Monster is a fast-paced thriller low on emotion and high on action that doesn’t quite unfold in real time, but feels like it does.
Seldom has the conflict between the promise of modern medicine and the reality of delivering care to actual patients been portrayed more starkly than in Rodrigo Plá’s A Monster with a Thousand Heads. The premise is simple: A man is dying of cancer, and there’s a treatment that will probably help him, but he can’t receive it without the approval of an insurance bureaucracy that makes a practice of denying claims. The family can’t afford to pay for the treatment themselves, and while the bureaucracy can stall more or less forever, the patient’s cancer is progressing and before long the issue may be moot.
You may recognize this setup as a variant on the Heinz dilemma, used by Lawrence Kohlberg to measure the moral development of children, where the crux is whether Heinz should break the law to obtain a medicine which will save his dying wife, but is only available from one source and is sold at an outrageous markup. In the film, the active character is a woman, Sonia (Jana Raluy), while it is her husband Guillermo who is dying, but the outlines of the dilemma are the same.
You might expect such a story to take place in the United States, but in fact Monster is set in a Spanish-speaking country (it’s not entirely clear which one, and that may be the point—such a story could take place in any number of countries). You might also expect a film based on such a story to be an inspirational weepie, but Monster is quite the opposite: a fast-paced thriller low on emotion (in fact, it keeps a distance from all its characters, even Sonia) and high on action that doesn’t quite unfold in real time, but feels like it does. Monster’s unusual treatment of a familiar subject, coupled with the quick pace and relatively short running time (74 min.), offer a welcome contrast with the bloated blockbusters that have become the norm for summer film releases.
Sonia begins by making requests through normal channels, visiting offices and trying to get the bureaucrats who work there to take her seriously. To her, it is a matter of life and death, and she tries to communicate this urgency to people for whom her husband’s case is just one file among many. Finally, she snaps, tracking down some of the high-level individuals who could authorize her husband’s treatment, gun in hand, teenage son (Sebastian Aguirre Boeda) reluctantly in tow.
Sonia’s problem is that she is not up against an evil person who could be identified and destroyed. Instead, she must battle the “monster with a thousand heads” of the title, a health care bureaucracy that embodies Hannah Arendt’s description of “rule by Nobody.” As Arendt put it, bureaucracy is “the rule by an intricate system of bureau in which no men, neither one nor the best, neither the few nor the many, can be held responsible, and which could be properly called the rule by Nobody. Indeed, if we identify tyranny as the government that is not held to give account of itself, rule by Nobody is clearly the most tyrannical of all, since there is no one left who could even be asked to answer for what is being done.”
I can see the hashtags now: #NotAllInsuranceCompanies or maybe #NotAllBureaucracies. Everyone likes to think of himself/herself as a good guy, and in truth, the individuals portrayed as part of the health care bureaucracy in Monster are not themselves monsters, but normal people working at a job and following the procedures they’ve been told to follow. If someone dies as a result, whose fault is it? That’s a serious question, and one to which there is no easy answer. | Sarah Boslaugh