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New films: The Waiting Room & Anna Karenina

The Waiting Room
Directed by Peter Nicks

If you’ve ever visited a hospital emergency room, in any other than a life threatening emergency involving arriving by ambulance, you’ve probably sat for a long period getting frustrated by the wait, compounded by the pain or infirmity of the condition (or companion) that caused the visit. One of several  things “The Waiting Room” does well is to convey the sense that the frustration exists on both sides of the big swing doors, with doctors and nurses having to deal with an overwhelming supply of both emergency patients and those seeking very basic interventions or prescription refills.

This documentary, shot during a 24 hour period in 2010, follows the patients and staff of the ER at Highland Hospital, the Alameda County Medical Center in Oakland, California. And it demonstrates through simple observation, and some brief commentaries from those involved, how broken the healthcare system in this country is. This isn’t a documentary full of facts and figures, or colorful infographics and animations, it’s a film about real people coping with real problems.

As is typical in ER’s and trauma centers, incoming patients are assessed by triage nurses and given a priority status that indicates how urgently they need to be seen. As more critical patients arrive, less critical patients who arrived earlier are pushed backwards in line – and victims of gunshot wounds or road accidents, etc., are taken directly to the trauma team who drop whatever else they’re doing. At least up to the point that the hospital simply can’t take any more patients and ambulances are diverted elsewhere while they play catch-up with the folks who have been sitting in line for hours.

The problem, of course, is that many of those waiting don’t have urgent problems – they have the kind of conditions and needs that a primary care physician, nurse practitioner, or clinic could address if only they had access to such people and facilities. But Highland Hospital is a public facility and the option of last resort for those who have nowhere else to go. So it’s where people go to get free Tylenol when they can’t afford it at the drugstore and it’s where the uninsured go to treat every routine problem. Several of the patients, or prospective waiting patients, make reference to being “at the doctor’s” rather than being at the hospital – this is the only place that they can see a doctor and for some of them it’s a regular visit.

Many also have more urgent concerns but at least some of them wouldn’t have been so urgent if they had been treated earlier. One young male patient is at Highland after paying to be diagnosed at a Kaiser facility and having multiple tests conducted, before being scheduled for surgery to remove a testicular tumor, and then being turned away when it becomes clear that he isn’t in a position to pay for it. Another older man has bone spurs that cause him chronic and acute back pain, but nothing can be done in the short term other than some limited form of pain control (which he must pay for), and he knows he must continue to work laying carpet as he has two younger generations of mouths to feed and an empty checking account.

Scenes of ER’s like this are hard to reconcile with America’s position as a world “superpower.” This is the only nation in the world with more than one operational aircraft carrier, for example (we have 11), and yet it’s probably the worst among its comparable trading partners at treating its own sick and dying citizenry. One of the statistics that often gets quoted when people criticize socialized or partially socialized healthcare systems in other countries is how long people wait to be treated. But the stats often compare those with coverage in each country – which would be everybody in a country like the UK and significantly less than everybody in the US – and so we don’t get an accurate count of those whose wait is infinitely long because they don’t have access to covered care at all.

Through it all, doctors and nurses like those at Highland somehow manage to stay positive and do the best they can with what they have to work with. Much of the process being a juggling game of logistics and resources, examination rooms and hospital beds, hallway gurney spaces and referral options.

If we’re going to avoid being the country that doesn’t even have these options of last resort, and that doesn’t want to watch people with minor infections and easily curable diseases routinely dying on the street, then in some manner those of us who are able to afford to contribute are going to end up covering the care of those who can’t. And that can either be done via massively increased premiums that get filtered and skimmed by large for-profit insurance companies and providers, or it can be done via a centralized system of taxpayer-funded healthcare (or some combination of the two). In Britain, the National Health System has operated hospitals and employed doctors for 64 years – and studies by the US government has concluded that the care provided is both better and cheaper than in the US. This shouldn’t be a partisan issue – if you’re fiscally conservative, you ought to like the idea of spending less money for better care and better outcomes on just about every major measurement of public health.

“The Waiting Room” is a simple but effective illustration of much of what’s wrong with our system. And it should be an example of why covering everybody in a centralized fashion makes sense. It’s a good film that was just nominated for an Independent Spirit Award earlier this week. And it can be enjoyed free of my ranting about healthcare provision.

“The Waiting Room” opens today in Sacramento at the Crest Theatre.

Anna Karenina
Directed by Joe Wright

“Anna Karenina” is a wonderful story by Leo Tolstoy, filled with drama, passion, love, regret, redemption and all the other components of classic literature. And this adaptation comes to the screen with multiple positive factors, including an A-list cast that includes Keira Knightley (as Anna), Jude Law (as her husband), and Aaron Taylor-Johnson (as her lover). All of which don’t add to the pleasure of watching the film but rather add to the disappointment associated with it being an annoying and distracting film to watch.

This version, directed by Joe Wright (“Hanna,” “Atonement,” “Pride & Prejudice”) seems to focus more on directorial flair than on the story. Much of the story is depicted in a large vacant theater, in which the cast moves around as though in a play, only without an audience (at least not within that context), and including action that takes place behind the theater’s scenes and up in the rigging.

Imagine a scene in which two characters talk and then agree to meet later at a restaurant. In most films, they would talk, make their arrangements, and then we would see them at the restaurant in a separate, later scene. Here they would be more likely to talk, then one would walk offstage, the other would do something along the lines of spinning around while donning a hat and coat, other cast members acting like crew would move scenery behind the spinning actor, the actor would continue in the same flowing motion and remove the hat and coat again, the other actor would reappear in a different jacket, and we would realize that several hours had passed in those few uninterrupted seconds and we’re now in the restaurant scene. It’s a type of flourish that seems better suited not just for the stage, but for a story set to music – and for much of the first several minutes I kept expecting the cast to burst into song.

And it isn’t even consistent in this regard, as the initial conceit isn’t held to as the film wanders between these overtly staged scenes and more straightforward scenes in separate locations, such as a farm field during the harvest.

The story of Anna, who deals with her brother’s infidelity prior to engaging in infidelity of her own is still there. The increasingly strained relationship with her husband the prim, proper and god –fearing government minister is still there. The passion is still there. The components are all in place. But the direction often seems to get in the way of the story, rather than facilitating its delivery. 

The beginning of this film reminded me of the beginning of “Moulin Rouge” which required a certain stylistic leap of faith from the audience (and where the cast did actually burst into song). I remember there being a point about 15-20 minutes into “Moulin Rouge” where it all started to click into place and I simply rolled with it and subsequently enjoyed it immensely. That didn’t happen for me with “Anna Karenina.”   I think the scale of the annoyance diminished, like a sharp head ache that becomes a dull pain, but it never went away entirely. And I think I would/could have enjoyed this screenplay and cast with more conventional direction. Instead, I reached a point where I felt the need to stay and watch the story play out but with a sense of semi-relief when it ended.

I don’t recall feeling quite that same way since experiencing a stronger version of those reactions at “Dancer in the Dark,” one of the most polarizing movies I’ve ever seen. And it’s worth noting, in that context, that early reviews for “Anna Karenina” from top critics (as aggregated by the review site rottentomatoes.com) are split evenly between good and bad opinions.

Anna Karenina opens today in multiple theaters in Sacramento.

About the author

Tony Sheppard

Tony is a Professor at Sacramento State, Co-Director of the Sacramento Film & Music Festival and a long-time writer, primarily on topics related to film and the film industry. He is an active supporter of the local arts community, an amateur photographer, and has an interest in architecture and urban planning topics. He is currently designing a 595 sq.ft. house on a very small infill lot in Sacramento.

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