I feel sick. You’re not supposed to make me feel sick.
— Sam (Jessica Alba)
Just 22 years old, Clay (Hayden Christensen) appears to have it all. A cute, smart, and social-minded billionaire businessman, he’s got good press and a doting mother, dramatically named Lilith (Lena Olin). But you know before Clay does that all this good fortune is about to end. For before he even shows up in Awake, his best friend Jack (Terrence Howard) attests to the pain he feels at losing Clay on an operating table. A New York-based heart transplant surgeon, Jack bemoans his loss with some passion. “You may think you understand when or why or how it happens,” he says. “You can’t.”
Except when you can. Though Awake makes a vague case against playing god in the operating room, it also argues, rather incoherently, for other sorts of manipulations. These might only be remotely effective, however, in this film’s fantastic universe, where the line between life and death is exceedingly traverse-able. This line is part of Awake‘s central gimmick, that is, the very disturbing and fuzzy factoid that one in 700 patients who go under anesthesia each year suffer “anesthetic awareness,” waking during surgery but remaining unable to move or speak, essentially hearing doctors’ inane chatter and feeling every cut, every rib crack, and every stitch, all while paralyzed.
If numbers on the phenomenon differ (one source has it as one in 1050 or so), the effect for a melodrama dressed up like a hospital thriller is plain. Indeed, Clay’s surgery is a grisly, loud, horrifying business, as he drifts off counting backwards then comes to within seconds, listening to Jack and crew’s conversation about the evening’s Knicks game and unable to make them know that as they’re swabbing and slicing into his chest. you hear his panicky queries sliding into outraged screams, the percussive score pounding home the point of his extreme and ongoing injury.
How Clay comes to this pretty pass is briefly set up before the surgery, then fleshed out as he tries to force himself into a “better place” during his waking nightmare. That place is occupied by his girlfriend Sam (Jessica Alba), whom he has been keeping secret from his mother, apparently out of fear that Lilith will disapprove, or be jealous, or otherwise irrational, as wealthy, controlling mothers tend to be in such melodramas. That’s not to say that Awake precisely blames Lilith for her son’s reckless behavior, but it does submit that this behavior is ridiculous when it comes to Sam. Consider the young-movie-beauties-in-love scenario, whereby Clay — who has waited over a year for a donor heart, takes piles of pills every day, and needs to sit down and gasp during arguments — spends precious minutes, after he learns an organ has come through, to have passionate sex with Sam before heading over to the hospital, where, you know, his new organ could be waiting on ice. His nonchalance regarding his condition is of a piece with his lack of curiosity concerning this perfect-seeming girl, is not only instantly in love with him, but also mysteriously well versed in his medical needs.
Neither does Clay pay much attention to his own surgical situation. He goes fishing with Jack in the East River, discusses his affair with Sam, and accepts as true Jack’s assessment that people only pursue malpractice suits “because they don’t know what to do with their grief, they want someone to blame.” It so happens that Jack is currently the target of four such suits, which might also say something about his practice, but the movie doesn’t dig into his background. Instead, he’s posed as the doctor Clay has chosen because his mother has chosen another, the world-renowned Dr. John Neyer (Arliss Howard), in line to become the next Surgeon General (“My hands have been inside presidents!” he asserts, by way of not convincing Clay he’s the better choice.)
The operation begins badly, with a last-minute substitute anesthesiologist, Larry (Christopher McDonald), arriving late and with a flask in his hip pocket. What kind of hospital is this, anyway, where surgical teams aren’t apprised of their members, where people can walk into and out of operating rooms with scrubbing, and where face masks and gloves are not necessary? Not to mention, where no one monitors the patient’s vitals closely enough to notice that he’s not only in egregious pain but also in tears on the operating table?
But Clay’s pain, uncomfortable as it surely is for you — at least during its first few minutes — can’t sustain a plot, even for 84 minutes. And so the film launches into a very convoluted and contrived business, based on betrayals and preposterous mistakes. It doesn’t help that this business is discovered by an out-of-body Clay, who runs around the hospital in scrubs (why is never explained, as he lies on the table in a hospital gown — obviously not a good choice for running through hallways or streets) and yells at various relatives and doctors in an effort to get them to see he’s “awake.” Lilith, anxious but relegated to near non-existence in the waiting room, is explaining to Sam how she can feel something is wrong in the operating room: “He’s not just my son” she whispers, “We grew up together.” Yes, this confession is potentially a little yucky. But by now you’ve long since determined that “something” else is very wrong in the film.