‘On Call’ (‘La Permanence’): Cinema du Reel Review

The current refugee crisis in Europe is the subject of the new documentary On Call (La Permanence) from French-born director Alice Diop, who is of Senegalese descent. The fascinating paradox at the heart of the material is how she manages to suggest so much about the complexity, enormity and extent of the problem without ever leaving a tiny and rundown doctor’s consulting room in a hospital in the Parisian suburbs.

The straightforwardly assembled film plays like an extremely claustrophobic — and, it has to be said, less polished — version of Frederick Wiseman’s films, with no voiceovers, direct-to-camera interviews or any other type of external editorializing, instead simply serving up scene after scene of observed reality filtered only through camera placement and editing. Like her previous feature, Le Mort de Danton, it premiered at the Cinema du Reel documentary festival in Paris and again picked up an award, this time the Prix de l’Institut français Louis Marcolles. It deserves to be seen far and wide and will hopefully further help put Diop on the map.

On Call practically never leaves the consultation room of middle-aged general practitioner Jean-Pierre Geeraert, who comes to the Avicenne Hospital in the Bobigny banlieue, to the northeast of Paris, twice a week for consultations with patients who don’t have access to regular healthcare. Practically everyone he sees there has an unresolved immigration status, which means they don’t have the right papers to have access to regular doctors and hospitals, and the sobering reality is that some of them will never get them.

Indeed, red tape is a major concern for a lot of the visitors that Diop has filmed coming in over several months, with a few of Geeraert’s patients needing specific medical certificates for their files and a lot having to be instructed on how to proceed with their paperwork. It doesn’t help that there’s an alphabet soup of acronyms for the various institutions that are hard enough to remember for a French speaker, let alone a foreigner.  

One patient requests a certificate for his constant headaches, hoping it will help him secure room in a shelter instead of under a bridge, while another is told he’ll get an answer to the request he filed with the local authorities in “about six months,” even though he doesn’t have a place to sleep for that period. There are flashes of humanity from Geeraert, who tries to cheer up the former with very black medical humor acting as a kind of defense against all the misery: “Should I write on your certificate that you have Ebola, so they’ll give you a single room?” he asks. Another man cries and implores Geeraert to literally save his life, which the doctor seems to think is part of an exasperating display of theatrics, even though he does matter-of-factly inform a colleague that the crying man’s father was assassinated after he left the country, for which he feels very guilty. 

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Most of the refugees and migrants come from Africa and the Asian subcontinent, and their ailments range from severe headaches and anxiety attacks to severe physical problems and heredity diseases. Quite a few still suffer from injuries incurred in their home countries, where they were beaten up by rebels, the police or members of their family, sometimes years before arriving in that tiny consultation room with the paint peeling off the doors in Bobigny.

On top of his job as a physician, Geeraert frequently gets to hear the stories of people who have fled wars or were otherwise abused and marginalized in their home countries, resulting in them abandoning their familiar surroundings, families and livelihoods. For the patients’ mental well-being, the doctor often insists they try to keep in touch with the home front, though as many point out, calling home, if there are phones available there, is a costly matter when they don’t have any money (they are not allowed to have jobs as long as their status is not clarified). In a simple but heartbreaking moment, a woman recounts how she finally managed to talk to her seven-year-old daughter back home, only to find out she seems to be starting to forget her mommy.

Except for an elderly man who insists he only speaks Urdu, most of the consultations are in French, Spanish or English, or a mix of these, with most of the patients not fluent and the doctor managing a conversation but in no way fluent in the latter two. Thankfully, for the patients as well as the physician, a female psychologist often sits in on the meetings and occasionally talks to the visitors separately when it’s clearly a mental and not a physical problem. Nonetheless, the lucid and no-nonsense doctor finds himself prescribing a lot of pharmaceuticals for his patients, who are often in hopeless-seeming situations with no clear idea of if and when their status might be resolved, with him readily admitting that often, “Giving antidepressants is but the expression of our own inadequacy.”

There’s not a lot of room for Diop, who served as her own cinematographer, to move around the doctor’s single desk in the miniscule office. She does go back and forth between setups that look over the shoulder of Geeraert to the patient and the reverse shot, over the shoulder of the patient, with the latter also a useful solution to maintain the anonymity of some of the people since only the backs of their heads are visible, such as the South African woman with a small baby who has four more children who’ve remained behind back home.

Camerawork and sound are both just above basic, with minor glitches, errors and spied boom mikes par for the course. Editing, by Amrita David, however, is superb, modulating the different visits (and occasionally, return visits) in ways that keep unlocking and highlighting new obstacles and problems that the undocumented face while simply trying to take care of their most basic needs. 

Production companies: Athenaise, Arte France
Writer-director-director of photography: Alice Diop
Producer: Sophie Salbot
Editor: Amrita David

Not rated, 99 minutes