Under the Skin: Lucien Castaing-Taylor and Véréna Paravel Discuss “De Humani Corporis Fabrica”

After plunging into the sea in "Leviathan" and cannibal testimony in "Caniba," the documentarians explore surgery and the human body.
Jordan Cronk
A decade after setting the course for modern experimental documentary filmmaking with the pioneering nautical ethnography Leviathan, directors Véréna Paravel and Lucien Castaing-Taylor have taken another deep dive into uncharted territory with De Humani Corporis Fabrica, a radical cinematic immersion into the far reaches of the human body. Shot at a number of Parisian hospitals over the course of five years, the film takes an unflinching look at various surgical procedures as they’re carried out by doctors in startlingly routine, occasionally lighthearted fashion.
Armed with specially made digital cameras, Paravel and Castaing-Taylor examine the operations from both inside and outside the body, moving through vistas of torn flesh and splayed muscle tissue to interior views of the many tracts, tubes, and cavities comprising the greater upper body. Filmed so intimately as to be rendered abstract, the images—in a manner reminiscent of both Leviathan and the more recent somniloquies and Caniba (both 2017)—unfold for large portions of the film in disorienting displays of texture and color. Occasionally, a body part or procedure will come into focus: a woman’s stomach being ripped open by hand to complete a C-section; a catheter being shoved unceremoniously into a man’s urethra; or a fully exposed spinal column held together by little more than clamps and screws. Unlike much of the duo’s recent work—or the film’s most obvious antecedent, Stan Brakhage’s The Act of Seeing With One’s Own Eyes (1971)—De humani breaks at times from its otherwise single-minded focus on the corporeal to explore areas in and around the hospital space: the corridors, basements, alleyways, and cafeterias that serve as central nervous systems of a sort for institutions like this where activity is constant but life often hangs precariously in the balance. With nary an inch given, the film opens up a newly humanist dimension in Paravel and Castaing-Taylor’s cinema, which only grows richer and more complex the further it burrows inward.
Following De Humani’s premiere in the Directors’ Fortnight program at Cannes, I sat down with the filmmakers to discuss mortality, manipulation, and transgressing the body. 

NOTEBOOK: Can you tell me a little about the origins of the project and how the film evolved? At one point I heard it was going to deal with corpses. Is that true?
VÉRÉNA PARAVEL: Yes, that’s true. We started with an idea that dealt with cadaver trafficking—specifically as it relates to Harvard, since so many people donate their bodies to the university for research. There’s a saying at the school: “If you can’t get into Harvard when you’re alive, you can get in when you’re dead!” Harvard actually sells a lot of bodies to other universities and medical institutions because there’s a shortage of corpses in the field, and because Harvard doesn’t have the fridge space to store the ones that have been donated to them. There’s this prestigious thing where people only want to give their bodies to Harvard. They don’t want to donate them to science, per se—just to this one university. So we started to read books about the various ways that donated bodies are used, which ranges from getting thrown out of airplanes to calculate the impact on the earth, to being used as crash test dummies to test seatbelts.
But the focus shifted once we started to explore the gross anatomy labs at Harvard, and then from there it solidified as we began to enter hospitals. Since it’s more complicated to gain access to the American hospital system, we decided to meet with the director of the Parisian public hospital system. He’s a cinephile—he was a friend of Chris Marker’s, and he gave us carte blanche. But we didn’t know exactly how we wanted to approach the film formally until we read Andreas Vesalius’s De Humani Corporis Fabrica Libri Septem, a book about human anatomy. That’s when the idea came to us to make a 21st-century version of De Humani, adding texture, movement, and color. The medical world has all these tools of visualization that we could import and borrow and bring into the cinema world that we otherwise wouldn’t have access to.
NOTEBOOK: Is there any symbolic reason to use only French hospitals that I might be missing?
PARAVEL: Not really. It was a mostly practical decision. Having unlimited access is very rare. But I guess the political or financial state of French hospitals is similar to the NHS hospital situation in the UK, which is pretty dire. Money goes into these hospitals, but it’s mostly used for technology when there’s a shortage of nurses and underpaid employees are being overworked. Conditions are bad. 
NOTEBOOK: How was the surgery footage shot and compiled? Is it all “your” footage, or was some of it recorded by doctors and reviewed by you two after the fact?
LUCIEN CASTAING-TAYLOR: There’s no medical footage used in the film that we didn’t supervise and download ourselves in real time. We were present at all the surgeries seen in the film. We didn’t ask the surgeons to create an image that they wouldn’t normally have created as part of their own medical process. They wouldn’t always record everything—images would flash on screen and then they would disappear. So we were the ones recording and downloading the footage that we wanted. In addition to that we were also almost always filming simultaneously with our own cameras outside the body. We ended up with 350 hours of footage. The film actually felt really long to me as I watched it with an audience for the first time yesterday. But in reality these operations take a long time. The prostate operation lasted four to five hours. And there was a liver transplant between a living donor, a mother, and her daughter that didn’t make it into the film that lasted about eighteen hours. At one point we cut that footage down to twenty minutes, thinking we would use it in the film, but there was a real violence to reducing it. If the film has any virtues at all I think it’s due in large part to the length of the surgery scenes. Otherwise the gore remains a spectacle. 
NOTEBOOK: What about the sound, specifically the dialogue between the doctors? Is it synced to the images we’re seeing at every moment? 
CASTAING-TAYLOR: It’s all sync. However, in the first cut of the film, which was ten hours and one minute long, there was a lot more of that commentary, since a lot of the footage came from universities and teaching hospitals, with professors operating and giving live commentary to doctors in the early stages of their careers. A lot of the editing, specifically in the last six months when we were trying to get the film down to two hours, revolved around getting rid of most of these moments. In these scenes it was more clear what body parts were being operated on, but we realized at some point that we wanted the audience not to know. It was at this point that things became more interesting for us conceptually. It allows the imagination to become activated in a much more creative way, rather than knowing exactly what’s wrong with this person you’re watching.
NOTEBOOK: As far as mixing and editing the sound, was it manipulated or accentuated much in post?
CASTAING-TAYLOR: People often ask that about our films. Manipulation is a hard word, because even before we start filming we’re thinking about how to record the sound, and then we’re choosing certain microphones and certain cameras. So in a sense we’re already manipulating, and that manipulation carries on in post, with lots of different criteria. The camera rig, which was engineered in Zürich, has a stereo microphone attached to it, which wasn’t very good but which we used a lot because we also recorded sound independently, outside the body. So we had two external sources of sound, plus hydrophones and contact microphones that were put on the bodies to give it a more physiological dimension, which we worked on in post.
And, like I mentioned, we were also interested in using dialogue, but it was so poorly recorded that it took our sound editors eight to ten weeks to clean it up—just to make it intelligible. But the more intelligible you make it the tinnier and crappier it sounds. So we had to make it more intelligible and then from there more corporeal. People have actually told us that when the film comes out it France that it’s going to be impossible for French speakers to understand. 
PARAVEL: We’ll have to subtitle it.
CASTAING-TAYLOR: People like you watching it here, non-Francophone people, are actually getting a lot more out of it.
PARAVEL: Oh, much more. I played detective yesterday at the screening and everyone was reading the subtitles. I had to read the subtitles, and I’ve seen the film probably 200 times!
NOTEBOOK: How many and what kinds of cameras were used to film the surgeries?
PARAVEL: The surgery footage came from three sources: the camera inside the body, which we call the “lipstick” camera; our mini camera outside the body; and the hospital cameras that are on the ceiling. Then we would sync the three sources with the sound—one of us was always recording sound—so we could go from inside the body to outside the body when editing.
NOTEBOOK: How did you decide on what surgeries you wanted to film? Was there any procedure you wanted to shoot that you weren’t able to?
PARAVEL: We were in hospitals for five years, so we got to know the doctors. For example, the liver surgeon: he would call us when he had what he called “a beautiful surgery.” One was for a woman who had a parasite eating her liver. He told us he’d have to cut her open entirely and clamp the blood going into the liver for something like three minutes.
In other cases we would contact certain doctors, like the cardiac surgeon, who we asked to spend a week with. We would film all the surgeries during that time and figure out which one was most interesting and then seek out more of those. Other times doctors would then ask us if we had seen certain surgeries—like orthopedics. They were like, “Oh, you must see this. They cut the back open—it’s amazing!” Every doctor had their favorite organ or operation to recommend—like lungs, or eye surgery. So they would guide us. It made our curiosity even bigger.
CASTAING-TAYLOR: One kind of imagery that’s different from the others is the back surgery. There’s footage in that sequence shot by our camera, the ceiling camera, and also close-up images taken by an outside surgeon who was developing software that would allow the operating surgeon to predict when they’re about to break through the bone. By calculating the density, mass, and magnitude of the bone they would be able to improve the surgical process. So that was done for completely other purposes but they gave us the footage. 
PARAVEL: That’s the footage of the back that gets really up close. We could never have filmed that ourselves. 
De Humani Corporis Fabrica
NOTEBOOK: Was there anything that surprised you during the making of the film? One thing that stood out to me was the humor.
PARAVEL: I think we had the same experience as the viewer does while watching—or at least I hope. At first it was like, wow, they’re talking about the rent while performing a colonoscopy! But as things went along we realized that that was the way for them to get through the experience. You’re dealing with disease, potential death, grave situations. You have to detach from that and objectify the body, or push the body to a certain distance. You have to dehumanize the body in order to transgress it. You cannot cut a person open, or insert something into someone’s nose, urethra or butt unless it’s not a body anymore. In that sense the process of distancing also relates to the language—language which here might deal with the rent, or the babysitter, or what to feed your dog, or what movie you want to see. There’s actually a lot of movie talk during surgeries. So at the beginning these kinds of things surprised us, but as you begin to understand the conditions for care you realize that it’s all part of the process.
NOTEBOOK: Can you talk about structuring the film and how you came to this idea to move between surgery footage and scenes set in other parts of the hospital? 
CASTAING-TAYLOR: It morphed out of recognition constantly. For a long period of time the scene in the psychogeriatric ward ran an hour and a half. And then we cut it down to one 15 minute shot of the two old women walking down the hallway, which in the film is broken up into two shots. In another cut we got rid of this scene altogether and were left with only surgery scenes and the shots of security guards. Véréna had the great idea to bring the scene back into the film but to break our resistance to cutting up the single shot, to allow ourselves to lose the magic of it being a one shot.
Deciding on what surgeries to include and in what order was very hard to find. One that we didn’t include was of this beautiful, vulnerable woman who was just completely ripped open, with her guts and intestines hanging out to one side. It was such a beautiful, cruel, transfiguring scene, in many ways more powerful than anything that ended up in the film. But anything that came after it played second fiddle—nothing could come back to life after that. But one place we hadn’t considered to put it was at the end, just before the party scene. And it worked—we thought we had saved it. But when we got feedback from people they agreed it was amazing and that it couldn’t go anywhere else, but they said that after being with the film for two hours that they couldn’t bear to see someone ripped open like that. It was just too much cruelty. So it’s not in there.
PARAVEL: The film needs some breathing moments. But we understood that the hospital works as a body too: it has its own arteries that patients go through and where doctors walk, and a kind of circulatory system made of those sci-fi-looking tubes that transport organs, biopsies, and blood tests around the hospital. So at some point it made sense to include other aspects of the hospital—there are so many inhabitants in and around hospitals that contribute to this movement: homeless people, drug dealers, prostitutes, security guards, people just passing through.
NOTEBOOK: Do you think your relationship with mortality has changed at all after making two films—Caniba and De Humani—that deal largely with death and the body? I can’t imagine not being changed after making these movies. 
CASTAING-TAYLOR: I can’t say for sure, but we’re both aging—we’re middle-aged now. Spending five years in hospitals has definitely changed our relationships with our bodies—our sense of vulnerability, fragility, and how we’re all hovering between life and death. Véréna was also very sick while making this film.
PARAVEL: Yeah, it’s kind of personal, but I have fibromyalgia, a somatic condition where I create pain. So I have pain all over my body—I have no pathology. But I’ve always been obsessed with death—I’m afraid of dying. I like living. Every single day I’m amazed to be alive.


InterviewsLucien Castaing-TaylorVerena Paravel
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