A twisted, gross, and great horror film, American Mary is so wonderful — until the last few scenes — that I almost want to say “go watch it” and leave it there. I won’t, though, because I know for some people “twisted” and “gross” are not necessarily positives. In fact, the entire premise of American Mary might put more people off than draw people in. It’s worth seeing anyway, in my opinion. If a film grosses you out then it’s made an impact on you, which is something most films you see won’t do.

Our film stars Mary Mason (Katharine Isabelle), a medical student who is behind on her bills, has no friends, and only converses with her professors and her grandmother. In an attempt to get money, she heads down to a strip club for an interview. As fate would have it, the club’s owner needs a surgeon for a man in his basement, so she’s offered $5,000 on the spot to try to save his life. Later, she’s approached by someone who has had multiple plastic surgeries to look like Betty Boop who offers her a job doing body modification on a friend. Mary decides that this should be her new profession.

I’m sure you’re thinking something along the lines of “where does the horror come in?” Well, that would be spoiling the fun. A traumatic event occurs midway through the film, and that sees Mary go from someone who just does body modifications to, well, torture. You can imagine how someone who does those types of modifications for a living could find some inventive ways to torture people, I’m sure. Yes, you get to see many of them.

The body modification scenes probably provide enough of an “ick” factor for most people. Add in the fact that some of them wind up being done to people who don’t want them, and you take things up to another level. If all you want are scenes like this one, you’ll get your fill and then some. However, American Mary isn’t great because of these moments — as fantastic as they are. It’s great because it works as well as a character study as it does horror.

Mary is an interesting character. She’s equal parts smart, powerful, and tragic. Katharine Isabelle plays her mostly in a deadpan state, meaning the few moments of emotion, whether they be joy or sorrow, become all the more powerful. Watching her handle certain situations becomes a lot of fun. You wonder how she’ll react and how far she’ll go to right wrongs. She is one of the stronger and more fascinating characters — both male or female — you’ll see in a horror movie. Watching her for 100+ minutes is worth it even without the “gross” parts.

The film was directed by Jen and Sylvia Soska, twin sisters who cameo in the film. They also directed the earlier Dead Hooker in a Trunk. They have a strong sense of style, and here showcase a surprising amount of restraint. They could linger on some of the more horrific moments but they don’t. We need more female filmmakers in general and specifically more in the horror genre. Give them more jobs.

Where American Mary falters — and it’s a brief one that unfortunately will be something you remember after it ends — is in its conclusion. The ending feels rushed and its events are underdeveloped. Because this is how it ends, this is the impression that will be left on your mind. The film tries to relate the ending back to an earlier event but it just doesn’t work and feels like it was simply a convenient way to draw the film to a close. And that’s not even getting into the personal feelings attached to it. I was disappointed by the resolution and how we got there, but only the latter is a problem with the way the film is structured.

Katharine Isabelle is a horror veteran at this point. You’ve likely seen her in the Ginger Snaps movies. She is fantastic in this role. She delivers just enough glimpses of emotion that we can get some insight into her psyche, even though for the most part she’s a stone-cold wall. Tristan Risk plays the Betty Boop lookalike, and completely disappears into that role (although it certainly helps that hardly anyone will know who she is beforehand). David Lovgren has some fun as a slightly creepy and unconventional college professor.

American Mary is a fun, thoughtful, stylish, icky, tense, and engrossing movie. Is it creepy? Absolutely. I’m sure its premise alone will turn off a lot of people. However, if you can get past that, you uncover a stronger-than-expected character study and more restraint than a lot of horror films would offer when it comes to the gross-out moments. It suffers from a rushed ending that, by being the conclusion, will linger negatively in some minds. But the first three quarters are fantastic and while it might not end well, it’s worth seeing for everything that leads up to it.