Psychiatric hospitals, nursing homes, and other long-term-care facilities have served as chilling backdrops to some of film’s most arresting psychological thrillers. But the foreboding lighthouse of Shutter Island and the macabre, labyrinthine hospital of One Flew Over the Cuckoo’s Nest pale in comparison with both movies’ animating horrors: the wretched treatment of the people trapped within. These works dramatize the cruelties that hospital administrators and caretakers exact upon their patients, especially those who have been admitted against their will, with Hitchcockian dread. In doing so, they challenge conventional wisdom about mental illness, authority, and the ethics of condemning people to isolation.
Recent productions about the complications of caregiving include Ratched’s clumsy attempt to revisit the tyrannical asylum nurse in One Flew Over the Cuckoo’s Nest as well as Falling, an intimate tale of a gay man whose aging, ailing, and conservative father comes to live with him. The latest addition to this loose category is I Care a Lot, which began streaming on Netflix last Friday. More neo-noir than nuanced character study, the writer-director J Blakeson’s film nonetheless shows how easily a shrewd scammer can manipulate systems that already cause grave harm.
Rosamund Pike plays Marla Grayson, a con artist whose grift is particularly cruel: She bribes a doctor into declaring elderly people unable to look after themselves, then becomes their court-appointed legal guardian. Marla is savvy and severe, but her greatest skill as a scammer is her knowledge of the countless ways that legal and health-care bureaucracies leave the elderly and disabled vulnerable. Under the guise of protecting her patients, Marla easily persuades doctors to alter their medications and isolate them from the loved ones who might guard them from her ploy. The movie’s message is clear: Marla may be remarkably evil, but these intersecting systems already enable the abuse of elders, people who have disabilities, and anyone else who doesn’t have the legal or societal power to fight back.
When Marla arrives at the lovely home of Jennifer Peterson (played by Dianne Wiest) to inform Jennifer that the court has ordered her to a care facility, it doesn’t matter that Jennifer insists that she’s perfectly capable of looking after herself. A few flashes of court documentation—and a quick nod to the police standing by—make clear that Jennifer is powerless to stop the impending takeover of her life and her finances. “She sounds a bit more like a prisoner than a guest,” another character later observes of Jennifer’s existence inside the facility. The film’s central scheme takes some unexpected twists: Without giving away too much, Peter Dinklage plays a menacing figure who comes to Jennifer’s defense, causing a wrinkle in Marla’s typically smooth operation. But even accounting for a handful of grisly action sequences, I Care a Lot’s most disturbing moments are the ones in which institutional violence seems far more threatening than any one person, no matter how steely his gaze or heartless her mission.
Unlike earlier films that focus on the psychological toll victims suffer, I Care a Lot emphasizes how systemic injustices can be maneuvered specifically to generate personal profit. After all, a single diagnosis can be enough to revoke someone’s basic rights under the guise of medical care, and all it takes is one conniving person to exploit those missing protections. Watching Marla deploy her femininity to nefarious ends, it’s immediately tempting to see an extension of Pike’s most famous role, Gone Girl’s Amy. Both women orchestrate diabolical schemes enabled in part by racist, sexist perceptions of white women’s perpetual innocence. Even Pike has nodded to the overlaps between the two: “I do think they would be two interesting women to get in a room together,” she told Entertainment Weekly. “I don’t think they would like each other very much at all.”
The characters have wildly different motivations, though: The titular woman in Gillian Flynn’s 2014 thriller seeks interpersonal damages, not wealth. I Care a Lot’s Marla, meanwhile, is a merciless capitalist villain. “To make it in this country, you need to be brave—and stupid and ruthless and focused,” she says during one climactic confrontation. “Because playing fair, being scared, that gets you nowhere. That gets you beat.”
I Care a Lot is most perplexing in moments such as this, when Marla’s reprehensible racket is cloaked in the language of Lean In feminism. “You know how many times I’ve been threatened by a man? Thousands,” she declares early in the film. “You know how many of ’em ever came to anything? Two.” In this scene, and in the several altercations she has with angry men, I Care a Lot casts Marla as a morally ambiguous character, despite the fact that her actions clearly harm scores of people, including other women. Though the film’s final scene suggests a clear judgment of Marla’s ethics, much of the preceding dialogue sets her up as the badass boss babe.
Much of I Care a Lot’s muddled conclusion about Marla’s principles is communicated through the literal image she projects: Marla trades the clinical presentation of Nurse Ratched for #girlboss couture, complete with a razor-sharp blond bob and a romantic partner who doubles as a femme-fatale co-conspirator (Eiza González). Real care work is grueling and unglamorous. The people most often caring for ailing family, especially now, are disproportionately women; many of those working as aides in the health-care industry are women of color. But in Blakeson’s film, the fraud victims, family members, and health-care workers all suffer at the hands of women who hide behind the rhetoric of bureaucracy and female empowerment.