Pauline (AnnaLynne McCord, THE HAUNTING OF MOLLY HARTLEY) isn't your average eighteen-year-old. Sure, she's moody, defiant, and has body-image issues; but she also has delusions of being a surgeon and a socially-detrimental recurring case of Herpes (thanks to her father [Roger Bart, HOSTEL: PART II] performing mouth-to-mouth on her when she almost drowned at the pool). Delusional she may be, but even she is sure she's clinically insane but her domineering mother Phyllis (Traci Lords, NOT OF THIS EARTH) won't "break the bank" to send her to a psychiatrist; instead, she is sent to Father William (John Waters) for free counseling (during which Pauline needles him with blasphemies). Far from being jealous of her younger, prettier, but terminally-ill sister Grace (Ariel Winter, TV's MODERN FAMILY), Pauline is honing her self-taught surgical skills in the event that Grace needs a kidney transplant (which, Pauline has read, is a very risky procedure in hospitals due to a high possibility of contracting infections).

Diehard horror fans will be disappointed by how much the film owes to more to films like AMERICAN BEAUTY and its ilk than an actual disturbing psychological character study or even a gross-out black comedy. Of course John Waters is the priest (Pauline's "religion and science don't mix" line to him will only shock the ultra-conservative fringe who wouldn't watch the film anyway, and only edify the hippest of hipster viewers), and Marlee Matlin shows up specifically to make a deaf joke (Malcolm McDowell as Pauline's math teacher and Ray Wise as the principal are wasted). The only interesting casting touch is Lords, who is as good as the stilted material allows (even though her casting was more likely an ironic reference to her own youthful indiscretions than her more recent status as a cult actress); although McCord's performance is certainly brave, given that she's a regular on a network series (the CW's 90210 rehash), and all-too-willing to explore her range with a character that teeter-totters back and forth between vile and pitiable. Most viewers of the film will already have had the ending spoiled for them by synopses that reference Pauline's final act of madness (although anyone else will have been clued in from the start by the very sight of Grace's treatments); however, that plot point is just dropped in after much meandering around the shaky foundation of Phyllis' house of cards - interspersed with Pauline's nicely-visualized surreal dreams of bare flesh, blood, and viscera - with little forward momentum to Pauline's breakdown (she is already off-the-deep-end before any of her awkward social and sexual relations with school- and churchmates). The final scene, however, is effective and moving in not losing sight of the damage wrought by the two principal characters (upon each other, other people, and themselves) in favor of the scene's Grand Guignol aspect.