In the five minutes before and after Nurse Mandy (Angela Bettis) clocks on at a small Arkansas hospital for her night shift, she’s committed enough crimes and misdemeanours – and demonstrated enough surly attitude and un-Nightingale-like contempt for colleagues and patients alike – that it’s a bit of a shock that she turns out to be the protagonist of writer-director Brea Grant’s gruesome black comedy.
Given to filching drugs for personal use, Mandy is also in cahoots with senior nurse Karen (Nikea Gamby-Turner) to euthanase hopeless cases (with bleach) and harvest their organs for sale to a criminal enterprise … but Mandy’s one streak of softness, a tolerant attitude to family members no matter how badly they’ve wronged her, gets her into an escalating crisis that runs the night through and racks up not only a body count but a lot of incidental illegality and nastiness. Mandy’s first big problem is that her brother Andy, who may have abused her horribly, is brought in after his latest overdose … but the real loose cannon in her clan is cousin-by-marriage Regina (Chloe Farnworth), who takes being a white trash dumb blonde so far that it goes beyond stereotype. Regina is so chatty and careless that she loses a kidney her brutal boss is counting on, and has to go back to the hospital to get a replacement – though she has no patience with Mandy’s careful, tracks-covering methods of stealing organs from the nearly-dead and takes to blunt slaughter (only she doesn’t know the first thing about anatomy).
Among the many others who happen along on this busy night are a seething cop killer (David Arquette) who ends up nonplussed that everyone he comes across seems to be more violent than he is, a nice guy cop (Kit Williamson) who shares with witchy Regina an inability to just shut up and let Mandy get on with things (Bettis does a lot with exasperated looks as others monologue), and an elderly woman (Missy Stahr Threadgill) who isn’t as confused as her diagnosis suggests. When even Regina takes too long – and more organs go missing – an enforcer (Dusty Warren) shows up to put on more pressure. Grant does a lot of prowling down hospital corridors after tired, desperate medical staff – a stylistic device oddly reminiscent of Alan Clarke’s very different one-long-shift-in-a-health-facility drama Funny Farm – so that the thrumm of tension almost becomes exhausting, with an array of minor characters who fit into the farcical scheme of things and always show up requiring attention when Mandy needs to be concentrating on saving herself.
Set in the late 1990s, with most of the competent cops in town off duty at a Y2K seminar, this has some of the sleazoid quirkiness of many backwoods crime dramas – but there’s also a very jaded view of the American healthcare system at the point where patients are literally commodities to be sold off to parasites.