With Canada's oldest hospital shutting down, this documentary commemorates its role in history

For Annabel Loyola, a moment of shock and sadness came when she read an obituary. But it wasn't a death notice for a person — rather, it was the 2013 newspaper article that declared that the Hotel-Dieu, Canada's oldest hospital, was to be shut down.

"I thought to myself, 'This can't be! The Hotel-Dieu is the heart of Montreal,'" Loyola recalls. "It is an institution that is larger than us."

A 20-year veteran of film and TV in both France and Quebec, Loyola is well versed in the history of the Hotel-Dieu and its founders. In 2010, she directed A Mad Venture: In the Footsteps of Jeanne Mance, a feature-length documentary about the legendary nurse who co-founded Montreal and established Hotel-Dieu, its first hospital, in 1645.

So when she heard that part of the Hotel-Dieu had been sold to the city, and that the hospital was to be phased out, with its operations moving to a new facility, Loyola felt a cinematic tribute was essential. She got clearance to begin filming three years ago, and moved her cameras in to capture the day-to-day operations of the hospital and staff. Located at the intersection of Pine Ave and Jeanne Mance, the massive hospital is an impressive historic structure surrounded by a finely-groomed garden run by the nuns of Hotel-Dieu.

After three years, Loyola had shot over 150 hours of footage, which led to the tricky part: editing it down to feature length. "That was extremely difficult," she concedes. "I decided to make the selection of shots and sequences in the spirit of the Hotel-Dieu, a place where so many people get treatments for heart ailments, and also where people go to live out their final weeks and days."

"The Hotel-Dieu is the heart of Montreal. It is an institution that is larger than us."- Annabel Loyola, filmmaker

Loyola says the analogy that struck her was an obvious one. "The Hotel-Dieu itself is like a living being. We had many shots of family members gathering around to support members who were ill. The long hallways were like arteries. The gardens seemed like lungs. The place is surrounded by nature. It felt very organic."

That also led to the capturing of literal heart surgery. "We attended five different heart surgeries, but we only chose to put one in the film. One man said to us, 'I only have about a month to live. But I really want to be in your film.'" (He made it into the final cut.)

Loyola thought of other documentaries as she shot and edited The Last Breath — in particular Frederic Wiseman's landmark 1970 observational documentary Hospital, which captured the frantic goings-on in an emergency ward in downtown Manhattan, and Jean-Henri Meunier's 2003 documentary La vie comme elle va (As Life Goes By), a glimpse into a day in the life of the people and wildlife in a small rural French village. Loyola says she appreciated the way that both of these directors paid homage to institutions while also focusing on intimate details of humanity.

If she has one hope, it would be that The Last Breath helps to raise awareness about what is happening to the Hotel-Dieu — and that public pressure will mount to maintain at least part of the institution's mandate. "I would hope the city would continue to offer services inside the hospital. I do hope it is not converted into condos. We need medical services for older people in Montreal, quite desperately. The space could also serve in part as a palliative care unit. There is a profound humanity to the place. I'd like to see it remain as a place for the entire community."

The Last Breath: At the Heart of the Hotel-Dieu de Montreal. Directed by Annabel Loyola. Opens Friday, April 7 with English subtitles at Montreal's Cinema du Parc and in its original French version at Montreal's Cinematheque quebecoise, Quebec City's Cinema Cartier and Sherbrooke's La Maison du cinema. www.hoteldieufilm.com