Co-writers Mark Neveldine and Brian Taylor are the guys that brought you the riotously fun CRANK and they bring a similar level of anything-goes exploitation movie vigor to this relish ably sour mainstream thriller. Its premise owes debts to earlier medical student horror thrillers like FLATLINERS, UNREST, both versions of NIGHTWATCH and the German ANATOMY. Add to this the nihilism of SE7EN : the morally bankrupt characters kill some of society’s most odious dregs just because they can and no one cares when they do. PATHOLOGY also exploit’s the public’s continual fascination with detailed CSI-style forensic gore and the SAW-era fondness for surgically precise death and gruel.

Buff HEROES star Milo Ventimiglia is engaged to lovely, well to do Alyssa Milano but moves away to enroll in a prestigious medical college. Almost immediately he becomes aware of the hedonistic lifestyle of a small number of callous, thrill-seeking fellow students, led by Michael Weston (a memorable psycho in SIX FEET UNDER, this guy does maniacally unhinged very well). Ventimiglia gets over his initial reservations and joins them to get high, has a lusty affair with manipulative bisexual redhead Lauren Lee Smith and participates in their self-created “games”. Figuring that there’s far too many people in the world and that many of them deserve to die, Weston challenges his pals to select a suitably deserving victim and subject them to a meticulously planned and obscure death. The “game” for the others is to figure out how the kill was achieved.

Ventimiglia – who spends much of the film in only his boxers – doesn’t show a great deal of range (or, indeed, facial expressions of any kind) but his character, the nominal “hero”, is refreshingly unredeemable : he commits heinous acts just like his amoral new buddies. Indeed, PATHOLOGY’s chief strength is its overt misanthropy : even a previously innocuous, uninvolved nice-guy character ends up being a key player in the finale’s carnage. The one purely decent character is cruelly snuffed out : Milano has the Gwyneth Paltrow in SE7EN role, and takes part in a post-mortem full-frontal nude scene that will appeal to any necrophiliac fans of CHARMED (you know who you are).

The movie feels more like a deliciously mean-spirited 70’s Euro thriller than it does a contemporary American one, and that can only be a good thing. It even comes complete with a startling nipple-piercing sado-masochistic sex scene that’s closer to Takashi Miike than Hollywood. It does suffer a tad from pacing lulls and some hokey dialogue, but it’s shot through with jet-black humor and doesn’t hold back on nudity (Smith is ultra-sexy as a duplicitous nympho), exuberant sex, grim autopsy-table gore and unconventional plot turns. The suitably nasty punch line satisfies and also distils the entire premise of the recent AWAKE into a nippy two minutes, thus saving potential victims (er, viewers) the misery of sitting through the whole thing.

Like this year’s UNTRACEABLE, PATHOLOGY is a thriller infiltrated by hard R-type horror, though the key difference is that this one is ballsy and offers no tidy resolution, just confirmation that the so-called good guys are as capable of calculated murder and mayhem as anyone. Incidentally, amidst the authentically icky gore, it’s just as startling to see a rough and very overweight Larry Drake (playing a character named “Fat Bastard”) as one of the more unsavory victims of the “game”.

– Steven West