April review - powerfully acted portrait of a conflicted doctor in eastern Georgia

It’s easy to see metaphors about the status of modern Georgia, once again threatened by the Russian boot, in its recent artistic output. So while there are no overt political allusions in director Dea Kulumbegashshvili’s April, at its core you sense a tacit and urgent debate about how to square your conscience with the “rules” that govern the country’s conduct.

The heroine of the piece is Nina (Ia Sukhitashvili), an actual heroine of a sort. She’s an OB/GYN hospital doctor who risks her career by dispensing contraceptive pills and performing (illegal) abortions in remote villages for women in extremis. Nina is no angel. She’s a basket-case, impassive and insomniac, with a libido that leads her to proposition total strangers working at night to have sex with her. She has no partner, having rejected her doctor colleague David (Kakha Kintsurashvili) eight years earlier, she says because she had no room for him in her life.

Before we meet Nina, though, we encounter the figure that accompanies the film throughout: a partially bandaged, decaying naked human who moves slowly through landscapes and pools of water, turning to look at its surroundings from time to time. It seems to be a man, but it’s hard to tell. Also ever-present is a soundtrack of somebody breathing – Nina, the bandaged figure? The point of view moves between long shots of wide landscapes or interiors, but also what seems to be the camera’s eye-view, moving forward into fields and ponds, sometimes stopping simply to contemplate yellow blooms in a field or the drama of gathering storm clouds.

The setting is eastern Georgia, with snow-capped mountains in the background. It is a dank, poor place mostly, prone to thunderstorms and inundations of rain that make its unpaved tracks even more unnegotiable for Nina’s jeep. Yet in the spring, bright-red bursts of poppy fields emerge, and branches of pink blossom appear against blue skies. 

The dark side of this life is encapsulated in a nighttime scene where cattle are traded from the back of lorries, skinny, forlorn-looking cows with muddy calves. It’s an all-male world, Nina the only woman in sight. These are the menfolk of her patients, some of them, she discovers, their abusers. The unhappy cows seem to be standing in for the men’s ill-used human possessions.

The second scene in the film has set up the narrative strand in which Nina will be implicated to the end: a sequence where a woman is in labour, her baby’s head crowning. It’s a scene shot full-frontally, no disguising that it’s an actual birth (later there will be a real C-section: swooners at The Years will need stronger stomachs here). The premature baby is born seemingly unresponsive and soon dies. Its father is consumed with hatred for Nina, blaming her for the death and determined to prosecute her and her hospital. 

Already the status of rules is in play. The parents of the dead child had not registered the pregnancy or gone through any of the automatic testing and checking that could have headed off the baby’s death. Nina had also had to grapple with the conflict that the mother told her she wanted a natural birth, hence a potentially life-saving C-section wasn’t carried out. David, in a private chat, goes through her decisions with her, but mainly warns her against her abortion-providing, which would result in ruin for her and probably the hospital too. “It’ll be five years of detectives visiting,” he notes, mordantly.

Whose rules should be obeyed? Official ones or humanitarian ones? The question becomes even more acute when Nina goes to visit Mzia, a woman in a remote village whose brood of children Nina has delivered. Now Mzia’s deaf-mute 15-year-old daughter may be pregnant. After an initial check on the living-room table (pictured below), Nina has to return for the termination, all done while Mzia’s husband is at work. If he knows what has happened, he will kill the (unnamed) father, and they will have to leave the village. If Nina aborts the foetus, though, she may damage the young girl’s fragile mental state. This abortion is eventually uncovered by the police, and Nina has to decide whether to fall in line with the chief doctor’s strictures or step up and admit she was the abortionist, with all the damage and opprobrium that entails. How much of her altruism is irresponsible? 

Kulumbegashvili’s narrative technique leaves the viewer’s imagination to do a lot of the running. Shorn of all trimmings, its soundtrack consists of just natural sounds or an odd fluting noise, as if somebody has blown down some plastic piping. She often sets the camera down to record what it sees, eventually slowly panning or zooming out. The viewer is instinctively drawn into filling in the information that isn’t provided. Inevitably, the bandaged figure remains a mystery: an embodiment of Death? In one dream sequence, it shares a bed with David, and he embraces it, as If accepting an exhumed corpse from his past.

As Nina, the skeletal Sukhitashvili gives an extraordinary performance, sometimes seeming only half-human. She's caring yet remote, at times is like a visiting alien, wordless and circumspect. Have her emotions been cauterised by her work? The chief doctor (Merab Ninidze) is a stern, imperious figure, invoking God in his judgment on the baby’s death, and the hospital he runs is a chilly place of empty corridors and white walls, devoid of human warmth. As a locus of power, it marks the limit to Nina’s desire for freedom, both for herself and for the women she treats. 

This is a remarkable film, rich in its spareness, reminiscent at times of Jonathan Glazer’s Under the Skin though creating a cinematic language all of its own. 

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