Wherever These Surgeries Went, the Camera Did, Too

An eye clamped open for a length of time that might make Malcolm McDowell shudder. A bloody robotic prostatectomy. A neurosurgeon turning a screw inside a conscious patient’s skull as they trade stories about their childhood love of construction sets.

It all plays out on the big screen in “De Humani Corporis Fabrica,” a radical experimental documentary from Véréna Paravel and Lucien Castaing-Taylor shot at hospitals in northern Paris. The title, Latin for “of the structure” or “of the workshop of the human body,” comes from the seven-part text on human anatomy that Andreas Vesalius wrote in the 16th century.

In New York this month with her fellow director, Paravel cited another antecedent, this one from the early history of cinema: Late in life, the pioneering moviemaker Georges Méliès recalled that when he had tried to buy the Lumière brothers’ filmmaking apparatus, he was told it was a scientific machine best used by doctors to film operations.

“De Humani” takes that premise at face value. But should doctors and their specialized cameras have exclusive access to the intimate secrets of the human body? “What if we go back to medicine, steal from them what they have stolen from cinema, and then see how the wedding goes?” Paravel asked.

She and her colleague are not just filmmakers but also anthropologists who jointly teach a course at Harvard, where Castaing-Taylor directs the Sensory Ethnography Lab. The basic premise is that participants with backgrounds in art, cinema, journalism and other disciplines can collaborate to reinvent ethnography. Paravel and Castaing-Taylor’s features include “Leviathan,” a vertiginous survey of life aboard a Massachusetts fishing trawler, and “Caniba,” a portrait of Issei Sagawa, a Japanese murderer and cannibal, that captures him at an almost dermatologic level.

“De Humani Corporis Fabrica” took more than six years to make. The finished film has footage principally from three hospitals, but the directors shot and conducted fieldwork at several others. Some surgical imagery was downloaded straight from cameras that the doctors themselves used while operating. Much of the other material was shot with a small, lipstick-size camera that Paravel and Castaing-Taylor had specially designed. The idea was that even outside the body, their camera needed to be as nonintrusive as the surgical cameras themselves, and to involve optics (wide-angle lenses, a long depth of field) similar to those of endoscopic cameras. Hydrophones — microphones for underwater use — and contact microphones helped capture sounds.

The goal was to be as nonintrusive as surgical cameras are.Credit…Grasshopper Film/Gratitude Films

Their initial notion for the film was even more conceptualized. “It would be seven parts to it, shot with seven different contemporary imaging medical devices in seven different countries, displaying seven different cutting-edge surgical interventions to the body,” Castaing-Taylor said. “And that went out the window immediately.”

For a start, there were logistical difficulties. The filmmakers began their fieldwork at hospitals in the Boston area, but negotiating access to shoot there proved too difficult. Then François Crémieux, at the time the chief executive of northern Paris’s university hospitals, who also runs a film series focused on care issues, let them in. He said he set two conditions: The filmmakers had to be accepted by the medical teams and department heads, and they had to have legal approval from anyone who appeared onscreen.

Having seen Paravel and Castaing-Taylor’s other work, Crémieux, now chief executive for Marseille’s university hospitals, recognized that he had no idea what they would make. “Whatever the rational discussion could be at the beginning of the project, I knew that there would be no way of knowing in advance what the end of the project would be, which for a C.E.O. of a hospital is strictly different from the relationship we usually have with filmmakers and documentarists and TV people,” he said by Zoom.

But these are also public hospitals, and he felt that reputable anthropologists should have access to them. “I think that we owe that to the public, and we owe that to citizens,” he said. He also noted that forbidding access would have meant losing a chance to preserve what’s happening in hospitals today for future generations.

Doctors became active collaborators in the project, introducing Paravel and Castaing-Taylor to other physicians and patients, and even recommending procedures to capture, the filmmakers said. Some doctors, Castaing-Taylor added, were wary, not knowing whether to view the pair as scientists or journalists. “If they thought of us as scientists — because we said we’re not really journalists, we’re anthropologists — then they would want to know what our hypothesis was, what were we testing,” he said. “And as anthropologists, we’re not really scientists, even though some people think of anthropologists as scientists.” The goal wasn’t to test but to observe.

Jean Kolaczek — the retired chemist who has the screw turned in his head — was undergoing an operation to ease the pressure of liquid in his brain. He said that his surgeon introduced him to the filmmakers, and that his comfort with his doctor led him to say yes.

“I was interested in seeing the operation from the outside, too,” he said through an interpreter. “I was the sick person, I was the patient, but I was also interested in seeing what happens in the operating room and around it.” Even when he was awake in the scene, he pointed out, he was medicated and not completely conscious.

Inviting Paravel and Castaing-Taylor into the operating room wasn’t entirely unusual for Dr. Raphaël Vialle, chairman of pediatric orthopedic surgery at the Hospital Armand-Trousseau. He is shown performing surgery to correct a spinal deformity. He said he had welcomed other outsiders into his operating room, citing somewhat looser rules in France than in the United States and the importance of allowing engineers, for instance, to see procedures. He doesn’t believe the presence of a camera affected how he worked. In any surgery, he said, “you completely cancel everything around you to be focused on your technical acts.”

The filmmakers say their goal was to present the surgeries as abstract and invite viewers to draw conclusions.Credit…Grasshopper Film and Gratitude Films

“De Humani Corporis Fabrica” is not the first film to deal with securing these sorts of permissions; indeed, it’s not the only such documentary shot in a French hospital this year. In “Our Body,” which won praise at the Berlin International Film Festival and opens Stateside on July 28, the filmmaker Claire Simon shot at Hospital Tenon, also in the north of Paris, focusing specifically on types of care that women experience (cesarean sections, treatment for breast cancer) from adolescence until death. Her approach is different, but some of her goals — showing the body, demystifying surgeries — are similar. “I think that we know a lot of things, but we don’t see them,” she said by Zoom.

She echoed the idea that French hospitals probably have a more open attitude toward letting in independent filmmakers than American ones, though in the United States the First Amendment offers directors freedoms in other areas. If she wanted to film Parliament, “it would be very complicated,” she said. But in hospitals, if you explain clearly what you want to do, “it’s not like that.”

Vialle said that “De Humani” was the first time filmmakers had observed him with an essentially artistic intent. The spinal surgery is perhaps the most workshop-like procedure in the film, as the doctors fiddle with a mallet and screws. At one point, Vialle complains that a tool — a French bender — needs adjustment from the manufacturer. Don’t worry, though. “In that moment in the film, everything was cool and was fluid,” he said.

Castaing-Taylor said it was a deliberate choice to forgo exposition, to present the surgeries as abstract and invite viewers to draw conclusions. Earlier cuts of the film had significantly more medical banter. “Once you understood as a nonspecialist what the point — whatever that means — of the operation was,” he said, “then you stopped looking at the body.”

And that was the idea. “The way we filmed it is also to enter a space that is very mysterious to us,” Paravel said, “and that we discover almost like a larger universe inside.”

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