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  • I was confused by the disorienting camera work, sudden jump-cuts and odd lighting choices. Such amateur things from Scorsese of all people? Halfway through I realized our perspective character was suffering from migraines. How do those manifest? Disorientation, noise and light sensitivity. When they were bad, the picture was bad. Realizing that really let me enjoy the movie, and it's about the only thing I'll forewarn about when I recommend the movie.
    • As a migraine sufferer, that bit of the movie ended up being the single most accurate portrayal of a mental phenomenon I've ever seen in any movie. The only significant difference between what is shown in the movie and what I experience, along with a portion of other migraine sufferers, is the lack of "auras". But migraines often present without them.
  • After spending most of the movie thinking to myself 'not another shaggy dog tale' I realised the movie was well aware of the shaggy dog nature of 'protagonist is dreaming/insane' stories, and contains at least one reference to it in the 'tag, you're it!' line.==Pistolero
  • The reason the nurses are so rude to Teddy is because they know he's crazy, and have heard this all before.
  • When Teddy is talking to the guy in Ward C they're actually talking about two completely different things. Teddy is talking about his fantasy, and the guy is talking about reality.
  • The entire story is littered with clues that Teddy is actually Andrew Laeddis, and has been a patient on the island for two years. Here are some of the more obvious ones:
    • The very first we see of Teddy is him throwing up on the ferry. He continues to suffer increasingly troubling symptoms throughout the film, including nightmares, hallucinations, and tremors, all of which seem to point to foul play on the part of the hospital staff, since they've been giving him pills. Turns out the reason he's experiencing all these symptoms is because they're not giving him anything and he's been going through withdrawal.
    • When Teddy notes that the guards seem nervous, their escort remarks: "Today, Marshal, we all are." On the first viewing, he appears to be talking about the lost patient, but is actually referring to the fact that they're basically giving Andrew, their single most dangerous patient, free run of the facility.
    • When the head of security asks the Marshals to hand over their firearms, Chuck struggles to get his gun out of the holster, which seems an odd thing for a Federal Marshal to have trouble with. That's because he's not a Marshal at all, but Andrew's primary psychiatrist, Dr. Sheehan.
    • Everything Dr. Cawley tells Teddy about Rachel Solando and what she did to get incarcerated at the hospital actually has to do with the case that landed him there. Drowning her children in the lake, shutting out reality, etc. Rachel Solando is also an anagram for Dolores Chanal, the name of Laeddis' dead wife.
    • It seems strange that the nurses are all so uncooperative and downright rude when Teddy interviewed them in a group, but when you realize that the nurses have had to put up with the exact same shit from Andrew for two years now, it becomes quite brilliant story telling.
    • When Teddy moves on to interviewing individual patients, he notices that they talk as though they were coached, and all of them mysteriously shut down when he asks them about Andrew Laeddis. One of them even writes him a note telling him to run. The audience is led to believe that this is because something sinister is going on at the hospital, but it's actually because they don't want him to find out that he is Andrew Laeddis until much later.
      • With one of the patients, Teddy asks her whether she'd ever heard of an Andrew Laeddis. Her reaction appears oddly emotional, which at the time we assume to be because of her nervousness of spilling the beans, but she is actually upset because the real Andrew is talking to her, and he has no idea.
    • Many of Teddy's memories of the war are likely combinations of what really happened and of the event he doesn't want to remember.
    • Slightly more subtle, but on the first viewing Chuck's character comes across as crudely written/acted hardboiled law enforcement officer, complete with cussing and a "know nothing" attitude. Brilliant as we later find out that "Chuck" Lester Sheehan, who is playing the stereotypical role as much as the actor.
    • When Teddy asks a patient about Dr. Sheehan, she becomes nervous. This is because Dr. Sheehan, who is pretending to be Chuck, is sitting right next to Teddy. The patient often glances at "Chuck" when coming up with answers, and makes sure to only say good things about Sheehan.
    • Teddy seems to trust Chuck awfully quickly, considering they only met on the ferry, even to the point where when questioned by an inmate he insists that he does. When you realise that Chuck is actually Laeddis's psychiatrist who he has been seeing for 2 years, this trust becomes indicative of their relationship over that time.
    • When confronted by the first patient he and Chuck interviewed, Teddy starts rubbing his pencil into the paper of his notebook, creating a squeaking sound, annoying him more and more until the patient cracks. When it's revealed that he's actually been a patient there for 2 years, and that he would probably know the patient they interviewed, it becomes conceivable that this unique way of getting under the interviewee's skin arose from Laeddis's subconscious knowledge of the patient and what would annoy him.
    • One scene has Cawley refer to Rachel in past tense to describe her escape, and Teddy asks him why he does that. He responds with: "Why do you think?" He is really referring to Dolores, the real life version of Rachel, who is dead.
    • When one inmate Daniels is interviewing asks for a cup of water, Chuck complies. In subsequent cuts the glass is there when Chuck is in frame but doesn't exist when he is not, showing Chuck isn't actually Chuck.
    • Subtler: the first time Daniels dreams about his wife, she is burning, then bleeding from the stomach, then both.
    • Even more subtle: Teddy meets, or thinks he meets, the real Rachel Solando in the cave. If she's not a hallucination or a fake, she would have had no way of knowing that the U.S. Marshals had been called in to look for her, so why does she call him "Marshal" before he says anything about what he's doing there?
    • When Teddy has an episode, Crawley tries to offer him some medicine. He sounds like a doctor trying to cajole an uncooperative, rather childish, patient into taking his meds, rather a newly-made professional acquaintance making a helpful gesture.
  • At the end of the movie it's implied that Andrew has regressed to his "Teddy Daniels" persona again and has to go through with the operation, but it's equally possible that he's intentionally pretending to have regressed in order to force them to lobotomize him -- once that's done, he can forget everything forever.
    • It's hard to tell what was intentionally being implied, but I think it's definitely true that he had not forgotten but consciously chose "dying as a good man" as Teddy Daniels instead of "living as a monster" as Andrew Laeddis.
  • When Dr. Cawley is introduced, he speaks about how he dislikes modern treatments of patients, of just giving them medication or lobotomizing them (seeing these as last resorts at best) and instead wants to cure them. First it comes off as sounding pompous, but is actually the whole reason he did everything we saw.
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