INTERVIEW: Nicolas Peduzzi on his stirring and haunting hospital doc – Cannes Film Festival 2023

We might assume that the healthcare system is the top priority of any European government, we might know that it never really is, or we simply might not think about it; in any case, and whatever your case is, certainly little do we know what are the hospitalizing and working conditions, especially in a public facility, especially in the psychiatric department.

‘On the Edge’ does not only give some clarity to the matter, from an exemplary Parisian perspective, but also recalibrates and repositions the overlooked mental decay in the scale of common needs. It stands next to Dr. Jamal (to be more accurate, runs behind him) to watch him catch up with his daily work challenges-which can be summarized by budget cuts, understaffing, and increasing need for mental care. Jamal Abdel-Kader is a young (and the only) psychiatrist holding the fort of the mental health of the Beaujon public hospital in the Paris suburb of Clichy. 

 The lack of (financial and emotional) brings Jamal and his colleagues to the boiling point daily. They are extraordinary individuals, sensitive, rational, and full of comion, which makes one think that even if the system is upside-down, driven by market demands or irrelevant politics, people like them can make a change. We see them working, and having conversations between them, sharing thoughts, objections, and fears. We also see Jamal performing his exceptional problem-solving skills and diplomatic manners, not only with his patients (most of which are intense cases of self-destruction, addiction, or schizophrenia) but also with the ‘system’ (e.g. police officers).

This is the third documentary of Nicolas Peduzzi, and it might not be a surprise, but it is an artful and piercing accomplishment. It also contains rare footage of mentally disordered cases. That alone makes this film a masterpiece, picked up by H:DOX and Cannes. Nicolas shared with us his thoughts. 

 

Your film has some rare footage of patients in need of psychiatric care. These realities demand a first-hand experience to gain a broader understanding within societies, and maybe for the patients’ protection (or due to protocols), they usually remain hidden. How did you manage to get permission to follow a psychiatrist in a public hospital and film him?

I was born in Paris, but I moved to Italy when I was 16. At that time, my father was itted to this specific hospital for a liver transplant. I was there all the time, so I know the place and the doctors. It is in a way a home to me. When the pandemic happened, my producer had the idea to do something about the hospital. The initial plan was to film an intern that was starting his career there during that time. But then I met Jamal in the emergency room. I saw the way he was dealing with the people and I was amazed. Actually, he had deep relationships with his patients, and found a way of introducing me, the camera, and why we are filming, that almost nobody refused. According to Jamal, for some patients, the presence of the camera became part of their therapy. They opened up in front of the camera because they felt that someone was interested in their story. Of course, it can also work the other way around, but Jamal made use of the camera to help his patients more.

Although the story is strong even if we read it as it is—the challenging working conditions of a psychiatrist in a public hospital—I think that by holding the camera to Jamal, you cast light on something beyond the walls of a hospital in the suburbs of Paris. Such as work burnout and inner mental threats, that lead back to the (maybe small-scale) implications of living within the capitalist mode of production. And in this sense, your title is sharp and just right. What are your thoughts on it?

Yes. Beyond the situation of the hospital, the film is about the system and the society, and the work we do every day. The reasons why we wake up. Jamal, Romain (the nurse), and the other people we filmed are in their 30s. It was very clear from the beginning that they are quite ionate about what they do. They didn’t want to be anywhere else—which is what might drive us to a gap. It is quite different from my environment, and I was immersed in that world. It is painful to realize that you are working within a bureaucratic and upside-down system, such as the French one. There is a lot of hope in seeing these young individuals giving so much. But it is also sad, as Jamal says at some point, maybe trying to fix the holes, we are participating in the capitalistic system. 

I knew beforehand about the lack of interest to invest in psychiatry and in carers. I knew already through friends who work in this environment that we are experiencing a mental pandemic. We don’t speak about it, while no one knows how to deal with it. We are stuck in the 60s on this matter. I didn’t realize how tragic this issue is until I visited this hospital. Which is worldwide renowned, especially for organ transplantation. During and after the COVID pandemic, a lot of people were in need of mental care. The demand to be taken care of is big. When I went to Jamal’s office, I saw this long list of people that jumped out of their windows. When I started filming, I felt the issue in my body. It was a shock to see this guy alone. To see someone that committed, while risking a serious burnout for himself. He told me that he doesn’t have a life. He is also teaching his job, while he is treating people. I see this situation as the ‘État Limite’ of our society. It is actually a phrase Jamal used for one of his patients. 

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You portray Jamal’s position with a very elaborate technique. You have a hand-held camera chasing him around the labyrinth of a quite inappropriate building to hospitalize those in need, and then you interrupt this frenetic situation with black and white photographs. These images are full of emotions, and they give a dramatized version of Jamal’s story, with a voice-over narration. How did you come up with this juxtaposition?

Jamal is a doctor in the emergency, and I had the idea of projecting him to the hand-held camera. But it is impossible for the viewer to just understand everything through a film, even if it is 3 hours long. You need much more time to really get what happens or what people do. So I thought of putting the situation on hold through photos, with the hope that this would give a bit a sense of everything that is happening. I also see it as a chance for respiration, to not get too close. Besides that, some things with the patients we couldn’t, or we didn’t want to film. They just didn’t feel ok to film, while the still images gave us the distance from the intimacy of the situation.

It was my mother who took the pictures. She used to be a war photographer. She was living in places like Nigeria. Later on, she also did architectural photography. I love her work and I wanted to collaborate with her. She also spent a lot of time at this hospital, when my father was ill, so she knows the place. Besides that, I think that her female presence there was important. Maybe it is a psychological thing. It was really important to collaborate with my mom. She was doing an irable job, but then she had me and my sister, so she stopped. She is very talented and humble.

The collaborations developed through the film seem to be the catalyst for the high artistic quality you achieved. Besides the hand-held shooting and the still images, the music score gives the ideal tempo of the situation. 

The way we all worked was quite organic. We focused a lot on the path of Jamal, and what was his rhythm. Not only for the music but for the pictures and the filming style as well. We worked a lot with the editor (Nicola Sburlati) for six months, trying to combine the footage, the photos, and the music, to find again what we saw in Jamal that amazed us. 

The score is by Gaël Rakotondrabe. He is a friend of mine, but he is also a great jazz pianist. He is travelling a lot, doing improv jazz. Now he is doing his first album. I love his work. When we started, I was sending him ideas and references. Especially from a Japanese musician I ire, thinking that it is impossible to do something as powerful. But in the end, he managed even better. 

‘On the Edge’ was premiered at the Copenhagen International Documentary Festival, and now it is selected to be shown in Cannes, as part of the ACID (Association for the Distribution of Independent Cinema) program. How do you think it resonates outside the borders of ?

Initially, I was surprised to see that it is a subject that can be presented in Copenhagen. Now I think it is a subject with an international interest. I know we are a bit obsolete in the ways we deal with mental issues in , and I don’t want to generalize, but I think disorders in our mental health are the outcome of the capitalistic society we live in. A psychiatrist for me is a reflection of what is going on everywhere. So my feeling is that people, no matter where they live, will understand. 

This is your third documentary, dealing with an intense subject. Are you already working on your next story?

I have ideas. But I was doing ‘État Limite’ for 4 years. I need to take a break and understand what subject I can approach. I don’t want to rush into it, and take the time to find the subject I want to work on. 

‘On The Edge’ (État Limite) received the Award – Honorable Mention at the H:DOX March, 2023. It is part of the CANNES ACID 2023 screenings (17 – 20 May). 

2023, Country: | 93’ | Dir/Camera: Nicolas Peduzzi | Editor: Nicola Sburlati | Music: Gaël Rakotondrabe | Photography: Penelope Chauvelot | Production: (, Documentary) A Gogogo Films in association with Arte Films production. (World Sales: Gogogo Films, Paris.) Producer: Carine Ruszniewski