Time to get on the soapbox about a subject that’s very near and dear to my heart as a student of bioscience: Medical research. Despite all the skepticism about Big Pharma, the FDA doesn’t just hand out approvals to the highest bidder. Each and every drug that legally enters the marketplace has to go through years of research and development, in addition to animal trials and clinical trials. There’s a track of red tape several miles long, set down to ensure that there are stringent procedures, documented evidence, and verifiable data to establish beyond reasonable doubt that a medicine is safe.

On the one hand, it’s good to know that there are safeguards in place to keep swindlers from selling horse piss and calling it a cure-all elixir. On the other hand, all of that arduous testing costs so much time, money, and manpower that there’s precious little incentive to push through a drug that won’t sell. For instance, if there’s some treatment or chemical that’s naturally-occurring — and therefore can’t be patented — the treatment will remain illegal because no one will pay the cash that it takes to put it through FDA testing. It sucks, but that’s the cost of a high ceiling for quality. It may not be a perfect system, but then, neither is science.

So here’s Dallas Buyers Club, which takes place during an especially turbulent time in the history of the FDA: The onset of the AIDS epidemic.

The film tells the story of Ron Woodroof, here played by Matthew McConaughey minus about thirty pounds. When we first meet Woodroof (I swear to you that every word of this is true and it’s literally in the opening frames of this movie) he’s snorting coke, banging two hot women, and watching a rodeo from backstage, all at the same time. A short while later, we see Woodroof punch a cop in the face and get dragged away in a cop car, just to escape some guys he lost a bet to.

Naturally, it would be an understatement to say that he’s a hellraiser. And of course, all of Woodroof’s rampant drug use and unprotected sex makes him a prime candidate for HIV infection, which he’s diagnosed with at the 15-minute mark. Keep in mind that this is back in 1985, when HIV/AIDS was a relatively new discovery. Moreover, AIDS was still a disease primarily associated with homosexual activity, so the bigots of 1980s Dallas are all too eager to call Woodroof a queer and spit in his face. Woodroof himself uses the tactic to keep himself in denial, saying that they must have mixed up the blood test and swapped his sample out with some gay person’s.

So the film comments on access to health care and LGBT acceptance. How timely!

Anyway, because HIV/AIDS is so new, the treatments for it are all in beta. However, the FDA has fast-tracked the clinical testing of a drug called AZT, which we now know to be a highly toxic drug that actually boosts the tenacity of HIV in the long term. Still, AZT testing is carried out, and the test subjects gradually start deteriorating as a result. As for Woodroof, he decides not to be treated as a lab rat without even the choice of getting an untested drug or a placebo. He instead gets his sticky fingers on some AZT until he overdoses and lands in the hospital.

So now we come to all the moral dilemmas at play. For starters, how do you give a prognosis of 30 days to live, and then say that a treatment is due for approval next year? Sure, the patient could be offered a chance to potentially sacrifice their precious remaining time to help perfect a drug for future patients, but that doesn’t seem very comforting to the person who’s still going to die.

But suppose that someone dreadfully sick had heard of alternative drugs that hadn’t been approved by the FDA. Sure, there’s absolutely no way of knowing what the stuff is or whether it’ll actually work, but what difference does that make to someone who’s going to die soon anyway? The results might even prove the effectiveness of the new drug, even if the “data” is so full of uncontrolled variables that no credible scientific organization would bother looking at it. In fact, it’s possible that the unapproved treatments might interfere with the approved treatments or vice versa, but again, the patient is going to die anyway.

The sad truth is that at this early point in time, AIDS patients have no good options. Science (especially medical science) is a process of trial and error, and these AIDS patients simply had the grave misfortune of being diagnosed during the “error” phase. Enter Ron Woodroof, who basically says “Fuck it. If I’m a dead man walking no matter what treatments I get, then I’m going to choose my own drugs!”

So Woodroof travels all over the world, using fabrications, bribery, and legal loopholes to collect all manner of non-toxic medical supplements that haven’t been approved by the FDA. But he doesn’t use the drugs all by himself. Instead, Woodroof decides to share the wealth by going out and treating his fellow HIV-positive Dallasites. However, because Woodroof still can’t legally sell or dispense these drugs, he creates a company that sells memberships; members who pay a monthly fee can get their contraband drug fix. And so the Dallas Buyers Club was born.

McConaughey is the driving force of the film, but that should go without saying at this point. The man may have been a laughingstock in the past, but he’s completely redeemed himself by now. The guy’s become a legit actor, and I can’t wait to see what magic he works for Martin Scorsese and Christopher Nolan in the next couple of years. Though seriously, how crazy is that? If you had told me five years ago that Matthew freaking McConaughey would be giving awards-worthy performances, taking above-the-title roles for cinematic masters like Scorsese and Nolan, I’d have laughed in your face. In any case, I’d hate to think that there are any filmgoers out there who still think that McConaughey is nothing but a pack of great abs. Well, his muscle tone is shot to hell for this picture, and he still brings the house down.

Unfortunately, the rest of the cast doesn’t fare quite as well. Jared Leto gives a sweet performance as Woodroof’s HIV-positive cross-dressing business partner, but Rayon suffers from a rather uneven development arc. Still, Rayon and Woodroof have a passive-aggressive sort of relationship that the two actors play extraordinarily well. Plus, when Leto gets on a hot streak, he’s on fire.

Alas, Jennifer Garner is totally wasted. She’s on hand to play the token compassionate doctor who plays by the rules even though she knows they’re wrong and she’s eventually won over by Woodroof’s charming ways and OH MY GOD THIS CHARACTER IS BORING. Garner is clearly trying, but her talents just aren’t enough to salvage this cliched and paper-thin character.

In fact, the “pro-science” characters in this film are all made of straw. Michael O’Neill is on hand to play a stuffy FDA bureaucrat, and Dennis O’Hare plays Dr. Sevard as a spineless little toady who takes orders and money from the FDA without any regard to the ethics involved. The film made a nasty habit of treating these characters as the villains, even when we know that the issues involved are not as simple as black and white.

No, I was much more fond of those moments when the film plays up these ambiguities. Those moments when Woodroof gets a heart attack after his treatment, when he turns away a prospective member who can’t pay, and any other time when it’s shown that Woodroof’s approach isn’t the end-all/be-all. Woodroof and Rayon aren’t saints, and the film is at its best when we’re reminded of that. In fact, that leads to some of the film’s funnier moments as well. A highlight comes when Woodroof solicits an HIV-positive woman for sex, which turns out to be way funnier than it looks on paper. Again, McConaughey’s charm goes a long way toward selling that.

On a technical level, the film does a fine job with its cinema verite presentation. There’s a bit of shaky-cam present, but it’s not too noticeable or annoying.

Dallas Buyers Club has an outstanding lead performance from Matthew McConaughey, though his co-stars are all hamstrung by characters who are either inconsistent or flat boring. Still, the film offers two or three nuanced moments for every blunt one, and the moral ambiguities involved are all quite intriguing. I wouldn’t put it up as an Oscar nominee, but I do think it’s worth a recommendation.

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