Foreign visitors who notice all those pharmaceutical advertisements on television often remark that Americans seem a sickly people. The innumerable diseases that afflict our population — in Hamlet's words, the thousand ills that flesh is heir to — apparently however meet their match in those glossy commercials, which promise treatments for such problems as allergies, arthritis, diabetes, headaches, low testosterone, and our old friend, erectile dysfunction. At the same time, the commercials also warn against a nightmare of possible side effects — blindness, deafness, stroke, nausea, diarrhea, constipation (simultaneously?), suicidal thoughts, and of course, death, making the whole business of medication a grand adventure.
The new medical thriller "Side Effects" addresses the current reality of prescription drugs, physician responsibility, and patient suffering both directly and indirectly, with some surprising twists and turns beneath its deceptively simple situation. Along the way it shows some of the methods of both the pharmaceutical companies and the doctors who sometimes work as much for them as for their patients.
The movie opens with the camera moving along a trail of bloodstains, then jumps back in time three months to show the history, the people, and events leading up to that moment. Emily Taylor (Rooney Mara) visits her husband, Martin (Channing Tatum), serving out the end of a four-year sentence for insider trading (they finally caught one!), but instead of celebrating his imminent release, complains to her mother-in-law, her friends, and her boss that she still suffers from a serious and lengthy depression.
That depression soon drives her to a suicide attempt, which lands her in the hospital and brings her in contact with the hospital psychiatrist, Dr. Jonathan Banks (Jude Law). For much of the movie Banks treats her with both consultations and a familiar assortment of medications like Prozac and Zoloft, but nothing seems to cure her profound melancholy and almost complete inability to participate in normal life. When a pharmaceutical representative enlists Banks in a clinical trial of a new drug, Ablixa, for a handsome fee, he prescribes it for Emily, which leads to the side effects of the title and an explanation of the bloodstains.
The picture keeps shifting its focus and perspective, moving through the expected demonstration of the dangers associated with medications to a courtroom discussion of criminal liability while under the influence of prescription drugs. With that shift, Dr. Banks becomes the major character and the target of possible legal challenges, an ethics investigation, and a reviled figure in the New York tabloids. When a former patient's parents write a slanderous letter accusing him of sexual relationship with their daughter, and later, some compromising photographs surface, his partners and even his wife (Vanessa Shaw) turn against him.
To clear his name and find out the truth behind the accusations against him, against the advice of the district attorney and everyone else, Banks decides to pursue his own investigation, which becomes something of an obsession. He employs the tools of his trade, including personality analysis, more drugs, and most important, consultations with Emily's former psychiatrist, Dr. Victoria Siebert (Catherine Zeta-Jones), who, as he discovers, holds the keys to unlocking the whole case.
"Side Effects" actually changes from a medical thriller to a finely constructed detective story, integrating the dubious tactics of the pharmaceutical industry with the history of Emily's illness and her previous treatments, and even the practices of Wall Street stock manipulators. The doctor's investigation uncovers complicated layers of motive and action that depend upon the side effects of Ablixa with a far different meaning from the movie's initial promise. It constantly exploits the thriller's penchant for metamorphosis, as numerous elements turn out to be not at all what they seem.
Although complicated and even unlikely in some moments, the film's controlled pace and the solid performances of the cast create an atmosphere of urgency and plausibility. As both detective and doctor, Jude Law provides an increasing sense of obsession and desperation, while Rooney Mara somehow maintains a constant sorrowful deadpan in every scene, the dull affectlessness of the deeply depressed. Perhaps the greatest directorial triumph lies in Steven Soderbergh's transformation of the voluptuous Catherine Zeta-Jones into a plain, repressed psychiatrist rather than the most beautiful shrink in cinema: we've come a long way from Sigmund Freud.