Sunday, 19 April 2015

Bogowie - film review

Customarily, long overdue, yet up for the release. The film biography of professor Zbigniew Religa, outstanding Polish cardiac surgeon, who first carried out a successful heart transplant in Poland, was hailed one of the best Polish films that went to the silver screen in 2014. The film received accolades and awards predominantly for the superiorly played role of the main character, so hats off to Tomasz Kot who did a splendid job of rendering what Mr Religa was like. The film is not just the memoirs of one of the most prominent individuals in the history of Polish medicine, or the homage paid to professor Religa. Its plot is multi-faceted and thread of Mr Religa’s endeavours to perform a successful heart transplant is intertwined with many other themes, likewise imperative to make the film whole.

Bogowie is about attaining the impossible. The plot is set in the 1980s and covers only a few most important years in Mr Religa’s biography; the period when as a surgeon in his mid-40s against all odds he attempts to overcome numerous impediments and perform a surgery that to almost everyone else seems out of reach.

The obstacles Mr Religa faces broadly have two ever-lasting dimensions: the system and the people. Bear in mind the story plays out in Poland in post-martial-law bleak mid-1980s; times of economic misery and social indifference. The slowly crumbling communist system was depicted incisively and with details worth remembering. The film can remind younger audience health care was quite well-developed in countries of the Soviet bloc. In terms of progress in medicine and access to health-care institutions communist countries had probably the littlest distance to catch up with the higher developed West. Talented young doctors, mostly those inconvenient for their superiors, were allowed to take internships in Western clinics and see cutting-edge development in the medicine. Obviously, they had to meet sullen individuals from the communist secret services and sign relevant papers; of course the choice criteria for foreign internships were flawed, yet plenty of young, up-and-coming doctors could bring a breath of fresh air to the Polish backwater. At that time the system, if you did not try to overthrow it, was not your biggest enemy and as it turned out, if you could make some concessions (Mr Religa at first avows he will never join the party and then goes back on his own promise to get a state subsidy), it could play along with you and somehow help you do your bit.

Much more nefarious than the system were the people. Depiction of senior, hard-line doctors, reluctant to move the Polish medicine ahead, discouraging the young generation from striving to attain the impossible, and laughing off their ambitions, is repulsive. In medicine, if the picture in the film is not distorted, the people, not the system, were to blame for backwardness of Poland. The ossified system, founded on the domination of old professors, was a drag on medical progress. In the film you could see something common back in the 1980s, namely the convention of addressing your superior per pan, while your superior would turn to you per ty, lack of symmetry today unthinkable in most places.

The film highlights the dark side of the Polish nature. “A Pole envies a fellow Pole even a calamity”, the sentence of a doctor who first, unsuccessfully, attempted to carry out a heart transplant, is meant to tell you in this cruel world you should not count anyone would support you, if you pull it off, your accomplishment will be detracted from, if you slip up, your failure will bring joy to your foes.

The film is about balancing humility and resilience. Knowing one’s own limitations is essential in doctor’s work and pursuit of one’s ambitions at all costs is absolutely reprehensible. Yet, some sort of obstinacy and determination not to give up is crucial if the path towards success is long, winding and full of obstacles. Stumbling, falling and the rising up must be counted in at the onset of the pursuit.

It is a film about ethics and risk management. The link between the two is elusive, yet worth paying attention to. In theory of economics you distinguish between pure risk and speculative risk. The former is observable when the outcome can be either neutral or negative. A good example is a risk of having a traffic accident – you either do not have an accident and are neither better off, nor worse off, or you have an accident and are worse off. An example of the latter is speculation on financial market – prices can move both favourably and unfavourably for you, you stand a chance of either losing or wining. At first glance, in the case of the heart transplant neither type of risk is exhibited. You face a situation which in theory of economics should never occur. The outcome might be either neutral or positive. A patient can either die soon or their life can be extended. From the ethical point of view, the dilemma is however more complicated, since by attempting to perform a heart transplant you might also accelerate the patient’s decease. The decision what to do rests than with a doctor who has sworn “not to harm”. The definition of harming can be vague as well. For older, backward doctors, putting the life of a patient who was bound to die within a few weeks at peril, fitted the definition of inflicting a harm. For Mr Religa, this was the price to pay for progress allowing to extend by several years lives of thousands of people.

Finally, the film is about striking a balance between career and personal life. Mr Religa in his pursuit of a method of saving lives of millions neglect his family. It not because he loves his job that much, it is because he wants to help people so much. The question which arises naturally then is whether outstanding individuals who want to sacrifice their lives to do something for posterity should raise families? Or maybe their families should be more lenient?

The film contains scenes of surgeries on open heart and it reminded me why I could not be a doctor. At such sights I nearly feel like passing out. Well, if everyone was cut out for every role, economic progress would have been far slower I guess…

1 comment:

Michael Dembinski said...

Best - most in-depth review of this film I've read in either language. In particular, how important the moral and social conditions of the time were - with surprises for those with too many staid preconceptions.

Makes me want to see it! (I write as the only member of my family not to have done so already)