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Great White Tower

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This movie was made decades ago, and yet its portrayal of the downward spiral of corruption and conspiracy is every bit as relevant today as it was then.

This movie is damning in its depiction of the medical system in general, and in university medical schools in particular. It succeeds because this depiction is so uncannily accurate. The characters, the situations, the scheming, the treachery ... all these are shown exactly as you would find them in any university medical system even today. Surely, any doctor who has ever worked in a university teaching hospital will recognize the main protagonists: the high flyer who was sold his soul to climb the ladder, the naive innocent who thinks he is still working in the patient's best interests, the tyrannical chiefs of departments, the serpent-like senior doctors who prostitute their loyalty, the intimidated residents who nonetheless will stop at nothing to save themselves. They're all here. And the movie fleshes out each of the characters so faithfully and fully, you shudder at how real they are. You recongize your boss, your colleagues ... and yes even yourself.

And you will recognize them all because although this is ostensibly a 'medical' movie, the evil that permeates this hospital is identical to what you will find in any office, any corporation. In medicine, all the rules are set by doctors, they are policed by doctors, and punishments meted out by doctors. Doctors look after their own. And if there is trouble with patients complaining or dying, whose side do you think the system will be on? But to stay in the system, or get ahead in it, anything goes. Bribery, blackmail, rumor-spreading, betrayals. When it comes to looking out for No. 1, doctors are no more angels than the rest of us. Even though this is a fictional movie, the portrayal of the medical system here is possibly darker and even more chilling than Michael Moore's 'Sicko' because it is even more authentic than any documentary. But that's when you realize that all of this evil is NOT unique to the medical profession. You find the same sort of bribery, blackmail, rumor-spreading, betrayals and worse in any office. You find the same culture of cronyism, treachery, dirty politics and back-stabbing in any corporation. In other words, it's not just doctors. Lawyers, businessmen, police, teachers, scientists, the military - there is virtually no profession onto which the story of this movie could not be transposed and work just as well. If this movie was about dirty doctors, it would be a good movie. This is a Great movie because its themes reach far beyond a single profession, and delves into the dark places inside each of us who have to work with others.

The script and the director's masterful pacing of the story-telling are wonderful. This story is not a barrage of evil events. Instead, it is a measured unfolding of increasingly desperate deeds and escalating levels of hateful reactions. It is indeed a spiralling descent into the worst depths of human nature. It starts with a young boy's wish to repay his mother's devotion by rising to the top of his profession. The ambition is greeted by the envy and suspicion of his seniors, who begin plotting against him out of spite. That in return is countered with Machiavellian manipulations of co-workers. Briberies bring out the weasels in both those paying and those receiving. The escalating scheming produces growing conspiracies on all sides, and then betrayals amongst conspirators. When presuasion fails, coercion and blackmail step in. Civilized men stoop to making threats of violence (mental and phsyical). Along the way, family, friends and patients become pawns, victims or simply cannon fodder. The stakes are raised so high eventually that winning is no longer about gaining a promotion: reputations both personal and institutional are on the line. Even the profession itself is threatened. Nobody can back down because the cost of losing now far exceeds the prize of winning. And so the desperation of the acts committed spirals unrelentingly greater. Where will it end? It is because this movie is so powerful and brutally frank that we become engrossed in awaiting the answer. It is like watching a train wreck in slow painful motion: the cars gradually come off the rails, the momentum becomes so great that the crash cannot be avoided, and you can see the bloody tragic end coming up - but you just can't look away. Absolutely captivating.

As a movie, there is so much to admire here. Besides the story's exploration of human evil above, there is also great direction, great photography, great acting. Even all the minor characters come vibrantly to life. Yes, this movie feels long - and it has to be to properly develop all the characters. But you don't resent the length, because it is so filled with thought-provoking plot developments, vivid imagery, and colorful characters that you don't want it to stop too soon. Worthy of singling out for attention are the unflinchingly graphic scenes of actual surgery. It's all in black-&-white, but you see and almost feel every cut and suture in explicit detail. Skin being cut, tissues being retracted open, organs being pulled out and resected. How did they ever get permission to film all that for a non-documentary movie? It's not there just for shock value though: these scenes feel absolutely essential to the movie, allowing the lay viewer to feel some of the extreme mental pressure the modern surgeon faces every time he picks up a scalpel - and gain some insight into why a skilled surgeon seems God-like in the eyes of patients, of lesser staff ... and of himself. Another example of the movie's frankness is the unabashed depiction of the overwhelmingly male-dominated society in Japan. Men are those of power. Women are the neglected wives, the daughters used as political currency, the escorts used to seal business deals, the whores to unlease frustations onto. It would have been so easy (even in the 60s) to whitewash this into the background, but this movie doesn't shy away. That's how it was (still is) in our world, and that's how you'll see it in the movie.

The end result of the writers' and director's efforts is that you finish watching the movie feeling entertained, but also deeply contemplative. You've just watched a masterpiece. It is like reading Camus or Dostoyevski. The scenario may not be immediately familiar, but the humanity is. You might not know medicine, but you will recognize all the inhabitants of this twisted world. You say to yourself, this sort of thing could happen in my office, the people I work with really could do that to me, and goodness I can even imagine doing some of these things myself. When a movie manages to make you think and reflect like that, it must be doing something right.

But the movie is not completely flawless. And one of the key reasons is that it tries to suppose some of its characters ARE flawless. Satomi and Saeko are inserted as tokens of virtue, supposedly representing angelic 'goodness' in their dedication to justice and truth. They are the voices daring to speak out against the corruption of the system and the blind adherence to feudalistic traditions. They would sacrifice themselves for their patients and to make the system better. And they are the only two characters in the movie that fall flat. It's not because they aren't well acted (they are), but the reality is just that such virtuous people don't exist. Nobody is that selfless, and certainly nobody can fail to make mistakes. The elimination of flaws in their characters also crucially eliminates much of their believability. This is disappointing given the exquisite development of the rest of the protagonists. Zaizen, the lead character, is a completely flawed human being despite his stellar skills. He cheats on his wife, he uses every nasty trick in the book against his perceived rivals, his obsession with power blinds him from his real duties as a doctor. But strangely, you are both repelled and attracted to him at the same time. And that is because the role is simply so believable. You know that in similar circumstances, maybe - just maybe - you could be a Zaizen too. But there's no way anybody could be a Satomi in the real dog-eats-dog world we live in. And to make things fair, the writer ultimately makes sure the idealists are properly put in their place. That's more like real life.