“The starting point was my sister Claire. She’s not doing it much now, but for a long time she was working as a hospital chaplain and she is the reason that I made this movie,” filmmaker Luke Lorentzen explains to Business Doc Europe why he turned to the hospital environment for his latest documentary. Or maybe that should read returned, given how his 2019 doc Midnight Family, about opportunist paramedics in Mexico City, also explores life at the margins of hospital life.
In A Still Small Voice, which garnered the Best Director prize at Sundance 2023, the main focus is placed on the outspoken and somewhat maverick hospital chaplain Mati, and her professional relationship with her mild-mannered and sensitive supervisor David.
At the beginning of Mati’s residency hopes are high that the process will be beneficial for all parties, but as the year progresses (Lorentzen spent 150 days filming in Manhattan’s Mount Sinai hospital) the strain of the work begins to show. Mati becomes physically and emotionally exhausted while David begins to doubt he has the “bandwidth” or the “fortitude” required to operate within such a high-octane supervisory capacity. Despite their inherent decency and dedication to the task at hand, the pair, it seems, were always destined for a fractious co-existence within the same occupational space, given they are like chalk and cheese temperamentally. Mati shoots from the hip when giving advice and is emotionally involved as she offers her condolences. David, meanwhile, is naturally cautious and advises that Mati creates self-protecting boundaries between herself and her patients, a suggestion she regards as anathema.
All of which makes for dramatic viewing as an inevitable showdown approaches, all the time set against the awful spectre of Covid and the constant presence of death on the wards. How did director Lorentzen manage to operate in such testing circumstances?
“It was one of the central concerns when I was embarking on making the film, and the question was, ‘can I be here with a camera and not make your job harder and not be a burden?’” he responds. “I think a few things made it possible. One is that I was there before things got too stressful at the beginning of the residency. David was energized, Mati was fresh out of grad school…and their energy was really different than it was at the end. What enabled that was the pretty substantial amount of time where we were building trust and getting to know each other and really coming up with a system for how we were going to film together.”
“By the time things started to stack on top of one another and become overwhelming, the filming…I don’t want to say became second nature to all of us, but it became very familiar, and wasn’t something that we were still discovering how to do together. I think that’s something that’s been true for all of my films. To be in the right place at the right time isn’t a matter of chance, it’s a matter of practice and really putting in the time.”
Not that Mati was without scepticism, at least at first, about the role she should be playing in the film. She was a chaplain at Mount Sinai for a reason, to deliver meaningful care to patients. And so Lorentzen had to be patient as he decided what shape his film should take, and the level of engagement of his core protagonist.
“I think with Mati it was very challenging because she was asking questions that were the right questions, but ones that didn’t have easy answers in terms of how we would approach filming with patients, what impact the filming would have on her, on David, what her authorship over the film would be,” the director elaborates. “Really questioning all of the director/participant traditions that didn’t apply in this context because the stakes were too high. And over time I learned that I needed to give over my control and I needed to give up this idea that I had final cut. I needed to let her have a say [over] what ended up in the film. I needed the patients to also have a say, David to have a say, and even [out] this playing field so that people felt more comfortable and more agency when being in the film. And that was really unnerving.”
The fraught professional relationship between Mati and David is counterpointed by two emotionally charged scenes during in which two very ill patients (Chaya and Shanay) are placed in the spotlight, highlighting their wisdom, their faith, doubts and innate lyricism (which never diminishes even on repeat viewing). They are scenes in which Mati refuses to countenance any notion of chaplain/patient barriers.
“I love how you see them [the scenes] as a counterbalance. I really see them that way too,” says Lorentzen. “The two of them [the patients] are astonishingly clear in articulating their experience and just so open and honest. I was in the hospital for this really long period of time and each day was introducing the project to patients. And the majority of those conversations that I filmed were meaningful in some way, but often it was the case that people were struggling to communicate, and it’s the chaplain’s job to sort of facilitate these deep, meaningful connective moments, but it’s not something that happens all the time. And I think it was one of the things that really drew me to Mati as a protagonist who was really talented at getting people to open up.”
Lorentzen tells how he and colleagues are currently organizing a series of screenings within hospitals, educational institutions, chaplaincy programs, “places where the film can be used as a tool to begin conversations that we feel are important. I think it’s something we’re looking to roll out through this next year and ideally would happen right on the heels of this initial release of the film,” and on the back of an Oscar short-list selection, he adds.
He further draws parallels, when prompted, between life within the worlds of documentary and medicine. “The first thing that comes to mind is, I think people who work in film and people who work in healthcare are generally overworked and unsupported. I think particularly in my circle of filmmakers and particularly at this moment, it’s so hard to make films and it takes so much of yourself.”
“Speaking for myself personally, I’m bridging this gap of a young filmmaker who thinks anything is possible maturing into somebody who wants it to be a sustainable career. And seeing that it’s possible, but it’s not an easy needle to thread. And I think that’s true for a lot of people who work in healthcare in a different but similar way, of choosing the field because it feels meaningful and important.”
“I felt there was a close parallel between chaplaincy and documentary. Loving to connect with people, to build these relationships, to spend time with patients through these important moments in their lives…and then getting five or 10 years in and realizing that the demands are miles high,” Lorentzen ends.
