Luke: Irish documentary looks at life at a Soviet-era health retreat in Ukraine, against a backdrop of war

Ireland’s entry for best international feature film for next year’s Academy Awards, Sanatorium, looks at lives of the staff and patients at a health centre in Odesa in southern Ukraine. 

The documentary follows the facility’s staff and the patients who are seeking solace and treatment at the sanatorium against the backdrop of the ongoing invasion of Ukraine by Russia.

The Kuyalnik Sanatorium was, at one time, a destination health resort for tourists seeking the healing properties of the mud and brine of the nearby estuary. Today, the sanatorium is less of a luxury destination.

Over the summer season, a film crew led by director Gar O’Rourke (in his feature debut), captures the daily lives of the staff and patients at the sanatorium. 

The resulting footage is a rhythmic and ritualistic view of respite and routine between the sound of air-raid sirens and constant pinging updates from the frontline on their smartphones.

There’s a technique used in nonfiction filmmaking called ”embedding”, where a film crew will work alongside their subjects to such an extent that they become part of the furniture. The idea is that a film crew will be so present that they become unremarkable.

After a time, the cameras and microphones and lights cease to exist and a film’s subjects begin to act as they normally would.

During this busy season at the sanatorium the pace of work is so brisk that embedding looks to happen incidentally. The action throughout feels like viewing snapshots of larger vignettes.    

At first, it’s all problems, all the time: lightbulbs need changing, lifts break down, the roof of the resort’s theatre is leaking and falling apart. No sooner is a leak fixed than a generator goes on the fritz. 

While patients enjoy therapeutic treatments, maintenance workers tap their feet, scratch their heads and hastily suck down cigarettes like they were Coca Cola.

The manager of the sanatorium is a mountain of a man who seems to walk miles and miles on any given day. 

When the camera finally manages to catch him at a rare moment of rest we see him sitting and sighing and rubbing his temples, thinking about how to tackle the next emergency, and inevitably, the one after that. 

In an early sequence, none of the maintenance crew volunteers to test a faulty elevator. The manager does so himself. A humorous cut to the security footage of the lift shows him looking around nervously with every jerk of the lift as it creaks on its journey up the many floors of the brutalist tower block. 

We see a photograph, dusty and sun bleached, that shows two other buildings that once operated alongside this one. In its heyday, the sanatorium treated 3,000 patients a season. 

Despite the diminished capacity, there’s always a hustle and bustle around the facility as patients shuffle to and from treatments and classes. The staff move about as if on rails after them. These routines observed from afar have a cuckoo-clock quality. Accidental Andersonian (Wes) dioramas featuring Anderssonian (Roy) figurines. 

There’s a sense of fun too around the many contraptions that we see in the treatment rooms of the health centre. In one sequence, a man sits with a fluorescent green tube in his nose attached to what looks like an ancient teletype machine. A retro-future device straight out of Soviet science fiction. 

So much of the building is a holdover from that era, including the pyramid-like facade of the spa’s enormous swimming pool where patients partake in aqua-aerobics lessons, that the glowing nostril apparatus may be a relic also. 

O’Rourke and crew prioritise a lightness of tone. The film is shot with a mind more to the structure that surrounds the documentary’s subjects than the subjects themselves. The architecture is grand and wide and so much of the film is shot in wides. A view of the general over the particular. 

This building – decaying, grim and haunting as it may be – is made fresh and fun with soft focus and distance. The history that’s there is incidental to the whimsy that we are allowed to see in close-up.

Sanatorium’s subjects are captured only as sketches. They are, like the rest of the picture, mostly humorous. 

A mother and her put-upon 40-something son visit the sanatorium for rest. The man’s mother hopes that he will meet a nice girl during their stay. 

With this in mind, a slow pan over a room of older women dancing at a disco later in the documentary raises a chuckle in the same way that the jump cut to the creaking lift did earlier. 

In another sequence, ladies gossip about and flirt with patients and staff over breakfast. On a patio an older patient talks to himself in an unbroken monologue only stopping to order beer with his breakfast.  

The library staff explain that most of the books they stock are in Russian and since a recent ban on Russian writing came into effect they can’t lend them out. Each sequence and character seems ready-made and primed for a little punchline. 

There are these sensible chuckles throughout, and Sanatorium is very watchable in its rhythmic pace and easygoing nature.  

This foregrounding of lighter elements means that when more serious-minded elements do appear, they are jarring. Patients and staff braving air-raid sirens are filmed in the same way as the scenes at breakfast or in the hallways of the facility. 

That the basement of the sanatorium looks much the same as the rooms and treatment areas makes for another bit of visual rhyming. It plays to the beats that preceded it, raising a smile, but should it?

Sanatorium’s closing sequences address directly what has been on the periphery for much of the film. Patients and staff gather to celebrate Ukraine’s independence day. 

All hold their heads high, hands on heart, tears running down their faces. Every far-off stare, blink and tear tells us more than the preceding footage ever could.

This sequence feels apart from the rest of the film. Not accidental but revealing of some shortcomings in approach. 

When the subjects are made so painfully real, having been drawn as comic sketches up unto this point, it feels jarring. Unsettling. 

And perhaps that’s the point that O’Rourke is getting at, even if not much that’s come before this sequence has gestured or suggested the same. 

These things are not trivial but when treated as quirky or framed predominantly as humorous, it makes it very difficult for a filmmaker to end on a serious note. 

Gar O’Rourke is surely aware of this because the credits feature an extended acro-aerobics sequence calling back to an earlier musical interlude. If there’s a smile to be had at that, it’s through gritted teeth.