Uncaring System

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Review of 'The Death of Mr Lazarescu', Director: Cristi Puiu, Tartan Video £19.99

This film charts not the actual death of Mr Lazarescu but the stripping away of his humanity. He lies in pain and distress from a removable brain clot while shoved from pillar to post at different hospitals during the course of one night.

The film is set in modern day Romania. But to anyone who works in the British NHS, the themes of under-resourced services, hierarchical staff structures and bullying management practices seem eerily familiar.

Mr Lazarescu is a retired engineer, living out a lonely and meagre existence, depending on alcohol and his three cats for solace. At the beginning he is on the phone in his flat, battling to convince the health service, then his sister, that the headache and stomach pains he is suffering are not just from the last bout of drinking. He calls an ambulance and waits.

In the meantime he seeks help from his neighbours. They too are reluctant at first, attributing everything to routine alcohol problems, but confronted with his distress and knowing something of his life, they are drawn to help him.

This is when the basic solidarity which ordinary people are, at least most of the time, capable of showing is contrasted with the indifference of official structures. As the neighbours search through their medicine cupboard, we also glimpse a system riddled with privatisation in which people self diagnose and self medicate - with unpredictable results.

The paramedics eventually arrive, examine him and attempt to drop him off at the nearest hospital. Yet when the paramedic reports to the consultant that she suspects colon cancer, she is berated for bringing in an alcoholic. Mr Lazarescu is subjected to aggressive and personal abuse about his cheek for expecting care at all and especially "when there are real emergencies". He musters his dignity and staggers out but collapses.

Over the following hours the paramedic becomes the advocate for this man. Only she sees how rapidly his health is deteriorating. She drives him around to get the head scan and operation he needs. He is passed from one hospital to the next because CT scanners and surgeons are struggling to cope with a bus crash.

The range of responses they meet reflect the different reactions of people delivering public services in a society where politicians blame social problems on the individual and where services are rationed. Mr Lazarescu is routinely treated to a lecture on alcohol abuse wherever he goes but beyond that the responses are different, some horrifying, some very moving.

The film was partly made as a response to the real life 1977 case of Constantin Nica who, after being turned away from a string of hospitals, was dumped in the street by paramedics and died.

But its main inspiration was the clash between director Cristi Puiu and the film authorities in post-Communist Romania. Puiu became intensely frustrated by the authorities' refusal to fund more than a very narrow range of films, so he set out to make his own way.

The result was a film that is the total opposite of a Hollywood production. Made with few actors, simple sets and a budget of £220,000, it is far from lavish. There are moments when the necessary repetition to mirror the patient's experience seems to go on a little long.

But this is a wonderfully engaging view of life not simply in an uncaring health system, but in an uncaring society very like our own.