The Death of Mr. Lazarescu is a hard film to watch. Directed by Romanian filmmmaker Cristi Puiu, the film tells the story of the titular Dante Lăzărescu (Ioan Fiscuteanu), an elderly man who lives alone in an apartment in Bucharest. Suffering from headaches one night, he calls for an ambulance. However, nothing arrives, resulting in his neighbors having to improvise remedies from whatever medication they have to hand. After repeated calls help finally arrives, but this proves to be of little use as the quest to the nearest hospital becomes an odyssey even Odysseus wouldn’t dare undertake.

In the true spirit of murphy’s law, everything that can go wrong does go wrong. A bus accident causes major delays on the road, and every hospital he arrives at is swamped by victims of the crash. Some doctors turn him away as they are tending to other patients, while others barely give him a second glance, assuming the drunken old wreck of a man has only himself to blame for his current predicament. Throughout the chaos a nurse called Mioara (Luminița Gheorghiu) diligently sticks by his side, tormenting herself to a barrage of abuse from fellow doctors, all the while Lăzărescu’s condition deteriorates. It’s a heartbreaking story, and one that provides a damning critique of the healthcare industry. One where bureaucracy runs rampant, egos matter more than anything, and doctors care more about treating the disease than the person.

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And it’s also a comedy. That might sound a little hard to believe given the previous description, but The Death of Mr. Lazarescu does wave the banner of being a comedy above anything else. Much like the films The Lobster or The Killing of a Sacred Deer by Yorgos Lanthimos, Puiu opts for a style of humor that is so utterly dry you would be forgiven for not even realizing you’re watching a comedy. The humor does not come from literal jokes (of which there are very few), but rather from the absurdity of the entire situation. The fact that such a simple task becomes a monolith epic that spans an entire city, while every single little thing that can go wrong does until you’re left wondering if Lăzărescu was cursed by the devil himself, does become a darkly amusing watch the longer it goes on. It’s a decision that will raise eyebrows, and one that could easily undercut any attempts at a serious examination of the healthcare industry, but in practice it becomes a vital element of the film’s message. Its use of comedy only accentuates the cruelty Lăzărescu finds himself in, making an already tragic story into one of the most painful films in recent years. But it also serves as a necessary break from the injustice that swamps the film, with its careful placement ensuring the anguish never becomes too overwhelming, while still leaving plenty of room for Puiu’s searing critique of the industry. The ease with which he pulls it off showcases why he is one of the crowning jewels of Romanian cinema, and provides the perfect template that other films can follow.

Despite existing at opposite ends of the emotional spectrum, comedy and tragedy have always been linked. Both rely on heightened emotions that take us away from our usual comfort zone, while also relying on two of the most basic human instincts. Our ability to laugh and cry are behaviors everyone can do, so it’s no surprise writers would create situations that force us to experience both at once. Comedy has always walked the line between acceptability and insensitiveness, with even the most basic of jokes requiring something to be the subject of mockery, so the concept of a dramedy is only a stone’s throw away. Laughing in the face of adversity has a history that goes back centuries, and while it can be an effective coping mechanism when faced with a difficult situation, it can also be a means of conquering your hardships and asserting power over them. It’s not surprising that many of our greatest comedians deal with great trauma and heartache in their personal lives, or that comics such as Jordan Peele or comic actors like John Krasinski have turned their attention to horror with their transition to directing. The ability to laugh at oneself opens a doorway into the human condition, allowing someone to reflect on their own personal misfortunes in a way that can also be healing or informative to an audience. In our darkest moments laughter can be the greatest medicine we have, and it’s this feeling that The Death of Mr. Lazarescu taps into beautifully.

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The film’s premise, inspired by Puiu’s case of severe hypochondria which resulted in two years of frequent trips to the hospital, exemplifies the notion of laughing in the face of hopelessness. Lăzărescu’s situation is clearly dour, and the condescension with which those around him subject him to only makes an already terrible ordeal even worse. He’s a tragic character, a widower who lives alone in a rundown apartment save for his three cats, and whose heavy drinking becomes the source of much conflict between himself and the various characters he encounters on this fateful night. It’s enough for many of his potential saviors to dismiss him on sight, believing their time is better spent on the survivors of the horrific bus crash rather than the old man who looks like he already has one foot in the grave when the film starts. That’s if he can draw them away from their search for a phone charger, that is, or from their endless chatter about trivial nonsense as the poor man at their feet slips ever closer to the other side. It’s abhorrent behavior from people who are supposed to have dedicated their lives to helping others, but the casualness with which they react to such an obviously sick man does lend itself to some strangely humorous moments. The line about his drinking habits recurs with such frequency it’s almost impossible not to laugh, and when combined with every obstacle under the sun blocking his path to salvation it’s as though the film is sucking away all your tears and common decency with every second until laughter is the only possible response you have left.

But why would Puiu do this? If his intention with The Death of Mr. Lazarescu was to present a thorough examination into the bitter truths of the Romanian healthcare industry (Puiu having stated in interviews that he wants to create films that raise difficult questions about our society), why take the comedy route? A straightforward drama would have been perfectly capable of achieving this, and debatably would have made for a more focused product. And while that may be true, it also would have lacked the emotional gut punch that the humor brings. Watching doctors refuse to help Lăzărescu is bad enough, but seeing them do so while joking about inconsequential things (or even Lăzărescu himself) elevates the whole situation to new levels of anger. There are moments when you’ll catch yourself smiling before immediately chastising yourself for doing such an awful thing, only adding to the emotional turmoil the film thrives on. This reaches its zenith towards the film’s conclusion when, after finding a doctor who agrees to help him after deciding a tumor is the cause of his problems, jokes that he’s only doing it so Lăzărescu can die from cancer at home rather than clogging up room at his hospital. It’s a shockingly dark moment, and turns the only doctor willing to help Lăzărescu into the most hated figure in the film yet, amplifying Puiu’s bitter critique of the industry in a way that a more traditional drama would have lacked.

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But it’s also one of the funniest moments in the film. His complete disregard for how a doctor should act, combined with the revelation that Lăzărescu is dying anyway (thus rendering the last two and a half hours of carnage somewhat pointless), ends the film with its darkest slice of humor yet. It’s the perfect example of gallows humor, and segues into the other way comedy enhances the film. In spite of its miserable tone, The Death of Mr. Lazarescu does contain a healthy dose of optimism, even if said optimism is buried beneath endless layers of gloom. Laughter is something that unites us all and stands as one of the crucial ways humans are unique when compared to every other species on the planet. It’s an unconscious vocalization that begins when we’re only a baby, and its positive effect on our health and our ability to communicate is well documented. It’s a profoundly human action, and our ability to laugh even in the worst situations is a luxury we don’t acknowledge enough. The Death of Mr. Lazarescu spends much of its runtime with a shocking lack of humanity, populated by corporate machines where bureaucracy is valued more highly than people. Its moments of levity can be the film’s darkest moments, but they can also be its most hopeful, serving as a warning call to everyone watching that the grievances displayed in this film must never be allowed to happen in real life.

It’s a testament to Puiu’s skills that his use of comedy can be both heartwarming and heartbreaking. At one moment he’s creating images of such unimaginable horror they will have people leaping to action to prevent such an event from actually occurring, and then a few seconds later he’s crafting one of the most darkly entertaining films of the century. At other times he’s doing both at once, and that’s not a skill just anyone can pull off. Despite everything, The Death of Mr. Lazarescu is a remarkably human film, a celebration of our desire to look for the best even in the worst situations, and that’s reason alone to recommend it.