiu in a cycle he calls “Stories from the Suburbs of Bucharest.” The second, entitled Aurora is in post-production and is expected to be released in 2010.

NOTABLE DVD EXTRAS: Pickings are slim, but there’s a feature on the U.S. Healthcare system that doesn’t compare too favorably with the events depicted in the film.

FINAL RATING: 8/10

TOMORROW: The Boy in the Striped Pajamas

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Four Months, Three Weeks and Two Days

Anamaria Marinca and Laura Vasiliu undergo a grueling night.

(IFC First Take) Anamaria Marinca, Laura Vasiliu, Vlad Ivanov, Alexandru Potocean, Ion Sapdaru, Teodor Corban, Tania Popa. Directed by Cristian Mungiu.

The communist regime in Romania was a particularly repressive one. There were strict laws governing the lives and morality of the people of Romania lived in constant terror of breaking those laws, which sometimes became necessary as in the case of a young unmarried woman facing an unwanted pregnancy. Abortion, you see, was illegal.

College roommates Otilia (Marinca) and Gabita (Vasiliu) are preparing for a night away from their noisy dormitory. This is no mere vacation, however. Gabita is pregnant and desperate and has turned to her roommate to help her obtain an illegal abortion.

Gabita is a mess. Unable to follow even the simplest instruction, she has no inertia, no drive. She more or less relies on everyone around her (i.e. Otilia) to take care of her. Otilia raises the money (much of it from her boyfriend Adi (Potocean) who comes from a professional family of doctors) and checks them into their hotel. Gabita even sends Otilia to meet the abortionist (Ivanov), a violation of the rules that the abortionist, Mr. Bebe, set in advance. In fact, Gabita had even been unable to make the reservations at the hotel Mr. Bebe had specified, leaving Otilia to scramble to find any kind of hotel that had rooms available.

Because of Gabita’s gaffe, Otilia is forced to find a more expensive hotel, leaving them short in the agreed-upon amount for the abortionist. He forces them to make up the amount in trade – a very explicit trade. Not just with Gabita, but also with Otilia. At first she balks, but eventually gives in. She even goes first.

As it turns out, Gabita has even lied about how far along she is in her pregnancy, adding more risk to the abortion. After Bebe does what he has to do, he informs Gabita that she must lie still while the drugs do their work. Afterwards, the aborted fetus must be disposed of – preferably, down the garbage chute. However, Otilia has made previous arrangements to attend a birthday party for her boyfriend’s mother and must leave Gabita alone for a short while.

This is a brutally stark movie that levels an unblinking eye on a time and place in history. The participants are flawed, frightened and all-too-human. Director Mungiu chooses a simplistic approach. There are no jump cuts, no montages, none of the things associated with modern short attention span cinematography. Instead we get simple one scene, one shot set-ups with close attention paid to camera angles. In fact, there is not any incidental music in the entire film.

This is a wise move in that it forces the viewer to focus on the performances and the story. The two leads do a remarkable job. Marinca in particular, is noteworthy. Despite the storyline, this is more her film than Vasiliu’s as her character is the one that really carries the action. Even so, Marinca’s Otilia gives in to pressure, attending the birthday party even though she knows her friend needs her; sleeps with the abortionist so that her friend can have the abortion. She’s a fascinating contrast of strength and weakness.

Vasiliu has more of a thankless job, playing a character that is passive and self-centered. Her final scene with Marinca has been decried as anti-climactic, but it is one of her finest on-screen moments in my opinion. We see a bit more of the girl’s personality, making it obvious that she has learned nothing from the experience. It’s just an unpleasantness to be put behind her as quickly as possible.

There are those who will be uncomfortable with the abortion scenes, which are fairly clinical and graphic. While those who are pro-life might object about a movie that is about seeking out an abortion, these scenes will sell the anti-abortion point of view far more effectively. It is hard to tell if the filmmakers have a point of view about the morality of abortion; I suspect they may be anti-abortion if anything. Nothing good seems to come of the procedure here.

In many ways, however, this isn’t a movie about the pros and cons of abortion. It’s about the characters and how they are changed by what they do. The depiction of Romanian society is chilling; the paranoia is dealt with in an almost matter-of-fact style, which can be a bit jarring for western audiences used to freedom.

The starkness of the film may be off-putting to some, but it is one of the things I liked most about it. This is an honest, unflinching look at a place and time, and how that place and time affected the people who lived in it. We in the west are very unfamiliar with that place and time, and it is worth the perspective of seeing a glimpse of it to make us appreciate what we do have all the more.

WHY RENT THIS: A stark, unflinching look at a repressive society that we in the States have little knowledge of. Remarkable performances by Marinca and Vasiliu are worth checking out.

WHY RENT SOMETHING ELSE: May be too graphic and honest for some. Subject matter may also be off-putting to those who find even the subject of abortion intolerable.

FAMILY VALUES: The is a graphic depiction of an abortion, as well as some nudity, and implied forced sex.

NOTABLE DVD EXTRAS: An extraordinary documentary about attempts to show the film in Romania. There is also a very interesting interview with director Cristian Mungiu.

FINAL RATING: 7/10

TOMORROW: Right at Your Door