ER meets Dante's Inferno

Released in 2005, long before Obamacare, The Death of Mr. Lazarescu is a Romanian drama, helmed by Cristi Puiu, that was representational of the Romanian New Wave, a film movement that emerged in the mid-2000s and gained international recognition for its socially and politically engaged cinema. The film dramatizes the story of a retired engineer named Mr. Lazarescu, played by Ion Fiscuteanu, who falls ill and spends a night being transported between different hospitals in Bucharest, Romania. We journey with Mr. Lazarescu's journey as he encounters a series of bureaucratic obstacles, apathetic medical staff, and overcrowded hospital wards, all of which make it increasingly difficult for him to receive the medical attention he needs.

Click here to listen to a recording of our CineVerse discussion of this film, conducted last week.

Shot in a documentary-like style, with long takes and a minimalistic approach to dialogue, which creates a sense of authenticity and immediacy, the film stands as a critique of Romania's healthcare system and the post-communist social reality of the country. It garnered significant critical acclaim and won several awards, including the Un Certain Regard prize at the 2005 Cannes Film Festival.

How does this picture stand out and make an impression? It looks and feels like a documentary, as if the filmmakers were simply following this patient along his futile journey and spontaneously recording what they observed with no interference. But the truth is that The Death of Mr. Lazarescu is a carefully scripted narrative fictional movie with professional actors playing these roles, including the health care providers.

That knowledge is remarkable when you ponder how realistic the shots and performances are and the extended length of many unbroken shots. It’s also admirable considering how detached the filmmaking style is and how the filmmakers allow the narrative to unfold naturally, without sensationalism.

In his review, Roger Ebert wrote: “It lives entirely in the moment, seeing what happens as it happens, drawing no conclusions, making no speeches, creating no artificial dramatic conflicts, just showing people living one moment after another, as they must.”

Even though this is not a documentary, it’s loosely based on the true story of a man rejected by five different Bucharest hospitals in 1997 who was abandoned by the paramedics to die on the street; additionally, director Cristi Puiu had suffered from hypochondria years before and attempted to receive medical care, his experiences around which helped fuel this production.

While our attention is focused on Dante’s plight and deteriorating condition, the central figure in this story is arguably the EMT Mioara, whom we closely follow in her quest to get Dante the attention and treatment he needs.

The movie is a difficult watch for many, as it tries to play both sides of a delicate coin: tragedy and comedy. The Death of Mr. Lazarescu isn’t replete with outright jokes, witticisms, one-liners, or slapstick, but it is infused with a dry humor that can make the viewer feel bad for laughing at Dante’s increasingly frustrating predicaments and the inhumane treatment rendered by so-called caregivers. To some, the movie can feel mean-spirited, exaggerated, and implausible, as if the filmmakers are piling on and continuing to kick Dante while he’s down just to make an ironic point about the failures of the public health system. Others believe the tonal duality and morbid humor are expertly balanced.

Matthew Mosley with Collider wrote: “Its use of comedy only accentuates the cruelty Lăzărescu finds himself in, making an already tragic story into one of the most painful films in recent years. But it also serves as a necessary break from the injustice that swamps the film, with its careful placement ensuring the anguish never becomes too overwhelming, while still leaving plenty of room for Puiu’s searing critique of the industry… The line about his drinking habits recurs with such frequency it’s almost impossible not to laugh, and when combined with every obstacle under the sun blocking his path to salvation it’s as though the film is sucking away all your tears and common decency with every second until laughter is the only possible response you have left.”

Murphy’s Law, in which bad luck accumulates in a cascading, cosmically unfair fashion, is a prominent theme. Dante seems cursed and damnably destined to die after being refused care by one health practitioner after another, whether that’s due to their insensitivity, bias, or fatigue or because of coinciding misfortune like the bus accident that drains the health care resources of the surrounding community.

Another message espoused by The Death of Mr. Lazarescu is the value of the good Samaritan, and how we are our brothers’ keepers. Mioara the paramedic refuses to allow Dante to slip through the cracks and be ignored, persisting in shuttling him to four different hospitals and ultimately refusing to abandon him until he’s cared for. While she’s not perfect (consider the scene in the back of the ambulance where Dante complains of thirst while she asks the driver for a beverage, which she proceeds to drink while Dante suffers), Mioara proves to be the patient’s guardian angel of sorts, increasingly committed to ensuring that he is properly cared for. Perhaps being closer in age to Mr. Lazarescu reminds her of her encroaching mortality, which triggers a quietly empathetic drive that stands in stark contrast to the callous and cruel attitudes of the younger doctors and nurses who speak condescendingly and demonstrate no compassion for this terribly ill man.

The movie also explores the dangers of bureaucracy and overtaxing crucial public resources—in this case, the health care system, which this film savagely indicts. The Death of Mr. Lazarescu is a searing critique of the operational paradigm of institutions that practice Western medicine and what happens when the public safety net is pushed to its limits. This criticism here isn’t necessarily limited to health care providers and facilities in Romania— the finger is pointed at any country where many patients receive insensitive and deficient care from unfeeling practitioners who selfishly ignore their Hippocratic oath.

Lastly, Puiu and company are reminding us not to judge a book by its cover. Every healthcare professional who encounters Dante either assumes his condition is caused by intoxication or that he’s not worthy of their time and attention away from other patients because he’s drunk. They continually dehumanize the man and rob him of any dignity with their sneering attitudes and outspoken disdain.

Similar works

• Dante’s Inferno
• The TV show ER
• Frederick Wiseman’s observational films and documentaries that explore American institutions, including The Cool World, Titcut Follies, City Hall, La Danse, and Ex Libris: The New York Public Library
• Dry humor dramedies like The Lobster and The Killing of a Sacred Deer by Yorgos Lanthimos
• L’Enfant and The Son, two works by the Dardenne brothers
• 4 Months, 3 Weeks, and 2 Days
• Bringing out the Dead
• The Waiting Room

Other films by Cristi Puiu

• Stuff and Dough
• Aurora
• Bridges of Sarajevo
• Sieranevada
• Malmkrog