Open Hearts is Susanne Bier's take on the Dogme 95 movement coming at a time in her career when she had already established her name as a noteworthy director within Danish cinema. The film deals with a young woman's effort to come to terms with her fiancé's quadriplegia and the relationship that develops between her and a doctor (Mads Mikkelsen) whose wife (Paprika Steen) is coincidentally the one responsible for the tragic accident. In this theme the film is slightly reminiscent of Lars von Trier's Breaking the Waves (1996) in which the main character, Bess McNeill, finds herself in a similar situation, struggling to come to terms with her husband's paralysis. Yet unlike von Trier's film, Open Hearts presents the viewer with a rather more realistic situation not only due to the aesthetic aspect, which owes its realism to the Dogme rules, but also in terms of the story itself and the way the characters are presented and developed.
The film starts with a sequence of the streets in the city, presumably Copenhagen, shot with an infrared camera, an aesthetic choice that according to the director depicts people's body temperature – having a warm interior and a cold exterior. Bier seems to follow this aesthetic in developing her characters and thus not only depicts their superficial actions but delves deeper into their inner core in order to find this 'warmth' that motivates them. Immediately after this external sequence, the characters are introduced sitting at a restaurant having a nice romantic dinner at the end of which Joachim (Nikolaj Lie Kaas) proposes to Cecilie (Sonja Richter). Cecilie is a 25-year-old woman who works as a cook at a restaurant and Joachim is a university student of geography. The first few scenes are very idyllic, depicting the couple's cheerful and affectionate relationship as they are about to embark on their common life. This situation is quickly and violently disrupted when one morning as Joachim is stepping out of his car and leans in to kiss Cecilie is knocked over by another car passing by at a frenetic speed. The contrast between the earlier blissful scenes and this tragic accident is quite shocking and it immediately changes the tone of the film. From that point onwards it becomes rather dark and oppressive yet with several lighthearted sequences scattered within the narrative, a typical characteristic of Danish films in which tragedy and comedy are inextricably combined.
The focus of the film remains on Cecilie and her effort to support a rather aggressive Joachim who tries to push her away rather cruelly. Cecilie is deeply traumatised by the abrupt derailment of her life but remains devoted to Joachim who tries to drive her away by being cruel but also explains to her that she still has the potential of a normal life without him. Unlike von Trier's film in which Bess ends up being exploited and sacrificed on the altar of love and marital devotion, Bier constructs a rather more realistic and believable narrative in which the different stages of emotional turmoil the characters go through are sufficiently elaborated and by the end they all reach a life-affirming conclusion. Cecilie having interrupted her affair with Neils to run to Joachim's side finally manages to get closure when Joachim releases her from any obligation towards him explaining again to her the impossibility of their situation but this time in a peaceful and tender manner saying “We were unlucky. That's no reason for you to suffer. Sweet, widefingered Cecilie...”. Niels and Marie who have been through a painful break-up that tore their family apart manage to overcome their problems; Marie accepts her new state as a divorced mother of three and achieves emotional independence which is shown in her gesture to pack the last of Niels' stuff, while Niels although he has been left by Cecilie sticks by his decision and does not go back to Marie, a gesture of respect for his own and his ex-wife's feelings. At the very end of the film Cecilie goes to Niels to tell him about her final separation from Joachim, telling him that she has to figure things out and asking him whether she can call him sometime. Although there is not a stereotypical happy-ending, in the way the relationships between the different characters are resolved, there is an overall sense of tranquility and optimism in the film's conclusion as it finishes in a cyclical pattern repeating the infrared camera shots motif. In this way Susanne Bier manages to use the Dogme 95 rules to create an intensely emotional film that is grounded in realism and even though it tackles a very melodramatic subject-matter, involving ordinary people in extra-ordinary circumstances, it avoids sensationalism through the gradual development of all the four main characters.