On the Road from Books to Thomas Lilti's Screen: Where Are the Country Doctors Heading?

Abstract

On the Road from Books to Thomas Lilti's ScreenWhere Are the Country Doctors Heading? Peter I. Barta (bio) "L'homme est un apprenti, la douleur est son maître" —alfred de musset: "la nuit d'octobre"1 Thomas Lilti (1976–), the French physician and internationally renowned film director, has attained significant recognition for three thematically related films on doctors, offering a kaleidoscopic cinematic representation of the state of medicine in contemporary France and beyond.2 The films are thematically linked and form a trilogy about the training of physicians, life in a large teaching hospital in the metropolis, and general practice in the country. They have elicited an unprecedentedly high level of engagement from the junior physicians in internal medicine on our courses in medical humanities at Texas Tech University Health Sciences Center. Lilti's cinema focuses on the physician as a vulnerable human subject. The first in the trilogy, the film Hippocrate (Hippocrates)—released in 2014—traces the fortunes of a junior doctor (Benjamin Barois, played by Vincent Lacoste) doing his residency in a large Parisian teaching hospital where his own father is the statutory professor and medical director. Actors in the main roles carry over to the two subsequent films. Marianne Denicourt (Dr. Denormandy in Hippocrate) plays the female lead—Dr. Nathalie Delezia—in the second film, Médecin de Campagne (Irreplaceable, 2016)3 and Vincent Lacoste is cast as the central character both in Hippocrate and the third film, Première Année (The Freshmen, 2018).4 The educational aspect dominates not only Hippocrate but the other two films as well: the plot of [End Page 54] Médecin de Campagne involves an established male general practitioner and a junior female doctor joining his practice in a rural area, and Première Année relates the friendship of two first-year medical students at a university in Paris. The specific focus of this article will be on Médecin de Campagne, the artistically most successful piece in the trilogy. Thematically it connects the village doctor with both the world of the hospital and the concerns about training junior physicians. Furthermore, the film unpacks problems related to the gradual disappearance of general practice, especially in remote rural areas. The title alludes to earlier literary texts about the physical and emotional life of "country doctors" whose profession obliges them constantly to be at the service of others in order to prolong lives and remove or minimize pain. Lilti updates these concerns with a clear view of today's shifting paradigm in the medical world where new technologies and corporate business interests keep diminishing the role of the physician. With this in mind, my purpose here will be to assess the place of Lilti's film in its literary context. Lilti's excellent knowledge of his subject matter has been discussed in multiple interviews, including my own with Marianne Denicourt in this issue. Lilti did his residency in a large teaching hospital after he had obtained his medical qualifications. Then he spent many years in general practice. His creation of the characters in Médecin de Campagne undoubtedly draws upon close familiarity with the work they do. "I like having direct contact with patients, and the idea of taking care of several generations of one family. That appealed more to me than surgery, for instance," he said in an interview.5 The trilogy's focus on apprenticeship, professional conflicts at work, and problematic family relations has been the subject of televised and published conversations with Lilti. From these it emerges that Lilti's father is a physician specializing in obstetrics and gynecology and that evidently, he was not especially keen for his son to pursue a career in the arts.6 Lilti comments: "I have always felt the lack of paternal recognition. I grew up feeling constantly deprecated by the doctor father of whom I felt unworthy. I had the impression of never being sufficiently handsome, cultured or intelligent."7 Lilti, unlike his two brothers, became a physician to demonstrate that he does not lack his father's abilities to pursue a career in medicine. The father-son [End Page 55] rivalry and the bad relations between the...