Major spoilers ahead, read at your own discretion.
Malignant starts out with an absolute bang. The first scene of this movie is intense, scary, and disturbing.
However, once the (amazing) opening credits roll by, we are treated to more haunted house schlock, when a woman and her husband are attacked by what appears to be a ghost. This is not a ghost, however, as it turns out, it was the woman all along, controlled by a parasitic twin she had growing in her brain since birth, and was supposedly taken out by doctors. The evil twin has hijacked the woman's mind after a hit on the head 'awoke' him, and is out for revenge to kill the doctors who tried to separate them, the woman's adoptive family, and their own birth mother.
At one point during the movie I told my wife: "This is like that episode of the Simpson's Treehouse of Horror, where Bart had an evil twin!", and she said I ruined the movie for her.
But yes.
This movie is a mixture of the Simpson's Treehouse of Horror Bart's Evil Twin episode, with that scene from Harry Potter and The Sorcerer's Stone where the dude had a face in the back of his head. Throw in Belial from Basket Case, and you got Malignant.
Despite its slight unoriginality the movie is amazing, due in large part to James Wan's expert direction, the movie's intense pacing, the superb acting, and the truly horrifying visuals James Wan and his team cooked up, and shot with beautiful photography.
The evil twin's face is in the back of the woman's head, so when the twin commits the murders, he moves backwards, making for some spectacular visuals.
The murders are violent, bloody and gory, and James Wan doesn't pull any punches. This movie has a lot of sickening and disturbing images of extreme violence.
Structured like many of his own horror movies (think The Conjuring), the story may be derivative, but it is relatively solid.
I did manage to find ONE PRETTY BIG PLOT HOLE during my first viewing. It is explained that while the twin commits the murders, the woman is put in an illusion where she believes she is living life normally, but she can have visions of what the twin does. In one scene she is seen sleeping in bed and having visions of the twin murdering a man in his own house, the movie tells us that these visions are connected, so she sees them as they happen simultaneously. But then she screams and her sister comes in to comfort her. In the next scene, the sister takes her to the police. If the twin (which is in the back of her head, mind you) was committing the murder with her own body, how could she scream in her own room, and how could her sister come in and find her there? Shouldn't she be in the apartment killing the man? A huge blow to continuity, and it's not even subtle if I noticed it during my very first viewing of the movie.
But the movie works well despite that, and it managed to keep me intrigued during most of its runtime. (Except for the scene in the police precinct, but that's a story for another time).
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