Russia's official submission to the Best Foreign Language Film Category of the 82th Annual Academy Awards (2010).
Many scenes, if not most of them, were shot in Mental Health Nursing Home No. 3 of Dmitrov District of Moscow Oblast, located in a former monastery. The story of the nursing home is briefly told in the film, its administration are thanked in the credits and most supporting characters are or were real patients of the nursing home, including those interviewed at the beginning of the film and appearing in some scenes afterwards. The roles that have the characters' names appended to them in the credits, plus some others, were played by professional actors while all the patients who appeared in the film are listed as extras although the interviewees had more on-screen time than Albina Evtushevskaya, Darya, or Aleksey Zharkov, the Old Chief Physician. The interviewer who never appears on screen is also listed as an extra.
In the novel, Ragin did not look like Vladimir Ilin: "His exterior is heavy - coarse like a peasant's, his face, his beard, his flat hair, and his coarse, clumsy figure, suggest an overfed, intemperate, and harsh innkeeper on the highroad. His face is surly-looking and covered with blue veins, his eyes are little and his nose is red. With his height and broad shoulders he has huge hands and feet; one would think that a blow from his fist would knock the life out of anyone, but his step is soft, and his walk is cautious and insinuating; when he meets anyone in a narrow passage he is always the first to stop and make way, and to say, not in a bass, as one would expect, but in a high, soft tenor: "I beg your pardon!" He has a little swelling on his neck which prevents him from wearing stiff starched collars, and so he always goes about in soft linen or cotton shirts. Altogether he does not dress like a doctor. He wears the same suit for ten years, and the new clothes, which he usually buys at a Jewish shop, look as shabby and crumpled on him as his old ones; he sees patients and dines and pays visits all in the same coat; but this is not due to niggardliness, but to complete carelessness about his appearance." Khobotov did not look like Evgeniy Stychkin either: he was described as "a very young man - not yet thirty - tall and dark, with broad cheek-bones and little eyes... He had only one book in his lodgings, "The Latest Prescriptions of the Vienna Clinic for 1881." When he went to a patient he always took this book with him. He played billiards in the evening at the club: he did not like cards. He was very fond of using in conversation such expressions as "endless bobbery," "canting soft soap," "shut up with your finicking..." He visited the hospital twice a week, made the round of the wards, and saw out-patients. The complete absence of antiseptic treatment and the cupping roused his indignation, but he did not introduce any new system, being afraid of offending [Ragin]. He regarded [Ragin] as a sly old rascal, suspected him of being a man of large means, and secretly envied him. He would have been very glad to have his post." Nikita was the hospital's porter, "an old soldier wearing rusty good-conduct stripes" who "is always lying on the litter with a pipe between his teeth. He has a grim, surly, battered-looking face, overhanging eyebrows which give him the expression of a sheep-dog of the steppes, and a red nose; he is short and looks thin and scraggy, but he is of imposing deportment and his fists are vigorous. He belongs to the class of simple-hearted, practical, and dull-witted people, prompt in carrying out orders, who like discipline better than anything in the world, and so are convinced that it is their duty to beat people. He showers blows on the face, on the chest, on the back, on whatever comes first, and is convinced that there would be no order in the place if he did not."
Like the interviewed patients of the nursing home, Anna Sinyakina appears at the beginning and at the end of the film. First she plays a nun who walks by the swamp, and then she is the girl who dances with Ragin at the New Year party.