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Pauline is a troubled child – well, she’s 18, so one should probably say she’s a troubled woman, although her mother still treats her like she’s 12. She’s trying to struggle with the normal teenage problems like parents, never having asked to be born and strange dreams full of semi-nudity and blood. She doesn’t get on with the cool, pretty people at school, or the teachers, or anyone else really.

She does occasionally chat to God – even though she doesn’t believe in Him and never got round to reading His book to the end. After all, it got mixed reviews, and there’s so much else out there to read. But who else are you going to tell that you’re planning on losing your virginity? The act will make God very sad, but He’ll forgive you anyway – isn’t that the deal?

The virginity losing is planned like a military operation. She finds a boy at school, tells him what she wants and gives him her number. When he rings and says he’s ready to go, she tells him to wait till Monday at noon. After having sex, she asks him to go down on her, which he does – briefly – until he realises that she’s on her period.

Her helicopter mum would like to send her a psychiatrist, but believes she can’t afford that (her plush house says otherwise) so sends her to see John Waters. Or Reverend John Waters as he is here. To be honest, Waters’s talents are squandered in a role that mainly requires him to look disapproving and shocked, as if John Waters would ever disapprove of or be shocked by anything.

There isn’t much development of character or plot in Excision, nor is it the sort of film where you’d expect that. Instead, we see a series of incidents in Pauline’s life. Towards the end of the film, her mother calls her sociopathic, though she remarks that that’s an adjective that applies to pretty much any adolescent girl.

Meanwhile there’s trouble at home. Mum is an obsessive snob, who’d like to shove Pauline into some sort of etiquette class, dad knows that his life is easiest if he says and does as little as possible, and little sis – who mum obviously prefers – has cystic fibrosis and is stuck for large periods of time to some sort of aqualung. Its only a matter of time before she’ll need a lung transplant.

Pauline switches between mild attempts to draw attention to herself – a nose piercing which she removes as soon as her mother disapproves, and a makeshift homemade cross tattoo on her arm: “don’t worry, I’m not a cutter”. She fights with fellow school students and teachers alike, inducing herself to be sick on one of them. Meanwhile, her dreams (and occasional daydreams) are even more extreme.

If this sounds just like a gross out movie – well, it is to a large extent. Its never quite as funny or as shocking as it thinks it is, but it does have something – maybe in AnnaLynne McCord as Pauline. She has the right mixture of sullenness and sass, and makes a plausible teen who just feels misunderstood by everyone and is just waiting till she can grow up and be a surgeon.

I’ve seen reviews that say that Pauline is ugly, which I don’t think is fair on her at all. She pays little obvious effort with hair and make up, and there’s always a little cheek and assuredness peeking through. Besides which, she is capable of the occasional hilarious one-liner – while the gross-out comedy is rarely too successful, there are some great lines of dialogue hidden away.

You get the feeling that, like Pauline, Excision is a little too needy – spending a little too much time making sure that we are paying attention. And yet if you’re prepared to indulge it, it’s worth your while. If only they’d have given John Waters a camper role that would have given him more opportunity to do what he does.

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