The director of “Saint Frances” returns with an intense and disturbing thriller

Few filmmakers can boast a 99% Fresh rating on Rotten Tomatoes for their small-scale debut, as Alex Thompson earned with “Saint Frances” in 2019. Fewer still follow up with an even more second act. strong.

Thompson co-wrote “Rounding” with her doctor brother Christopher, and their psychological panic is almost visionary in intensity. He’s described this film as inspired by the B-movie thrillers he watched on TV as a kid, but that drastically understates its enduring power.

Indeed, the B-movie moments – ominous threats, demons manifesting – are the low points of an otherwise tense and terrifying emotional nightmare.

Namir Smallwood (“American Rust”) is outstanding as James, an ambitious medical resident who strays from the fast lane when one of his patients dies. Though his sympathetic mentor (Ed Kross, Amazon’s “Patriot”) urges him to keep going, a shocked James insists on leaving his prestigious metropolitan hospital for a rural, underfunded place called Greenville.

Greenville leader Dr. Harrison (Michael Potts, “The First Lady”) welcomes her, noting that there is “a real capacity to make an impact here.” That’s exactly what James wants to do, so it’s a surprise when he finds himself facing one hurdle after another. He is particularly concerned about his patient Helen (Sidney Flanigan, “Never Rarely Sometimes Always”), a teenager repeatedly readmitted for asthma. Helen’s labs, which look relatively normal, certainly don’t match the increasingly dramatic treatments assigned to her.

And when James learns that she is preparing for a lung transplant, he completely freaks out. Does Helen’s (Rebecca Spence, “Candyman” 2021) mother victimize her daughter, in a Munchausen case by proxy? Does Helen’s attending physician, mysteriously unavailable for consultation, mistreat her? And why is Dr. Harrison so reluctant to reconsider the current plan?

Sidney Flanigan, star of

As Helen’s transplant date approaches, James finds his own health failing. He’s too obsessed with work to deal with a sprained ankle, which has deteriorated so badly that it’s become difficult to make daily rounds. He cannot sleep, making it harder to assess his own instincts whenever they are undermined or dismissed. And although he reassures his worried mother that he is fine, he is tormented by hallucinations in which he sees disturbing images.

The Thompsons’ father, also a doctor, served as a consultant on the film, and as a result, James is surrounded, often disconcertingly, by a meticulously detailed world. Flanigan, who earned accolades for her 2020 acting debut, doesn’t have enough to do as the ailing Helen. But the constant undercurrent of vaguely unsettling hospitable sounds inside and outside her room is as impactful as Quinn Tsan and Macie Stewart’s thoughtful, responsive score. And there’s a whole community embedded in the slightly tense banter between the perpetually exhausted medical staff; many of the cast and crew are “Saint Frances” alumni, including costars Kelly O’Sullivan, Charin Alvarez, Hanna Dworkin and Max Lipchitz.

Cinematographer Nate Hurtsellers (himself a “Saint Frances” vet) films James in judiciously dim light or stifling darkness, his life a waking fear he is still trying to escape. The film even begins with a reference to the dream state of enkoimesis, in which ancient Greek physicians were visited by a god who inspired exorcism-like treatments. But this brooding introduction, like the intermittent flashes of religious or paranormal iconography, is a red herring. James’ visions and memories are frightening not for their madness intimations but for their basis in reality.

Elizabeth Banks will star in the medical drama

Although he’s clearly going through a very personal breakdown, James’ relatability is what makes him such an effective hero. His sincere desire to help his patients is continually blocked by bureaucratic impassivity; his power as a doctor is no match for the helplessness of an individual desperately trying to move a brick wall.

Smallwood and the Thompsons take that sense of vulnerability even further, with James also replacing helpless patients. An inevitable aspect of illness is the realization that one’s fate is, to some extent, out of one’s hands. Everyone in a hospital bed depends on the compassion, skill, and even guesswork of others. For some, it is a comfort. For others, it’s a truly terrifying place, both physically and mentally.

James embodies the all-too-valid horror of life that relentlessly spirals out of one person’s control. “Rounding” doesn’t always work like a traditional thriller, but that’s only because its ambitions are larger than its structure. Thanks to Smallwood’s beautifully modulated performance and the equally insightful vision of the Thompson brothers, it’s a deeply unsettling experience nonetheless.

“Rounding” makes its world premiere at the 2022 Tribeca Film Festival.

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