‘Patient #1’: Tallinn Review

Dir: Rezo Gigineishvili. Georgia. 2023. 114mins

At the ragged end of the Soviet era, an old man (Aleksandr Filippenko) lies dying in a Moscow hospital. He is the General Secretary, figurehead of a regime that is as frail as he is. But the old man clings to life almost as fiercely as he clings to power; his survival is a matter of national importance, and the pressure on Sasha (Olga Makeeva), assigned the thankless task of serving as his nurse, is unimaginable. The latest film from Georgian-born director Rezo Gigineishvili (Hostages) is a mirthless farce, a striking and all-too-pertinent tragicomic study of decaying power structures and the desperate, behind-the-scenes wrangling of a failing state.

 A mirthless farce

The recipient of the annual Werner Herzog Award, Patient #1 evokes the uncertainty and wariness of its 1980s Eastern Bloc backdrop with suffocating effectiveness - much like Gigineishvili’s previous film Hostages,. The Herzog endorsement should serve to raise the picture’s profile and, following its premiere in competition in Tallinn, further festival exposure is likely. Films depicting quixotic, autocratic Russian leaders may be a tough sell commercially right now, yet, as a talking point title, it could catch the eye of a bespoke streaming platform or adventurous arthouse distributor.

The sickness of the leader – the character is a composite of three General Secretaries who died in quick succession at the end of the Soviet period, Brezhnev, Andropov and Chernenko – bleeds into every aspect of the filmmaking. The colour palette of the film seems terminally diseased, a combination of mausoleum greys and jaundiced yellows; it looks as if it might smell like a stale ashtray. A tight, boxy aspect ratio emphasises the airlessness within the frame, as the old man struggles to catch his breath. And the score is clanging and discordant, a symphony played on surgical instruments.

The wider culture of paranoia and suspicion is magnified in the hospital as the ’heart of the nation’ falters in one of its beds. It is an environment that can be unhealthy for those who do not abide by the rules. Fear and trepidation run through the nurses when they are called, unexpectedly and mysteriously, into a room where they wait to be interrogated.

Sasha is questioned about the death of her brother, a shameful stain on her family about which she denies all knowledge. The powers that be reject her as a carer for the old man, but they are overruled by the patient himself. And Sasha finds herself in the precarious position of being responsible for the survival of a dying man whose failing health has done nothing to soften his cantankerous and spiteful spirit. “I give the orders,” he snaps, when the doctors offer him advice. And woe betide the comrade who tries to withhold a cigarette. This is the kind of power that is not accustomed to being denied.

It is also the kind of power that is magnetic – Sasha finds herself used as a conduit by desperate party members who have unfinished business with the old man, or who hope to cement their positions within the party before it’s too late. Everyone, even perhaps Sasha’s handsome new boyfriend, has ulterior motives.

But if Sasha is the more relatable character, the old man is perhaps the more intriguing as a study. Illness has rendered him physically weak – rehearsals are required when he needs to be seen by television cameras to walk unaided. But the hard kernel of his cruelty and ruthlessness is a constant. He knows all too well that when he loses that, he loses his power: power that is as pernicious and deadly as the disease that ails him.