I have visited the country of Ukraine many times since 1994, and I have never failed to be fascinated by it on each visit. Its surreal mix of humor, emotion, tragedy and wonderful visuals is utterly captivating, and I kept promising myself that one day I would make a film there.
In 2003 I met brain surgeon Henry Marsh, and we soon discovered that we shared a love of this strange and forsaken land. He had been going to Kyiv for over a decade to help a Ukrainian protégé named Igor Kurilets create a viable brain surgery clinic, and theirs was an incredible story. Battling against massive logistical odds and the wrath of the old Soviet health system, Igor and Henry had been denounced, banned and finally shut down. But by smuggling in discarded National Health Service (NHS) medical equipment from the U.K., Henry was slowly able to equip Igor to do operations no one else in Ukraine could do. Patients flocked to see them, and Igor's clinic became very popular.
In early 2006 I went with Henry on one of his many trips to Kyiv, and after spending just a few minutes with him and Igor in a small consulting room seeing an endless queue of desperate patients, I knew I had the film about Ukraine I had wanted to make for years.
Why? Because that country's political struggle to change itself for the better was mirrored in the moral and logistical struggle Henry had to continue working as a good doctor.
Here was a man patients saw as a great savior from the West, a man parents thought could save their dying children and a man Igor saw as a god and a benefactor. But for all the direct satisfaction that Henry gets from going and, indeed, saving lives, he also constantly sees misdiagnosed patients he could have helped had their problems been identified correctly, children he can't save and old equipment and untrained staff that threaten the very risky operations he and Igor are trying to carry out. Henry says, "It's like selling your soul to the devil, but what can you do? My son had a brain tumor as a baby and I was desperate for someone to help me. I simply can't walk away from that need in others."
It is precisely this dilemma — a dilemma of his own making — that renders Henry so interesting, and it is this same dilemma that lets us see his troubled and compassionate humanity. His godlike surgical power to save lives is set against his fallible humanity, as a haunting memory of losing a young Ukrainian girl in an operation some years ago has led Henry to painfully embrace what he calls the "nobility of failure." Indeed, this is the emotional center of my film and the universal theme at the heart of it: the struggle to do good things in a selfish and flawed world.
This is ultimately not a medical film, nor is it a portrait of a saint. Rather, it is about a man who openly wrestles with moral and ethical issues that touch every one of us.
—Geoffrey Smith, director/producer, The English Surgeon