Beneath the washed-out, drab setting of The Mountain is a vein pulsing with rage. Set in the 1950s, the movie follows a veteran lobotomist, played by Jeff Goldblum, as he sets up shop in mental hospitals across America, snipping off chunks of his patients' brains through their eye sockets and leaving them in near-catatonic states. In the film, such procedures have reached the end of their era, on the verge of being replaced with psychotropic drugs amid mounting evidence the surgeries are causing serious widespread harm. Yet this man and his ego press on, desperately grasping for the sense of authority his "expertise," his promise to delete all the bad thoughts, once conferred upon him. There's a sickness here, all right, but it's not in the patients.

Writer-director Rick Alverson loosely based his nightmare vision of American nostalgia on the story of Walter Freeman, a real-life neurologist who performed thousands of lobotomies as cure-alls for "mental illnesses" ranging from depression to homosexuality. But The Mountain isn't focused on the finer points of either medicine or history, so most of the ways in which Goldblum's Dr. Wallace "Wally" Fiennes operates aren't spelled out for the viewer. What the film does instead, brilliantly, is capture the unsettling, sinister mood of watching a society punish dissenters and nonconformists because they interfere with its carefully constructed vision of sanity. If thy right frontal lobe offends thee, cut it out.

Goldblum is his usual roguishly charming self, tap-dancing in bowling alleys and picking up women with sly wit, channeling Philip Seymour Hoffman in The Master. His giddy charisma stands in stark contrast to the morose way Alverson and cinematographer Lorenzo Hagerman stage the surrounding action: brain-dead onlookers slumped over in hospital gowns, shuffling across brown-and-white linoleum floors, amid lighting so pale it's downright sickly. This is not Wally's perspective, but that of his young assistant, Andy, played with a lumpy uncertainty by Tye Sheridan. His skeptical viewpoint frames the film, which has been stripped of almost all dialogue.

What kind of guy is Andy? The kind who's hopelessly out of step with the America he sees around him: a withdrawn, sexually repressed loner. Haunted by memories of his institutionalized mother, who seems to have fallen victim to one of Wally's procedures, he shrivels under the authority of his father, a figure-skating coach played with clipped German anger by Udo Kier. The early scenes at their ice rink are striking visual compositions of long-skirted women synchronized to the second (Alverson skated as a child). When Andy's father dies, the young man leaves the rink and falls under Wally's wing, replacing one kind of social repression for another. His role: snapping photographs of the lobotomies, and helping to pretty up the post-op patients as a way of controlling the narrative.

Funny enough, given its bizarre subject matter and minimalist presentation, The Mountain is Alverson's most coherent, even-keeled film to date. Active in independent circles for the last decade, the Richmond, Virginia-based director is known for rejecting traditional story structure and provoking his audiences with deeply unpleasant characters and themes. He found a (marginally) wider audience for his last two films, The Comedy (2012) and Entertainment(2015). Both starred Adult Swim alt-comics (Tim Heidecker and Gregg Turkington, respectively) as angry, disturbed men with little in the way of emotional truth to ground their sour behavior. Entertainment, which found Hell in the desert backroom bars where its horrible lead comedian performed,critiqued America's love of ribald, hyper-masculine comedy with a bitterness straight out of Michael Haneke: it deployed an invigorating visual style to mock its audience for the very idea they might have fun while watching it.

These films had a narrow range of focus but attacked their targets with gusto. They were arch deconstructions of hipster irony that were themselves designed for ironic hipsters. By contrast, The Mountain tries out a broader canvas, and what at least appears to be a traditional story structure, along with characters who have real weight behind them. These things benefit the film's focus, and sharpen its larger takedown of this specific dark period in American history... at least until it hands over the third act wholesale to the expressionist French actor Denis Lavant (Holy Motors), who curves his spine menacingly while delivering bilingual rants about the fraudulence of art.

Maybe it's fitting to end a movie about large-scale repression with a giant troll. You can sense Alverson barely containing his laughter from behind the camera. He gets to lobotomize us.

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