There are so many scenes in A Still Small Voice that will stay with viewers. Or at least it feels that way. In truth, the 90-minute documentary mostly consists of a handful of powerful interactions between a hospital chaplain named Mati and her patients. Additional interactions between Mati and her administrator David are equally compelling.
With the Sundance selection now arriving in theaters, we got the chance to speak with the film’s director, Luke Lorentzen, about the long, tactful process of capturing these essential moments without ever feeling intrusive. The location (Mount Sinai Hospital in New York City) suggests privacy and care. And A Still Small Voice somehow conveys that feeling while also revealing extreme emotions in extraordinary circumstances. Lorentzen speaks to this tightrope walk of a production, and the laborious editing process that followed.
This interview has been edited for length and clarity.
The Film Stage: How do you get into that hospital? How does the subject of hospital chaplains and their work come to you? The access is mind-blowing to me.
Luke Lorentzen: The starting point for the project was my sister, Claire, who works as a hospital chaplain. She was the one that just pulled back the curtain and showed me what this work really is and got me researching it really deeply. I had a lot of preconceived ideas about what a chaplain does and I needed Claire to show me a much deeper version of the work to get started. But I think the biggest barrier from the beginning was access. It was like these incredibly meaningful, difficult, profound conversations are unfolding between chaplains and patients. But how on earth could we ever be there? Especially during a pandemic.
And the starting point for that was just reaching out to programs all over the country. I spoke with probably a hundred different hospitals starting in the Bay Area––which is where I was living––and sort of working my way across the country towards New York and Mount Sinai responded super openly and with a lot of excitement for the project. Amy Strano, who’s the Director of the [Spiritual Care & Education] Department [at Mount Sinai], saw the value in showing this work. I think chaplains in general are very overlooked, overworked parts of the healthcare system. Even a vast majority of the staff within Mount Sinai didn’t know what the work that chaplains were doing. And [Amy] wanted that work to be seen. I think having a key person in a position of authority come with such support for the project opened doors at higher levels at the hospital. It started with just a week test shoot where Amy could see––and the whole department could see––what it was like for me to be there and I could sort of get a sense that this was a project I wanted to continue.
Then from there it was a full year of being on site, building relationships with all of the different people in the film. And that began with David [Fleenor] and then all of the residents in the cohort. And it was a matter of being, you know, a very reliable, consistent presence where they could learn to trust me in these very delicate moments. And it was a matter of getting a lot of reps. Of being there in moments where the stakes were lower and having it be an experience that wasn’t just meaningful for me as a filmmaker, but where the people in the film had their own very specific, thoughtful reasons for wanting the film to be made. Which I think was a very big learning for me throughout making this film and looking to future projects––really wanting everybody in my films to have their own sturdy thought-out reasons for why they’re doing it. Doors really open widely once those questions are actually answered.
It’s a big challenge to set for yourself, obviously, with all that’s being tackled. One thing that occurred to me on this rewatch is that the David and Mati elements are very central to the film. When you’re filming are they revealing themselves to you over that year? Or is that something that happens more in the editing room?
It’s a little bit of both. I filmed rather equally with all four residents in the cohort, and it wasn’t until the edit of the film that it became clear that Mati was the true protagonist of the film, which was a really difficult and sort of painful decision in some ways of needing to let go of chaplains who I care about deeply and whose work was incredible and facing the reality of needing to make a 90-minute film with a very specific focus. But Mati and I, it took months of being together and talking through the project for the doors to start opening.
It started with me just going over to her apartment and ordering takeout and talking and then slowly progressed to filming her in staff meetings, very low stakes. And then phone calls with patients where I would only film her side of the conversation. And then going on to her units and just filming her interactions with medical staff, just slowly building our way towards being in the room with patients. And she was very careful about bringing the project to people she had long and careful relationships with. She was usually the first person to introduce the film, usually without me even there. So there were sort of a variety of sort of steps that we would go through and even bringing the project to her patients, both so that she as a chaplain felt comfortable and uninhibited and also so the patients again, could answer that question of what what would you get out of being in this documentary?
There are harrowing scenes that are very honest… as a young father, I’m like ‘My God, I can’t even imagine.’ There’s real bravery here. you’re seeing every version of every emotion [in the film]. And you’re right about the chaplain thing. The whole role of the chaplain feels in the vacuum of another time. And obviously that’s not the case and the movie does a good job revealing that. In terms of intrusiveness, it sounds like that was really important to you. To never feel like there was a manipulation. That anything you captured was [from a comfortable place].
I think we were very slow and thoughtful about answering these questions of when are we invited to be in the room and when are we not? And it wasn’t just for ethical reasons. It was also because when those questions were answered most thoughtfully, the material itself really took off and I think the film would have been very difficult to watch if there was ever a feeling of me or the audience voyeuristically peering into these rooms. And I needed with Mati to come up with a way of being there where I felt included in and a part of what was happening And the sort of framing that Mati I came up with is, you know, chaplaincy is so much about making people feel seen and understood. And we started to use the cameras sort of as an intervention or tool to heighten that feeling of being seen, understood, told your story matters, you matter. We are curious about you. There’s a study that David has mentioned to me on a few occasions that proves a certain emotional lift in patients who are asked to participate in a survey, which is not what you would expect. But it is a very similar idea of telling people their opinion matters that we care about what you think. And the filming latches onto a similar sort of idea. It’s easy to assume nobody would ever want to be filmed in the hospital. And it’s true that many people don’t. And there’s a subset of people who are we discovered a lot of excitement about the project.
How big was the crew?
Just you?! Oh my God! Well that makes sense I guess… you don’t want to be coming into the hospital [with a bunch of gear] and freaking people out, probably. So it’s a year filming and then how long in the edit room?
I mean, it was about exactly a year to edit as well.
I imagine you must have another whole narrative that you could probably––if you wanted to spend another year––you could build out.
Yeah, I think. I think I probably could. And it was surprising to me how once we really chose our focus, how few moments we had to really put the film together.
Right. Rewatching I was struck that there’s not that many scenes.
Not a lot of scenes, yeah.
It’s kind of shocking. It speaks to the power of the film. It feels like so much has happened. You feel [for everyone in the film]. We haven’t spoken much about David, but you feel for David. There’s an administrative element to the film that’s fascinating too. It feels like a generational thing happening a little bit [between David and Mati] where you’ve got this guy who’s maybe a generation older than Mati and it’s like, you know, he’s coming at [issues] from a different way. [The conflict between them] isn’t his fault, it’s not her fault. It’s fascinating and tense. It must have been brutal to narrow down to that in the edit.
I think in simplifying the edit to a few key scenes, they each needed to be delivering a very specific set of things for the film to feel cohesive. And so there were not many alternate options for each of those moments. And the big challenge of the edit was just like really learning to lean on our best material very heavily and to let those scenes play out fully and to get back to that feeling of just being there. Not wanting the audience to feel any sort of manipulation in camera. And the same was true in the edit of wanting the audience not to feel like I was editing their path through this film, but that they were there in the room and can sort of take their own bits and pieces from each of the scenes. While still having a cohesive arc and forward momentum. Finding that through-line was the central challenge of the edit.
Yeah, and it’s smart to start the movie where [David and Mati] are already frayed, right? You’re opening the movie and they’re tired at the third minute, right? I’m always curious with documentaries: is [figuring out] the ending a herculean task? Are you worried about putting a period at the end of the sentence a little bit?
Yes, I think to a certain degree. And also a certain trust that like life will give you moments, closure. And if you’re there and paying attention natural moments of finishing or ending will come. And I think with this film, one of the safety nets of it was it’s a year-long residency and there is a beginning and there is an end and I will be there for that period and whatever happens, the residents will not be in the same place in July as they were [at the beginning]. The challenge that came with that was only having one chance. There was no going back to keep filming once the residency was over. My previous film, Midnight Family, was like, they’re still doing the same thing every day. So I think that resulted in more shoot days and a real sort of anxiety about not wanting to miss anything because it wasn’t happening again.
What do you have on the horizon? Is it kind of an exploratory process for you?
I don’t know yet. I’m taking it a little slow. I think if I’ve learned anything in making this film, it’s just the commitment and energy that’s needed to make these things is gigantic and each of my last two films have been like 3 to 4 years of my life and worlds that I have had to fully live and embody. And I like to be very careful and intentional about what I choose to spend that much time thinking about. And I haven’t yet sort of found the next thing, but I’m doing a bit of teaching. I teach in the Stanford Film Program and like tooling around with a little bit of fiction writing, screenplay writing, and always looking for the next thing.
A Still Small Voice is now in limited release and will expand.