Hot Docs

The English Surgeon

 (Documentary -- U.K.)

By JOHN ANDERSON

London brain surgeon Dr. Henry Marsh travels to the Ukraine to improve medical conditions.

An Eyeline Films-BBC/Storyville-ITVS Intl. presentation of an Eyeline Films/Bungalow Town production. Produced by Geoffrey Smith, Rachel Wexler. Executive producers, Greg Sanderson, Nick Fraser, Sally Jo Fifer. Directed by Geoffrey Smith.
 
With: Henry Marsh, Igor Kurilets, Marian Dolishny.
 

"Brain Surgery in Ukraine," with its suggestion of bloody horror and low comedy, could have been the title of "The English Surgeon," which is, in turn, both horrible and very funny. It's also deeply touching, resonant and even sentimental, in its affirmation of human goodness. The BBC pedigree assures broadcast, but there's enough stylish cinema in this Geoffrey Smith film to smuggle it into the arthouse. And enough emotional richness to keep it there.

What would have been a good story under any circumstances is elevated by its subject, Dr. Henry Marsh, an esteemed London brain surgeon, a self-deprecating wit and haunted man. Marsh has been going to the Ukraine since the early '90s, when he first visited Kiev and discovered an appallingly medieval medical system. Inventing tools, buying equipment (like drills) at street markets and improvising on modern medicine, Marsh does what he can to improve the situation.

For all the good he's done, however, and the nonchalant way he does it, he is haunted by one failed case, which seems to temper every subsequent good deed he does or any success he achieves on the operating table.

Helmer Smith gives us Marsh not only in the near-squalid environment of Ukrainian medicine, but in London, where the National Health Service is driving him slowly crazy with bureaucracy. While his Ukrainian colleague and collaborator, Igor Kurilets, works in a system where failure means dismissal, and doctors are therefore afraid to take risks, Marsh works in a system so encumbered by paper that he almost can't practice either. Whatever "The English Surgeon" is, it isn't an endorsement of socialized medicine.

The spine of the film is the case of Marian Dolishny, a poor, smalltown Ukrainian whose brain tumor is causing him epilepsy. Although he's told the tumor is inoperable -- it seems every tumor is inoperable, according to Ukrainian diagnoses -- he goes to Marsh, who prepares to extract the noncancerous lump. The footage of Dolishny's operation is intimate, fascinating and gruesome.

One of Marsh's more distinguishing characteristics is his self-possession in the face of imminent catastrophe, his grace under pressure. Told that Dolishny is having a fit (he can't see his patient's face, only his open skull), Marsh is unperturbed. When he has to deliver really crushing news -- that, for instance, a four-year-old girl is permanently blind, that the time has passed for removal of her tumor to restore her sight -- he is matter-of-fact. It is a devastating moment in the film, and one of several.

Marsh's preoccupation with Tanya, the girl he operated on years before and failed -- in his mind, he violated his Hippocratic oath, and actually did harm -- is a constant reminder of the depths of Marsh's feelings. As is his devotion to Ukraine. "Bloody Cossacks," he mutters at one point, a point at which we already appreciate the deep well of empathy at work in a rare man.

Production values are first rate.

Camera (color, HD cam), Graham Day; editor, Kathy O'Shea; music, Nick Cave, Warren Ellis; sound, Darrell Briggs; second unit directors, Slava Feofilaktov, Shreepali Patel; second unit camera, Anatoly Gagramanov. Reviewed at Hot Docs, Toronto, April 19, 2008. Running time: 94 MIN.