“I have so much respect for anyone in the medical profession, like, any area. I really think it’s the most important thing you can do with your life. Almost.” –Maud
Saint Maud is only partially about religion. It’s also about the horrors of isolation, end of life care, and mental illness. During this crucial moment when we’re lauding our healthcare workers as heroes, it’s also about the trauma of caretaking work and the easy neglect of those who do it.
Check out the trailer for Saint Maud here:
This post includes spoilers for the film.
The plot of Saint Maud (dir. Rose Glass) follows Maud (Morfydd Clark), whose horrific experience in a hospital led her to become a private carer for the dancer Amanda Kӧhl (Jennifer Ehle), who has stage four lymphoma of the spinal cord. Maud’s exit from her hospital nursing career coincided with an extreme religious conversion, and she is confident that God has a plan for her. She believes she finds it when her care of Amanda leads to her patient’s conversion. Unprofessional invasion into Amanda’s life, however, gets her thrown out of her position and into a period of doubt that culminates in her most extreme test of faith yet. The entire film is entrancing, but the last few minutes are simply incredible.
While the audience gets close to Maud and her inner life (so much so that it can be difficult to tell what’s real and what’s not), all of Maud’s half-hearted attempts at intimacy—through caregiving, sex, and religion—ultimately fail. References to loneliness and isolation are unmistakable. Amanda comes right out and says, “You must be the loneliest girl I’ve ever seen,” so to say that Saint Maud is about the psychological and physical impact of loneliness is low-hanging fruit. The horror lies in what has led Maud to this point and how far her psychosis takes her from reality. Seeing the unrelenting effects of disconnection during this historic moment when we’re all feeling isolated from social networks and too stuck in our own heads makes it all the more worrying. We might all be checking ourselves, that the pandemic rituals we’ve created to keep us sane don’t have the opposite effect.
While there would be much to say about religious iconography in Saint Maud and in the horror tradition more broadly, my focus here will be on the role of the caregiver: its vulnerability to trauma, its associations with gender, and its relationship to pain.
Palliative Work as Unacknowledged Trauma
In the first moments of Saint Maud, we see Maud in hospital scrubs crouched in a corner, a low-angle shot of a hospital bed in disarray, blood dripping in the background. This the first of many shots of Maud’s entranced expression, looking up at something only she can see. The moment is clearly one of violence between nurse and patient. Unfathomably, Maud is left to deal with the trauma of whatever happened all alone. We know from later conversations with her co-worker Joy (Lily Knight), that she was never included in the community of nurses, who saw she was struggling and did nothing to help her. Struggling with what exactly, we don’t know. In the midst of growing mental health concerns without support, this trigger moment is grounded in the capability of healing hands to harm, even against their will.
What we know about this hospital is that it’s always overcrowded and short staffed, to the extent that Joy bemoans the state of beds in the hallway. Designed to be medical machines of collaboration and codependency between practitioners and departments,[1] a hospital where practitioners are “spread too thin,” as Maud explains, cannot function for long without someone getting hurt. What’s more, the combination of responsibility for a growing population of vulnerable lives, potential for burnout, and natural fallibility of both the human body and those caring for it—without a community of support—creates the perfect conditions for trauma. How many images of medical workers crouched in corners with their heads in their hands have we seen recently? And the sheer anatomical materiality of crowded medical spaces increases the chance of accidental violence. Someone, sooner or later, will have blood on their hands. In light of these pressures, Maud’s turn to private care seems like an improvement. We, as the audience, worry about how her new blind faith will impact her priorities as we search each scene for signs that she may sabotage her patient’s care in some misguided pledge to God. But, as a carer, this is not an Annie Wilkes or Nurse Ratched. Maud is capable and kind.
The less violent and more lasting trauma of caregiving lies in Maud’s continued isolation, even when she wants to make a connection. Again and again, we see scenes of her wandering Amanda’s house alone. This type of loneliness is shown in other films about caregiving, like I Am the Pretty Thing That Lives in The House, Never Let Me Go, and even Misery. The carer-patient relationship is one-sided, one being paid to care for the body of another, including administering medicine, occupational therapy, cooking, cleaning, and bathing. Unlike the typical hospital situation, these tasks are performed without a medical support team. This creates a potential vulnerability on multiple levels for both patient and carer. Amanda needs a carer and a cure for her boredom, but Maud needs a cause, and her need is greater. As Glass described their relationship, “Each of them misguidedly thinks they can help the other, and they just both completely misunderstand each other…. We’re all living in the same real world but subjectively experiencing it through these fleshy bodies we’re stuck [in] and these brains we have.”[2] Having witnessed the pain and violence of the body, Maud does her duty for Amanda’s physical care but is devoted to her spiritual salvation. As Maud says, “it takes nothing special to mop up after the decrepit and dying.” So, when Amanda, herself alone and lonely in her new role as dying woman, acts as though she is inspired by Maud to feel the presence of God herself, Maud falls head-over-heels in possession and obsession with her new convert and intoxicated with power, not to heal a body but to save a soul.
Later in the film, after Maud has been dismissed from her post with Amanda, she begins to stalk the new carer, Ester (Rosie Sansom), and strikes up a conversation with her without giving any indication of who she is (the setting for the quote at the beginning of this post). Cheerful Ester waxes lyrical about the role of the carer and the precarious but valuable relationships she’s formed with her patients. She has clearly been able to succeed in a meaningful relationship with Amanda where Maud has failed. Ester’s point that “You’re often right there at a very important time in people’s lives,” meaning the moment of death, is a slap in the face. This is the prime opportunity to witness Amanda returning to God that Maud craves. Where Ester finds fulfillment in her medical work, Maud cannot. Having found no gratification in caring for bodies—in fact, she seems to have gotten used to being dismissed, though it’s unclear why—she constructs a “higher” form of satisfaction, for which she feels acknowledged and reworded. The repeated neglect of caregiver mental health and well-being is one clear source of this psychosis. Not everyone can be an Ester.
Women’s Work
Saint Maud is comprised of an almost all-female cast, the characters also husbandless and childless. This emphasizes the thankless and all-consuming job of caregiving as predominantly women’s work, paid or unpaid. This is not the cinematic female community it could be, however. Maud does not seem to desire community. In addition to her lack of connection to her nursing coworkers, she never seeks out a church of fellow believers after her conversion and instead praises William Blake for his eschewal of organized religion. In fact, Blake and the pious figures in his prints and paintings are the only Men Maud has much use for. Throughout the film, men are unmissed and unneeded. In fact, the few men who appear simply demand more caregiving from the independent women who stoically comply. Nursing and sex work—again, paid or unpaid—are depicted as simply two types of caregiving.
In one scene, after losing access to Amanda, Maud attempts and fails to socialize at a bar, alone at a table surrounded by drunk and happy anonymous groups. The only connections she manages are through passionless sex, first giving one man a flirtation-less hand job and then going home with another after. Maud associates sex with nursing, flashing back to the traumatic incident in the hospital and placing her hands on her partner’s chest exactly as she had her patient’s, beginning chest compressions on both. It is here we learn the true extent of that violent moment of trauma when her hands crash right through the patient’s frail chest.[3] Her reaction in the present prompts her only sign of passion in this whole scene: she says “no” just as the sex becomes a rape. I read this as a direct statement of nurse—and caregiver more broadly—abuse in the overworked systems that fail to acknowledge their wants and needs.
In scenes of both caregiving and nursing, none of Maud’s actions are for her, but her association of religion with both is. When we learn that her pre-conversion life was more social and more sexually active, Maud’s choice of Mary Magdelene—culturally depicted as a prostitute—as her saint makes sense. It also speaks to the emotional importance of what Glass calls her “Godgasms”: the orgasms/seizures that occur when she feels the holy spirit but that could also be caused by the stress of her chronic stomach pain.[4] It is Amanda’s mimicry of Maud’s “Godgasms” that convinces Maud she has saved a soul. In this confidence, Maud attempts to isolate Amanda from everyone except herself, telling the woman Amanda sleeps with—also a prostitute—to never come back. In the brief period before Amanda finds out, Maud’s assessment of her patient’s progress has nothing to do with medicine: speaking to God, she says, “She radiates peace, and I am reminded of myself in the first flushes of your love. We don’t need anyone else.” It is Maud who is then told to leave.
The Body is a Stage
Pain is a constant condition throughout the film: in her role as carer, Maud is hired to ease suffering but repeatedly and intentionally causes herself pain. This calls into question how a carer could competently manage a patient’s pain if she herself finds pain so valuable. “Never waste your pain,” she repeats, turning it into a performance of devotion. Maud discovers a book Amanda wrote—The Body is a Stage—shortly before she begins burning herself, then eventually putting nails in her shoes. If she expects this pain to bring her closer to God, it is no wonder she idolizes Amanda in her worsening condition. Some of her self-harm seems to be inspired by her medical practices, as we earlier see her poking Amanda’s feet to check for sensation, and needles make a continual appearance. The stretches on the floor she does with Amanda as part of her therapy are mimicked in the seizures brought on when she feels the presence of God. Her final attempt to save Amanda’s soul becomes almost the most violent scene in the film, accomplishing the sabotage of long hours of palliative work that we’ve been expecting all along. Importantly, it mirrors the traumatic chest injury with which the film began. Healing hands have hurt once again.
Of the ending, Glass said, “I wanted people to sort of realize, like, ‘Oh, fuck. This is actually a very vulnerable young woman who got to a very dangerous [sic] and who very badly needed some help quite a long time before this and didn’t get it.’”[5] The tragedy of Saint Maud is that the vulnerability and isolation of unsupported caregiving at any level has the potential to ultimately negate palliation, harming both patient and practitioner. Maud’s misguided efforts to find connection only perpetuate a cycle of loneliness, violence, and trauma, that ends in murder and suicide, shocking acts for someone with medical authority.
You can stream Saint Maud on Amazon and other streaming services (ad):
[1] For a great history of hospital construction and function, see Kisacky, Jeanne, Rise of the Modern Hospital: An Architectural History of Health and Healing, 1870-1940 (University of Pittsburgh Press, 2017).
[2] Zemler, Emily. “Rose Glass Examines the Private Horror of Mental Illness in ‘Saint Maud.’ Los Angeles Times. Feb. 14, 2021.
[3] According to Glass, this is based on a true story! Handler, Rachel. “Saint Maud’s Rose Glass Explains What’s Real and What’s Imagined in her Unholy Horror Debut.” Vulture. Jan. 29, 2021.
[4] Glass, who repeatedly prioritizes psychological and physical interpretations over spiritual ones, said she based this on the possible epilepsy of Joan of Arc that allowed her to see visions. Handler, “Saint Maud’s Rose Glass”
[5] Foreman, Alison. “Saint Maud Writer-Director Rose Glass on the Devilish Details You May Have Missed.” Mashable. Feb. 5, 2021.
Related: Top 10 films about the horrors of caregiving.
Laura Kremmel is Assistant Professor of English in the Humanities and Social Sciences Department at South Dakota School of Mines. She is the co-editor of The Palgrave Handbook to Horror Literature (2018) and publishes work on Horror/Gothic Studies, the History of Medicine/Medical Humanities, Disability Studies, and British Romanticism. Laura has written previously for Horror Homeroom on disability in Don’t Breathe, American Mary and the Gothic heroine, I Am the Pretty Thing That Lives in the House,and Crimson Peak. You can find her on twitter at @LKremmel.
Follow Horror Homeroom on Twitter, Facebook, Instagram, and Pinterest.
