Movies about impostors and grifters tend to view their roguish heroes with everything from indulgence to outright admiration, but rarely disapproval. One reason, I think, is that the movie business attracts BS artists of every stripe, from the hustlers peddling grade-Z action pics in film market booths (and getting hustled in turn by their none-too-solvent Third-World buyers) to the young first-time directors making decisions for their vastly more experienced staff — and trying desperately to hide their ignorance.

But the hustler sometimes make his buyers rich, while the green director sometimes makes an evergreen classic. In the movie business, as in many others, competence is less a given than a possibility. That is, many of us go through our lives feeling like frauds, while hoping that no one gets wise before we figure out what we’re doing.

Miwa Nishikawa’s take on this theme in her new film “Dear Doctor” departs brilliantly from the usual broad winking and rib poking. Not that she tut-tuts disapprovingly through her story of a fake doctor in a rural middle-of-nowhere, but she takes it seriously. Unlike the grifts that damage only bank balances and egos — phony medicine, she shows us, can kill.

Dear Doctor
Director Miwa Nishikawa
Run Time 127 minutes
Language Japanese
Opens Opens June 27, 2009

So why does her hero, the elusive Dr. Ino (Tsurube Shofukutei) still have supporters and sympathizers, even after the police expose him to his former patients and colleagues as a con artist? This, not the case the cops are trying to close, is the film’s central question — and Nishikawa, who also wrote the script, explores it with a deep, delicate probing of emotional realities behind social masks, while refraining from pat answers.

She does, however, offer plenty of insights, including the one that the right look (white coat and thinning hair) and manner (authoritative and reassuring) make the medico, especially in a village hours from the nearest hospital, where almost any doctor is welcome.

Ino begins the film as an escapee from justice, headed unseen for parts unknown. Our first view of him is in happier days at his clinic, where he greets a young medical school grad (Eita), awakening from a bump on the head after an accident on a country road. Named Soma, he has come up from the city in his fancy red convertible to work under Dr. Ino for a couple summer months before returning to civilization.

Soma, however, is inspired by Ino, who spends long, unprofitable hours visiting his mostly elderly patients in their homes, patiently listening to their troubles and cheerfully dispensing advice. Soma, whose own father was a doctor of the all-business school, marvels at Ino’s self-sacrificing attitude — and starts to think of staying on rather than cutting out.

But Soma also starts to realize that, while Ino’s bedside manner is impeccable, his medical skills are suspect. He is not the only one — Ino’s stoic veteran nurse (Kimiko Yo) and a smarmy drug salesman (Teruyuki Kagawa) also know that Ino is living a charade, but for reasons of their own, don’t call him on it.

The film’s narrative core, however, is Ino’s ambiguous relationship with Kazuko ( Kaoru Yachigusa), a widow who has been fainting from stomach pains, but has never been to the clinic for an examination. After caring for her invalid husband for years, she has no wish to inflict similar trouble on her own daughters, especially her youngest, who is studying medicine in Tokyo. When Ino finally uncovers her secret — a possible fatal illness — she asks him to lie for her.

But though his entire life is a lie, Ino is torn. He wants her to get proper treatment, even though the truth may come out — including the truth about him.

Nishikawa also examined the problem of truth and its unintended consequences in her previous film, the 2006 “Yureru” (“Sway”), which won a number of domestic prizes and was screened in the Directors’ Fortnight section of the Cannes Film Festival. But whereas “Yureru” was a courtroom drama with a forced whodunit story arc, “Dear Doctor” is a character study that has no false notes whatsoever.

Not that Ino’s character is easy to grasp. As played by Shofukutei, he is a riddle wrapped in an enigma who shifts with every tremor of the physic and social wind.

A well-known rakugoka (comic storyteller) and TV personality, Tsurube has been appearing more frequently on the screen in recent years, including a well-received turn as a ne’er-do-well uncle in Yoji Yamada’s World War II family drama “Kabei” (“Kabee: Our Mother,” 2008). Though he can glide by on folksy shtick when it suits him, Tsurube delivers the double-jointed performance of a lifetime as Ino, shifty in his sincerity, genuine in both in his desire to help and deceive. There is something of the little-boy-lost in this character, who seeks love by lying — even when he knows the lies will destroy the love.

To her credit, Nishikawa does not fall into jokey cynicism in telling Ino’s story, though she does leaven it here and there with wry humor. At the same time, she does not turn it into a cautionary tale, with a faked justice-triumphs-over-evil ending (though that is the story arc the cops want to manufacture).

Within the flow of the film’s naturalistic surface, however, she has inserted notes that resonate at a deeper, metaphorical level. One is Ino’s pen, which he inherited from his physician father and carries as a token of promises unfulfilled. Another, is the scene that opens the film — a distraught Soma thrashing through the weeds in the dark, seemingly searching for his disappeared mentor. Or it is his own illusions that have gone missing?

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