by Kerry McLeod
Geoffrey Smith has achieved the holy grail of documentary filmmaking; he’s moved from the world of television to feature docs with a powerful, moving and funny film, The English Surgeon. Premiering at this year’s London Film Festival, and screening at next week's Sheffield Doc/Fest, the film is about maverick British neurosurgeon Henry Marsh, who travels every year to the Ukraine to lend his help to doctors and patients there. In the film, we see Henry tackle a complicated operation on Marian, a man whose tumour has been deemed inoperable and who suffers from epileptic fits as a result.
Tell me about the genesis of film.
Henry is somebody I met four years ago, 2003, and we just got on extremely well. The BBC did a series called ‘Your Lives in Their Hands’ which was a look at surgeons. I was the last person to come on in the series, and I said to the series producer: ‘Who is the most humane and interesting one; forget the medicine, who’s the most interesting person?’ And he said, ‘Oh, Henry Marsh, no question at all!’
Because actually Henry’s more like an artist than a surgeon. He’s incredibly eclectic in his tastes. He makes amazing furniture, and has just completely renovated his house: he’s into all sorts of things. He loves the whole Eastern bloc; he’s been going to the Ukraine, actively, since 1992, which is only two more years than I’ve been going. And when you meet someone who a, you feel very warm to and b, who’s open to being honest about things, AND on top of that, goes to the Ukraine with such a mindset, knowing such things and loving such a place, as I do, it was just a marriage made in heaven, really. And we made this great film together, which won an RTS award that year, and we’ve just been incredibly close since then. I would go along there every week almost, stay overnight, drink lots of vodka, talk until the wee small hours about everything under the sun, wrestle with the dilemmas of medicine. Because he’s interested in that, and he wants the public to understand what it’s like, and I want the public to understand that difficulty but also the struggle that’s worth it. I hope the film does that, that’s what we both set out to do. And Ukraine is such a place where you can probably say more, because it’s raw, it’s so in your face. He would see more of those dramatic cases in a weekend in Ukraine than he might in a whole year in London, because there is no healthcare, the whole system is in a nightmare state. So we both thought that was a great place to go; it’s a journey and it’s exotic and I love the country, I’ve always wanted to make a film there. So it was my opportunity to do that.
Was it difficult getting access to film in Ukraine?
You can film in the Ukraine relatively easily, but that place [where the documentary is filmed] is a KGB hospital. Henry’s got such a good relationship with the man who runs the hospital that he said, well I trust Geoffrey, this is a film that will help you ultimately, that will put you on the map as a go-ahead organisation. So there was an initial sort of brokering period for access. I’d been out there with a small camera, sitting in the consulting room with Henry and Igor [the Ukrainian consultant and friend of Henry]… and as soon as I got serious about finding money, they said yes. And it’s a huge kick; it’s like getting into MI5. I mean, not that we’re interested in anything other than the patients that Henry and Igor are seeing, but still it adds a certain atmosphere to the film because of where we are.
How did you go about getting funding?
I believed in the film, I thought it would work because Henry is a bankable character – he had six million viewers on BBC 1 when we got Your Life In Their Hands shown. And lots of people wrote in and emailed and phoned in about Henry. Some about the patient, but most people responded to Henry because he’s prepared to be vulnerable, he’s prepared to admit doubt and failure and difficulties, and people love that. They genuinely feel he’s a human first and then a surgeon, rather than the other way around, rather than someone who’s so arrogant they can’t keep in touch with humanity.
I went to the BBC, I went to commissioner who I know and who is a great champion of mine, and honestly it was like showing a crucifix to a vampire. It was like, come off it Geoffrey – the Ukraine, ethics, you’re never going to get this proposal off the ground, so just get real, we are living in the post-Birtian age at the BBC.
I’d met Rachel Wexler on another course, who’s my co-producer, and she’s really plugged in to the whole international dimension, because I think that’s key here. And meeting Leena [Pasenen, head of the EDN and main tutor on DFG’s European Funding and Pitching course] made me think well these people in Europe, and even in the States, they’re so much more appreciative of filmmakers, they’re so much more appreciative of the end product and the struggle really. Here, it’s a contemptuous process, terribly, terribly demoralising, and I just thought well, I’m going to think about this thing on a completely different scale.
But I had written to Storyville by then and entered into a relationship with Roger Thompson who’s a wonderful behind the scenes player at Storyville, and in the end they said, make us a film that’s not a medical drama, we’re interested in Henry the man, the place and the motivation. And then they offered a certain sum of money, to which I said you just cannot begin to make the film that you need to make, logistically, on that kind of money. We’ve got to go and raise a lot more anyway, but we just need more from you guys. Anyway, they virtually doubled it, and I said yes. And once you’ve got Storyville on board, I think it sends a completely different signal to so many other people, because Nick’s so well respected and so well connected that if you get him saying this is something we’re behind, other people pick up on it. Finland came on board instantly.
And then we’d applied to the States, the ITVS international call, which is a healthy sum of money despite the exchange rate. It’s a long process, you go through about five steps, it was even after we’d finished shooting, because I wanted to shoot in the winter and we set the whole going in February or March, and we got the ITVS money in May or something. What people should probably realise is that the Wellcome Trust is interested in broadcast and they have money. They knew my previous film and they had it in their library, and I applied. It’s a rolling thing and you can apply for anything up to £30,000, which is a hell of a lot more than many European broadcasters. Then the DFID fund, which gives you anything up to £10,000, said we love it, and here’s at least £10,000 to help you. Because by then I was in the cutting stages, and I hadn’t got the ITVS money and it’s quite difficult to cashflow. But it’s worked.
Henry is an amazing character on film. I also wanted to ask you about Marian [the man with a brain tumour whose story is followed throughout the film]. How did you find him and get him to agree to take part?
Igor’s in Kiev but he has an office in the West, where he’s from, and also in the South. And people come to those clinics in the outlying towns and cities and then they get referred to Kiev if there’s a problem. And Marian comes from far in the West, and he gets the scan done and that doctor sends the scan to Igor. Andre, one of Igor’s junior doctors, had said, he’s a lovely guy, and the village people had been collecting money for him and he’s been deemed inoperable, because people don’t want to touch those sort of tumours. And Henry said look, I’m sure we can do this, but we have to have him awake because that’s how he operates and why he gets the successes he does. So I thought well, this is an interesting story and I went out in January on a dedicated trip to go and see Marian and we just fell in love with Marian and the place. He’s like Jean-Paul Belmondo with no teeth, he just has this beautiful sort of innocence and expression, and his whole demeanour and his faith in Henry is so touching and so moving, and I just thought you can’t go wrong. Let’s face it, you’re living in this forsaken place in a hovel with no heating, no hot water, and some western god, as far as they’re concerned, has deemed it worthy to try and save your life. These people have never met, and across 3,000 miles, a completely different social background and everything else, Henry sort of plucks him out of obscurity and says, we’re gonna cure you, get rid of your epilepsy and remove this threat to your life. And it’s so profound; that’s the relationship he has with many of his patients.
So we had a camera in there for the journey that Marian made. I went down and we got him on the bus, and then somebody else took over.
You had two units didn’t you?
Yes, we had three cameras. I was using mine for some of the time, Graham [Day, the Director of Photography] and the Ukrainian team, which was really handy because of the language.
Henry arrived on the same morning that Marian arrived in Kiev. It was cut that way but that’s exactly how it happened. So we had these great journeys and we had Marian, and we had this situation. Somebody asked me at the screening [at the London Film Festival] if it had all gone wrong would you have kept going? And I said of course, that’s what we’re there for. It’s not a patient-led film; it’s about surgeons and how they deal with things. And the scene with the blonde girl [whose tumour is inoperable but who has no idea of this] is a very telling example of how they struggle to deal with things.
The film is treated like a feature film.
When you want to put it on the big screen, it really does pay to do what features do to sound, to make it big and to clean it all up. You go along and you see films and the sound is so thin and small. TV sound has got no comparison to cinema, and I think if documentaries are going to compete – and we need to – we’ve got to match the baseline standards of cinema. And it’s not as if it’s cripplingly expensive as a percentage of the budget... And it feels like a film, you know? It’s one of those things that you unconsciously recognise when you go into the cinema, it’s somehow distant and thin and pokey and small and muffled and dirty. You’re not really there, you know? And it’s not some sort of luxury item. I think it’s essential.
Nick Cave does the music: how did that come about?
Nick’s someone I know from Australia, he grew up in the same town at the same time as I did. I know his friend and collaborator John Hillcoat better. John made a feature film two years ago and Nick wrote the music for it, and I used a bit of Nick’s music from that film on my trailer, the one I played down in Brighton [at the DFG European Funding course] actually, because it just seemed right. And I really just kept thinking that this was the right person to do it. John showed Nick the proposal, and they just loved the idea. I met him and Warren [who] is really a genius when it comes to soundtracks. They just fell in love with the film and ended up saying how much of an honour it was to be part of it, and they are so involved with it, and that I think comes across because it’s understated music, it’s the right sort of music for the film.
Obviously, the film is very moving and very harrowing – especially the operation – but it’s also very funny. There’s a natural humour in the situation and characters but then you’ve got sequences where you really bring the humour out.
It’s so important. To me, that’s the Ukraine. You could not make a film about the place if you didn’t reflect people’s humour, because they need humour to survive what is a difficult and dangerous situation most of the time, so it’s reflection of the country. We needed humour to go between the terrifying stuff – the grandma, the little blonde girl, and the blonde woman at the end, plus the sense of general tragedy, because it would be too black, and it doesn’t reflect their character.
Even Marian, he’s got a sense of humour, the way he describes things, his innocence and those jokes – he’s part of the humour. We thought it was extremely important, because it helps the audience deal with it if you have some laughs as well. It’s very understated, but last night it was great to see the audience laugh. And to watch the operation as well, because it’s unrelenting and it’s also so interesting that you almost feel you need to watch it because someone’s alive, awake, communicating with the surgeon. We tried to shoot it sensitively, we had three cameras in there, because you can edit this like a drama. I come back to that all the time – try to make it look as good as possible. Use multiple cameras, use decent sound recording, get a soundtrack, because it really will pay off, and there’s no narration, it’s a character-led drama, and that’s why Michael [Hayden, Programmer of the London Film Festival] chose it. We have to compete don’t we, we have to compete with drama, so why not?
Dir. Geoffrey Smith, UK 2007, 94 mins
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