"Threshold" is a film with a very clear, heavy presence of reality. The trade-off of this, of course, is the same as all such realist films - pacing. This is not something you can watch for big thrills and the explosive energy of medical trauma. Richard Pearce, and his cinematographer, Michel Brault, create a world that looks and feels so human it's almost painful. Each successive scene is like a new revelation on light and colour and depth of field. Brault gets right into the action, the movement, the emotional expression. The most remarkable thing about James Salter's script is how it avoids all those common medical clichés and falsehoods so often employed in such stories. The three lead actors - Donald Sutherland, Jeff Goldblum, and Mare Winningham - are observed in an almost documentarian way. They are people of depth, but not in a way we commonly see in films. The characters in "Threshold" are not distant, no, but what we get from them depends on our power of perception. They are laid out in front of us in much the same way as each person we encounter in life. That's the great strength of Pearce's direction here (his next film, "Country", has a similar approach)."Threshold" is mostly unknown, and not available on DVD. There is one main reason for this - it was a Canadian production, released at a time when such films weren't widely seen, and commonly forgotten soon after. I paid a significant amount to purchase the VHS online. I don't regret this, but the breathtaking cinematography deserves a modern format.

Amazingly to me, this film appeared on cable very often when my child was an infant with congenital heart defects. The makeup giving Mare Winningham the look of oxygen deprivation was very realistic and gives the viewer a picture of the "dusky" skin tone of some heart patients. The restraint of the Vrain/Carol relationship was right on, and the peripheral but agonized part of the parent was poignantly depicted by Carol's father. The film is almost a relief from the typical "dramatized" film about illness. Heart difficulties are inherently dramatic to the lay person (perhaps not to doctors, though) and need no melodramatic treatment. The understatement, the lack of statement all serve the subject well. The cold, orderly world of the (urban, state-of-the-art)hospital that contains so much extraordinary work comes across beautifully in this film. I'm glad others appreciate it.

Like most physicians, I tend not to watch medical shows in Movies and on Television; partly because they aren't usually very realistic - the real world seldom has sufficient drama to make good entertainment - and partly because one doesn't normally look for relaxation or entertainment in the same field in which one works. I saw Threshold for the first time recently only because I am a great admirer of Donald Sutherland's considerable talent. In this film, Sutherland is at his best, creating a portrait of a Cardiovascular Surgeon which is so real I could recognize several of the surgeons I know personally. He embodies both their strengths and weaknesses. Perhaps the most notable attribute he gives the fictitious Dr. Vrain is the total commitment and life absorbtion which a heart surgeon must have, even when it weakens his ability in other facits of life. One of the film's advisors was Dr. Denton Cooley, the pioneering Dallas Surgeon; Sutherland must have studied and worked with him extensively to so perfectly capture the personality and persona. The film follows his lead in making nurses, and their daily routines in the hospital unusally true and realistic also. This film is worth seeing just for the strength of Sutherland's portrayal and the realistic view of the medical world alone.

I wasn't really looking forward to seeing this film, and only ended up watching it because it stars Donald Sutherland and Jeff Goldblum, two of Hollywood's most talented and inimitable actors.In the end, though, I glad I did watch it - THRESHOLD turned out to be an engaging and absorbing drama. It's a fictional account of the first ever artificial heart transplant, and feels so realistic that you'd never guess it was made two years before the artificial heart became a reality.Donald Sutherland's first-rate performance is probably the highlight of the movie - when he's this good, you wonder if there's anyone he couldn't act off the screen. A then unknown Jeff Goldblum holds his own admirably as the idealistic young doctor who invented the artificial heart, and the film features some impressive camerawork, most notably the opening tracking shot.All in all, it helps if you're a Sutherland fan, but it's not essential; this is one of those movies whose relaxed pace, absorbing atmosphere and strong performances will have you hooked right from the start.