On the Edge

État limite

Mirjam Wiekenkamp (Noise PR)

VERDICT: Nicolas Peduzzi’s doc following a devoted Paris psychiatrist on hospital rounds is as warmly human as it is indignant at the capitalist gutting of public services.

The Beaujon Hospital in the Paris inner suburb of Clichy used to have a psychiatric ward, but now funding is pinched and the understaffed building has only one psychiatrist employed to cope with its hectic rotation of patients in urgent need. French director Nicolas Peduzzi, whose first two feature-length documentaries Southern Belle (2017) and Ghost Song (2021) were portraits of troubled lives in Houston, Texas, has turned his eye homeward with his third feature On the Edge, screening in the Cannes parallel section ACID after garnering a jury Special Mention at documentary festival CPH:DOX in Copenhagen.

We tag along with Beaujon’s devoted but overworked psychiatrist, 34-year-old Jamal Abdel Kader, and his interns on their daily rounds. Peduzzi’s vision of this often thankless line of work is compassionate and staunchly anti-capitalist. He allows us to connect with both staff and patients as individual personalities in all their human drama, while framing their frustrations as symptomatic of a much wider crisis in public institutions in France, and of a society that insists on quantifying relationships of trust and care that are intrinsically priceless. Hooking audience attention through relatable warmth, humour and pathos, the film speaks to widespread global anxieties about the gutting of public services to bolster unequal wealth; it should also play well to festival audiences outside France.

Jamal, whose Syrian parents were also both doctors, feels a calling to his profession that goes far beyond status or material concerns. He is no stranger to multi-tasking at speed, and voices his two cents on the precarious state of the public health system to the camera as he navigates the corridors and twisting stairwells, from bedside to bedside. Gregarious with an engaging wit, he obviously cares deeply about the people who wind up here, often after desperate acts, at all hours of the day and night. He takes time to listen to each one. Their behaviour can be erratic and alarming, and it’s clear that professional intervention to lessen the risk of harm can’t wait. One patient, diagnosed with schizophrenia, fears being around open windows because he has an urge to throw himself out. Physical restraint is a last resort for another, drunk and violent, who resists treatment. The vulnerability of a disoriented woman from Maastricht, who has no relatives in France and has joined a religious group, makes the doctor wary of discharging her. The frenetic pace of the hospital and unpredictability of encounters can be overwhelming, as the camera keeps us close to it. Black and white stills break up the chaos, giving us a breather and conferring dignity upon staff and patients in valuable moments of connectivity.

Jamal tries to not only connect on a human level with his patients, but to broker better family support systems between them and relatives strained to breaking point by the extreme manifestations of illness. He explains to the sisters of drug-dependent Alienor, who has lost her legs and a forearm after falling from a bridge, that her addiction issues are not a simple matter of choice, and that she was prescribed benzodiazepine from a very young age by a French health system that heavily medicates its citizens.

There would be scant need for psychiatric facilities at all if he had his way, Jamal insists, and urban communities looked out for their most vulnerable citizens, rather than excluding those who do not produce according to capitalist logic. As it stands, with no budget allocated to rehabilitate people after they go home, he is nagged by a sense of sending his patients off into a world that has not been structured to aid their recovery. His fears are not ungrounded: the film is dedicated to Wendy Eduoard, a patient who dies from a suspected drug overdose just after getting out.

The heroically committed staff are accustomed to putting on a brave face while they work, exhausted, through understaffed conditions. But the film’s title nods not just to the precarity of patients in a state of desperation, but to the hospital employees who can identify all too well with psychological strain, and are not so far from finding themselves on the other side of medical attention. Alice, an intern, takes the stress home with her. Romain recalls the shock of having seen a fellow nursing trainee admitted with burnout. Jamal says he fears the staff have become accomplices in keeping the system upright, when they are overloaded and somehow keep functioning. On the Edge warns that broken systems create rather than cure broken people.

Director: Nicolas Peduzzi
Producer: Carine Ruszniewski
Editor: Nicola Sburlati  
Sound Design: Alexandre Bracq, Benoit Dechaut
Music: Gael Rakotondrabe
Production company: GoGoGo Films (France)
Sales: Lightdox (Switzerland)
Venue: Cannes (ACID)
In French
93 minutes