Filmmaker Jerome le Maire spent a year hanging out in Paris’ Saint-Louis hospital getting to know the staff prior to filming Burning Out.

Bernard Dichek
Bernard Dichek is a Canadian-Israeli filmmaker and journalist living in Tel Aviv currently working on a film series about Africa.

This was time well spent, judging by the intimate rapport he established with the doctors.  They talk to him openly about their dissatisfaction with how the hospital is run, and he is able to unobtrusively capture several tense scenes which illustrate his main thesis: staff energy is being sapped by the bureaucracy.

It also is refreshing to see medical professionals who we normally only encounter as impersonal figures hidden behind surgical masks and scrubs, as multi-faceted people. Anesthesiologist Marie-Christine Beck reveals herself to be a person with both a social activist and philosophical bent. Beck arranged for Pascal Chabot, the author of Global Burnout, to speak to the staff, organises public demonstrations and makes philosophical comments like: “What is a good question? Maybe one that has no answer.”

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Many viewers however, may find little in the film particularly surprising. As most of us, at some point, have suffered traumatic experiences in the hands of large institutions, it is fair to assume that monoliths can be frustrating places for its employees. As pointed out in the film, the surgical ward doctors who form the focus of Burning Out, are among 20,000 doctors and about 100,000 workers who are all managed by one single, central Paris hospital administration.

Many may also find it difficult to feel sorry for the doctors who are the film’s main protagonists. They spend a lot of time complaining about the decline in their level of job satisfaction, now that management – in its quest for increased profitability – is constantly rotating staff from one department to the other, “like balls in a pinball machine” as le Maire suggests.  The doctors bemoan the good old days when they claim they used to work seamlessly in closely-knit teams where everyone knew one another.

Clearly, there is room for improvement. But, you have to wonder what all the fuss is about and whether their whining is justified – considering the conditions for doctors and patients elsewhere.  I am familiar with medical facilities in three other countries – Canada, Israel and Uganda – and the impression that Saint-Louis hospital creates in this film, with its attentive staff and modern facilities, by comparison, is quite favourable. It is also noteworthy that the film fails to mention France’s famous (and leisurely) 35-hour work week and the extent to which this may be the root of some of the malaise.

Indeed, the fact that le Maire finds it necessary to proclaim, at the beginning of the film, that he “was taken by the depressive atmosphere that dominated the place”, suggests a concern that if we are not told what we are supposed to be seeing, we may well reach an altogether different conclusion.

Another shortcoming, is that we never hear management’s side of the story. This lack of balance is especially misguided, because it is clear that the doctors are closely cooperating with le Maire in order that they get their message out. Consequently, the credibility of some of the film’s scenes is questionable, such as when one of the surgeons berates a nurse until she breaks down in tears.  Later on, in a meeting with management representatives, he acknowledges that he acted ‘rudely’ but blames the circumstances under which he is forced to work as the cause. As he is one of management’s most vehement critics, we may suspect that he deliberately acted as he did, to prove a point.

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This problem can occur when a filmmaker and the film’s subjects work hand in hand. As approach, it is very different to that of legendary American filmmaker Fred Wiseman who has perhaps made more films about institutions, including hospitals, than any other documentarist. Wiseman’s method is to only shape the movie after he has gathered his footage, without a pre-conceived point of view.

Burning Out also suffers from a somewhat contrived and unsatisfactory ending.  After witnessing the doctors talking to le Maire, seeing them in action in the operating room and hearing them make their case in front of an auditing panel, someone comes up with the idea of creating a staff suggestion box. For a while, there is suspense in whether or not anyone will actually use it. When it turns out that they do, the film ends on a positive note as if to imply that change is possible.

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As the film concludes with general hospital shots, Bob Dylan’s famous protest song The Times They Are A Changin is heard, seemingly suggesting that the film be seen as a wakeup call to management. A better choice, if Dylan is going to have the last word, might have been to feature a line from his song It’s Alright Ma: “he not busy being born is busy dying.”

That is the film’s entire in a nutshell: companies and institutions, large or small, if going to succeed, are in constant need of renewal.


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