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At the end of the film there is what I would call the "Oh Crap" moment, where the Doctor suddenly realizes the truth of what has transpired. We've all had one of those moments and can identify with that sinking feeling in one's stomach. I like to compare it to the first episode of the series “Nip/Tuck,” where the doctors perform massive facial reconstruction on a drug lord's lackey because he apparently fooled around with the boss's daughter and needs to hide out. The doctors willingly perform the surgery - after all, who hasn't wanted to bang their boss's hot daughter? But it is only once the man is in recovery that they learn the horrifying truth - the boss's daughter was a child, and the man they just helped sneak away is a pedophile. Talk about your "Oh Crap" moment - especially when the boss comes calling. It's a really great way of suddenly grabbing the audience and bringing them into that moment.
The biggest problem, however, lay in the fact that the film seemed to go overboard on the drama to make up for its lack of cohesive story. There are a lot of music cues that imply intensity where there is none, there are many random shots and cutaways that appear to be trying to go heavy on the drama when they don't make a lot of sense. A lot of important story elements aren't explained, which seems to be an attempt to keep an air of mystery, but instead it seems more confusing. For example, there is no explanation of just what kind of surgery Ryan is having, and though one doctor is willing to lie, it seems improbable that a whole host of others are too. It also does not go into detail about how Ryan killed his girlfriend and went on to cover up the crime, which completely discounts a full police investigation which would likely uncover the false medical records.
There are some sections of redundant dialogue where scenes start to drag a bit - and that isn't helped by multiple flashbacks later on that just repeat everything again. Also some logic problems, like the fact that Ryan is shown first walking into surgery and later wheeled in - most of the general public has watched enough “ER” or “Grey's Anatomy” to know this is incorrect procedure. Finally, another bit of cryptic wording - though this might just be a mistake - was text at the beginning of the film coupled with an image of three crosses which read, "Thou shalt not bear false witness against thy stranger." Now, I'm no Bible scholar, but I did grow up in a Baptist family. I'd like to think I know a lot of lines from the Good Book, and I'd wager a pretty hefty sum that that's not one of them. My guess is that they were trying to use the ninth commandment, “Thou shalt not bear false witness against thy neighbor.”
This film certainly gets props for a great imitation of the Film Noir style. Not only was it shot in black and white, but it imitated a lot of those great shadows and silhouettes that fans of Bogart and Hitchcock will drool over. It seemed as though the filmmakers even attempted to make a bright sunny day look moody and mysterious. (As a Goth, this makes me very happy.) The film didn't stick to the style the entire time, which might have been interesting given the subject matter, but even with less shadows I didn't notice any contrast issues - which can be a real problem when shooting in black and white.
There were a lot of really nice shots in this film - several b-roll and aerial shots of the city, as well as a really nice image of a plane taking off. There were several handheld shots which added to the mysterious and surreptitious feeling, and, for the most part, they looked good without being too shaky. There were the obligatory cutaways of various objects and doctors during Ryan's surgery, but they were very well-done. My favorite shot by far was an image of Ryan standing silhouetted against the light from a window, while the camera slowly zoomed in toward said window and focused on the dome of a church which was visible outside. It was a really beautiful image.
The place where the entire ending is finally told could have likely been done in a better way. There were some nice effects of "rewinding" time in the mind of the doctor as he realized what crime he had been party to, but that entire sequence just drug out to such an extent that eventually I wondered if the conclusion I had actually come to was right after all. And, upon reaching the last and final kick in the stomach - the girlfriend/doctor connection - there was a shot of Ryan bending over, at which point I had rather hoped that he was about to suffer complications from his surgery, but eventually realized he was looking at a photograph on the doctor's table. But instead of shooting a cutaway of the photo, it was just pasted into the frame like a news anchor graphic. Not only was the shot used very poorly composed, but it would not have taken long at all to shoot a quick cutaway of the frame. Even if there was no photo available for the shooting day, Ryan could have been filmed looking at or holding a blank frame without any need to show what was in it.
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