There have been many recent documentaries capturing the harrowing destruction of the Syrian civil war, but none that descend to the literal depths of “The Cave.” Director Feras Fayyad’s gripping followup to the Oscar-nominated “Last Men in Aleppo” takes place almost exclusively within the confines of an underground hospital that may as well be post-apocalyptic. As Russian bombs rain down on Eastern Gouta, and government forces keep some 40,000 people trapped within the city limits, Fayyad captures a desperate struggle for survival at the behest of a young doctor and her team. It’s a frantic, unnerving window into Syria’s collapse, and a nerve-wracking thriller that alternates between acts of courage and utter despair; through that paradox, it captures the struggles on the ground in intimate detail.
Fayyad’s “Aleppo” unfolded as a real-time thriller about volunteer recovery missions, and “The Cave” operates as a thematic sequel, deepening his exploration of the raggedy ecosystem that has sprung up to sustain life during wartime. However, “The Cave” goes beyond merely lingering in its setting, and roots its drama in the efforts of a fascinating young figure. Aspiring pediatrician Dr. Amani has twice been elected managing director of the hospital, where hordes of patients — many of them quite young — crowd the narrow hallways and dark tunnels on a regular basis. Appearing in nearly every scene, Amani provides a fascinating entry point to exploring the desperate circumstances that have necessitated the hospital to go underground.
Whether she’s battling sexism from male patients or guiding a lost child to the x-ray room, Amani’s commitment is a fascinating psychological case study that provides the story with its center. “Keep on smiling for the children,” she tells one peer. “That’s the least we can do.” Amani’s hospital teeters on the verge of chaos, as the walls often shake from the mayhem up above, and she looks increasingly despondent as the movie drags on, aware that life in the city has become a lost cause, but sticking around to save lives anyway.
What makes this determined young woman tick? Speaking through a voiceover that guides the narrative along, Amani recalls growing up under “a racist and autocratic regime,” and how the war drove her to “respond to the terrible reality” through her work. At one point, a male relative of one of her patients confronts her, demanding a man be in charge. When one of Amani’s peers comes to her defense, the showdown serves as a keen snapshot of the doctor’s struggle on several fronts. Beyond encapsulating the city’s devastation, “The Cave” is an implicit critique of a war-torn society still at the mercy of antiquated values. Even in this desperate moment, her selfless acts face backlash from stern traditionalists. With nothing to lose aside from the hospital itself, Dr. Amani has no qualms about speaking her mind. “This religion is just a tool for men,” she says.
“The Cave” follows another documentary about Syrian hospital workers from earlier this year, “For Sama,” in which filmmaker Waad al-Kateab describes her own experiences at Syrian hospitals overwhelmed by death. Unfolding over the course of several years, “For Sama” provides a more intimate look at the toll of remaining in the country and trying to make a difference. However, “The Cave” comes closer to evoking the moment-to-moment dread of actually being there.
Fayyas elaborates on the hospital’s trepidatious circumstances by sketching out the daily routine, with comical attempts to cook enticing meals as resources dwindle to rice and margarine, and jokey moments between the staff. But “The Cave” never ventures too far from jolting reminders of the perils at hand. An endearing birthday celebration ends with the sudden shockwave of another attack; the doctors even manage to stage a whole carnival underground before another wave of patients overtake them. Unlike “Aleppo,” Fayyas doesn’t quite succeed at developing an immersive story so much as he lingers in this haunting setting, while Matthew Herbert’s touching (if occasionally overbearing) score weaves the action together. Nevertheless, Fayyas excels at finding small moments that take on poetic resonance, including one memorable scene that finds a doctor playing ballet music on his iPhone while enmeshed in a delicate surgery. In the throes of mayhem, they do what they can to maintain some semblance of normalcy.
“The Cave” eschews broader sociopolitical context for the sake of you-are-there intensity, and its abrupt ending suggests there’s a lot more of this story than what we see onscreen. But as a pure cinematic immersion into Syria’s civil war, it’s an unprecedented look at the deterioration of a country with no ground left to stand on. The movie’s horrific final stretch is an eye-opening look at the aftermath of chemical attacks, and its graphic details prove essential: Introduced by an ominous yellow fog overtaking the city’s horizon, the sequence provides an jarring look at systemic genocide impossible to convey through reductive headlines from afar. As the stench of chlorine overtakes the room, Fayyad doesn’t hold back on disturbing glimpses of burnt flesh and cries of pain.
“We live so we can become something important,” Dr. Amani tells one young patient, and she certainly seems to take that assessment to heart. But “The Cave” doesn’t merely celebrate her commitment to the task at hand. Instead, the movie amplifies her profound work and explains why it matters, but at the same time, it’s a chilling wake-up call to the limitations at her disposal. Dr. Amani may be a genuine hero, but under these circumstances, she can only do so much.
“The Cave” premiered at the 2019 Toronto International Film Festival. National Geographic will release the film theatrically this fall.