Alive is the sort of cinematic experience that borders on cruelty…but in a very enjoyable way, like S&M at the hands of a wild-eyed lover who may or may not murder you before the climax.
The movie begins with a mid-30s man waking up in an abandoned hospital, bound to a gurney. He doesn’t know how he got there, what his own name is, or how he came to be covered in stitches from several recent surgeries. When he escapes the room, he crawls down the filthy poorly-lit hallway toward freedom…only to be caught at the last second by his supposed surgeon, who smiles like a proud parent before dragging the man back to bed and mending his stitches.
“You’re in pain. That’s good,” the doctor tells his patient. “Pain means you’re alive.”
Despite being the obvious inflictor of these many pains, the doctor tells the man he’s bound to the bed for his own good and promises him he’ll be completely healed soon. There’s so much love in the doctor’s voice that we start to wonder if we as viewers are misreading the situation. That is, until we meet the second patient, a woman who’s also covered in stitches and has no memory of her life prior to waking up in this hospital. Together, the unnamed man and woman stitch together clues to their identities as they work together to outsmart the sadistic doctor who repeatedly insists his sadistic operations and cruel “recovery” methods are for their own good.
Gore, tension, and character interaction makes this very simple plot work well. I honestly wasn’t bored for a single moment throughout the story, and by the time the movie reached its climax I was on the edge of my seat. People seeking jump scares and other tropes won’t be displeased, but the story caters more to horror fans who value slow buildup and character development.
That’s not to say the makeup effects are minimal; trust me, there’s blood and guts aplenty, hallways of carnage from unnecessary surgeries of which we get a strangely titillating view.
Your first thought upon reading these descriptions might be, “Oh sweet! Sounds like Guinea Pig and Saw III had a baby!” Fortunately, that’s not the case (I mean, can you imagine those two fucking?) Alive stands on its own and plays its own set of games all the way until the unforgettable love-it-or-hate-it ending.
Alive wouldn’t work half as well without the right actor playing the doctor. Angus Macfadyen (Braveheart, Saw IV) knows how to play unsettling without becoming cheesy or cartoonish, and it’s because of Macfadyen’s skill that we keep asking ourselves (despite heavy evidence to the contrary) if the doctor really is the loving caretaker in the situation. Even when he’s sewing sutures with dirty needles or ripping open unhealed wounds during physical therapy, Macfadyen’s performance makes us believe, albeit begrudgingly, “Now that’s a guy I could count on seeing at the local charity drive!”
Camille Stopps and Thomas Cocquerel, who play the unnamed female and male patients, have very good character chemistry. This makes the cat-and-mouse game of escaping their doctor quite enjoyable to watch, even as their tactics continually fail and they find themselves in increasingly dangerous situations.