The terms are often used interchangeably, but there's a difference between "naturalism," which tries to capture the rhythm of everyday interactions, and "realism," which takes a broader view of life at its crappiest. Cristi Puiu's pitch-black comedy The Death Of Mr. Lazarescu seems on the surface like pure realism. It's about miserable, lonely old drunk Ion Fiscuteanu, whose chronic pains prompt a long, hellish journey into the Bucharest hospital system, with lots of waiting, filling out forms, and getting bumped from one emergency room to another. Throughout, Puiu doesn't disguise his disgust with the condescension of doctors and the dehumanizing processes of modern medicine, which are less about listening to patients' troubles than about getting them treated and streeted.
But though Mr. Lazarescu is bleak, it's far from grueling. It's an invigorating combination of Frederick Wiseman's unblinking documentaries, the Dardenne brothers' jittery social dramas, and one of the more visionary episodes of ER, all sprinkled with real wit. When Fiscuteanu sits around his apartment waiting for the ambulance–which he does for about the first 40 minutes–Puiu concentrates on the amusingly mundane conversations his neighbors have about compote recipes and power tools, enjoying the texture of the speech itself, as well as the irony that it's taking place in front of someone for whom such minutiae no longer matters. Then paramedic Luminita Gheorghiu shows up, and the movie swings through a series of masterfully choreographed setpieces, as Gheorghiu makes it her mission to get one harried doctor or one pissy nurse to take Fiscuteanu's condition as seriously as she does. She calls in favors and endures brow-beatings, while Puiu keenly observes the health-care circus, from the ridiculously snappy patter of a devil-may-care CAT-scan tech to the petty power plays of an ER intern.
Ultimately, The Death Of Mr. Lazarescu is more naturalist than realist, and it has a lot in common with the hyper-naturalism of writers like David Mamet in the way it exaggerates the mundane into something exotic. Puiu's film can be read as an indictment of the inefficiencies of socialized medicine, or, given the fact that the title character's name is a play on "Lazarus," as a spiritual allegory. But more than anything, The Death Of Mr. Lazarescu is an intoxicating performance piece in which skilled actors pinball off each other with such energy and nuance that the audience almost forgets about the dying man on the edge of the frame. The style alone makes the movie's point.