Strangely it did not make me think of my own mortality; it is actually a feel-good movie.
In his true style, esteemed director Costa-Gavras once again draws attention to an international and controversial issue with his latest work, Before What Comes After. Although this film is highly emotive, subtle hints throughout point to the profit-driven motives and political tensions that exist within the medical system. Inspired by the work of Régis Debray and Claude Grange, themes of mortality, dignity, and the patient experience are explored in this film.
Looking around at the people in the cinema, which was about fifty percent full, most of the audience members would have been in their late fifties and up. There was only a handful of people who looked my age (45). I bring this point up because I think that this is a good film for all mature audiences to watch, not just those middle aged and above. After all, dying is part of living. Just as caring for an elder might be part of your life.
When we listen to the discussions between the two protagonists – philosopher Fabrice Toussaint (Denis Podalydès), and head of palliative care Doctor Augustin Masset (Kad Merad) – one’s personal judgements about people’s views on death may become more compassionate. The film really just made me think that the differing views on death are not cultural, rather they are highly individual, as shown through the experiences of various patients and how distressing it can be when others intervene. The plot was driven mainly through conversations between Toussaint and Masset, interwoven with flashbacks of Masset’s interactions with the patients and their families before their deaths.
To emphasise how much death can affect anyone, the patients in this film include a gypsy, a personal and very wealthy friend of Masset’s (and credit must be given to Charlotte Rampling’s fleeting role here, she is frightening authentic!), a biker, a young woman with terminal cancer, an older man with terminal cancer, and a father estranged from his children, just to name a few. The variation in patients raised other questions such as – in death, do we forgive? How does wealth impact the patient experience? Does a family have a right to know if their loved one is dying? Does chemo rob you of the chance to truly live before dying? Possibly the only type of patient left out is someone leaving the world truly alone, with no family or friends around to support.
This narrative structure enriched the emotional experience as it made me, as an audience member, more than just an observer. I witnessed the emotional and visual experience of the patients, while simultaneously hearing the philosophical reasoning behind each patient’s decision. Understanding their fears, their decisions, and their acceptance was a key theme throughout, and no doubt Costa-Gavras intention, who at the age of 91, is reflecting on his own life and mortality in this film. I was intrigued to discover that it was a bit of a family made production with Costa-Gavras, Michele Ray Gavras, Alexandre Gavras all listed as co-producers (along with KG productions)
Merad as Masset does an excellent job as the palliative care doctor, portraying compassion to the patients and the family with much patience and understanding. He extends his care beyond the patient to the family and in conversations with Toussaint, exposes the selfishness that often underpins the medical system, which upholds preserving the sanctity of life in a system that profits from keeping people alive even when they no longer desire it. This is a film about dying with dignity and personal choices, but above all it is a film about truly listening to the ones you love and care for.
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