Like the prefix bio- of biomedical, biopolitics, biology, and so on, Italian documentarian Gianluca Matarrese plays on the titular prefix to examine encounters between one fascinating subject, Dr. Maurizio Bini. Dr. Bini, who works at Milan’s Niguarda Hospital—a public hospital, in particular—thus becomes the central focus of Matarrese’s new film, GEN_, which just world premiered in Sundance’s World Cinema Documentary Competition. The filmmaker’s unique approach stays in the consultation room for nearly the entire runtime in an unwavering commitment to exploring these conversations as they stand in the relationship doctor and patient. In particular, this relationship is between a charismatic, deeply committed doctor and his diverse set of patients, all seeking his help on matters related to hormone therapy.
We sat down with Matarrese to zoom out and discuss the filming process, how the body of the film connects to the film’s subject, and his uniquely personalised angle in a cinematic space with an increasing number of films turning their focus toward biomedicine and issues of biopolitical control.
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Can you give us a wide-angle look at what first led you to your subject, Dr. Bini?
Films for me are encounters. This is the case of a real encounter and especially a dialogue between me and the co-author of the film, Donatella Della Rata, a professor of communications and media studies at John Cabot University in Rome. She was about to write a book dealing with hormones and how we take hormones for these two different specialties [of fertility treatment and medical transition]. She was advised to Dr. Bini as he would have been the perfect match for her observation. Since she knows my cinema and what I usually talk about in my films, and she told me, “Why don’t you come with me for this observation, and maybe there will be a film on this topic. From day one, when we were both together in the room during the consultations with the patients, I understood exactly that there was a film there. I understood exactly the proper dispositif, or device, for the storytelling. After the first morning that I met the doctor, there was this flood of humanity in the room.
What was this dispositif to you?
I thought straight away that this film was about healthcare and the interactions between doctor and patients. I wasn’t interested in digging deep into people’s private lives. Me, and also Donatella—we always used to attend queer events and queer film festivals, for example, also as the jury. Very often, I see stories from a personal point of view. Very often, all the stories are focused on the pain of this journey. This time, I didn’t want to go that way. I always sometimes feel not at ease to be looking from above and saying, “Oh this is a very hard life. It’s a very painful life I wanted, actually, in both cases procreation and fertility and also transition and gender assignment.” I wanted to show the interaction and humanity that happens when you are followed and supported by healthcare—how complicated it can be, administratively speaking, but also what a good doctor looks like, even if he has to sometimes pass over the legality. Because sometimes what is right for the patient is not right for the law. But I didn’t want to be complacent or have pity towards all these patients.
What was the mood or atmosphere like in the room during the filming process?
There were so many different emotions. Sometimes patients will be so happy to have a place to show the world what it means to go through these journeys. Sometimes they will forget about you because they were so centered on their own desire. Sometimes there will be so much depending on the doctor’s point of view. I think for everyone, there’s this thought that the doctor is God, someone who can resolve all your problems. Sometimes there’s also contradictions. Other times there’s a real confrontation because the doctor is not always politically correct. There’s also the context of Italy in all this. So there’s also the Italian way of finding solutions. There’s always people coming in and out of this room and renovation work everywhere around them. It’s a big metaphor for our society, in which conditions you always have to keep going, even if everything is falling apart or being rebuilt. It’s also a big metaphor on building bodies, creating life, and changing life through your body—desires related to bodies.
There are many different patient cases throughout the film. How did you decide which ones and what to narrow in on?
I had to exclude many other things that were so good. There was the doctor’s wife sitting in that [patient’s] chair. There’s all the pharmaceutical [salespeople] those who are selling products. That is a good narrative that I had to cut because there was too much—all the capitalism behind these procedures, you feel that already a little, but there was even more. There were other doctors. There was a feminist urologist from Naples. She was amazing. I also filmed them in their own offices. The therapist and the psychologist were very important. But then when I was editing, we had a version of the film that was four hours long, and it was another film. It worked, but it was Frederick Wiseman-style where you’re observing the institution. I had to go back to my primary intention and intuition. This film is not observing the institution. It’s not a political film or a militant film in itself. It becomes political because intimacy is political, but it’s not because I want to make a statement, like I’m advocating for something precise. I will have, and I already have, a lot of questions about politics. That’s natural, but this is not my main intention.
Even if the intention of the film isn’t innately political, how do you feel like the film speaks to topics around biopolitical control in Italy, Europe, or the world today?
I’d like the audience to really get something out of this: a list of what it means to have medical care. This is really important. This is the main message. For example, for an American audience, instead of saying it’s a militant film, I want this to be an example of a vision of a society where the individual is supported by the state, where the individual is taken care of by the state and government. This is instead of against another vision of society where the individual is left alone, or you only have the right to be taken care if you have money. You can be heard if you have a strong voice. You can be followed if you have a big audience. We all understand the difference between two different audiences, the different societies. Of course, the entire world is going through another kind of, I’ll just say, “influence”. But this is a good example of society, especially a hospital located in a very Catholic region, in a very conservative country like Italy now. It’s a little miracle, and I love it to be an example even for other societies and countries where they also have big conservative governments. This is probably what I’d like people to get from the film—that there are other ways. There’s another way possible for society, especially in this important context, which is health.
How do you see your film in relation to other films on similar topics of bodies and biopolitical control, like Claire Simon’s Our Body and Elina Psykou’s Stray Bodies, to name a few?
I really wanted this to look not just like a sociology thesis. I wanted to also have the flavour of a film where you also work with metaphors and where the image is saying something, especially about the way you look reality. I think the other films you were mentioning are more frontally political. I wanted it to be a more artistic product or being, in a way, like Frankenstein, building a body ourselves. When we were editing, it was very hard, because you have this narrative of the doctor going on retirement that holds all the stories. That was holding everything together. There would have been thousands of ways of editing this film. Every time you would take out a patient, you would have to think about if you were also changing the complexity of your film. Maybe there’s a patient embodying, I don’t know, the issue of religion or philosophical issues, ethical or eugenics. If you take that away, would it be a more simple reflection? So it was very hard. It’s like a body: if you take organs away, if you keep them. It could be very complex, very simplified. It was very hard to find the balance. At the end of the day, it’s a film and you don’t want people to get bored if it’s too technical. This is the fourth project I edited together with Giorgia Villa.
Another interesting aspect is the music, which I found very playful for the material at hand—a really unique touch. It’s bouncy and light.
Cauntautoma is the composer—it’s the seventh film we are making together. There’s always this way of working with music, which is very dramaturgic in the sense that I’m not giving him examples or putting examples in my film and then asking him to do “lookalike” sounds. I really talk about intention. He proposes to me something, and then I use it, and then the narrative also evolves thanks to music, and the music evolves thanks to the editing. He had this idea of using this music called exotic, typical of the ‘70s in Italian cinema, using synthetic and more digital sounds with real instruments. There’s always this confrontation between natural and technical and scientific. Also, the environment of Italy—we had this funny idea to use the soundtracks they were using in the ‘50s, ‘60s, and ‘70s in Italian comedies.
