The Dardenne brothers’ L’Enfant will be justly hailed as a brilliant work, but for gritty observational verisimilitude The Death of Mr. Lazarescu outstrips it at every turn. How does director Cristi Puiu do it? By letting the film turn in on itself, by being even less obtrusive, by eschewing melodrama (a goal to which the Dardennes come closest in their unparalleled oeuvre), and by populating it with characters that breathe with unrivaled complexity and nuance. I’ve written elsewhere that Ira Sachs’s Forty Shades of Blue feels more observed than directed, its main character’s emotions more felt than acted. I regret having made that analysis for Sachs’s film, for it perfectly describes The Death of Mr. Lazarescu, a work in which the machinery and constructedness of cinema is obliterated. The camera becomes transparent, characters as they are commonly construed melt away, the director’s hand felt only in whisper-light touches, the writer’s not at all. The Death of Mr. Lazarescu is not merely the finest exemplar of Bazinian realism—it also virtually becomes documentary, so real and affecting are its moment-to-moment emotions. There can be no higher praise for fiction filmmaking. I don’t know if it’s the one of the greatest achievements in the history of cinema as another Reverse Shotter blogged, but for my money, The Death of Mr. Lazarescu is the finest film of this young century, far and away the best entry in this year’s New York Film Festival.

For a film so profoundly moving, its premise is deceptively simple: the chronicle of an ailing man’s last 12 hours on this earth. Dante Remus Lazarescu (Ion Fiscuteanu) is a 62-year-old alcoholic, abandoned by his children and living alone in a barren Bucharest apartment. On this one and only evening in question, Lazarescu comes down with acute abdominal pains for which no one seems to exhibit any profound concerns. Certainly not his intermittently feuding neighbors, who pass it off as the consequence of too much booze, nor his out-of-town daughter, nor a spate of doctors, all of whom are quick to admonish him for the same. The only character truly sympathetic to his needs is Mioara (Luminita Gheorghiu), the EMT charged with ferrying Lazarescu from one under-staffed hospital to another, his only custodian through the red tape of an overexerted health-care system. As the night wears on, and our protagonist’s impending death nears, Lazarescu’s cognitive functions fail along with his cancer-ridden organs, and he recedes to the background. The drama becomes more concerned with the foreground of interpersonal dynamics between Mioara and the doctors and nurses—their concord and discord, petty squabbles and romantic intrigues, their obstinate adherence to bureaucratic strictures and rule-breaking moments of heartrending kindness. An all-encompassing world of incident and sentiment is crammed into a considerable (but shockingly fleet) two-and-a-half hours that embody the manifold potentials of human interactions—including the world’s great immutable leveller, which coincides with the terminating final reel. As he lays dying, we realize that we’ve learned less about Lazarescu than the motivations and makeup of all the supporting characters. As doctors and nurses admonish our decreasingly present protagonist, it says more about them than him. It doesn’t mean that Lazarescu isn’t important: he’s a vital structuring absence, a stimulant that catalyzes human emotions.

But Lazarescu is far more than a mechanism. If there’s been a more wrenching, complex, or agonizing portrayal of human morality and fragility than Ion Fiscuteanu’s, it’s missed my attention. In the opening sequence, before he’s rushed to the first hospital, Lazarescu comes off as a little obstinate, and certainly indictable for abusing his body for so many years. He’s fumbling and less than dextrous as longtime drinkers often are, but certainly cogent. Over the course of various hospital transfers, Lazarescu imperceptibly loses a grip on reality, slipping ever so slowly toward second childishness. He’s eventually reduced to repeating only a few feeble words in response to the doctors’ various questions, his voice cracked and gravelly. The effect is devastating: My moral righteousness changed to slack-jawed wonderment at such a naked and unadorned expression of corporeal frailty. From there, wonderment became horror and outrage at the immense, near criminal indifference with which successive doctors met Lazarescu’s plight. Wheeling Lazarescu into his penultimate emergency room, Mioara attempts to impress upon the hospital staff the seriousness of her charge’s ailment, but they will have none of it, being guilty of staunch snobbishness; the doctor is more interested in asserting his clinical authority and indemnifying himself against liability than attending to the needs of a dying man. Never before have I wanted to vault myself through the screen to throttle a character. Forgive the personal asides, but there’s no other way to convey the triumph of Mr. Lazarescu’s immersive visceral experience.

Mr. Lazarescu recalls the best Cassavetes, a film that allows direct, seemingly unmediated access to its characters and their emotions. Yet it also is a marvel of minute structuring, reflecting on the very mechanics of the cinematic apparatus. Though Puiu suggests an intimate back-story predating the opening sequence, and another that continues after its protagonist dies, his narrative is also self-contained. With the raspy, uneven breaths that accompany the film’s opening shot, the film stock literally breathes life into Mr. Lazarescu. And with the final shot, cut abruptly as a prostrate Dante Remus is being turned over for surgery prep, the camera takes life away. As the minutes pass, the drama accelerates, but not through any formal trickery, for Puiu maintains his measured, even pacing to the last. Rather, the slowly dawning realization that Lazarescu is facing imminent death makes every passing minute increase in import. Where earlier in the film, Mioara’s ambulance idling for several minutes in the parking lot was little cause for concern, a delay of even seconds as orderlies argue over gurneys at the end takes on gargantuan significance. Paradoxically, Puiu also undermines the concept of the epic, taking the legs out from underneath his own title. “The Death of Mr. Lazarescu,” and the hero’s name (Dante Remus Lazarescu) have lofty overtones, evoking the decline and fall of great men, but which, like Arthur Miller’s Death of a Salesman, chronicles the passing of an ordinary soul.

Given the largely perfunctory treatment Dante Remus is given during this night, it’s tempting to see Mr. Lazarescu as excoriating the Romanian health-care system, but that misses the point. (And it’s also a testament to Puiu’s ability to adapt nonfiction techniques—unobtrusive handheld camera, natural sound, etc.—to a dramatic form.) The true focus is on the very real process of dying and its ordinary, messy details—tragic, but not aggrandized with that word’s theoretical connotations. All of this world’s petty stratagems, conflicts, and intrigues are stripped away, and life is laid bare with surpassing unadorned craft. The Death of Mr. Lazarescu is a raw ode to mortality, illuminating that at the end of it all, we are simply alone.