‘Map for Love’ Helmer Constanza Fernandez Examines the Health Care System in ‘(Im) Patient’

“(Im)Patient” (“El Pa(de)ciente”), the Sanfic Work in Progress entry by Chile’s Constanza Fernandez, deals with a universal hot button issue, health care.

The drama follows an elderly but fit doctor who is suddenly hospitalized with the little-understood Guillain-Barré syndrome, a rare disorder whereby a body’s immune system attacks the nerves. He begins to record his experience in the hospital where his position as an expert in the field of bioethics gets him some preferential treatment but does not spare him entirely from the indignities that most patients undergo in a hospital and inexpert treatment from harried nurses in a far from perfect health care system.

As in the title, this doctor grows ever more impatient with the inadequacies of his care. The film tracks his journey through his illness and his newfound appreciation of what he has long taken for granted, his family.

Produced by Roberto Doveris’ Niña Niño Films, Fernandez’s second feature follows her feature debut “Mapa para Conversar” (“Map for Love”), winner of the best director prize at 2012 Sanfic (Santiago International Film Festival).

Fernandez took some time out from working on its post-production to converse with Variety:

It’s said that doctors make the worse patients. Your movie is evidence of that adage, but do you agree?

It’s a fact that doctors are among those who most frequently postpone their medical check-ups and are the least hospitalized compared to the rest of the population. The causes of this, I believe, are in part due to their knowledge of the risks that hospitalization implies, as well as over self-sufficiency. Now, once admitted, they differ from other patients; they expect to be treated differently because they are doctors themselves. Medical services are imparted with a tremendous asymmetry between those who receive them and those who give them. The system is used to that and abuses that ignorance, so when someone appears who is aware of the goings-on, they easily become the “difficult” patient.

Your film reveals the failures of the Chilean healthcare industry. Does Chile offer universal health care? Or is it similar to that of the U.S. where a catastrophic illness could lead to financial ruin?

I wanted to have a more universal look at this issue with the film and include testimonies that spoke of hospitalizations not only in Chile but in other countries. What is very Chilean – and is one of our exports – is the commodification of everything. Chile has an underfunded public health system and a private health system which works more like the hotel industry. However, we have made some progress with laws that have contributed to minimize this inequality, such as a law that obliges private clinics to attend to you when your life is at grave risk. The state will then cover the costs.

Did you know someone with Guillain-Barré syndrome? How much research did you have to do for this movie?

The film is based on the testimonial book of Dr. Miguel Kottow who, apart from being an expert in bioethics, is the grandfather of my son, the father of my ex-partner, so I witnessed the entire process of his illness. Now, in my two years of research on this project, I did not focus only on the peculiarities of Guillain-Barré though I hope to shed some light on this relatively rare disease. I also looked for experiences of extreme vulnerability that we could all relate to.

Your movie feels like a documentary at times. Did you use real nurses in some scenes?

Yes, I used some real nurses; we filmed at a surgery center where the real events took place meters away.

Do you hope that your film will produce some change in the Chilean health system?

The film was sponsored by a Medical College, a trade union for doctors in Chile and important universities, so I think that it will be a powerful cultural tool to reach those who are trained as health providers. It would be more difficult to measure its impact on the system but I don’t doubt that it will contribute to debate.

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