The English Surgeon (2007)

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General		Extras
Category	Documentary	None
Rating
Year Of Production	2007
Running Time	93:00
RSDL / Flipper	Dual Layered	Cast & Crew
Start Up	Menu
Region Coding	4	Directed By	Geoffrey Smith
Studio Distributor	Madman Entertainment	Starring	Henry Marsh
Case	Amaray-Transparent
RPI	?	Music	Nick Cave Warren Ellis Kathy O'Shea

Video		Audio
Pan & Scan/Full Frame	None	English Dolby Digital 2.0 (224Kb/s)
Widescreen Aspect Ratio	1.78:1
16x9 Enhancement
Video Format	576i (PAL)
Original Aspect Ratio	1.78:1	Miscellaneous
Jacket Pictures	No
Subtitles	English	Smoking	No
		Annoying Product Placement	No
		Action In or After Credits	No

    In 1992 prominent British Neurosurgeon, Dr Henry Marsh was invited to the Ukraine to deliver a lecture. The visit changed his life. Here was a doctor highly experienced and respected in his field accustomed to attending to his patients using the most cutting edge techniques for diagnosis and treatment or brain tumours. In the Ukraine he saw patients lying in filthy beds and stuck in corridors untreated and considered untreatable with the most advanced stages of tumours. There was simply no money and no technical skill in the country to treat these people.

As a result, and every year for the past 15 years, Dr Marsh has travelled to the Ukraine to perform complex neurosurgical procedures free of charge in a rundown Kiev Hospital. His earlier trip gave him one reason for hope. He met a young Ukrainian surgeon, Igor, who was determined to make a difference. Despite almost non existent funding and sometimes hostile government intervention, Igor's work continues and when Dr Marsh returns he needs to perform some of the most complex and difficult brain operations.

The English Surgeon is a 2008 British documentary which both details Dr Marsh's history in the country and his 2007 trip during a frighteningly cold Ukraine winter. Parallel to this visit is the story of a young man named Marian who is afflicted with a life threatening tumour. A few years ago Marian began suffering terrible fits. A scan revealed a large tumour in his brain which was considered inoperable. We follow Marian's journey from his small town 500kms from Kiev into the big city where the operation is to take place.

The return of Dr Marsh is treated with jubilation by both Igor and the scores of afflicted patients who turn up at the Hospital. However, skilled as he is, Dr Marsh is no miracle worker and the film is at times as depressing as it is uplifting. To see these queues of poor, sick people (including one child) come into the doctor's rooms only to be told that their condition is inoperable is heartbreaking. This is doubly so as most could have been treated in a health system that has the skills and resources to enable early detection and aggressive treatment.

Igor and his team work with makeshift equipment in the bankrupt health system. In fact Dr Marsh has made it his job to try to get as much equipment sent to the Hospital as possible. On this trip he has brought a collection of surgical drill bits. In the UK they cost 80 pounds each and are discarded after each operation. Igor has been working with the same drill bit for 10 years! He has also been working without the benefit of an experienced team of anaesthetists capable of responding to the needs of complex neurological surgery.

In the scene that could have been taken from a horror movie, Igor calmly translates to Marian the news that due to the lack of anaesthetists his complex brain operation will have to be performed using only local anaesthetic. He will be awake whilst his skull is drilled and sawn open. He has little choice. It is either accept the manner of treatment or wait for death.

Dr Marsh is a kind, genial man who is determined to make some small difference. He takes his role very seriously. Despite the immense good that he has done, Dr Marsh is still haunted by a grand failure - the treatment of a desperately ill girl several years ago. Despite bringing her to London, the operation was not a success and Dr Marsh is racked by guilt as to whether he made the right choice in operating.

Therein lies the continual conundrum. Where a patient is seemingly doomed to only a few more years of life, do you intervene with a risky operation that may either end that life or significantly reduce its quality? Dr Marsh cannot forget Katya and in an emotional coda to the film he travels into the country to visit Katya's family.

The English Surgeon has had limited festival showings around the world, picking up some minor awards. It deserves far more. This is a superbly directed (by Geoffrey Smith) documentary that deserves a place amongst the very best non-fiction films. A warning for the squeamish, however, the film does depict surgical procedures. When those procedures are being performed using hardware store cordless drills, it somehow makes it doubly stomach churning. These scenes are amazing but they are not why I found the documentary so powerful. The quiet humility of the patients either putting their absolute trust in the doctor or bravely accepting his sad diagnosis is incredibly powerful.

In one scene a 23 year old woman attends at the surgery with her scans. She believes that she may have some virus after being bitten by a tick. Dr Marsh looks at the scan with a familiar realisation. It is a terminal condition that could only be remedied in the most advanced hospital systems. In front of the ever-smiling woman Igor and Dr Marsh debate in English what they should say to this woman who is convinced that her problem is minor. Dr Marsh applies a simple maxim: never give bad news to a person alone and they arranged for the woman to return with her mother.

Though at times achingly sad, the documentary is underpinned by Dr Marsh's wry humour and the interplay between him and Igor is engaging. Amongst the gloom of poor treatment and frequent misdiagnosis the film at least gives hope that, with the doctor's training, Igor will be able to perform some of the more complex operations on his own. Also, there is bare patch of ground, thick with snow, upon which Igor intends to build his own neurological surgery. I wish him luck.

Buy this DVD.

Video

   The English Surgeon was filmed on digital video and comes to DVD at a 1.85:1 aspect ratio. It is 16 x 9 enhanced.

There are three basic types of video sequences in the film. These are of varying quality. The overall look of the film is quite clean and impressive with sharp image, strong colours (as strong as you can get in snow bound Kiev and the interior of a hospital) and only minimal noise. Then there are scenes in the car as Igor drives Dr Marsh which are either using a different camera or serve to expose the weaknesses of the existing camera. These sequences are quite noisy as are the night shots in the film.

The third source of content is the video footage of Dr Marsh's original visits and some subsequent visits. This reflects both the poor quality of the equipment at the time and more likely the belief that it would never be used for anything else than a home movie. Video noise is rampant throughout these images. However, they are perfectly suited to the material.

There are sub titles in English which accurately convey the dialogue. There are no technical problems with the transfer other than those stated above.

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Audio

    The English Surgeon comes to DVD with a Dolby Digital 2.0 sound track running at 224Kb/s in both English and Ukrainian. Not all the dialogue is subtitled.

This is perfectly adequate for the material. The dialogue is rendered clearly and is easy to understand. All appears to be in audio sync (no ADR here!).

A surround sound track is not missed. The front of the DVD case states in large letters that the music for the film is by Nick Cave and Warren Ellis. I am not sure whether this is to try to get fans of Cave/The Bad Seeds/The Dirty Three/Grinderman to buy the DVD. Anything that serves to sell this worthy film is alright by me. As it happens, the pair contribute only sparsely to the film. Their pieces are mournful, plaintive and quite moving. The violin and piano pieces recall the soundtrack for The Assassination of Jessie James and other moments reference the "almost-Ukrainian" composer Arvo Part. The contribution is perfect for the film conveying the conflicted nature and the awful situations confronting Dr Marsh.

Audio Ratings Summary

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There are no extras.

  This DVD is available in region 1 and region 2. According to the official web site www.theenglishsurgeon.com, the DVD cannot be supplied to the US as yet due to forthcoming theatrical release. That web site also has a link for people interested in donating to the fund to establish the new Hospital in Kiev.

    Last year I suggested that Oscar winner Taxi to the Dark Side was the one documentary you should watch in 2008. Although it is still early The English Surgeon is the documentary you should watch in 2009. With its enormous humanity and powerful emotion in the face of terrible but often preventable illness, the film is an unembossed genuine eye opener to a world less fortunate. The DVD is presented well and despite the lack of extras is an excellent purchase.

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