Invasive procedure

Extreme Measures makes medicine sinister and Hugh Grant heroic

I almost never react to situations the same way that people in movies do. Maybe I'm just too short-tempered and confrontational, but I always sense that if the hero isn't as adept at defending himself against unwelcome verbal attacks as I imagine myself to be, then he's not much of a hero after all. I strongly believe that the best defense is a strong offense.

Sure enough, at the beginning of Extreme Measures, dedicated surgeon Guy Luthan (Hugh Grant) gets a disapproving look from a nurse (Sarah Jessica Parker) and immediately crumbles when she stares down her nose at him. Although Grant appears to be a full foot taller than Parker, she looks tougher, more rugged, like she's the only one who doesn't know she's short. But just a few minutes later, the unexpected occurs: A condescending coroner gives Luthan a hard time, and he comes back with a rapier-wit reply, then another, and another. He actually says what real people would say, and despite the fumbling British stutter, there's an undercurrent of threat in his voice: not of violence, but of an intellectual superiority so unquestionable that given time he could talk you into chewing your own left leg off.

It was at about this moment that Extreme Measures tipped the scales for me. From that point on, I decided the film would have to do something shockingly wrong--some boneheaded act so egregious as to constitute actual betrayal--for me not to recommend it. Although there are a lot of boneheaded things the movie could do, and some it inevitably does, Extreme Measures stays loyal to its audience by remaining true to a single idea: That getting a panicky rush of adrenaline is one of the things people go to the movies for.

Extreme Measures revolves around a sinister surgical procedure conducted in secret on involuntary homeless subjects, and the lone doctor whose curiosity about a patient's condition threatens to expose it. There's hardly a more reliable way to get the heart racing than to suggest the dire consequences when doctors who have taken the Hippocratic oath to "first do no harm" see their patients not as humans with free will, but as clinical studies--as means to their own ego-glory. Hokey as they sometimes get, movies including Coma, Malice, and Dead Ringers share a cold, creepy detachment about medicine that's unnerving; they stand as cautionary reminders about how any form of power left unchecked is corrupting and ultimately more dangerous than anarchy.

To work, cautionary tales require a compassionate narrator, and that's where Luthan comes in. Only a young physician still suffering from the self-deluding haze of idealism is fully qualified to draw the moral line between blind devotion to the culture of medicine and the more fundamental precepts held by society as a whole. The best narrator is flawed and human and engaging, all of which Grant embodies with silky ease. A friend of mine only passingly familiar with the movie said he'd always thought Grant would make an excellent evil doctor. That was just a bad guess on my friend's part: Grant has to be the hero here, because he's the prettiest member of the cast. If he were the villain, what would there be left for Gene Hackman to do?

This is Grant's first wholly dramatic role since his star-making performance in Four Weddings and a Funeral, and skeptics who thought he was nothing more than a lightweight comedian might be astounded at how adeptly he wears the heroic mantle. He carries the film with an effective mix of affability and brio.

What's really surprising is that this tightly composed, economical film is directed by Michael Apted. Apted is one of the most prolific hacks in Hollywood--puzzlingly overemployed, in fact, considering the low quality of his output, both commercially and artistically. Most of his movies are tedious, sluggish mysteries that have an imprecise, gummy quality about them: Blink, Class Action, Thunderheart, Agatha. (Apted is English, and English directors have an intriguing capacity for making American cities look as dreary as London on a blustery January morning. Maybe that's why his only movies to register more than a quick blip on the entertainment radar--Coal Miner's Daughter, Gorillas in the Mist, and Nell, all with women in strong, feisty roles--have rural settings.) Apted's films tend to be suspicious of American social institutions, and in particular the banal cruelty of bureaucracy. Sleazy lawyers and corrupt policemen are popular targets, so it was merely a matter of time before he narrowed his sights on the medical profession.

Extreme Measures is friskier and more majestic in its conception of hellishness than Apted normally attempts--maybe he was inspired to explore new boundaries after seeing Seven--and for once his sour, overcast images of a city in its most somber moods are put to good use. There's a Gothic grandeur to the seaminess, exemplified by the cavernous subway tunnels that Luthan creeps through in his quest for answers. As Danny Elfman's score overdoses on shrill slivers of violins, the underground architecture conjures up the mythological labyrinth, with Dr. Luthan acting as Theseus following the thread out of a maze of conspiracies and subterfuge.

What Apted and his screenwriter, Tony Gilroy, set out to achieve is something nearly Kafkaesque in the structure of its paranoia. Occasionally the storytelling devolves into silliness--subtlety is not Apted's long suit--but Extreme Measures succeeds by remembering that half the fun in movies like this lies in making the highly improbable seem possible. When the filmmakers have a wickedly good time doing it, it makes more sense to breathe deeply of the soothing ether than to resist.

--Arnold Wayne Jones

Extreme Measures. Castle Rock. Hugh Grant, Gene Hackman, Sarah Jessica Parker. Written by Tony Gilroy, from the book by Michael Palmer. Directed by Michael Apted. Opens September 27.

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