Excision is not that kind of movie. It’s dark, and bloody, and painful, and it isn’t at all interested in making you feel comfortable. But it’s definitely going to make you feel something. Pauline dreams of becoming a surgeon… and she also dreams about sex. The two things seem to be linked in her mind, as her elaborately staged masturbatory fantasies are full of blood, gore, and corpses. Considering herself too intelligent for school, she teaches herself the skills she thinks she’ll need while annoying her teachers and disgusting her peers. See, it’s not just that Pauline is unpopular because she’s a bit strange: she actively tries to freak people out. She wants to provoke a reaction. She clashes constantly with her mother, but there is one person she really does care about. Her younger sister, Grace, is pretty, sweet, and much more pleasant than Pauline; she’s clearly her parents’ favourite, and Pauline adores her, too. The only problem is that Grace has cystic fibrosis, and is becoming more ill by the day. Researching her condition, Pauline becomes determined to do something to help her… And it seems, for a while, like things might turn out to be okay in the end after all. Despite Pauline’s repulsiveness, her parents are doing their best to find ways to accommodate her and help her get her life in order; although she’s not liked, she’s avoided more than bullied at school; and her affection for her little sister reveals a tender side to her that suggests she might not be so awful after all. There are moments of dark comedy, and the film allows us a few glimmers of hope. Pay attention to the details, though, and you’ll realise that there’s no way this can end happily. The final scenes are truly shocking, as much because our expectations have been thwarted as because what happens is horrible. All the way through, the movie has played with the established tropes of the genre, offering characters and scenarios that appear to be familiar but really aren’t. Excision might be writer/director Richard Bates Jr’s first film, but it has the kind of confidence you’d expect from a much more experienced filmmaker. It’s bold, daring, and utterly devastating. This isn’t the kind of story that’s told very often, and it’s deeply unsettling. If you’ve got the stomach for it, it’s a hell of a piece of work. Excision is out on DVD and Blu-ray now. Follow our Twitter feed for faster news and bad jokes right here. And be our Facebook chum here.