Before his shift toward the mainstream with his remakes of The Wicker Man and Death at a Funeral, Neil LaBute was both popular and infamous for ruffling audience feathers. Following the indie and critical successes of In the Company of Men and Your Friends & Neighbors (both among the most memorable films of their respective years and the former among the genuine best of 1997), LaBute offered up a true anomaly with Nurse Betty, which adopted his typically transgressive approach to fit slightly more palatable material. The word “palatable” is a funny one in any case involving LaBute, of course, particularly in the early period of his career, so take the word with the tiniest imaginable grain of salt.

This is still as transgressive as the two films that put the director on the map. Working from a screenplay by John C. Richards and James Flamberg, the story follows Betty Sizemore (Renée Zellweger), who is not a nurse at all but a diner waitress and the hapless wife of the loutish Del (Aaron Eckhart), a car salesman with a most unfortunate mullet. Del’s been bedding another woman for quite a while, but that’s not all: He also supplements his income by selling drugs on the side. This gets him into hot water with a pair of assassins, Charlie (Morgan Freeman) and Wesley (Chris Rock), whose connection to each other is one of the film’s most fascinating twists.

A traditional plot synopsis must pause here for a moment to cover the major character quirk belonging to Betty in this story: She is generally obsessed with “A Reason to Love,” one of the most popular soap operas currently on television, and specifically enamored with “Dr. David Ravell,” the protagonist of the show played by actor George McCord (Greg Kinnear). Indeed, she is so obsessed that her reaction to the film’s plot incident directly ties into the show-within-the-movie: Unbeknownst to Betty, who is watching the program in the other room, the assassins interrogate, torture and murder Del when he fails to give them what they have been hired to exfiltrate.

They do not just murder Del, though. Wesley, who is both an arrogant fellow and a cold-blooded psychopath, scalps him, much to the chagrin and protests of Charlie, who finishes the botched job with a couple of silenced rounds, as was intended. It leaves much more of a mess for Sheriff Eldon Ballard (Pruitt Taylor Vince) and reporter Roy Ostery (Crispin Glover) than it should, as well as for the assassins when they realize that Betty saw the murder part of the liaison. Luckily for them, the act of witnessing the carnage shocked Betty into a detached fugue state, leading her to believe that she is “Leslie,” the latest romantic interest of “David,” and to seek out the good doctor to fulfill her storyline.

This only covers approximately the first half-hour of the movie, which divides its time equally between Betty’s road trip to find “David” that lands her a temporary roommate in the form of Rosa (Tia Texada) and the two pairs (Charlie and Wesley, Ballard and Roy) in pursuit of her. In the process, we become more accustomed to a collection of characters who are either barely tolerable or worthy of sympathy but all brought to life by expert writing and performances. Freeman is surprisingly warm as a cold-hearted killer who grows a conscience far too late to count (namely, when the revelation of his relationship to Wesley comes), and Rock is frankly terrifying as a revolting twist on his own wisecracking persona.

They’re slightly more functional in the narrative, as it happens, acting as something of a human ticking clock for Betty, whose own storyline also goes in unforeseen directions. She finds “David” and, in the process, George (played by Kinnear with his usual charm – until the other shoe drops), and through a misunderstanding, the actor and his producer (Allison Janney) decide that her extended Method acting might translate well in the form of a role on “A Reason to Love.” Zellweger is phenomenal here, playing everything with a glaze over her eyes that communicates Betty’s sudden departure from reality with equal amounts of quirk and pathos.

That other shoe must eventually drop, however, and it’s a testament to the absolute control of tone that LaBute, Richards and Flamberg never lose sight of the story to such an explosive mix (the denouement wraps things up with a truly twisted joke, accompanied by a hilarious Rolfe Kent score that parodies the flowery offerings of Alan Silvestri with real panache). That carries over to the insane finale, by the way, as the assassins find their target, the sheriff and the journalist arrive to intervene, and a shootout develops that would make Ethan and Joel Coen proud for the way it mixes really rough violence with tying loose ends and providing genuine closure. That’s what Nurse Betty comes down to: tone control.

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