Photo: La Fille Inconnue promotional poster

In a previous post, I lamented John Berger’s failure to represent realistically contextualised doctor-patient relations in his photo essay (with Jean Mohr) A Fortunate Man. By way of contrast, in reviewing The Unknown Girl or La Fille Inconnue, I argue that the tightly framed  micro-portrait of a doctor in the context of her patients over-reaches social realism, to something more like hyper-realism.

Dr Jenny Davin (played by Adèle Haenel) is a young locum running a single-handed General Practice in the depressed town of Seraing, near Liege, Belgium. The ageing doctor who owns the ‘cabinet’ – a small consulting room off a grim street beside a dual carriageway – is retiring due to ill health. Despite a job offer from a sleek medical practice of welcoming colleagues, Jenny decides to take over the single-handed surgery. Without a receptionist or any partners, she has to buzz patients in from the street to await their turn in a dingy waiting room. She is intensely focussed on, and hugely committed to her patients, despite the risks of working in isolation. Despite being violently threatened by opportunistic junkies when they are refused medication, she nonetheless opens her door to all comers.

All comers except for one. The film hinges on the moment when, after a long day of consultations, Jenny refuses to open the street-level door, despite repeated buzzing on the intercom. This moment of refusal implicates Julien, Jenny’s pale young intern, who earlier in the day failed to react appropriately when a child having a seizure on the waiting room floor. Even when Jenny barked at him to fetch equipment, Julien remained frozen, staring at the prone young boy. In the evening, as they sorted out the day’s paperwork and referrals, the buzzer sounded and Julien went as if to answer it. At this move, Jenny rebukes him sharply, saying that after a long day a good doctor must know when to set the limit on patient demands. Upon this rebuke, Julien flees into the night, later announcing that he has decided to give up his medical studies.

The following day Jenny’s consultations are interrupted by detectives looking for CCTV footage of the surgery’s street-level door. They are investigating the discovery of the corpse of a young woman on a nearby river bank. The body has not been claimed and cannot be identified. The surgery’s security camera footage shows a girl frantically buzzing Jenny’s intercom the previous evening. This girl, who was refused entry, has now become an unidentified and unclaimed corpse.

The remainder of the film is procedural in the sense that Jenny is determined to discover the identity of the girl to whom she denied refuge. In the process of finding out who the dead girl was, the identity of her murderer may also be revealed, which causes various people to attempt to block Jenny’s amateur sleuthing with more or less guile and violence. The girl was an irregular migrant who had worked as a prostitute and various locals are implicated as the story of her death unfolds.

La Fille Inconnue is the directors’ eighth full-length film since 1996 and was widely reviewed as one of their less accomplished pieces. The Dardenne brothers are regularly nominated Masters of European realism and their portrayal of the risks and micro-pleasures of being a GP in a run-down small town is crammed with intimate details of patient contact. The intimacy of the doctor-patient relationship is not only spatial and sensory – you can almost smell Jenny’s hair as she palpates her patients – but also social. In the old-fashioned kitchen of a diabetic house-bound patient, Jenny accepts a cup of coffee, while home-cooked waffles are shared in another home. In a moment of absurdist humour, a box of panettone is lowered from a first floor flat window, as the doctor leaves a home visit.

Jenny’s professional role is her whole persona: she announces her arrival at patients’ homes as ‘Le docteur’ and has access to most aspects of their lives. She is fearless in investigating their illnesses, as well as offering her help, whether or not it is welcome. Her approach is lacking in sentiment and arrogance: she recognises the constraints under which her patients live but is totally absorbed by and convinced of the righteousness of her medical mission. The total conviction with which she administers to her patients is Jenny’s strength as a community doctor.

This conviction suffered a severe blow when she forbade her intern from opening the door to the girl’s after-hours buzz for help. The film is Dr Jenny’s quest to regain her sense of righteousness and moral rectitude in the face of the twin failures to help the girl in need and to support Julien the intern in his induction to the medical profession.

Dr Jenny urgently seeks out the unknown girl’s identity to make contact with her family and avoid an anonymous funeral. While legal justice is not her aim, she reveals the girl’s murderer in her search for redemption. The girl was from Africa, staying with her older sister who works in a neighbourhood cyber-café and was being pimped by the sister’s boyfriend.

A Fortunate Man’s portrait of a country doctor focuses on the noble figure of the doctor and pretends to the documentary while employing lyrical language and story-telling technique. Where John Berger was entranced by the romance of the principled rural General Practitioner’s symbiotic existence with his parish of peasant-patients, La Fille Inconnue offers another figure altogether.

La Fille Inconnue’s physician-figure is also idealised, with the doctor in question a blank canvas, lacking in personal attributes. While the sense of everyday routine health work is well-represented – the never-ending stream of patients punctuated by isolated meals eaten standing in the cramped surgery kitchen  – there is scant indication of the doctor’s personal or private life. Dr Jenny only exists in relation to her patients and this pared-down portrait provokes questions about responsibility and social ethics in the practice of community medicine. Through an intimate portrait of a single-handed, driven young GP, this film asks profound ethical questions about what we owe one another when we live in an unequal and uneasy society.

Many reviewers saw this film as a failure; fewer saw it as a radical realisation of threads in the Dardennes’ existing oeuvre which explores how a person can live ethically in a hostile world.

La Fille Inconnue manages a similar combination of material as that found in A Fortunate Man: the intimate proximity of the doctor-patient relation in the context of a discussion of the ethics of the medical mission. John Berger’s fiction-flavoured documentary effaced the patients’ context, beyond their isolation in a rural idyll. La Fille Inconnue is a fiction that feels all too real: by representing the complex interaction of poverty, racism and fear, the Dardenne brothers ask how an embodied existence can proceed in the face of an everyday, pervasive threat of violence that is both structural and inter-personal.

The film offers a vision of health care work that goes beyond what documentary methods can provide. The techniques and forms of fiction offer an understanding of the experience of illness and health services in social context, which mere empiricism cannot achieve.