A few years ago, a magazine pondered the question "What is the worst country in the world?" Just being an aggressive dictatorship wasn't enough to make the list. One of the key questions used to determine which country made the cut was "If you have a medical emergency in Country X, will an ambulance be available to pick you up?" The importance that people place on health care, and the gut reaction they have when its not provided in a timely, professional way, is a huge subject that's not often dealt with in fiction films. After watching Cristi Puiu's latest film, you may develop a whole new appreciation for America's crappy system. The Death of Mr. Lazarescu begins in the kitchen of a filthy, newspaper-strewn apartment in dilapidated Bucharest, with Mr. Lazarescu (Ion Fiscuteanu) nervously dialing for an ambulance. He informs the person on the other end of the phone that he has had a severe headache for four days, which can't be a good sign. Instead of sending out the ambulance immediately, however, they decide to quiz him to make sure he's on the level.

Do they know him to be a hypochondriac with a history of crying wolf? Can they tell that he has had too much to drink tonight? Or is this just how things are done in a resource-strapped society? It's unclear, but the phone call does not end reassuringly. Not convinced that the ambulance will even show up, Lazarescu decides to impose on his neighbors in the apartment down the hall for medicine. They know him to be an amiable drunk and hardly take his pleas seriously, until he throws up ropes of blood on their carpet. The next two hours of The Death of Mr. Lazarescu consist of a rainy blur of ambulance lights and street lights, and endless cross-talk between people trying to get a rapidly failing man to where he needs to be. Needless to say, Lazarescu is not a lucky man, and his luck on the night in question is horrendous. Lazarescu's emergency coincides with a local bus crash that fills every regional emergency room with trauma patients. Anyone who has ever been forced to wait for emergency room care will be gripping the edge of their seats during the scene where we see a physician stop the parademics in the parking lot from unloading Lazarescu.

After spending the first hour of the film getting to know Lazarescu's neighbors, while they wait patiently for the paramedics to arrive, the cavalry finally shows up and Lazrescu is whisked away. We go with him, never seeing or hearing of the neighbors again.Their part in the story is just over. This quality of unsympathetic, no-frills realism in the film underlines the notion that dying alone is more or less inevitable, even if the paramedics and your loved ones manage to get you to the right doctor in time. Eventually your time will come, and no one else will be coming along on the final journey. The brief opening interlude with Lazarescu alone in his apartment is enough to convince us that his time has come, anyway. An elderly widower with a hanging belly and no companionship except his mangy cats, he doesn't live so much just 'exists.' The neighbors and paramedics who enter his apartment are forced to comment on the ghastly smell of cat shit and who knows what else; we get the sense that Lazarescu has been hiding out from the Grim Reaper longer than he has any right to.

Whether or not his death is inevitable, however, there's still a lot of blame to go around for his awesomely bad treatment. Witness an infuriating scene late in the film where two doctors casually discuss the batteries in their Nokia phones while Lazarescu, lying on a gurney, begins to drift out of consciousness. By this point, he has been asked to state his name dozens of times for doctors throughout the night, but he is suffering from a subdural hematoma and paralysis is quickly setting in, destroying his ability to respond and assist in his own care. When asked to state his name once again by the Nokia doctors, he can only stare and blink. In the film's most shocking moment, and perhaps the only time when the fictional nature of the piece draws attention to itself, a complete nightmare of a doctor cynically asks the babbling, non-responsive Lazarescu to sign a consent form for surgery. After he does not, the doctor has him thrown out of the hospital. Illegal, right? I hope so. Unfortunately, it's probably closer to reality than we'd like to believe that doctors in countries like Romania are left to rely on their own good sense, or lack of it, when it comes to deciding who gets treated in emergency situations and who gets the sidewalk.

Mr. Lazarescu is not really a performance-driven film, since the main character spends most of the film slumped over in a wheelchair or stretched out on a gurney, sinking into deeper levels of unawareness. But it is a dramatic one, with subtle and effective performances. There's a stoic paramedic, Mioara, (Luminita Gheorghiu) who stays with Lazarescu throughout most of his ordeal and goes above and beyond the call of duty in order to make sure he gets to a hospital that will not discard him like trash. Mioara is told at every stop along the way that, having deposited Lazarescu, she is now free to leave. But she senses correctly that leaving Lazarescu in the hands of overly-busy or uninterested doctors will be a death sentence for him. She continues to load and unload him at various stops, long into the night, after he has lost the ability to even respond or appreciate her efforts. In one of the film's final, and most touching scenes, she pulls Lazarescu into an empty emergency room waiting area just as the staff is clearing out. Shifts are turning over and everyone is going home. Just when it seems like this will be the latest dead end, Mioara spots a young, female doctor on her way out the door. The doctor looks tired enough to collapse, but with a sigh, she braces herself and decides to listen to what Mioara has to say about the man on the gurney.