“How are you feeling? What do you need?” Margaret “Mati” Engel asks attendees at Manhattan’s Mount Sinai Hospital in “A Still, Small Voice,” bringing out a cart of iced tea and ready to pour for anyone that asks. She generally is in other wings offering spiritual care patients as part of a program to train chaplains, but no one perhaps has any greater sense that the staff could also use some attention as hours can go by without breaks tending to others and their expertise in treating the body hardly covers the emotional toll it can take on the mind. In Luke Lorentzen’s magnificent second feature, it is this less obvious pain that can be illuminated as Mati is called to bedsides to lend a kindly ear to patients going through unimaginable anguish and can only extend her sympathy and compassion in return, an exchange where an outsider can see the impact on the ailing who can take heart that someone is there for them, yet can’t help but feel inadequate to the caretaker who would like to do so much more.
In Lorentzen’s previous film “Midnight Family,” the director tagged along – or more accurately hung on for dear life – with a freelance ambulance driver and his son in Mexico City, serving a noble purpose when the nine-million strong metropolis had less than 50 such vehicles roaming around in case of emergency yet endure the stress of competing against other ambulances for business and are forced to collect their fees directly from patients in a system in need of great reform, and in some ways, “A Still, Small Voice” is a look from the other end of the spectrum where Mount Sinai is rethinking how they treat patients with an innovative system under the purview of Reverend David Fleenor, where radical empathy is deployed as any other medication would be. However, even Rev. Fleenor needs to consult with her previous mentor as he is looked to be a flock of four trainees, all of whom are absorbing the pain of others and need guidance as to where they can reroute it after it takes up residence in their bones, holding the weight of holding hands with a patient as they passion and often having to comfort their grieving loved ones.
On both films, Lorentzen operated as his own crew, having a remarkable eye and a possibly even more impressive ability to recognize patterns as he’s filming to pick the right spots for both expression and to stay out of the way of sensitive situations, letting their enormous power emerge gradually. He also locates a fascinating person to follow in Mati, who has a massively open heart, yet is reluctant to share why she was interested in this particular line of work and is continually confronted with the question of how much she should protect her personal space in order to do the best job she can for others. While she enters some of the most unenviable of circumstances and can become frustrated when she doesn’t have all the answers, few films are as inspiring when presenting those generous enough of spirit to volunteer themselves for such positions. One of the most profound documentaries in recent memory, “A Still, Small Voice” is now beginning a theatrical rollout across the country following its premiere earlier this year at the Sundance Film Festival and recently, Lorentzen spoke about how he came interested in this evolving professional calling, capturing great intimacy and employing sound as much as image to create a sense of serenity.
How’d this come about?
The origin of the project is my sister who worked as a hospital chaplain and was the first one to open my eyes to the field and really show me how special the conversation she was having with patients are. From there, I started reaching out to hospitals all around the country, really just to learn more. We talked to as many people in the field as I could and I met Amy Strano, the director of the spiritual care department at Mount Sinai. They had an enormous amount of enthusiasm for the film and invited me to come meet them. We did a week-long scout shoot together and that kicked everything off.
This had to be during COVID. Did that complicate things in a hospital setting?
I did have a conversation about the project before COVID, and then when the pandemic hit, it started to feel more urgent. In a backwards way, it felt like something that was possible to make during the pandemic for a few specific practical reasons, but also in such an unpredictable time, it felt in some ways safer to go towards that than to try and make a story that didn’t have anything to do with the pandemic. That energy was just so infused into everything and I really wanted to be working on something, so this is where I went.
You see in the film how the staff at Mount Sinai is feeling out the rules for themselves about how to approach this work when it’s largely uncharted territory. Was it similar in how certain parameters might’ve been set for filming?
It was a really long process of many months of working together with Mati and David and the other residents to come up with a not just an ethical and sturdy way of filming but something that actually felt potentially useful or meaningful for everybody. That was a huge learning [curve] for me as a director. When the people in my films have great reasons for participating so much becomes possible and it really opened up the filming into a true collaboration instead of me just asking for things. Specifically, Mati and I, when working with patients, started to think about the camera as an added way to make patients feel seen, understood, and cared about. we would offer it to people and found a large amount of patients who really received a lot of meaning from their stories being documented. Of course, not everybody. There were some people that wanted nothing to do with it, but there were some who got something from it that was very in touch with what Mati as a chaplain was trying to deliver, which is a sense that “you matter. I’m here to listen to you and hear you out.”
What made Mati stand out in the first place as somebody you should be following?
She definitely stuck out as a deep thinker, somebody who was always pushing back on the way things are done to do it better. She had just an energy about her that I connected with, and in our own complicated way, we got along from the very beginning, but it took months of talking to begin filming. It started with me just going over to her house and having dinner, [then] slowly starting to film some staff meetings and phone calls with patients where we would only hear Mati’s side of the conversation. We built trust in a way of being together that, to use a word Mati used earlier today, didn’t contaminate the work. And we got there maybe month six of the nine-month residency. A lot of what you see in the film came in that sort of final three months period together. The same is true with David as well. It took months of being with him to be invited into his own sessions with his advisor and an enormous amount of trust that he gave me to have me there in the room.
On “Midnight Family,” I remember the film started teaching you how it wanted to be shot and you could learn from the inherent repetition of your subjects’ practice. Was that true here as well?
Totally. There was repetition in the day-to-day flow. so when I was walking into a patient’s room on a technical basis, I already knew exactly how it would be shot. Each patient room in Mount Sinai is more or less identical and that let the technical side of the filmmaking melt away a little bit and be deeply familiar to me so that some of this relational work could be focused on more. It really was a muscle that Mati and I built together of getting reps and comfort together that made something like the baptism scene possible, for example.
Was there anything that happened during the course of this that changed your ideas of what this could be?
I think the film became the best version of what I could have imagined. I wanted to make a film about spiritual care, particularly focusing on the experience of chaplains themselves. But I had no idea that it would be about Mati and about some of the very specific questions that she is working through in the residency. It wasn’t until we were partway through the edit that that focus really came to life. I had filmed with all four residents in the cohort and the first assembly of the film was trying to tell four stories at once, but it became clear that a more specific personal approach would really let the film breathe. That was a very difficult decision to make, letting go of a lot of a lot of things.
The rhythm of it is part of that deep level of engagement you’re able to achieve. Was that tricky to figure out?
Some of my first cuts of conversations were just trying to be really efficient, trying to cut out all of the spaces between words and just condense things down [when] there’s this fear of “Okay, who’s going to watch a bunch of people wearing masks, sitting in chairs, talking to one another?” The first attempt was to condense it, but that just took all of the meaning and air out of these conversations. Once I started to just let them be, they started to come back to life, and a lot of the challenge of the edit was to bring the audience into a pacing where sitting and listening to somebody speak for eight minutes was absorbing and captivating, really teaching the audience in the first shot, this is what you’re in for, slow down, take a breath. From there, the pacing slowly picks up where each scene is a little quicker than the one that came before it to give this intensifying feeling, but there’s a spaciousness to it that really focuses on one of the core ideas that I had when shooting, which is just wanting you to feel like you’re there in the room and invited to be there.
I wouldn’t want to demystify it too much, but a feeling of real intimacy is also cultivated by the sound design where there’s a layer of serenity or silence that I have never felt in a movie before. What was it like to express that sonically?
It was a lot of work to achieve that. Hospitals are so loud, and what that meant was a lot of the dialogue when recorded was a little messy or full of ambient sound and we did a lot of work to create as much silence in the film as possible, to really let the voices lift and exist in a very clean way. A lot of that was leaving things as they were. There are very few sounds in the mix of the film that weren’t recorded on site at Mount Sinai. “Midnight Family” had dozens [for the] sound work of the car chase stuff, but in this film, it was way simpler, but in some ways that was very challenging to just keep it that clean.
What’s it been like to get out into the world?
It’s been up and down, to be honest. We’re slowly finding our people and we’ve had really good responses from festivals and continue to get really positive responses from press and audiences, but getting robust distribution has been so difficult. It’s hasn’t been until very recently that with some support from some of the funders of the film and a lot of collaboration between different people that we’ve been able to put together a theatrical release, so it’s been a lot of work to continue to fight for the film and get it to a place where the people who should see it and want to see it are able to. But we’re there and it’s very exciting.
“A Still Small Voice” is now open in New York at the DCTV Firehouse and opens on November 17th in Los Angeles at the Laemmle Royal.