Sleeper Celluloid: Real Reviews of Fake Movies

Bad Medicine: Maile Chapman Reviews David Cronenberg’s Take On Dirty Endoscopy Clinics in Dr. Disgrace

Director: David Cronenberg; Cast: Sandra Vergara, Abigail Breslin, Zendaya, Isis King, Robert Patrick, Daniel Dae Kim, Patti Hansen, Tommy Lee Jones, Sonia Manzano, Brian Cranston, and Johnny Depp as Dr. Dipak Desai

Dr. Disgrace begins with a patient (Robert Patrick) heading home after—joy of all joys—a routine colonoscopy in a crowded clinic. “What about this?” he asks, tapping the bandage on his forearm. “Just take it off when you get home,” he’s told. He rides in a cab down streets lined with beige medical buildings and little stucco offices with signs in English and Spanish—lawyers, payday loans, bail bondsmen—before turning into a neighborhood of tidy ranch-style houses in grassless yards. Jagged red mountains ring the desert skyline; only as he unlocks the battered security door of his house do we see the iconic lights of the Las Vegas Strip in the distance. When the man pulls the tape from his arm, a red spray of blood saturates the rug at his feet and he finds an IV needle, left behind in his vein at the clinic.

So begins the film: glittering riches in the distance, the gorier realities of life firmly in the foreground.

If you’re squeamish, stop here. If not, meet Dr. Dipak Desai (Johnny Depp). Depp’s Desai is based on a once real-life physician, owner of several successful endoscopy clinics, and generous donor to the local Hindu temple. But when real-life Desai, who lived with his wife in a $3.4 million home in the Vegas Valley, began cutting corners to save money, his scrimping would eventually expose 40,000—yes, forty thousand—patients to HIV, Hepatitis B, and Hepatitis C through tainted injections, unclean instruments, and the kind of carelessness that leaves needles behind in patients’ bodies.

In director David Cronenberg’s version of these now-public events, the whole disgraceful affair is parsed by a class of college students at the University of Nevada, Las Vegas, who devote a semester to sifting through the events at the clinic and the ensuing media attention under the guidance of their ethics professor (Sonia Manzano, in a role that will gladden the hearts of every forty-something who remembers her as Maria from Sesame Street). Her calm delivery is hypnotic and horribly lurid as she makes the students sprawling around a library conference table aware of the details of case. The youngest of them snickers at the anatomical references. Others eye the piles of legal documents, planning to skim, until, folder by folder, week by week, the contents draw them in, through photos, interviews, news clippings, and the uncomfortably intimate details of the lives of complete strangers.

“He did this on purpose,” says one of the young women, a week or two into the project, genuinely puzzled.

“Of course he did,” says another.

“But it’s not normal,” the young woman persists. “If this is normal behavior…”

“Get used to it,” says the film’s requisite troubled young man, pushing away his wrapped takeout lunch. “People do bad things when nobody’s looking.”

“Don’t think about it too much,” says another girl, reassuringly, but it’s too late to ignore what some of them firmly believe already and others won’t accept: that Desai is evil, and that evil is everywhere, just out of sight, all the time… until a shift in perception brings that evil into constant focus, everywhere, every day, everywhere the students seem to look.

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The cast includes Sandra Vergara, Abigail Breslin, Zendaya, and Isis King as an assortment of pretty young co-eds with lives that seem so easy, until we see that one has addiction issues, one is a teen single mom, one is transgendered, and one has, well, let’s just say a bad boyfriend and a questionable side job. Tommy Lee Jones, an abrasive libertarian rancher who “doesn’t believe the hype,” joins the crew alongside Daniel Dae Kim, the quietly traumatized veteran who believes in conspiracies of silence. The group also includes Patti Hansen as a woman returning to finish her bachelors degree after her kids leave for college (mirroring her own return to the screen after a hiatus of nearly three decades), and an odd performance by Jaden Smith as a physics prodigy who appears bored during discussions about ethics. Together, the class absorbs the grisly details of the case, condemning Desai by degree, yet without totally dismissing his humanity. (Which is not to say that Desai isn’t an evil man; fans of Cronenberg who come to Dr. Disgrace expecting a film along the lines of Dead Ringers or The Brood may find this film disappointing… until the scenes of Desai gowning up and conducting procedures in his clinic.)

Some of what Cronenberg’s Desai does is beyond ludicrous and yet terribly mundane, like making his staff cut disposable hygienic bed pads in half to save twenty cents, or skimping on basic cleaning supplies. Some of what Desai does is disturbingly meticulous, like hiring certified nurse anesthetists rather than anesthesiologists, a distinction that lets him (over)bill insurance companies and avoid the scrutiny of his medical peers. But this is all nothing compared to his actions in the procedure room (more on that in a moment) and his inexcusable decision to reuse bottles of anesthesia intended for single use with a single patient. Desai deliberately violates the drugmakers’ guidelines and routinely puts his patients at risk—and when the bottles get low, he consolidates the contents, spreading the risk as far as possible. (In real life, eight patients with acute Hep C are known to have gotten it in Desai’s clinic, and one of them has since died; so far, over a hundred more have been identified, including those infected indirectly.)

As the students come to realize, the bigger picture is complicated by the question of drug company liability, the failure of Desai’s bullied staff to blow the whistle, and the degree to which the HMO he worked for is responsible for the injuries he caused. This last is a central question. His services were cheap: were they too cheap? He did more colonoscopies more quickly and for less money, and there’s no doubt that the HMO rewarded his “efficiency.” But did they know he was a rotten doctor and decide to look the other way? This is the type of suspicion that haunts the students, whose growing distrust of medical authority leads them into increasingly bizarre forms of paranoia. One refuses to immunize her baby; another stops taking anti-seizure medication, preferring to risk brain damage than trust the student health center staff. One who works nights at a hotel on the Strip gets fired and then arrested for overreacting (and how) to a random drug test, while another suffers insomnia to the point of violent sexual hallucinations with all-too-real consequences. These ruptures happen in addition to their other challenges; some are first-generation college students, or non-native speakers of English, all are strapped for cash, and the economic crisis looms constantly in the background like the glittering skyline of the casinos behind the law school library where they meet each week.

Even so, it’s really Depp’s movie, though he never speaks. Depp captures Desai’s heavy face, the empty bloodshot eyes, and the creepily aggressive silence; he radiates deep malevolence even as his defense attorney tries to convince a judge that he isn’t fit to stand trial because of a series of jailhouse strokes (brought on, no doubt, by the strain of being held accountable). One doesn’t want to be unkind to a man who isn’t well… especially not during an exploration of ethics and the failure of professional empathy… but it’s hard to see Desai as a fellow human being. Robert Eglet, legal counsel for the patients who sue the HMO (Brian Cranston, in a pin-striped suit and heavy glasses), is the embodiment of contained moral outrage in the courtroom scenes. His summation—taken from transcripts—uses monkey see, monkey do, and monkey say to illustrate the secrecy, failure to act, and pressure to remain silent at the clinic (his graphics would be in terrible taste if the whole affair weren’t already so over-the-top). Eglet is as sensational as he needs to be, describing Desai as the “fastest endoscopist in the west,” what others in the field call a “jammer” —Desai was so fast, in fact, that he’d been known to splatter feces on the walls and ceilings when yanking his scope out of the viscera of his unconscious patients. (Knowing this, his refusal to give his staff enough disinfectant to properly clean the scopes of blood, tissue, and waste between procedures is all the more indecent.)

The students form their own conclusions, according to their political and religious beliefs; one prays for Desai, another wants to see him get the death penalty, and a third contemplates killing him with a high-powered rifle. By the end of the film, a jury finds the HMO liable for $24 million in damages, pharmaceutical companies are sued to the tune of $500 million, and Desai is charged with second-degree murder, among other crimes. But there’s little satisfaction in any of this, especially when the attorneys gather their files and step aside, and we see, sitting in court, the patients who got sick. Almost all of the students in the group finish the semester knowing that convention alone is the fragile basis of public trust, and that our safety and peace of mind have always depended on the non-malevolence of strangers. In other words, don’t expect a happy ending.

Maile Chapman is the author of the novel Your Presence Is Requested At Suvanto. She lives in Las Vegas.