From a health care professional in the U.S.:

Someone has to have a response.

Yes, I think it is a bit over the top, the director clearly tried to emphasize on the complete lack of care of the doctors to prove his point that no one cares these days, that loneliness and lack of communication is a disease of the modern world.

But whether he was a bit extreme in his portrayal or not, I will share with you a bit of my short (thank God) experience with the Romanian medical system.

One: the story of this movie is inspired by actual events. There was a big story in the news when an old man was taken from hospital to hospital until he died on a stretcher. The story was "tabloidized" back then and apparently it didn't become a serious issue. With this movie it was merely "artized" and I don't think it influenced the civil society to take action either.

Two: A friend of mine, about 20 years of age, definatly not an alcoholic or a bum and coming from a normal, caring family, woke up one night coughing blood. Her parents called the ambulance, it arrived quite late (and the emergency operator usually asks questions for about 15 minutes before deciding whether or not to send an ambulance, my experience as well when I thought my father had a heart attack), they took her to a hospital where they said she doesn't have a medical record or something so she must go to another one. Then on to the second, where she was told they don't have the necessary equipment and then on to the third one... I think she lost count. In the end, she didn't die because her illness wasn't fatal, not because of doctor's efficiency. And she still struggles to find out what was wrong with her as all the analisys that were done were unconclusive.

Two: I went to the emergency room once for a minor injury. I actually felt like I was intruding there. Overcrowded, people with real sickness were yelled at and left waiting with everybody else in a dirty hallway. I needed an X-Ray and while waiting in front of the X-Ray lab I witnessed the doctor coming out of his little room from once in a while, yelling with this over-confident, yet victimized voice at people waiting, pushing a guy in a wheelchair out of his way and taking breaks while the queue in front of his door was getting bigger and bigger. When it was my turn to get in, I rushed as fast as I could and followed his "instructions" because I felt my little finger inury was keeping real sick people waiting. And he did nothing. The whole X-Ray thing was actually taken by his abused and very polite assistant while the doctor walked back and forth complaining about his own miserable job.

Then again, I tried to put myself in emergency doctors shoes. They are underpaid, understaffed, have to deal with tons of bureaucracy, work impossible hours and basically have to do abbattoir medicine. It's like war surgeons that decide who lives and who doesn't because they don't have the time to take care of everybody. I think it's more like the system's fault than the doctors. After all, they choose to do it when they are fully aware of the conditions.

Another issue is that in our medical schools there are constantly scandals involving buying diplomas! There are doctors out there that have never set foot in a medical school and that's what terrifies me most. Although they probably don't get to work in an ER or critical jobs, the quality of these fake doctors is close to zero. And this should really be an issue because forging a doctor's diploma is a bit more serious than forging a lawyer's or engineer's one.

Regarding the movie's style, it's Puiu's choice, very popular with our young filmmakers who show you horrible tragedies from a completely neutral point of view without any moralizing effect. The excessively long shots and the voyeuristic hand-held camera are meant to add to the viewers angst and you have to agree they do their job. It's not a "feel-good" movie, it's not a "let's take action" movie, it's just meant to put you, the viewer, in Lazarescu's shoes for three long, gripping hours.

P.S.: I just heard on the news they will be enforcing a European law that doesn't allow anybody, including doctors, to work for more than 48 hours a week. That's good news for doctors, maybe they'll be more relaxed from now on, although it will also affect their pay but I wonder who' s going to fill in for them...

While the US health system is nowhere near as dysfunctional as that presented in the film, there's a lot of places where the film still struck home to me.

In my various journeys through our health system, I have seen physicians who can't seem to pass up an opportunity to berate their patients for not taking care of themselves. I have seen physicians who even though they are in front of patients are quick to assert their place at the top of the medical pecking order (don't they realize that their patients are also their customers, and that it's extremely unprofessional to act that way in front of a customer?). I have also seen physicians who treat their patients with very cold detachment and brusque manner. That said, I have also seen very compassionate physicians, and even the worst physicians still managed to give their patients the treatment they needed.

And something must be said about people like Mr. Lazarescu. When I was a kid, my father hired a crackerjack mechanic, who, it turned out, was also an alcoholic. Over the course of several years he systematically destroyed himself, first with circulation problems that took his legs, then a stroke that took his language and other skills, and finally death. During this time his family, my father, and others tried to stop this man from going down his self-destructive path, at a great emotional toll to themselves. When his circulation problems first arose and threatened to take one of his legs, a VA surgeon heroically worked overnight to save all but a couple of toes (score one for the medical profession). But a year later he lost both legs anyway and continued down his path of self-destruction. After both legs were gone and he couldn't get around anymore, he used to call up taxi drivers and bribe them to bring him booze. So I can certainly understand the weariness and dismay of any medical professional when somebody like Mr. Lazarescu shows up at your door.

Actually this could have very well been about the US. This looked very familiar to ERs in the states. It's a GLOBAL problem.

And you can find far worse even here-http://www.youtube.com/watch?v=WFWi1bqncLU

This movie is sadly accurate.

Hi, i'm from Romania, and even if i'm not 100% familiarized with the medical issues here, there are obvious problems that i feel the need to adress.Not beacause of arrogance or anything, but beacause i have personally confronted some and, if they are not brought to attention, they will remain unchecked and unchanged to a point where doctors are actually endangering human life, and not saving it.Four years have passed since "The Death of Mr.Lazarescu" and the problems protrayed in the movie still persist.
First of all, of course the movie dramatizes the health problems here, but only beacause the director wanted to adress as many issues as he could in about 2 hours, so he kind of jamed them all in there.It's not that they are not real or anything, but it's unlikely that someone will confront them all in the course of one night.
Let me just relate some examples that have happened to me personally and that might shed some light on the health care here:
First: About a year ago, my grand-father, who suffered from leukemia, was having serious problems that required him to be taken imediately to the hospital.So we called the ambulance, wich arrived very late.But when it came, the nurses in there told us that they cannot place him on a stretcher (when we asked why not, they did not tell), so I had to take him by the shoulders and basically drag him down to the ambulance from a 6 story flat.It was an ordeal, both for me and for him.But when we arrived at the ambulance, the nurses were just sitting there, relaxed and smoking.And of course, there was a stretcher in the ambulance.When i asked them why didn't they use it, they finnally gave us an answer: my grand-father, in some sort of ceisure, involuntarilly released his bowels, and they did not want to get near him.And that after 20 years of my grand father giving little attentions and downright cash to doctors (coruption is another issue) for just being able to be cured and stay alive.
Second: My dad is in a hospital right now.Due to a lack of funding (there has always been a lack of funding in our hospitals ever since i remember) there are no pills or vitamins for him.So we have to buy them for him.But when, after a while, when we asked him if the nurses gave him the pills, he said no.We found out that the nurses were giving his pills, the pills we bought, to other patients, patients who gave them little attentions or cash, or anything.It was just like stealing.

I don't know what image i have managed to paint through these examples, and of course you can say "well, you just saw some isolated cases".But no, these are not isolated cases.Ask any romanian you can find, and each and everyone of them will have one story or another about the corrupiton and the lack of empathy from the doctors and nurses.The problem is this: during the communist era, due to a lack of efficiency from the state institutions, normal citizens were forced to give little atentions or "shpaga" as we call it (the envelope of money discretely placed in the pocket) to reprezentatives of these institutions in order to get the attention or care they needed.Cop pulled you over? Give him some money and problem solved.You need you're kid to pass an exam? Pay his teacher and problem solved.You're sick and don't want to die? Pay the doctor, and he'll treat you better than the rest of the patients who, due to them being poor, are literally left to die.And after the collapse of the communist regime, these doctors and teachers and policeman retained they're jobs, and beeing used to these little attentions and "shpaga", continued to demand them from the citizens.Citizens who, in they're turned, became used to giving them.It's a problem that continues to this day.And so of course there is no empathy since these reprezentatives of state institutions see citizenz as merely money bags, and nothing more.
Traffic of influence, corruption, these are social diseases bred by the communist regime, disseases that manifest themselves to this day.And the lack of funding is highly related to them.The politicians bred by the same communist regime are still in high places.Since the fall o communism, i cannot recount one time when i heard of founding being transfered to schools, hospitals, police agencies, or any other state institutions.Even the europeean funds given by the EU are filtered through so many pockets that little to none arrives to it's destination.Two years ago a huge amount or europeean money was given by the EU in for the construction of a big romaninan high-way.I haven't seen a meter of high-way being built.Pills and other medicines are donated by the EU to hospitals, but doctors monopolize it, steal it basically, and give it to the they're "special" patients, while others are left to die.
And of course, those of you living in western countries will say "well ok, but we too have to pay for health care, schooling, etc."True,but you don't pay the doctors,teachers, cops personally, there is no generalized rule of "little attentions", and so you don't give them the role of God, you don't give them the personall right to chose who lives and who dies, who gets in and who gets out.Plus, we also have health insurance here, it is paid for, and still, people with health insurance are forced to pay certain doctors just to keep living.
It's an endless cycle and the problem is that newer generations in medical schools take note from these examples, see the easy way of making a couple of bucks extra from "shpaga" or any other forms of corruption, and continue to demand it.
Ok, i see this post grew way longer than i expected.I don't know what image i managed to paint, but i felt the need to adress these issues out of pure rage generated by the helplessness that i, as a citizen, feel in not being able to confront these problems.There is nobody you can call to protect youreself from these corrupted people, there is nobody you can sue, there is basically nothing you can do.State institutions do not serve the citizen in this country, the citizen serves them.They are God here, and the citizen humbles himself when coming close to them.It's a bleak image in a bleak society, a society that just might need another revolution like that in 1989 in order to change.

P.S: Please excuse my english if i made some mistakes.Not beeing english, i'm not perfect in speaking or writting the language.

I doubt you want to hear this, but... Everything we saw corresponds to my experience of the U.S. health care system.

I assume it was all greatly exaggerated for clarity. It would be almost completely masked by a higher standard for bedside manner. But I found the gist of it spot-on. The reality here in the U.S. is much more subtle ...but if you listen closely enough it's not really different.

Sure, whether the U.S. health care system is actually like this or only perceived like this debatable. But like it or not the U.S. health care system is widely perceived like this.

Folk wisdom seems to assume that if each and every individual is doing a good job, then the overall system is perforce a good one. I find the U.S. health care delivery system to be a prime counter-example, one where the vast majority of individuals indeed do a very good job, and yet the overall result is dysfunctional. One is very hard pressed to identify any individual who's not performing above and beyond the call of duty, and even so the net result is inefficient, inappropriate, and expensive.

Europeans tend to be more blunt, but be honest, beneath your false friendliness you American nurses are just as indifferent. 100% of your patients will die, it's a joke